Universal Service - Rural Health Care Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 466 RHC, Telecommunications Program, Description of Request for Funding (FY2022+)	Form and Instruction	Modified	Available
Form FCC Form 463 RHC-HCF-Description of Request for Funding Disbursement (FY2021+)	Form and Instruction	Modified	Available
Form FCC Form 467 RHC, Telecommunications Program, Connection Certification Form (FY2020+)	Form and Instruction	Modified	Available
Form FCC Form 462 RHC, HCFP, Description of Request for Funding (FY2020+)	Form and Instruction	Modified	Available
Form FCC Form 461 RHC, HCFP, Description of Request for Services (FY2021+)	Form and Instruction	Modified	Available
Form FCC Form 466 RHC, Telecommunications Program, Description of Request for Funding (FY2021+)	Form and Instruction	Modified	Available
Form FCC Form 466 RHC, Telecommunications Program Description of Request for Funding (FY2020)	Form and Instruction	Modified	Repair queued
Form FCC Form 465 RHC, Telecommunications Program Description of Eligibility and Request for Services (FY 2021+)	Form and Instruction	Modified	Available
Form FCC Form 465 RHC, Telecommunications Program, Description of Eligibility and Request for Services (FY2020)	Form and Instruction	Modified	Available
Form FCC Form 463 RHC, HCFP, Description of Request for Funding Disbursement (FY2021+)	Form and Instruction	Modified	Available
Form FCC Form 463 RHC, HCFP, Description of Request for Funding Disbursement (FY2020)	Form and Instruction	Modified	Available
Form FCC Form 461 RHC, HFCP, Description of Request for Services (FY2020)	Form and Instruction	Modified	Available
Form FCC Form 460 RHC, HCFP, Description of Eligibility and Registration	Form and Instruction	Modified	Available
Form FCC Form 460 Universal Service - Rural Health Care Program	Form and Instruction	Modified	Repair queued
3060-0804 Non Sub Change_FCC Form 466_ 5.27.2021_v2.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-05-27	Repair queued
3060-0804 FCC Form 463 NSC memo final.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-02-04	Repair queued
Revised Supporting Statement 05.22.20 (final version).docx	Supporting Statement A	Uploaded 2020-05-22	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	RHC, Telecommunications Program, Description of Request for Funding (FY2022+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC-HCF-Description of Request for Funding Disbursement (FY2021+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, Telecommunications Program, Connection Certification Form (FY2020+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, HCFP, Description of Request for Funding (FY2020+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, HCFP, Description of Request for Services (FY2021+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, Telecommunications Program, Description of Request for Funding (FY2021+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, Telecommunications Program Description of Request for Funding (FY2020)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, Telecommunications Program Description of Eligibility and Request for Services (FY 2021+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, Telecommunications Program, Description of Eligibility and Request for Services (FY2020)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, HCFP, Description of Request for Funding Disbursement (FY2021+)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, HCFP, Description of Request for Funding Disbursement (FY2020)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, HFCP, Description of Request for Services (FY2020)
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified	RHC, HCFP, Description of Eligibility and Registration
31049	Universal Service - Rural Health Care Program	Form and Instruction	Modified
207576	Universal Service - Rural Health Care Program	Other-Invoice Form (FY2020)	Unchanged
199666	Universal Service - Rural Health Care Program	Other-Post Commitment Form (FY2021)	Unchanged

ICR Details

OMB Control No: 3060-0804	ICR Reference No: 202105-3060-014
Status: Historical Active	Previous ICR Reference No: 202102-3060-001
Agency/Subagency: FCC	Agency Tracking No: WCB
Title: Universal Service - Rural Health Care Program
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/16/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/27/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2023	05/31/2023	05/31/2023
Responses	93,687	0	93,687
Time Burden (Hours)	382,741	0	382,741
Cost Burden (Dollars)	0	0	0

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Abstract: This submission is being made for a non-substantive change to an existing information collection pursuant to 44 U.S.C. § 3507. The Commission submits the modified request for Funding Form (FCC Form 466) to be included as part of the existing information collection for the Rural Health Care Program for funding year 2022, from July 1, 2022, to June 30, 2023. The existing information collection was approved by the Office of Management and Budget (OMB) on May 22, 2020. There are no proposed changes for the FCC Forms 465 or 467. Summary of Proposed Change: We propose to modify the Request for Funding Form to delete a certification related to rural rates that was made moot by a recent Federal Communications Commission, Wireline Competition Bureau order waiving the required use of the Rates Database for Rural Health Care Program funding years 2021 and 2022 (DA 21-394). The purpose of this non-substantive change is to avoid applicant confusion while the waiver is in effect. There is no change in the burden hours and no costs are associated with this collection. This submission is being made for proposed non-substantive changes to an existing information collection pursuant to 44 U.S.C. § 3507. This submission seeks to make non-substantive changes to certain fields for the FCC Form 463 (the Invoice and Request for Disbursement Form for the Healthcare Connect Fund) and the Telecom Program Invoice Form to add a certification of compliance for service providers participating in the Rural Health Care program and the Connected Care Pilot program regarding rules adopted by the Commission in the Protecting Against National Security Threats to the Communications Supply Chain Through FCC Programs First Report and Order and the Second Report and Order, (WC Docket No. 18-89, FCC 19-121 (First Report and Order) and FCC 20-176 (Second Report and Order)). There are no proposed changes for the FCC Forms 460, 461, 462, 465, 466, or 467. The FCC Form 463 and the Telecom Program Invoice Form are contained in an online database. The FCC seeks approval to: (1) extend some of the existing information collection requirements for the Healthcare Connect Fund and Telecommunications (Telecom) Programs; (2) revise some of the information collection requirements for the Healthcare Connect Fund and Telecom Programs and (3) add some new information collection requirements applicable to both the Healthcare Connect Fund Program and the Telecom Program as a result of the 2019 Promoting Telehealth Report and Order. The FCC also seeks approval to reformat and revise the Telecom Program Invoice Template and create a new Post-Commitment Request Form consistent with the changes adopted in the 2019 Promoting Telehealth Report and Order and to promote transparency into the RHC Program procedures and requirements.

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Authorizing Statute(s): US Code: 47 USC 201 - 205 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 154(i) - 154(j) 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 151 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 403 Name of Law: Communications Act of 1934, as amended
   US Code: 47 USC 254 Name of Law: Telecommunications Act of 1996, 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	84 FR 54952	10/11/2019

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 5430	01/30/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 19475	04/07/2020
Did the Agency receive public comments on this ICR? Yes

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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
Universal Service - Rural Health Care Program	FCC Form 463, FCC Form 466, FCC Form 460, FCC Form 461, FCC Form 463, FCC Form 463, FCC Form 465, FCC Form 461, FCC Form 462, FCC Form 467, FCC Form 465, FCC Form 466, FCC Form 466	RHC, HCFP, Description of Eligibility and Registration ,   RHC, HFCP, Description of Request for Services (FY2020) ,   RHC, HCFP, Description of Request for Funding Disbursement (FY2020) ,   RHC, HCFP, Description of Request for Funding Disbursement (FY2021+) ,   RHC, Telecommunications Program, Description of Eligibility and Request for Services (FY2020) ,   RHC, Telecommunications Program Description of Eligibility and Request for Services (FY 2021+) ,   RHC, Telecommunications Program Description of Request for Funding (FY2020) ,   RHC, Telecommunications Program, Description of Request for Funding (FY2021+) ,   RHC, HCFP, Description of Request for Services (FY2021+) ,   RHC, HCFP, Description of Request for Funding (FY2020+) ,   RHC, Telecommunications Program, Connection Certification Form (FY2020+) ,   RHC-HCF-Description of Request for Funding Disbursement (FY2021+) ,   RHC, Telecommunications Program, Description of Request for Funding (FY2022+)
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	93,687	93,687	0	0	0	0
Annual Time Burden (Hours)	382,741	382,741	0	0	0	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: No

Burden Reduction Due to:

Short Statement:

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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? No

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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: 05/27/2021

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