1. www.caltelehealth.org New Member Installation Toolkit The mission of the California Telehealth Network is to promote advanced information technologies and services to improve access to high quality healthcare focusing on medically underserved and rural Californians.

2. www.caltelehealth.org Welcome! Welcome to the California Telehealth Network (CTN)! You are now part of one of the largest broadband telehealth networks in the country. CTN is here to provide you with an affordable, medical grade broadband connection. This toolkit contains all the information necessary to make your installation quick and efficient and to make the most of your new high speed broadband connection. This presentation includes:  Detailed description of installation steps  Installation flow diagram  Progress checklist  Variety of tools and templates We strongly suggest that share this Installation Toolkit with your administrative, clinical and technical staff.

3. www.caltelehealth.org Toolkit Reference Guide To complete the install, you will be working with the following:  CTN Staff  AT&T Staff  Local Exchange Carrier (LEC) staff  Your site’s staff The following items are available in this toolkit to guide you through your high speed broadband installation process: 1. Installation Instructions – slides 4 - 6 2. Color-coded Installation Flow Diagram – slide 8 3. Installation Checklist – slide 9 4. Installation Document Center – slides 10 - 18  FAQs  Letter for reception  Signage for the Minimum Point of Entry (MPOE)/Telephone Closet  Press Release template  Inside Wiring Requirements & Instruction

4. www.caltelehealth.org Installation Instructions High Speed Broadband Circuit Installation The process described below is a step by step progression, involving CTN, AT&T, the Local Exchange Carrier and your own site’s staff. To assist you, this kit contains a color-coded installation flow diagram, a checklist so you can keep track of where you are in the installation process and additional resources. INSTALLATION INSTRUCTIONS 1. Upon receipt of your signed membership agreement, CTN staff submitted the following on your behalf: a)Request for funding from the Universal Service Administrative Company (USAC) for the network speed you ordered b)A circuit order to AT&T 2. After circuit order submission, a technician from the Local Exchange Carrier (LEC) will arrive at your facility to check the Minimum Point of Entry (MPOE). The MPOE is a room or closet with a telephone panel where phone service enters your building. The technician will ensure adequate facilities are available to deliver the ordered data circuit.

5. www.caltelehealth.org Installation Instructions High Speed Broadband Circuit Installation 2 (b). It is very important to let your staff know that an unscheduled site visit could occur. Please give necessary instructions to your staff in order to allow the technician to access your MPOE. LEC technicians will have proper identification when requesting access. Refer to slide 13 for front office staff instructions and signage. 3. The LEC technician will install the CTN data circuit and a phone line. These two steps will not occur simultaneously. In cases of higher speed circuit installation, a LEC pre-survey may be required. The data circuit provides your broadband and the phone line allows remote management of the new router. 4. If you plan to locate the CTN router at your MPOE, other than installing telephone jacks, no additional wiring concerns exist as your router will be next to the CTN circuits. If you plan to locate the CTN router in a location other than your MPOE, you will need to extend inside wiring (both data circuit and phone line) from your MPOE to your planned router location. Refer to slide 15 for inside wiring requirements.

6. www.caltelehealth.org Installation Instructions High Speed Broadband Circuit Installation 5. When the necessary inside wiring has been completed or extended, notify CTN at (855) 385-5082. 6. AT&T will schedule a site survey. This may happen while inside wiring is in process. The site survey will consist of the following: a) Confirm that the circuit and phone line has been installed. b) Ensure your sites inside wiring is extended to the router location. c) Confirm that space and environmental requirements at the router location are satisfactory. 7. Within two weeks of the completion of the site survey (step six), AT&T will schedule a router installation, test and turn-up. The router will be shipped directly to your site. Do not open the router box upon acceptance of delivery. The router box should be opened by the AT&T technician only. Please have your technical representative available at the time of installation, test and turn up of the router and circuit. Your new high speed circuit is ready to go!

7. www.caltelehealth.org Installation Instructions High Speed Broadband Circuit Installation 8. After installation of the router you will receive an e-mail from CTN with your IP addresses. Please pass this information on to your IT staff. If you have not received this e-mail within five business days after installation, notify CTN at (855) 385-5082. 9. Your technical staff can connect any existing equipment for use on the CTN. CTN is available to schedule video testing anytime. To schedule testing, please call (855) 385-5082. 10. Congratulations! Your installation is now complete.

8. www.caltelehealth.org Installation Process Flow Diagram

9. www.caltelehealth.org Installation Checklist Use this checklist to track your progress of each step.

10. www.caltelehealth.org Installation Document Center FAQs Reception Area Signage Signage for the Minimum Point of Entry (MPOE) / Telephone Closet Inside Wiring Requirements & Instructions Press Release Template High Speed Broadband Circuit Installation The following items are available in the Document Center:

11. www.caltelehealth.org Installation Document Center - FAQs 1. Who can I call for technical assistance?  Contact CTN at (855) 385-5082 2. When will my site be turned up?  The process takes about 90 days to complete once the order is placed with AT&T. Through that process, you will be visited by the LEC to do a survey and install the circuit in the MPOE. You will then be visited by the AT&T Managed Router Technician to do a survey and prepare for installation. They will return once your inside wiring is complete and complete the install. 3. It seems to take a long time from the time I sign the agreement to install. Why is that?  The process we have deployed in supporting the turn-up of each site is very complex and involves many different tasks. The coordination of these tasks, including filing all paperwork with USAC, takes about 90 days if all goes well. While it is a lengthy process, it is necessary for reimbursement and assuring that each site gets the quality, medical grade network they are requesting.

12. www.caltelehealth.org Installation Document Center - FAQs 4. What service speeds can I get?  1.5 mbps, 6mbps, 10 mpbs or 45 mpbs 5. Can I use the CTN network to connect to the internet?  The CTN circuit can be connected to the internet, but used only to support healthcare activities (such as administration/business functions, healthcare information, etc.). It cannot be used for gaming, connecting to or downloading non-healthcare related materials (music, videos, etc.), shopping and other questionable sites (adult sites, etc.). Traffic on the CTN circuit will be monitored for inappropriate and questionable activities. 6. I’m a model community site and I have telemedicine equipment showing up shortly. Who will put it together and install it?  CTN provides the circuit and can provide training. The equipment you receive is provided through grants. In some cases those grants provide for installation, in others it is the site’s responsibility. Please check with your coordinator to see what help is available. If help is unavailable, CTN will attempt to coordinate and/ or provide assistance.

13. www.caltelehealth.org Installation Document Center - Signage SIGNAGE – Reception Area

14. www.caltelehealth.org Installation Document Center - Signage SIGNAGE – Telephone Closet (MPOE) PLEASE POST THIS NOTICE

15. www.caltelehealth.org Installation Document Center – Wiring Requirements Your site is responsible for preparing the wiring, electrical and room for the installation of the CTN equipment. This equipment consists of a router and a modem. Please provide a copy of this page to your IT support staff. Power and Wiring Requirements Three 110/125 VAC receptacles for the new equipment that will be installed within five (5) feet of the location of the CTN equipment. A plug strip will not be acceptable. If the CTN equipment is to be installed in a location other than the MPOE, the customer is responsible to extend the inside wiring and network services to the equipment. The specific inside wire requirements will depend on the type of service you have. See the next slide for service speeds.

16. www.caltelehealth.org Installation Document Center – Wiring Requirements Service Speeds:  For speeds 1.5M (2 Pair) and 6M (8PR), AT&T will require copper twisted pairs for the data circuit and 1 pair for the phone line.  For 10M delivered on copper, AT&T will require 12 copper twisted pairs plus one pair for the phone line.  For 10M and 45M delivered on fiber optics, the inside extension will be two coax cables for the data and one copper pair for the phone line. Important: When your site has completed the necessary wiring and room preparation, contact CTN at (855) 385-5082. Heating and Cooling Sufficient heating/cooling is required to maintain a suitable temperature.

17. www.caltelehealth.org Installation Document Center – Wiring Requirements Hazardous Chemicals The MPOE/telephone closet must be free from hazardous chemicals and materials such as cleaning chemicals and hazardous waste. Safe Work Environment The MPOE/telephone closet should be free of clutter, allowing technicians access to the work area. If the room doubles as a storage area, any items that interfere with access to the work area or that present a safety hazard due to spillage/falling must be appropriately relocated. Local Area Network It is up to individual site(s) to integrate the CTN connection into their network in a way that best suits their needs.

18. www.caltelehealth.org Installation Document Center – Press Release Template Insert Site Logo/Letterhead (Insert Site Name) announced today a major improvement in providing access to health care in (Insert Community Name). The California Telehealth Network (CTN), completed installation of high speed broadband network services that will enable (Insert Community Name) access to medical specialists, preventative health care and other health care services via telemedicine. Telemedicine allows patients to see providers of care remotely using videoconferencing technologies. INSERT YOUR COMMUNITY INFORMATION The CTN project intends to leverage and build upon California's historic and recent investments in telehealth by continually supporting rural health clinics that are providing vital services to individuals and families in need. “We are pleased to be able to offer our patients and local clinical staff access to remote health care services through the CTN. This is a significant step in improving health care and the health of our community,” stated (name). The CTN is a statewide broadband network dedicated to health care with the goal of significantly increasing access to acute, primary and preventive health care in rural and medically underserved areas of California.

19. www.caltelehealth.org  California Telehealth Network 2001 P Street, Suite 100 Sacramento, CA 95811  Contact Information 855-385-5082  Website: www.caltelehealth.org  http://www.facebook.com/CALTELEHEALTH  http://www.twitter.com/CALTELEHEALTH

20. www.caltelehealth.org THANK YOU!