1. Universal Service Support for Rural Health Care Georgia Partnership for TeleHealth Conference – March 26, 2010 Rural Health Care Division Universal Service Administrative Company Washington, D.C.

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4. Eligible Public and Non-profit Rural Health Care Providers Post-secondary educational institutions offering health care instruction, teaching hospitals, or medical schools Community health centers or health centers providing health care to migrants Local health departments or agencies Community mental health centers Not-for-profit hospitals Rural health clinics Consortia of one or more of the above entities Part-time HCPs (of above types) Emergency rooms of for-profit hospitals

5. 5  Eligible telecommunications providers (ETPs) may provide discounted telecommunications (Urban/Rural difference support) or 25% discount on Internet access.  Internet Service Providers (ISPs), cable companies, or others, may only provide discounted Internet access.  Support is for monthly recurring cost and standard installation charges.  Support cannot include equipment, internal wiring or network buildout.  Services must be for the provision of health care. Service Provider Eligibility

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19. Funding Year 200420052006200720082009 Form 465's Posted294534493353356435633520 Post-secondary ed institution34 32 23 Community health center333360389352389274 Local health department/agency359596513404383395 Community mental health center265267270312304276 Not-for-profit hospital9731,1061,0471,1221,1021096 Rural health clinic9701,0331,0921,3351,3601,454 Consortium of the above3403 Emergency dept for-profit hosp6127722 Part-time eligible entity21

20. 20 FCC FORM 466

21. 21 FCC FORM 466-A

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25. HCPs FY 1998 Total Of HCPNum by ZIP Code Sites per Zip Code

26. HCPs FY 2000 Total Of HCPNum by ZIP Code Sites per Zip Code

27. HCPs FY 2002 Total Of HCPNum by ZIP Code Sites per Zip Code

28. HCPs FY 2004 Total Of HCPNum by ZIP Code Sites per Zip Code

29. HCPs FY 2005 Total Of HCPNum by ZIP Code Sites per Zip Code

30. HCPs FY 2006 Total Of HCPNum by ZIP Code Sites per Zip Code

31. HCPs FY 2007 Sites per Zip Code

32. All Fund Years Combined Total Of HCPNum by ZIP Code Total Commitments for All Fund Years

33. 33 FOR IMMEDIATE RELEASE September 26, 2006 FCC ADOPTS PILOT PROGRAM UNDER RURAL HEALTH CARE MECHANISM Pilot will Enhance Access Health Care Providers’ Access to Advanced Telecommunications and Information Services Washington, D.C. – Today, the Federal Communications Commission (FCC) adopted an Order that establishes a pilot program to help public and non-profit health care providers build state and region-wide broadband networks dedicated to the provision of health care services, and connect those networks to [a] dedicated nationwide backbone…

34. 34 Overview of Pilot Program Support for state or regional broadband networks and to connect to I2, NLR, or public Internet for health care. Support is 85% (15% match required). Urban HCPs eligible, but network must connect more than deminimis number of rural HCPs. HCP eligibility same as Primary program, but non- eligibles may join networks if they pay fair share. Projects submit quarterly reports to show progress and compliance with FCC rules. Quarterly reports also help FCC evaluate possible changed to the Primary Program

35. 35 Overview of Pilot Program 81 applications filed, 69 selected by FCC 11/07, with combined $417.8M budget over 3 years (2007-2009). With mergers, there are now 62 projects. One year no cost extension for all projects for 2010. Selected projects represent:  42 States  3 territories  6,000 HCPs

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37. Locations Posted for Bids

39.  Replace 25% Internet Access support with Broadband Fund  Create Broadband Infrastructure Fund to build networks.  Support long-term care, admin, data ctr and similar facilities.  HCPs to meet performance measures like meaningful use.  Periodically publish a Health Care Broadband Status Report.  Congress should consider supporting for-profit institutions serving vulnerable populations. The FCC will soon issue Notices of Proposed Rulemaking (NPRMs) to detail and seek public comment on implementing these items. USAC will highlight NPRMs on its website. National Broadband Plan Recommends FCC Revamp RHC Program

40. QUESTIONS? William England, Ph.D., J.D. Vice-President, Rural Health Care Division, USAC Ph 202-776-0200 wengland@usac.org