Funding Year 2004 Process Overview

1. HCP completes Form 465 and submits it to RHCD
2. RHCD processes Form 465
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 service provider
6. HCP completes Form 466 and/or 466-A
7. HCP submits Form 466 and/or 466-A packet to RHCD
8. RHCD reviews Form 466 and/or 466-A packet
9. After forms are reviewed, 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)
12. After crediting the HCP, the service provider invoices RHCD

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 service providers for services to be used for the provision of health care. Applicants indicate on a single Form 465 whether they are applying for support for telecommunications service or Internet access discounts or both. 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 must download a Form 465 (see forms), complete and sign it, and mail it to the address shown on the form. When the form is received, eligibility is determined, and if the HCP is eligible, an HCP number is issued and the Form 465 is posted. 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 service providers. A separate Form 465 must be completed for each HCP physical location within the consortia that is eligible to receive support.

The initial Form 465 must be submitted on paper. It can be completed by filling out a paper form downloaded from the RHCD website. To expedite the RHCD review process, applicants with Internet access are encouraged to complete Form 465 online through the Applicants section of the RHCD website. 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 465s on the RHCD website. All applicants that have successfully posted a Form 465 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

First-time applicants will receive a letter notifying them of their HCP number and password, if they are determined to be eligible. 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

When a Form 465 is received from a new applicant, RHCD confirms the HCP's eligibility, determines the largest city 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 largest city in the HCP’s state. The largest 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 service providers to bid to provide services.   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 service provider.

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

In addition to posting on the RHCD website, an HCP may choose to issue its own request for proposal (RFP) for telecommunications or Internet 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. Service providers contact HCPs directly to negotiate rates and conditions for providing service. RHCD is not involved in contract negotiations between HCPs and service providers.

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

5. HCP chooses most cost-effective service provider

In choosing a service provider, an HCP must consider all bids received and select the most cost-effective method to meet its requirements. 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 telecommunications support, the selected carrier must be a “Common Carrier”. If an HCP is unsure if a telecommunications carrier is a common carrier, they may call 1-888-641-8722 for more information about service provider eligibility. Any telecommunications service and/or Internet access necessary for the provision of health care is eligible for support, but equipment charges are not eligible for support.

All Internet service providers are eligible to participate in the program; however, only the monthly charge is eligible for support.

6. HCP completes Form 466 and/or 466-A

Once the service providers and services are selected, the HCP completes and submits Form 466 (Funding Request and Certification Form) and/or Form 466-A (Internet Service Funding Request and Certification Form). The Forms 466 and 466-A specify the type(s) of service ordered, the cost, the service provider(s), the terms of any service agreements, and certifies that the selections were the most cost-effective offers received.

HCPs may request telecommunications 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 any city with a population of 50,000 or more in the HCP’s state. HCPs requesting support for Internet access charges will receive support for 25% of their Internet charges, if eligible.

In order to obtain the information and documents necessary to complete Forms 466 and 466-A, 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 and 466-A. Paper Form 466 and 466-A submissions must have a dated original (not photocopied) signature of an authorized person. E-certification may be used for Form 466s and 466-As submitted through the RHCD website.

7. HCP submits Form 466 and/or 466-A packet to RHCD

Upon completion of Form 466 and/or 466-A and all related documentation, the HCP mails all documents to RHCD for review. A Form 466 and/or 466-A submitted with e-certification requires supplemental documentation to be sent to RHCD by mail. Forms with missing or incomplete information or documentation cannot be processed. A form and its supporting documentation is called a “packet.”

8. RHCD reviews Form 466 and/or 466-A packet

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

9. After Forms are reviewed, RHCD issues a Funding Commitment Letter (FCL)

Upon packet approval, RHCD mails to the HCP a Funding Commitment Letter (FCL) and a copy of Form 467. A copy of the FCL is also sent to the service provider. (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 support mechanism to reduce the cost of its services to maintain an adequate cash flow, the HCP and the service providers 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 support as expected. Among other reasons, denials or support reductions may occur because:

• The HCP violated the 28-day competitive bidding requirement by selecting a service provider during the 28-day posting period or by signing a 466 and/or 466-A 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 1st, to qualify for full year support.
• The ISP does not have a SPIN (Service Provider Identification Number), and is not approved to participate.

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 service provider, it submits Form 467 (Receipt of Service Confirmation Form) to RHCD. The HCP must submit Form 467 in order to receive discounted 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 service provider(s) an HCP Support Schedule (HSS). At this point, the service provider can begin crediting the HCP's bill with the monthly recurring support amount or issue a check for the discount. As soon as the service provider has issued a credit or check to the HCP, it invoices USAC for that amount.

12. After crediting the HCP, the service provider invoices RHCD

For telecommunications carriers, USAC will then credit or reimburse the carrier’s Universal Service Fund account. For Internet service providers who have a USF account a credit will given. Those who do not have such an active account and have not been issued a SPIN number, you must fill out a FCC Form 498 and then reimbursement will be by check or direct deposit as you designate.