Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 460 Federal Government	Form	New	Available
Form FCC Form 460 State, Local or Tribal Governments	Form	New	Available
Form FCC Form 460 Business or other for-profit	Form	New	Available
PRA Emergency Request Letter.pdf	Supplementary Document	Uploaded 2020-04-03	Available
IC xxxx - COVID-19 Telehealth Program (SS).4.3.20_final version_v2.docx	Supporting Statement A	Uploaded 2020-04-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
241112	Federal Government	Form	New
241111	State, Local or Tribal Governments	Form	New
241110	Business or other for-profit	Form	New

ICR Details

OMB Control No: 3060-1271	ICR Reference No: 202004-3060-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 04/08/2020
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/06/2020
	Date Received in OIRA: 04/03/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	6 Months From Approved
Responses	28,020	0	0
Time Burden (Hours)	173,326	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Federal Communications Commission (FCC) seeks approval of a new collection as part of the COVID-19 Telehealth Program. This new collection is designed to obtain information from applicants that will be used by the Bureau to evaluate the applications and select applications to receive funding under the COVID-19 Telehealth Program, make funding determinations and disburse funding. In selecting participants for the COVID-19 Telehealth Program, this information is necessary to select applications that target areas hardest hit by COVID-19 where the support will have the most impact on addressing immediate health care needs.

Emergency Justfication: The Federal Communications Commission (Commission) requests OMB approval to submit the information collection described herein under the “emergency processing” provision of the Paperwork Reduction Act (PRA) of 1995 (5 C.F.R. § 1320.13). The Commission is requesting clearance for a new information collection entitled: Promoting Telehealth for Low-Income Consumers and COVID-19 Telehealth Program. We respectfully request OMB approval for this collection by April 8, 2020. On April 1, 2020, the Commission adopted a Report and Order entitled Promoting Telehealth for Low-Income Consumers, COVID-19 Telehealth Program, WC Docket No. 18–213, WC Docket No. 20-89, Report and Order, FCC 20–44 (2020). In the Report and Order, given the growing evidence of the benefits of connected care services provided through broadband connections, the Commission established a Pilot Program to explore whether and how the Universal Service Fund (USF) can help defray health care providers’ costs of providing connected care services to patients in their homes or at their mobile location, particularly to low-income Americans and veteran patients. Additionally, due to the ongoing Coronavirus 2019 Disease (COVID-19) pandemic, the Commission also established the COVID-19 Telehealth Program, funded through a $200 million Congressional appropriation under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, to immediately support health care providers responding to the pandemic by providing funding for telecommunications services, information services, and devices necessary to provide critical connected care services for treatment of COVID-19 or other health conditions during the pandemic. The Commission expects that the COVID-19 Telehealth Program will provide immediate assistance to help health care providers provide connected care services in response to the COVID-19 pandemic. Specifically, the COVID-19 Telehealth Program is open to eligible health care providers, whether located in rural or non-rural areas, and will provide eligible health care providers support to purchase telecommunications, information services and devices to provide connected care services in response to the coronavirus pandemic. The COVID-19 Telehealth Program will provide selected applicants full funding for these services and devices. Currently the COVID-19 Telehealth Program has a Congressionally appropriated $200 million budget, and these funds will be available until they are expended or until the current pandemic has ended.

---

Authorizing Statute(s): US Code: 47 USC 201-205 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 214, 254, 303(r), 403 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 1-4 Name of Law: Communications Act of 1934, as amended
   PL: Pub.L. 116 - 136 134 Stat. 281 Name of Law: Division B of the Coronavirus Aid, Relief, and Economic Security Act
   US Code: 47 USC 151-154 Name of Law: Communications Act of 1934, as amended
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
State, Local or Tribal Governments	FCC Form 460	Description of Eligibility and Registration
Federal Government	FCC Form 460	Description of Eligibility and Registration
Business or other for-profit	FCC Form 460	Description of Eligibility and Registration

---

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	28,020	0	0	28,020	0	0
Annual Time Burden (Hours)	173,326	0	0	173,326	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: The Commission is reporting program changes/increases to this new information collection. These increases to the total number of respondents of 7,300 and total annual responses of 28,020 and total annual burden hours of 173,326 will be added to OMB’s Active Inventory.

---

Annual Cost to Federal Government:

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? Yes

---

Common Form ICR:  No

---

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: 04/03/2020

---