Funding Year 2003 Process Overview

1. HCP completes Form 465 and submits it to RHCD
2. RHCD processes Form 465 and determines eligibility of HCP
3. RHCD posts Form 465 on web site and sends the HCP a posting letter
4. 28-day posting begins and service providers bid to provide service
5. HCP chooses most cost-effective telecommunications carrier
6. HCP completes Form 466
7. HCP submits Form 466 packet to RHCD
8. RHCD reviews Form 466 packet
9. If packet is approved, RHCD issues a Funding Commitment Letter (FCL)
10. HCP completes and submits Form 467 to RHCD
11. RHCD reviews Form 467 and issues HCP Support Schedule (HSS)

1. HCP completes Form 465 and submits it to RHCD

All health care providers (HCPs) must complete Form 465 (Description of Services Requested and Certification Form).  Form 465 is the means by which HCPs request bids from telecommunications carriers for services to be used for the provision of health care. It is the HCP’s certification that it meets program eligibility requirements. 

Each HCP is assigned an HCP number. The five-digit HCP number is the primary means by which RHCD tracks applications and is a required field on all forms used in the application process.  It is consistent across multiple funding years, so if an HCP has applied for support in previous funding years, it should not request a new HCP number. 

If an HCP does not have an HCP number, it may call the RHCD Customer Service Support Center (CSSC) at 1-800-229-5476 to obtain one.  A user changeable password is issued with the HCP number, for use on the RHCD website, to complete forms or review HCP specific information.

RHCD recognizes that many health care providers belong to groups or consortia that share resources and negotiate with telecommunications carriers.  A separate Form 465 must be completed for each HCP physical location within the consortia that is eligible to receive support.

Form 465 may be completed and submitted to RHCD online or by filling out a paper form  downloaded from the RHCD website. To expedite the RHCD review process, applicants with Internet access are encouraged to submit online through the Applicants section our our web site.  However, both paper AND ONLINE APPLICANTS MUST PRINT, SIGN, AND MAIL a paper Form 465 to RHCD, unless they have enabled e-certification.  E-certification allows applicants to electronically sign and immediately post their Form 465 on the RHCD website.  All applicants that have posted a Form 465 in a previous funding year may enable e-certification.  See more about e-certification.

Paper submissions of Form 465 must be signed and mailed to RHCD for review and posting at:

Rural Health Care Division
80 S. Jefferson Road
Whippany, NJ 07981

Paper filers will receive a letter confirming the posting and giving the allowable carrier selection date, which is 28 days after the posting date, and is the first day an HCP may sign an agreement with a service provider. Applicants who use e-certification for Form 465 will receive the confirmation letter by e-mail.

2. RHCD processes Form 465 and determines eligibility of HCP

When a Form 465 is received from a new applicant, RHCD confirms the HCP's eligibility, determines the nearest large city (of population 50,000 or more) in the HCP’s state, and calculates the maximum allowable distance (MAD), which is the distance from the HCP to the far side of the nearest large city. Charges for mileage beyond the MAD cannot be supported.  The nearest large city and MAD are added to the form by RHCD when it is posted.

3. RHCD posts Form 465 on web site and sends the HCP a posting letter.

Once RHCD reviews a Form 465 and determines it is complete, it is posted on the RHCD website and a letter is sent to the HCP to confirm the posting.  The posting invites telecommunications carriers to bid to provide services.  The posting also indicates whether the HCP is requesting support for new services or services it is already receiving.  See Search 465 Postings.  The posting date starts the 28-day competitive bidding process.  All HCPs expecting support must complete the 28-day posting requirement before entering into an agreement to purchase services with a carrier.  (The 28-day posting requirement does not apply to contracts signed before July 11, 1997, if they are still in effect under their original (not renewed) term of service).

4. 28-day posting begins and service providers bid to provide service.

In addition to posting on the RHCD web site, an HCP may choose to issue its own request for proposal (RFP) for telecommunications services.  However, such RFPs do not exempt an HCP from the requirement to post a Form 465 on the RHCD website, or to wait 28 days before contracting for services.  Telecommunications carriers contact HCPs directly to negotiate rates and conditions for providing service.  RHCD is not involved in contract negotiations between HCPs and telecommunications carriers.

HCPs need not wait for telecommunications carriers to contact them after Form 465 has been posted on the RHCD web site.  Rather, HCPs are encouraged to contact and discuss their needs with telecommunications carriers serving their area.  However, HCPs must wait 28 days from the date of posting before entering into any agreement to purchase services with a carrier.  HCPs that enter into an agreement to obtain telecommunications services before the 28-day posting period has been completed, or who sign a Form 466 (indicating selection of a carrier) before completing the 28-day posting period, may be ineligible to receive universal service support. 

5. HCP chooses most cost-effective telecommunications carrier

In choosing a telecommunications carrier, an HCP must consider all bids received and select the most cost-effective method to meet its health care telecommunications needs. The most cost-effective method is defined by the FCC as the method of least cost after consideration of the features, quality of transmission, reliability, and other factors relevant to choosing a method of providing the required services.  To be eligible to receive support, the selected carrier must be a “Common Carrier”.  If an HCP is unsure if a telecommunications carrier is a common carrier, they may contact RHCD's Customer Service Support Center at 1-800-229-5476.  Any telecommunications service necessary for the provision of health care is eligible for support, but telecommunications equipment charges and Internet service charges are not eligible for support.

6. HCP completes Form 466

Once the telecommunications carrier and services are selected, the HCP completes and submits Form 466 (Funding Request and Certification Form). The Form 466 specifies the type of service ordered, the cost, the service provider(s), the terms of any service agreements, and certifies that the selection was the most cost-effective offer received.

HCPs may request support based strictly on their circuit distance (mileage-based charges) or may request support based on the difference between what they pay and what an equivalent circuit would cost in the nearest urban area.

In order to obtain the information and documents necessary to complete Form 466, the HCP may need to work with a representative of the selected service provider. The service provider representative may be needed to provide detailed circuit information, a circuit diagram, a documented urban rate, or contract information.  All certification boxes must be checked on Form 466.  Paper Form 466 submissions must have a dated original (not photocopied) signature of an authorized person.  E-certification may be used for Form 466s submitted through the RHCD website.

7. HCP submits Form 466 packet to RHCD

Upon completion of Form 466 and all related documentation, the HCP mails all documents to RHCD for review.  A Form 466 submitted with e-certification may require supplemental documentation to be sent to RHCD by mail.  Forms with missing or incomplete information or documentation cannot be processed.

8. RHCD reviews Form 466 packet

RHCD reviews the packet for accuracy and completeness.  If RHCD has questions about the  application, the HCP or telecommunications carrier will be contracted.  HCP and telecommunications carrier representatives are strongly encouraged to respond to RHCD inquiries in a timely manner to expedite processing of the packet.

9. If packet is approved, RHCD issues a Funding Commitment Letter (FCL)

Upon approving a packet, RHCD mails the HCP and telecommunications carrier a Funding Commitment Letter (FCL) and a copy of Form 467.  (In some circumstances, zero support FCLs may be issued, such as multi-bill circuits where the first circuit segment is under the urban rate, so support does not accrue until the next circuit segment.)

If an HCP is depending on the Rural Health Care Telecommunications support mechanism to reduce the cost of its telecommunications services to maintain an adequate cash flow, the HCP and the telecommunications carrier may want to wait for the FCL before commencing services to ensure that support is as expected.  It is possible that a packet might not supported as expected.  Among other reasons, denials or support reductions may occur because:

• The HCP violated the 28-day competitive bidding requirement by selecting a carrier during the 28-day posting period or by signing a 466 during that period.
• The HCP requested support for service from a telecommunications carrier that is not a  common carrier.
• The HCP did not submit Form 465 to RHCD and therefore did not meet the 28-day posting requirement.
• Information supplied by the HCP, such as the certification of eligible HCP type, was determined incorrect during packet processing.
• The HCP did not complete the required 28-day posting by July 1^st, to qualify for full year support.

These are only the most common situations involving non-compliance with program rules and denial of support. This is not a complete list of reasons that packets have been denied.

10. HCP completes and submits Form 467 to RHCD

After the HCP begins to receive service from the telecommunications carrier, it submits Form 467 (Receipt of Service Confirmation Form) to RHCD. The HCP must submit Form 467 in order to receive discounted telecommunications services.  RHCD cannot process Form 467 unless a Funding Commitment Letter has been issued to the HCP.  Form 467 is also available for e-certification, which allows RHCD to receive the form immediately.

11. RHCD reviews Form 467 and issues HCP Support Schedule (HSS)

Once Form 467 is received, reviewed, and approved, RHCD will send the HCP and its telecommunications carrier(s) an HCP Support Schedule (HSS).  At this point, the telecommunications carrier can begin crediting the HCP's bill with the monthly recurring support amount or issue a check for the discount. As soon as the carrier has issued a credit or check to the HCP, it invoices the USAC for that amount and USAC then credits or reimburses the carrier's Universal Service Fund account to complete the support process.