Universal Service - Rural Health Care Program/Rural Health Care Pilot Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 465 Universal Service - Rural Health Care Program	Form and Instruction	Modified	Repair queued
0804_SS_092811.doc	Supporting Statement A	Uploaded 2011-09-28	Available
0804_Attachment9_100411.xls	Supplementary Document	Uploaded 2011-10-04	Available
0804_FCC465 Attachment Excel Template_092811.xls	Supplementary Document	Uploaded 2011-09-28	Available
0804_InvoicingTemplate.xls	Supplementary Document	Uploaded 2011-09-28	Available
0804_Network%20Cost%20Worksheet%20Excel%20Template(5)_092811.xls	Supplementary Document	Uploaded 2011-09-28	Available
0804_RHCPPSampleLOA(4)_092811.doc	Supplementary Document	Uploaded 2011-09-28	Available
0804_RHCPPSampleProjectCoordinatorCertification(3)_092811.doc	Supplementary Document	Uploaded 2011-09-28	Available
0804_RHCPPSampleVendorCertification(2)_092811.doc	Supplementary Document	Uploaded 2011-09-28	Available
0804_Transfer of LOA Template(1)_092811.docx	Supplementary Document	Uploaded 2011-09-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified
198476	Universal Service - Rural Health Care Program/Rural Health Care Pilot Program		New

ICR Details

OMB Control No: 3060-0804	ICR Reference No: 201107-3060-008
Status: Historical Inactive	Previous ICR Reference No: 201002-3060-017
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Universal Service - Rural Health Care Program/Rural Health Care Pilot Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 10/04/2011
	Date Received in OIRA: 09/28/2011
Terms of Clearance: Withdrawn to be resubmitted.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2011	36 Months From Approved	11/30/2011
Responses	59,464	0	59,464
Time Burden (Hours)	67,468	0	67,468
Cost Burden (Dollars)	0	0	0

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Abstract: The Commission is submitting this collection as a revision. The FCC seeks OMB approval for eight templates, samples and spreadsheets provided to program participants to facilitate the reporting, recordkeeping and/or 3rd party disclosure requirements under this IC. In 1997, the Commission established the Rural Health Care support mechanism, which provides universal service support to ensure that rural health care providers pay no more than their urban counterparts for their telecommunications needs and Internet access in the provision of health care services. In response to underutilization of the current program, the Commission established a Pilot Program and selected 69 participants. The Pilot Program assist public and non-profit health care providers build state and region-wide broadband networks dedicated to health care.

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Authorizing Statute(s): US Code: 47 USC 151 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(i) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(j) Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 201 - 205 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 214 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 254 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 403 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: US Code: 47 USC 151 Name of Law: Communications Act of 1934, as amended
US Code: 47 USC 154(i) and 154(j) Name of Law: Communications Act of 1934, as amended
US Code: 47 USC 201-205 Name of Law: Communications Act of 1934, as amended
US Code: 47 USC 214 Name of Law: Communications Act of 1934, as amended
US Code: 47 USC 254 Name of Law: Telecommunications Act of 1996
US Code: 47 USC 403 Name of Law: Telecommunications Act of 1996

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 44006	07/22/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 58810	09/22/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Universal Service - Rural Health Care Program/Rural Health Care Pilot Program
Universal Service - Rural Health Care Program	FCC Form 467, FCC Form 466-A, FCC Form 465, FCC Form 466	Universal Service - Rural Health Care Program - For seeking bids ,   Universal Service - Rural Health Care Program - Form for funding request and certification ,   Universal Service - Rural Health Care Program - Form for selection of service provider ,   Universal Service - Rural Health Care Program - Form for notification of service initiation

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The Commission has created eight templates, samples and spreadsheets provided to program participants to facilitate the reporting, recordkeeping and/or third party disclosure requirements under this IC. In response to the underutilization of the rural health care support mechanism, the FCC released the Rural Health Care Pilot Program which established a Pilot Program to assist public and non-profit health care providers to build state and region-wide broadband networks dedicated to the provision of health care services and connect those networks to a dedicated nationwide backbone. The construction of such networks will bring the benefits of innovative telehealth, and particularly, telemedicine services to those areas of the country where the need for those benefits is most acute. By connecting to a dedicated national backbone, health care providers at the state and local levels will have the opportunity to benefit from advanced applications in continuing education and research. In addition, a ubiquitous nationwide broadband network dedicated to health care will enhance the health care community's ability to provide a rapid and coordinated response in the event of a public health crisis.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/28/2011

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