If you have been diligently keeping up with my quarterly technology articles, you will recall that we discussed how the government uses some of the tax dollars you pay on your telephone bill—coded as Universal Service Fund. In the November issue, we discussed a funding source for schools nationwide, a program called E-rate. The second funding source is the Rural Health Care Program. This program is also run by the Universal Service Administration Company (USAC), which is overseen by the Federal Communications Commission. According to USAC, “The program is intended to ensure that rural healthcare providers pay no more for telecommunications in the provision of healthcare services than their urban counterparts.”

This is a relatively new program. There was a pilot program enacted by USAC in September 2006 to help public and private facilities connect to Internet 2 facilities.

So what is this program?

It is an avenue for rural healthcare systems to apply for funding assistance to level out the costs involved in bringing communications and Internet services to a healthcare facility. These services can include T1 lines for Internet or voice communications, DSL circuits, standard telephone lines, etc. Further, there is assistance for long distance used for dial-up Internet services. This does not have to be a new service; the funding can be applied to existing services or used to add services that have been desired but are out of the budget realm.

The level of funding is based on the location of the facility as well as the filing accuracy of the required documents. The facility must conduct a competitive bid process for all services for which they are seeking funding. After bids are received, the healthcare provider has a responsibility to choose the most cost-effective method of providing the desired service. The FCC defines the most cost-effective solution 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.”

So why is this important?

Healthcare is changing rapidly, and technology in the field is keeping up. Images from simple X-rays to CT Scans to MRIs are transmitted and stored off-site. These are mission-critical files, not to mention files large enough that dial-up Internet service using standard telephone lines is not going to accomplish what is necessary. There are also collaboration tools, such as video, screen sharing and others, available to further benefit patient care if the bandwidth to run the services is accessible.

Part of our work with clients allows us access to various types of services. A client in Peoria can get a T1 connection to the Internet for $200 per month. Some facilities, depending on size, could even get by with a DSL circuit, lowering the cost even further. Some high-bandwidth ADSL (i.e. 6MB download/1MB upload) circuits will cost a client less than $100 per month. However, if we use the same scenario in a rural setting, we get a much different result.

First, we will most likely be told that there are no DSL services from the phone company available in that switch station. This leaves the facility no choice but to look at a T1 for Internet service. Some local telephone companies provide T1, while others do not. Local providers in rural settings have charged close to $400 per month for a partial T1. If a long-distance company is needed to provide this service, it could be as much as $600 per month, depending on the location of the facility in need. This is just Internet access and does not include low competition for local telephone service. As you can see from this quick example, rural facilities have very different service options and costs available to them. This is what the USAC program is trying to minimize.

How do you know if you are eligible?

There is a published list on the USAC website that will allow a facility to search by census district if it complies with the geographic footprint. For instance, not all of Peoria and McLean County are eligible, but some parts of each county are. The sample report shows that in Peoria County, the following rural areas would be eligible to apply for funding: 0036.01, 0036.02, 0037.00, 0038.00, 0040.00 and 0049.02. The following rural areas in Mclean County are eligible: 0052.02, 0053.02, 0055.01, 0055.02, 0056.01 and 0056.02. All of Fulton County is considered rural. For more information, visit www.usac.org/rhc/tools/rhcdb/Rural/2005/result.asp.

Certain forms are required for filing, and site visits may be conducted to verify rural status. USAC may also require audits; they routinely audit random facilities to ensure the funding is being used in appropriate ways.

Many hospitals and other qualifying healthcare facilities don’t even know this program exists, or, if they do, deadlines are missed and no funding is appropriated. We hope that by reading this article, more healthcare providers will take advantage of this USAC program. Rural facilities can be more competitive in the healthcare marketplace, freeing up operation funds to provide specialized care closer to rural homes. IBI