[Federal Register Volume 79, Number 187 (Friday, September 26, 2014)]
[Proposed Rules]
[Pages 57853-57856]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-21848]


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FEDERAL COMMUNICATIONS COMMISSION

47 CFR Part 54

[WC Docket No. 02-60; DA 14-853]


Wireline Competition Bureau Seeks Comment on Healthcare Connect 
Fund Annual Reports

AGENCY: Federal Communications Commission.

ACTION: Proposed rule; solicitation of comments.

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SUMMARY: In this document, the Wireline Competition Bureau (Bureau) 
seeks comment on how best to measure the performance goals identified 
in the Healthcare Connect Fund (HCF) Order and how to structure the 
reports for funding year 2014 and beyond in efforts to assess progress 
for broadband connectivity to eligible individual and consortium health 
care provider applicants.

DATES: Comments are due on or before October 27, 2014. Reply comments 
are due on or before November 10, 2014.

ADDRESSES: Pursuant to Sec. Sec.  1.415 and 1.419 of the Commission's 
rules, 47 CFR 1.415 and 1.419, interested parties may file comments on 
or before October 27, 2014 and reply comments on or before November 10, 
2014. Comments are to reference WC Docket No. 02-60 and may be filed 
using the Commission's Electronic Comment Filing System (ECFS). See 
Electronic Filing of Documents in Rulemaking Proceedings, 63 FR 24121 
(1998).
     Electronic Filers: Comments may be filed electronically 
using the Internet by accessing the ECFS: http://fjallfoss.fcc.gov/ecfs2/.
     Paper Filers: Parties who choose to file by paper must 
file an original and one of each filing.
    Filings can be sent by hand or messenger delivery, by commercial 
overnight courier, or by first-class or overnight U.S. Postal Service 
mail. All filings must be addressed to the Commission's Secretary, 
Office of the Secretary, Federal Communications Commission.

[cir] All hand-delivered or messenger-delivered paper filings for the 
Commission's Secretary must be delivered to FCC Headquarters at 445 
12th St. SW., Room TW-A325, Washington, DC 20554. The filing hours are 
8:00 a.m. to 7:00 p.m. All hand deliveries must be held together with 
rubber bands or fasteners. Any envelopes must be disposed of before 
entering the building.
[cir] Commercial overnight mail (other than U.S. Postal Service Express 
Mail and Priority Mail) must be sent to 9300 East Hampton Drive, 
Capitol Heights, MD 20743.
[cir] U.S. Postal Service first-class, Express, and Priority mail must 
be addressed to 445 12th Street SW., Washington, DC 20554.

In addition, we request that one copy of each pleading be sent to each 
of the following:

[cir] Elizabeth McCarthy, Telecommunications Access Policy Division, 
Wireline Competition Bureau, 445 12th Street SW., Room 5-A346, 
Washington, DC 20554; email: [email protected]; and
[cir] Charles Tyler Telecommunications Access Policy Division, Wireline 
Competition Bureau, 445 12th Street SW., Room 5-A452, Washington, DC 
20554; email: [email protected].

     People with Disabilities: To request materials in 
accessible formats for people with disabilities (braille, large print, 
electronic files, audio format), send an email to [email protected] or 
call the Consumer & Governmental Affairs Bureau at 202-418-0530 
(voice), 202-418-0432 (tty).

FOR FURTHER INFORMATION CONTACT: Elizabeth McCarthy, Wireline 
Competition Bureau at (202) 418-1529 or TTY (202) 418-0484.

SUPPLEMENTARY INFORMATION: This is a synopsis of a document released by 
the Commission on June 19, 2014 in WC Docket No. 02-60, DA 14-853 . The 
complete text of this document is available for inspection and copying 
during normal business hours in the FCC Reference Information Center, 
Portals II, 445 12th Street SW., Room CY-A257, Washington, DC 20554, or 
at the following Internet address: https://apps.fcc.gov/edocs_public/attachmatch/DA-14-853A1.pdf. The document may also 
be purchased from the Commission's duplicating contractor, Best Copy 
and Printing, Inc., 445 12th Street SW., Room CY-B402, Washington, DC 
20554, telephone (800) 378-3160 or (202) 863-2893, facsimile (202) 863-
2898, or via the Internet at http://www.bcpiweb.com.

[[Page 57854]]

I. Introduction

    1. The Wireline Competition Bureau (Bureau) seeks comment on how 
best to measure the performance goals identified in the Rural Health 
Care Support Mechanism HCF Order, FCC 12-150, 78 FR 13935, March 1, 
2013 by optimizing the content and format of the annual reports filed 
by the Rural Health Care Pilot Program (Pilot) and HCF consortium lead 
entities. In the Order DA 14-854, the Bureau waived the annual 
reporting requirements for Pilot and HCF consortium lead entities for 
funding year 2013; thus, we seek comment on how to structure these 
reports for funding year 2014 and beyond.
    2. In December 2012, the Federal Communications Commission 
(Commission) created the Healthcare Connect Fund (HCF) to direct 
universal service support for broadband connectivity to eligible 
individual and consortium health care provider applicants. As part of 
the new HCF program, the Commission adopted performance goals, and 
annual reporting requirements to measure progress towards those goals, 
for Pilot and HCF consortium lead entities under Sec.  54.647 of the 
Commission's rules.

II. Discussion

    3. In the HCF Order, the Commission identified three performance 
goals for the newly constituted HCF: (1) To increase access to 
broadband for health care providers (HCPs); (2) to foster the 
development and deployment of broadband health care networks; and (3) 
to minimize the burden on the federal universal service fund by 
ensuring the cost-effectiveness of the program. To ensure that the data 
collected appropriately assess whether these performance goals are 
being met while also minimizing the burden on program participants, the 
Commission delegated to the Bureau the authority ``to work with [the 
Universal Service Administrative Company (USAC)] to accomplish these 
tasks, and to modify specific reporting requirements.'' In keeping with 
this delegation of authority, we seek comment on how best to collect 
the types of data identified in the HCF Order and described in more 
detail below.
    4. To measure progress toward the first goal of increased access, 
we propose to collect data on: The extent to which program participants 
subscribe to higher levels of broadband over time; participation in HCF 
relative to the universe of eligible participants; the bandwidths 
obtained by different types of HCPs; and whether those bandwidths are 
sufficient for their needs. Specifically, we propose that consortium 
lead entities collect the following information on these data points: 
anticipated increases in bandwidth or service level upgrades for HCPs 
on their networks and whether their service agreements allow for such 
increases; the average bandwidth obtained per HCP site and price paid 
per megabyte, categorized by HCP type; potential growth of the network 
categorized by number and type of HCPs; the number of outages and 
duration of time when service is unavailable, to the extent that data 
is already being collected; and the types of technologies consortia use 
to receive service (e.g., fiber, coaxial cable, copper, wireless or 
satellite). We seek comment on the benefits and burdens of including 
such information in the annual reports. Are there additional data 
points that would prove useful to the Bureau in measuring progress 
toward the first goal for HCF?
    5. In evaluating progress toward the second goal--fostering 
development and deployment of broadband health care networks--we 
propose to collect data on: the extent to which eligible HCPs 
participating in HCF are connected to other HCPs through broadband 
health care networks; the reach of broadband health care networks 
supported by our programs, including connections to those networks by 
eligible and non-eligible HCP sites; and how program participants use 
their broadband connections to deliver health care, including whether 
and to what extent HCPs are engaging in telemedicine, exchanging 
electronic health records (EHRs), or participating in health 
information exchanges, remote training, and other telehealth 
applications.
    6. Finally, to assess progress toward the third goal of maximizing 
the cost-effectiveness of the HCF program, we propose to collect data 
on: the cost of administering the program as compared to funds 
disbursed to program participants; the prices and speeds of the 
broadband connections supported by HCF; and the number and nature of 
all responsive bids received through the competitive bidding process, 
as well as an explanation of how each winning bid was chosen. Should we 
allow filers to request that competitively sensitive information 
submitted during the competitive bidding process be treated as 
confidential? We seek comment on these proposals and on how best to 
obtain these data.
    7. It is important to note that HCF was designed so that the forms 
used to apply and receive services in the program, FCC Forms 460, 461, 
462 and 463, also collect data that may be used to evaluate progress 
towards the program's goals. In addition to the proposed collections 
listed above, what other data points would be most useful to the 
Commission in measuring its performance goals for HCF, and how easily 
can HCPs or consortium lead entities provide them? We have a particular 
interest in quantitative data that will allow the Commission to monitor 
trends as HCF evolves. The HCF Order expressed a preference for 
collecting data, to the extent feasible, through automated interfaces 
on USAC's web portal. We thus propose to collect the consortium annual 
reports required by Sec.  54.647 of the Commission's rules through 
USAC's ``My Portal'' web interface. We seek comment on which data 
points would lend themselves particularly well to such automated 
collection and, conversely, whether there are any types of information 
that would be ill-suited for collection through a simple web interface. 
Finally, we seek comment on ways to minimize any burden imposed on 
filers.

III. Procedural Matters

A. Paperwork Reduction Act

    8. The document does not contain new or modified information 
collection requirements subject to the Paperwork Reduction Act of 1995 
(PRA), Public Law 104-13. In addition, therefore, it does not contain 
any new or modified information collection burden for small business 
concerns with fewer than 25 employees, pursuant to the Small Business 
Paperwork Relief Act of 2002, Public Law 107-198, see 44 U.S.C. 
3506(c)(4).

B. Initial Regulatory Flexibility Analysis

    9. Pursuant to the Regulatory Flexibility Act (RFA), the Commission 
has prepared this Initial Regulatory Flexibility Analysis (IRFA) of the 
possible significant economic impact on small entities by the policies 
and rules proposed in this Public Notice. Written public comments are 
requested on this IRFA. Comments must be identified as responses to the 
IRFA and must be filed on or before October 27, 2014. The Commission 
will send a copy of the Public Notice, including the IRFA, to the Chief 
Counsel for Advocacy of the Small Business Administration. In addition, 
the document and IRFA (or summaries thereof) will be published in the 
Federal Register.

[[Page 57855]]

a. Need for, and Objectives of, the Document

    10. On December 12, 2012, the Commission adopted rules that 
reformed its system of universal service support mechanisms for health 
care providers (HCPs) and created the HCF. Among other rules, the 
Commission adopted a requirement that consortium lead entities in HCF 
submit annual reports to provide the Commission with the ability to 
measure progress toward the performance goals the Commission identified 
for HCF. These goals include: (1) Increased access to broadband for 
HCPs; (2) development and deployment of broadband health care networks; 
and (3) reduced burden on the Universal Service Fund by ensuring the 
cost-effectiveness of the program.
    11. This document is a part of the Commission's ongoing effort to 
implement and improve the reforms adopted in the HCF Order. In it, we 
propose to collect needed data in a way that will: (1) Allow the 
Commission to evaluate the efficacy of HCF in meeting the three 
performance goals identified in the HCF Order; and (2) minimize the 
burden on consortium lead entities, many of which may be small entities 
within the meaning of the RFA.
b. Legal Basis
    12. This document is authorized under sections 1, 2, 4(i), and 254 
of the Communications Act of 1934, as amended, 47 U.S.C. 151, 152, 
154(i), 254, and Sec.  54.647 of the Commission's rules, 47 CFR 54.647.
c. Description and Estimate of the Number of Small Entities to Which 
Rules Will Apply
    13. The RFA directs agencies to provide a description of and, where 
feasible, an estimate of the number of small entities that may be 
affected by the proposed rules, if adopted. The RFA generally defines 
the term ``small entity'' as having the same meaning as the terms 
``small business,'' ``small organization,'' and ``small governmental 
jurisdiction.'' In addition, the term ``small business'' has the same 
meaning as the term ``small business concern'' under the Small Business 
Act. A small business concern is one that: (1) Is independently owned 
and operated; (2) is not dominant in its field of operation; and (3) 
satisfies any additional criteria established by the SBA. Nationwide, 
there are a total of approximately 29.6 million small businesses, 
according to the SBA. A ``small organization'' is generally ``any not-
for-profit enterprise which is independently owned and operated and is 
not dominant in its field.'' Nationwide, as of 2002, there were 
approximately 1.6 million small organizations. The term ``small 
governmental jurisdiction'' is defined generally as ``governments of 
cities, towns, townships, villages, school districts, or special 
districts, with a population of less than fifty thousand.'' Census 
Bureau data for 2002 indicate that there were 87,525 local governmental 
jurisdictions in the United States. We estimate that, of this total, 
84,377 entities were ``small governmental jurisdictions.'' Thus, we 
estimate that most governmental jurisdictions are small.
    14. Small entities potentially affected by the proposals herein 
include eligible rural non-profit and public HCPs.
    15. Rural Health Care Providers. Section 254(h)(7)(B) of the Act 
defines the term ``health care provider'' and sets forth seven 
categories of health care providers eligible to receive universal 
service support. In addition, non-profit entities that act as ``health 
care providers'' on a part-time basis are eligible to receive prorated 
support and we have no ability to quantify how many potential eligible 
applicants fall into this category.
    16. As noted earlier, non-profit businesses and small governmental 
units are considered ``small entities'' within the RFA. In addition, we 
note that census categories and associated generic SBA small business 
size categories provide the following descriptions of small entities. 
The broad category of Ambulatory Health Care Services consists of 
further categories and the following SBA small business size standards. 
The categories of small business providers with annual receipts of $7 
million or less consists of: Offices of Dentists; Offices of 
Chiropractors; Offices of Optometrists; Offices of Mental Health 
Practitioners (except Physicians); Offices of Physical, Occupational 
and Speech Therapists and Audiologists; Offices of Podiatrists; Offices 
of All Other Miscellaneous Health Practitioners; and Ambulance 
Services. The category of such providers with $10 million or less in 
annual receipts consists of: Offices of Physicians (except Mental 
Health Specialists); Family Planning Centers; Outpatient Mental Health 
and Substance Abuse Centers; Health Maintenance Organization Medical 
Centers; Freestanding Ambulatory Surgical and Emergency Centers; All 
Other Outpatient Care Centers, Blood and Organ Banks; and All Other 
Miscellaneous Ambulatory Health Care Services. The category of such 
providers with $13.5 million or less in annual receipts consists of: 
Medical Laboratories; Diagnostic Imaging Centers; and Home Health Care 
Services. The category of Ambulatory Health Care Services providers 
with $34.5 million or less in annual receipts consists of Kidney 
Dialysis Centers. For all of these Ambulatory Health Care Service 
Providers, census data indicate that there are a combined total of 
368,143 firms that operated for all of 2002. Of these, 356,829 had 
receipts for that year of less than $5 million. In addition, an 
additional 6,498 firms had annual receipts of $5 million to $9.99 
million; and additional 3,337 firms had receipts of $10 million to 
$24.99 million; and an additional 865 had receipts of $25 million to 
$49.99 million. We therefore estimate that virtually all Ambulatory 
Health Care Services providers are small, given SBA's size categories. 
We note, however, that our rules affect non-profit and public 
healthcare providers, and many of the providers noted above would not 
be considered ``public'' or ``non-profit.'' In addition, we have no 
data specifying the numbers of these health care providers that are 
rural and meet other criteria of the Act.
    17. The broad category of Hospitals consists of the following 
categories, with an SBA small business size standard of annual receipts 
of $34.5 million or less: General Medical and Surgical Hospitals, 
Psychiatric and Substance Abuse Hospitals; and Specialty (Except 
Psychiatric and Substance Abuse) Hospitals. For these health care 
providers, census data indicate that there is a combined total of 3,800 
firms that operated for all of 2002, of which 1,651 had revenues of 
less than $25 million, and an additional 627 firms had annual receipts 
of $25 million to $49.99 million. We therefore estimate that most 
Hospitals are small, given SBA's size categories. In addition, we have 
no data specifying the numbers of these health care providers that are 
rural and meet other criteria of the Act.
    18. The broad category of Social Assistance consists, inter alia, 
of the category of Emergency and Other Relief Services, with a small 
business size standard of annual receipts of $7 million or less. For 
these health care providers, census data indicate that there were a 
total of 55 firms that operated for all of 2002. All of these firms had 
annual receipts of below $1 million. We therefore estimate that all 
such firms are small, given SBA's size standard. In addition, we have 
no data specifying the numbers of these health care providers that are 
rural and meet other criteria of the Act.

[[Page 57856]]

d. Description of Projected Reporting, Recordkeeping, and Other 
Compliance Requirements for Small Entities
    19. The reporting requirements proposed in this document could have 
an impact on small entities. However, even though the proposals may 
impose some financial burden on smaller entities, the Commission 
believes these requirements are necessary to ensure that progress 
toward the stated goals of HCF can be measured.
    20. The document seeks comment on the data collection process for 
the consortium annual reports that will allow the Commission to measure 
progress in increasing HCP access to broadband, fostering the 
development and deployment of health care broadband networks, and 
ensuring the cost-effectiveness of HCF.
e. Steps Taken To Minimize Significant Economic Impact on Small 
Entities, and Significant Alternatives Considered
    21. The RFA requires an agency to describe any significant 
alternatives that it has considered in reaching its approach, which may 
include the following four alternatives, among others: (1) The 
establishment of differing compliance or reporting requirements or 
timetables that take into account the resources available to small 
entities; (2) the clarification, consolidation, or simplification of 
compliance or reporting requirements under the rule for small entities; 
(3) the use of performance, rather than design, standards; and (4) an 
exemption from coverage of the rule, or any part thereof, for small 
entities.
    22. In this document, we make a number of proposals that may have 
an economic impact on small entities that participate in the universal 
service support mechanism for HCPs. Specifically, as addressed above, 
we seek comment on collecting data to measure the Commission's goals 
that HCF identified: (1) Increase access to high-speed broadband for 
eligible HCPs; (2) foster the development and deployment of health care 
broadband networks; and (3) reduce the burden on the Universal Service 
Fund by ensuring the cost-effectiveness of the program. If adopted, 
these proposals will provide the Commission with much-needed data to 
assess the efficacy of HCF in achieving these goals and to inform any 
potential future reforms to the program.
    23. In seeking to minimize the burdens imposed on small entities 
where doing so does not compromise the goals of the universal service 
mechanism, we have invited comment on how these proposals might be made 
less burdensome for small entities. We again invite commenters to 
discuss the benefits of such changes on small entities and whether 
these benefits are outweighed by resulting costs to rural HCPs that 
might also be small entities. We anticipate that the record will 
reflect whether the overall benefits of the proposed annual report 
contents would outweigh any burden on small entities and suggest ways 
in which the Commission could further lessen the overall burdens on 
small entities. We encourage small entities to comment.
    24. To minimize the economic impact on consortium lead entities, we 
propose to collect the annual reports through the Universal Service 
Administrative Company's ``My Portal'' web interface, with which all 
consortium applicants are familiar. Filling out and submitting these 
reports online will significantly reduce the amount of time and 
resources needed for consortium lead entities to comply with the annual 
reporting requirements of Sec.  54.647 of the Commission's rules.
f. Federal Rules That May Duplicate, or Conflict With Proposed Rules
    25. None.

C. Ex Parte

    26. The proceeding this document initiates shall be treated as a 
``permit-but-disclose'' proceeding in accordance with the Commission's 
ex parte rules. Persons making ex parte presentations must file a copy 
of any written presentation or a memorandum summarizing any oral 
presentation within two business days after the presentation (unless a 
different deadline applicable to the Sunshine period applies). Persons 
making oral ex parte presentations are reminded that memoranda 
summarizing the presentation must: (1) List all persons attending or 
otherwise participating in the meeting at which the ex parte 
presentation was made, and (2) summarize all data presented and 
arguments made during the presentation. If the presentation consisted 
in whole or in part of the presentation of data or arguments already 
reflected in the presenter's written comments, memoranda or other 
filings in the proceeding, the presenter may provide citations to such 
data or arguments in his or her prior comments, memoranda, or other 
filings (specifying the relevant page and/or paragraph numbers where 
such data or arguments can be found) in lieu of summarizing them in the 
memorandum. Documents shown or given to Commission staff during ex 
parte meetings are deemed to be written ex parte presentations and must 
be filed consistent with Sec.  1.1206(b) of the Commission's rules). In 
proceedings governed by Sec.  1.49(f) of the Commission's rules or for 
which the Commission has made available a method of electronic filing, 
written ex parte presentations and memoranda summarizing oral ex parte 
presentations, and all attachments thereto, must be filed through the 
electronic comment filing system available for that proceeding, and 
must be filed in their native format (e.g., .doc, .xml, .ppt, 
searchable .pdf). Participants in this proceeding should familiarize 
themselves with the Commission's ex parte rules.

Federal Communications Commission.
Radhika Karmarkar,
Acting Deputy Chief, Telecommunication Access Policy Division Wireline 
Competition Bureau.
[FR Doc. 2014-21848 Filed 9-25-14; 8:45 am]
BILLING CODE 6712-01-P