Universal Service - Rural Health Care Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 467 RHC - Telecommunications Program - Description of Request for Funding Disbursement	Form and Instruction	Modified	Repair queued
Form FCC Form 466 RHC - Telecommunications Program - Description of Request for Funding	Form and Instruction	Modified	Available
Form FCC Form 465 RHC - Telecommunications Program - Description of Eligibility and Request for Services	Form and Instruction	Modified	Available
Form FCC Form 463 RHC - Healthcare Connect Fund Program - Description of Request for Funding Disbursement	Form and Instruction	Modified	Available
Form FCC Form 462 RHC - Healthcare Connect Fund Program - Description of Request for Funding	Form and Instruction	Modified	Available
Form FCC Form 461 RHC - Healthcare Connect Fund Program - Description of Request for Services	Form and Instruction	Modified	Available
Form FCC Form 460 RHC- Healthcare Connect Fund Program - Description of Eligibility and Registration	Form and Instruction	Modified	Available
2019 RHC SS-0804_052019.docx	Supporting Statement A	Uploaded 2019-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
31049	Universal Service - Rural Health Care Program	Other-Network Cost Worksheet _Template	Modified
207576	Universal Service - Rural Health Care Program	Other-Pilot Program Invoice Template	Modified
199666	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC - Telecommunications Program - Description of Request for Funding Disbursement
199666	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC - Telecommunications Program - Description of Request for Funding
199666	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC - Telecommunications Program - Description of Eligibility and Request for Services
199666	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC - Healthcare Connect Fund Program - Description of Request for Funding Disbursement
199666	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC - Healthcare Connect Fund Program - Description of Request for Funding
199666	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC - Healthcare Connect Fund Program - Description of Request for Services
199666	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC- Healthcare Connect Fund Program - Description of Eligibility and Registration

ICR Details

OMB Control No: 3060-0804	ICR Reference No: 201904-3060-023
Status: Historical Active	Previous ICR Reference No: 201606-3060-028
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Universal Service - Rural Health Care Program
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/16/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/26/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2022	36 Months From Approved	09/30/2019
Responses	117,042	0	137,846
Time Burden (Hours)	275,090	0	289,454
Cost Burden (Dollars)	0	0	0

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Abstract: The FCC seeks approval to: (1) eliminate the requirements for the Pilot Program and (2) extend the existing information collection requirements for the Healthcare Connect Fund and Telecom Programs.

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Authorizing Statute(s): US Code: 47 USC 154(i) - 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, as amended
   US Code: 47 USC 151 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: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
3060-AI85	Final or interim final rulemaking	71 FR 65517	11/08/2006

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 9339	03/14/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 24139	05/24/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Universal Service - Rural Health Care Program	FCC Form 460, FCC Form 461, FCC Form 462, FCC Form 463, FCC Form 465, FCC Form 466, FCC Form 467	RHC- Healthcare Connect Fund Program - Description of Eligibility and Registration ,   RHC - Healthcare Connect Fund Program - Description of Request for Services ,   RHC - Healthcare Connect Fund Program - Description of Request for Funding ,   RHC - Healthcare Connect Fund Program - Description of Request for Funding Disbursement ,   RHC - Telecommunications Program - Description of Eligibility and Request for Services ,   RHC - Telecommunications Program - Description of Request for Funding ,   RHC - Telecommunications Program - Description of Request for Funding Disbursement
Universal Service - Rural Health Care Program
Universal Service - Rural Health Care Program

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	117,042	137,846	0	-668	-20,136	0
Annual Time Burden (Hours)	275,090	289,454	0	-602	-13,762	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

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

Burden Reduction Due to: Changing Regulations

Short Statement: The Commission is reporting program changes/decreases of -50 to the total number of unique respondents, to the total number of annual responses of -668, and to the total annual burden hours of -602. These program changes are due to the removal of the requirements for the Pilot Program. The Commission is also reporting an adjustment/increase of +830 to the total number of unique respondents, and adjustments/decreases to the total number of annual responses of - 20,136 and to the total burden hours of -13,762. These adjustments are due to updates to the number of respondents to reflect data by unique respondent and updates to the number of annual responses for the Telecom and Healthcare Connect Fund Programs since the last collection.

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Annual Cost to Federal Government: $0

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 05/26/2019

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