*Pages 1--13 from C:\Pdf2Text\Ready4Text_in\pdf\54063.pdf* 5 - 1 5. Rural Health Care Support The portion of the 1996 Telecommunications Act that covers universal service support for rural health care providers states that “[ a] telecommunications carrier shall . . . provide telecommunications services . . . to any public or non- profit health care provider . . . at rates that are reasonably comparable to rates charged for similar services in urban areas in that state.” 1 The Commission's universal service rules permit eligible health care providers 2 to receive support for any telecommunications service. 3 In 2003, the FCC significantly changed the universal service support mechanism for rural health care providers, effective in Funding Year 2004 (July 1, 2004 – June 30, 2005). Dedicated emergency departments of rural for- profit hospitals that participate in Medicare are now deemed “public” health care providers eligible to receive prorated rural heath care support. 4 Further, rural health providers may now receive support for any form of Internet access reasonably related to the health care needs of the facility. 5 Rural health care providers may also use “safe harbor” categories to compare the urban and rural rates for functionally similar services as viewed from the perspective of the end user. 6 Also, rural health care providers may compare their rural rates to urban rates in any city with a population of at least 50,000 in the state, as opposed to the nearest city with a population of 50,000. 7 Finally, rural health care providers may 1 47 U. S. C. § 254( h)( 1)( A). 2 47 C. F. R. § 54.601. 3 A 1.544 Mbps (T1) maximum bandwidth cap was employed in Funding Years 1 and 2. See Federal- State Joint Board on Universal Service, CC Docket No. 96- 45, Report and Order, 12 FCC Rcd 8776, 8952- 94 (1997). The Commission removed the bandwidth cap for year three and beyond. See Federal- State Joint Board on Universal Service, CC Docket Nos. 97- 21 and 96- 45, Sixth Order on Reconsideration in CC Docket No. 97- 21, Fifteenth Order on Reconsideration in CC Docket No. 96- 45, 14 FCC Rcd 18756 (1999) (Fifteenth Order on Reconsideration). 4 See Rural Health Care Support Mechanism, WC Docket No. 02- 60, Report and Order, Order on Reconsideration and Further Notice of Proposed Rulemaking, 18 FCC Rcd 24546 (2003) (Rural Health Care Order) at 13. 5 See Rural Health Care Order at 22. 6 See Rural Health Care Order at 33. 7 See Rural Health Care Order at 37. 1 5 - 2 receive discounts for satellite services even where alternative terrestrial- based services may be available. 8 In December 2004, the Commission released a Second Order 9 that further modified the Commission’s rules for rural health care support. In this Second Order, the Commission changed its definition of rural for the purposes of the rural health care support mechanism. Now a “rural area” is an area that is not located within or near a large population base. Specifically, a “rural area” is an area that (a) is entirely outside of a Core Based Statistical Area (CBSA); (b) is within a CBSA that does not have any urban area with a population of 25,000 or greater; or (c) is in a CBSA that contains an urban area with a population of 25,000 or greater, but is within a specific census tract that itself does not contain any part of a place or urban area with a population of greater than 25,000. This new definition was effective as of Funding Year 2005 (July 1, 2005 – June 30, 2006). Several other rules also were changed. The Commission expanded funding for mobile rural health care providers by subsidizing the difference between the rate for the satellite service and the rate for an urban wireline service with a similar bandwidth. June 30 is now the final deadline for applications for support for health care providers seeking discounts for a specific funding year under the rural health care support mechanism. In addition a rural health care provider in a state that is entirely rural may now receive support for advanced telecommunications and information services. USAC recently streamlined the application process for the Rural Health Care mechanism. USAC combined the information from two forms onto one, 10 allowed the new form to be filled out electronically, and, where possible, prefilled the form with that applicant’s information. 11 Now, an eligible rural health care provider seeking funding must first submit FCC Form 465 (description of services requested and certification form) to the Rural Health Care Division (RHCD). 12 If the 8 See Rural Health Care Order at 44. 9 See Rural Health Care Support Mechanism, WC Docket No. 02- 60, Second Report and Order, Order on Reconsideration, and Further Notice of Proposed Rulemaking, 19 FCC Rcd 24613 (2004) (Second Order). 10 FCC Forms 466 and 468 were combined into the new FCC form 466. 11 See http:// www. rhc. universalservice. org/ whatsnew/ 062003. asp# 2 12 The Rural Health Care Corporation merged into the Universal Service Administrative and became the Rural Health Care Division on January 1, 1999. See Changes to the Board of Directors of the National Exchange Carrier Association, Inc., Federal- State Joint Board on Universal Service, CC Docket Nos. 97- 21 and 96- 45, Third Report and Order in CC Docket No. 97- 21 and Fourth Order on Reconsideration in CC Docket No. 97- 21 and Eighth Order on Reconsideration in CC Docket No. 96- 45, 13 FCC Rcd 25058, 25064- 65, para. 12 (1998). 2 5 - 3 RHCD determines that the health care provider is eligible, it posts the Form 465 on its website. 13 28 days thereafter, the rural health care provider may contract with the most cost- effective bidder. The health care provider then fills out FCC Form 466 (funding request and certification form), and submits it to the RHCD. Upon receipt and approval of FCC Form 466, the RHCD sends a Funding Commitment Letter to the rural health care provider. The letter explains that the request has received preliminary approval, and provides an estimate of the amount of support that can be expected. The rural health care provider must respond by submitting FCC Form 467 (receipt of service confirmation form) to verify that the service has begun. RHCD then sends a Support Schedule to the carrier and the health care provider. The carrier provides service to the rural health care provider, and then invoices the RHCD for the support amount. Upon approval of the invoice, USAC reimburses the carrier. By rule, the Commission has established a $400 million per funding year cap for the rural health care mechanism. 14 For more information on the Universal Service Program for Rural Health Care providers, visit the RHCD website. 15 USAC supplied the Commission with funding commitments and disbursements information as of June 2, 2005. Table 5.1 summarizes funding disbursements for all funding years by service speed. Tables 5.2 through 5.4 show details for Funding Years 2002 through 2004. For details on the preceding funding years, see the previous editions of the Monitoring Report. 16 Table 5.2 summarizes funding commitments and disbursements on a state- by- state basis. Funding Year 2002 was July 1, 2002, through June 30, 2003. All activity for Funding Year 2002 is complete. 17 Final figures show that over $23.3 million was committed, and over $21.3 million was disbursed. 18 Funding Year 2003 was July 1, 2003, through June 30, 2004. USAC reports that it received 3,172 Form 466 packets. 19 Of those, 56 were denied, 231 were withdrawn by the applicant, and 14 13 The forms may be viewed at . 14 47 C. F. R. § 54.623( a). 15 See www. rhc. universalservice. org. 16 Universal Service Monitoring Report, CC Docket No. 98- 202, November 6, 2001, October 9, 2002, and December 22, 2003. 17 Universal Service Administrative Company, Federal Universal Service Support Mechanisms Fund Size Projections for the Third Quarter 2005, at 15. 18 See Table 5.2. 3 5 - 4 were incomplete or require clarification. As of June 2, 2005, over $26.0 million had been committed, and over $18.7 million had been disbursed. 20 Funding Year 2004 was July 1, 2004, through June 30, 2005. USAC reports that it posted 2,793 Form 465 packets, and received 1,981 Form 466 packets. Of the 1,981 Form 466 packets, 1,029 have been completely processed, 89 are awaiting supervisory approval only, 120 are complete and ready to process, 88 have been withdrawn by the applicant, 15 have been denied, and 640 were incomplete or require clarification. 21 As of June 2, 2005, over $20.1 million had been committed, and over $2.1 million had been disbursed. 22 Table 5.3 shows state- by- state disbursements by service speed. In some instances, such as with frame relay service, the service speed was not clearly identifiable. Whenever possible, the most likely speed for each service was assumed. For example, Frame Relay theoretically could be provided at voice grade speeds, but the vast majority of it is provided at broadband speeds (200K to 1.49Mb), so Frame Relay was assumed to be broadband at that level. Table 5.4 shows, for Funding Years 2002 and 2003, state- by- state disbursements from the Rural Health Care Support Mechanism, the population of the rural areas, and the disbursements per person in rural areas. 19 Universal Service Administrative Company, Federal Universal Service Support Mechanisms Fund Size Projections for the Third Quarter 2005, at 16. 20 See Table 5.2. 21 Universal Service Administrative Company, Federal Universal Service Support Mechanisms Fund Size Projections for the Third Quarter 2005, at 17. 22 See Table 5.2. 4 Table 5.1 Rural Health Care Funding Disbursements by Funding Year Voice Grade Broadband Other Service Funding 56K to 200K to 1.5Mb or Speed Year 199K 1.49Mb and faster Unknown Total 1998 $202,778 $880,375 $2,292,252 $0 $3,375,405 1999 452,992 1,073,816 2,719,619 58,132 4,304,559 2000 613,595 3,015,004 6,685,573 0 10,314,172 2001 319,539 8,110,537 10,125,267 0 18,555,343 2002 423,522 10,614,090 10,342,844 0 21,380,456 2003 415,461 7,878,340 10,455,720 2,200 18,751,722 2004 83,859 534,105 1,491,558 16,300 2,125,823 Note: Disbursements through June 2, 2005. Because of the appeals process, funding commitments and disbursements may be made after the program year ended. Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. 5 - 5 5 Table 5.2 Rural Health Care Funding Commitments and Disbursements by State Funding Year 2002: July 1, 2002 through June 30, 2003 Total Providers Total Providers Funds Receiving Funds Receiving State Committed Support Disbursed Support Alabama $25,969 4 $23,988 4 Alaska 14,008,346 164 12,670,097 158 Arizona 1,201,363 57 997,097 48 Arkansas 69,264 30 60,442 26 California 354,689 70 345,832 69 Colorado 140,658 13 140,658 13 Connecticut 0 0 0 0 Delaware 0 0 0 0 District of Columbia 0 0 0 0 Florida 249,386 51 220,004 45 Georgia 43,465 3 43,465 3 Hawaii 230,975 16 227,758 16 Idaho 110,423 17 94,748 16 Illinois 114,643 30 111,572 28 Indiana 14,672 6 14,565 6 Iowa 160,686 40 158,091 40 Kansas 228,222 51 220,499 51 Kentucky 540,945 162 534,665 160 Louisiana 1,552 1 1,552 1 Maine 43,472 4 19,305 4 Maryland 0 0 0 0 Massachusetts 0 0 0 0 Michigan 597,812 49 590,740 48 Minnesota 894,318 91 836,859 85 Mississippi 80,628 16 76,389 13 Missouri 49,883 11 33,383 9 Montana 510,429 56 501,491 55 Nebraska 549,256 29 524,119 29 Nevada 65,337 18 55,608 16 New Hampshire 0 0 0 0 New Jersey 0 0 0 0 New Mexico 238,893 25 234,954 24 New York 20,620 3 20,620 3 North Carolina 196,481 21 170,665 18 North Dakota 478,202 49 466,897 49 Ohio 124,651 9 124,651 9 Oklahoma 75,955 25 71,437 24 Oregon 55,583 15 25,556 10 Pennsylvania 12,211 7 12,211 7 Rhode Island 0 0 0 0 South Carolina 20,974 2 20,974 2 South Dakota 374,660 45 355,608 44 Tennessee 81,733 26 55,836 16 Texas 33,054 9 20,658 7 Utah 400,322 21 361,311 17 Vermont 0 0 0 0 Virgin Islands 66,209 8 66,209 8 Virginia 195,418 20 195,186 20 Washington 78,333 29 77,199 28 West Virginia 49,022 8 49,022 8 Wisconsin 425,357 82 395,886 81 Wyoming 155,387 12 152,648 12 Totals $23,369,457 1,405 $21,380,456 1,330 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: All activity for Funding Year 2002 is complete. 5 - 6 6 Table 5.2 Rural Health Care Funding Commitments and Disbursements by State Funding Year 2003: July 1, 2003 through June 30, 2004 Total Providers Total Providers Funds Receiving Funds Receiving State Committed Support Disbursed Support Alabama $28,736 4 $26,591 3 Alaska 15,006,652 193 11,138,143 111 Arizona 1,182,242 62 460,643 41 Arkansas 113,247 36 51,236 19 California 378,376 77 242,427 32 Colorado 142,852 15 105,305 12 Connecticut 0 0 0 0 Delaware 0 0 0 0 District of Columbia 0 0 0 0 Florida 259,622 44 96,526 6 Georgia 70,580 5 69,731 4 Hawaii 211,966 20 211,966 20 Idaho 212,171 22 80,396 16 Illinois 91,725 25 57,857 12 Indiana 26,375 8 18,976 5 Iowa 186,674 41 127,441 32 Kansas 377,833 62 316,036 48 Kentucky 477,586 207 449,609 197 Louisiana 6,501 3 1,198 1 Maine 83,600 9 1,580 1 Maryland 0 0 0 0 Massachusetts 0 0 0 0 Michigan 551,152 50 432,552 37 Minnesota 1,005,904 101 748,323 63 Mississippi 113,354 14 97,482 7 Missouri 101,525 26 63,214 18 Montana 551,206 61 463,343 55 Nebraska 615,389 33 594,167 29 Nevada 66,767 18 21,397 7 New Hampshire 0 0 0 0 New Jersey 0 0 0 0 New Mexico 314,361 49 155,135 13 New York 14,252 3 13,651 2 North Carolina 149,423 16 71,038 8 North Dakota 460,135 58 389,599 49 Ohio 142,734 8 80,352 6 Oklahoma 106,114 35 30,296 11 Oregon 21,586 9 3,152 1 Pennsylvania 47,646 13 19,251 8 Rhode Island 0 0 0 0 South Carolina 7,323 3 4,320 1 South Dakota 421,819 49 301,947 28 Tennessee 31,717 14 9,201 3 Texas 139,929 28 2,560 1 Utah 687,450 28 548,384 24 Vermont 1,265 3 1,040 3 Virgin Islands 115,575 9 113,637 8 Virginia 166,495 28 162,199 27 Washington 68,592 28 37,565 11 West Virginia 123,204 29 72,180 18 Wisconsin 983,229 92 739,355 71 Wyoming 155,530 12 120,722 10 Totals $26,020,414 1,650 $18,751,722 1,079 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: Disbursements through June 2, 2005. Because of the appeals process, funding commitments and disbursements may be made after the program year ended. 5 - 7 7 Table 5.2 Rural Health Care Funding Commitments and Disbursements by State Funding Year 2004: July 1, 2004 through June 30, 2005 Total Providers Total Providers Funds Receiving Funds Receiving State Committed Commitments Disbursed Support Alabama $792 1 $619,536 11 Alaska 12,798,279 148 37,450 5 Arizona 428,833 38 11,863 3 Arkansas 75,970 13 48,961 10 California 295,331 32 8,969 1 Colorado 39,258 5 0 0 Connecticut 0 0 0 0 Delaware 0 0 0 0 District of Columbia 0 0 0 0 Florida 135,344 17 0 0 Georgia 109,557 7 27,124 2 Hawaii 267,772 21 7,800 1 Idaho 58,210 16 23,184 9 Illinois 172,666 29 5,868 5 Indiana 127,905 6 0 0 Iowa 132,756 30 84,710 12 Kansas 387,708 50 24,686 5 Kentucky 657,288 175 262,245 148 Louisiana 498 1 0 0 Maine 32,295 6 0 0 Maryland 0 0 0 0 Massachusetts 0 0 0 0 Michigan 176,567 21 19,856 6 Minnesota 649,921 80 177,540 29 Mississippi 144,804 11 44,302 6 Missouri 105,996 23 4,406 9 Montana 458,301 47 86,466 12 Nebraska 700,612 42 11,296 5 Nevada 24,558 4 0 0 New Hampshire 2,483 1 1,241 1 New Jersey 0 0 0 0 New Mexico 74,493 21 9,500 1 New York 7,274 1 0 0 North Carolina 24,687 7 9,984 1 North Dakota 458,017 71 223,898 36 Ohio 37,344 5 22,518 4 Oklahoma 32,851 2 0 0 Oregon 3,667 1 0 0 Pennsylvania 36,016 9 0 0 Rhode Island 0 0 0 0 South Carolina 42,679 10 0 0 South Dakota 358,208 29 283,216 23 Tennessee 41,621 19 6,235 1 Texas 365,695 26 0 0 Utah 149,152 19 20,600 14 Vermont 23,549 6 4,105 4 Virgin Islands 0 0 0 0 Virginia 15,459 2 9,221 1 Washington 42,243 10 0 0 West Virginia 40,871 10 0 0 Wisconsin 412,911 48 29,045 8 Wyoming 43,620 4 0 0 Totals $20,194,060 1,124 $2,125,823 373 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: Disbursements through June 2, 2005. Because of the appeals process, funding commitments and disbursements may be made after the program year ended. 5 - 8 8 Table 5.3 Disbursements by Service Speeds Acquired by Rural Health Care Providers Funding Year 2002: July 1, 2002 through June 30, 2003 Voice Grade Broadband Other Service 56K to 200K to 1.5Mb or Speed State 199K 1.49Mb and faster Unknown Total Alabama $0 $153 $23,835 $0 $23,988 Alaska 0 8,315,687 4,354,410 0 12,670,097 Arizona 0 142,394 854,703 0 997,097 Arkansas 4,160 5,483 50,799 0 60,442 California 181,726 111,820 52,286 0 345,832 Colorado 2,432 0 138,226 0 140,658 Connecticut 0 0 0 0 0 Delaware 0 0 0 0 0 District of Columbia 0 0 0 0 0 Florida 0 168,333 51,671 0 220,004 Georgia 0 0 43,465 0 43,465 Hawaii 0 0 227,758 0 227,758 Idaho 0 78,152 16,596 0 94,748 Illinois 0 11,257 100,315 0 111,572 Indiana 0 1,194 13,371 0 14,565 Iowa 530 31,633 125,928 0 158,091 Kansas 31,973 74,483 114,044 0 220,499 Kentucky 35,267 303,816 195,581 0 534,665 Louisiana 0 1,552 0 0 1,552 Maine 17,689 1,616 0 0 19,305 Maryland 0 0 0 0 0 Massachusetts 0 0 0 0 0 Michigan 16,492 31,626 542,622 0 590,740 Minnesota 3,066 348,498 485,295 0 836,859 Mississippi 14,937 17,763 43,689 0 76,389 Missouri 0 10,034 23,349 0 33,383 Montana 1,769 16,676 483,046 0 501,491 Nebraska 0 70,107 454,011 0 524,119 Nevada 0 31,615 23,993 0 55,608 New Hampshire 0 0 0 0 0 New Jersey 0 0 0 0 0 New Mexico 0 161,609 73,345 0 234,954 New York 0 1,129 19,491 0 20,620 North Carolina 0 22,658 148,007 0 170,665 North Dakota 23,733 55,507 387,657 0 466,897 Ohio 173 4,632 119,847 0 124,651 Oklahoma 199 5,109 66,128 0 71,437 Oregon 0 20,111 5,445 0 25,556 Pennsylvania 1,566 0 10,645 0 12,211 Rhode Island 4,644 0 16,330 0 20,974 South Carolina 5,364 98,457 251,788 0 355,608 South Dakota 0 0 0 0 0 Tennessee 9,596 26,124 20,116 0 55,836 Texas 1,726 1,841 17,091 0 20,658 Utah 0 105,963 255,348 0 361,311 Vermont 0 0 0 0 0 Virgin Islands 1,128 0 65,081 0 66,209 Virginia 0 77,709 117,477 0 195,186 Washington 1,267 26,574 49,358 0 77,199 West Virginia 0 41,365 7,657 0 49,022 Wisconsin 64,084 141,429 190,373 0 395,886 Wyoming 0 49,980 102,668 0 152,648 Totals $423,522 $10,614,090 $10,342,844 $0 $21,380,456 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: All activity for Funding Year 2002 is complete. 5 - 9 9 Table 5.3 Disbursements by Service Speeds Acquired by Rural Health Care Providers Funding Year 2003: July 1, 2003 through June 30, 2004 Voice Grade Broadband Other Service 56K to 200K to 1.5Mb or Speed State 199K 1.49Mb and faster Unknown Total Alabama $0 $0 $26,591 $0 $26,591 Alaska 22,766 6,604,768 4,510,609 0 11,138,143 Arizona 0 13,263 447,380 0 460,643 Arkansas 0 3,330 47,906 0 51,236 California 176,002 14,109 52,316 0 242,427 Colorado 15,114 0 90,191 0 105,305 Connecticut 0 0 0 0 0 Delaware 0 0 0 0 0 District of Columbia 0 0 0 0 0 Florida 0 2,244 94,282 0 96,526 Georgia 0 0 69,731 0 69,731 Hawaii 0 0 211,966 0 211,966 Idaho 0 39,609 40,787 0 80,396 Illinois 0 16,056 41,801 0 57,857 Indiana 0 0 18,976 0 18,976 Iowa 0 23,545 103,896 0 127,441 Kansas 21,684 202,215 92,136 0 316,036 Kentucky 1,795 214,797 233,017 0 449,609 Louisiana 0 0 1,198 0 1,198 Maine 0 1,580 0 0 1,580 Maryland 0 0 0 0 0 Massachusetts 0 0 0 0 0 Michigan 3,120 8,528 420,905 0 432,552 Minnesota 6,133 168,028 574,162 0 748,323 Mississippi 0 3,989 93,493 0 97,482 Missouri 0 12,687 50,527 0 63,214 Montana 0 8,428 454,915 0 463,343 Nebraska 22,517 67,708 503,942 0 594,167 Nevada 0 0 21,397 0 21,397 New Hampshire 0 0 0 0 0 New Jersey 0 0 0 0 0 New Mexico 0 85,459 69,676 0 155,135 New York 1,975 0 11,676 0 13,651 North Carolina 0 876 70,162 0 71,038 North Dakota 10,758 24,696 354,146 0 389,599 Ohio 179 1,332 78,841 0 80,352 Oklahoma 0 10,220 20,075 0 30,296 Oregon 0 0 3,152 0 3,152 Pennsylvania 1,686 35 17,530 0 19,251 Rhode Island 4,320 0 0 0 4,320 South Carolina 4,859 7,079 290,009 0 301,947 South Dakota 0 0 0 0 0 Tennessee 5,547 0 3,654 0 9,201 Texas 2,560 0 0 0 2,560 Utah 0 115,225 433,159 0 548,384 Vermont 0 1,040 0 0 1,040 Virgin Islands 0 0 113,637 0 113,637 Virginia 0 451 161,748 0 162,199 Washington 0 0 37,565 0 37,565 West Virginia 0 39,329 32,851 0 72,180 Wisconsin 114,447 133,857 488,851 2,200 739,355 Wyoming 0 53,858 66,864 0 120,722 Totals $415,461 $7,878,340 $10,455,720 $2,200 $18,751,722 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: Disbursements through June 2, 2005. Because of the appeals process, funding commitments and disbursements may be made after the program year ended. 5 - 10 10 Table 5.3 Disbursements by Service Speeds Acquired by Rural Health Care Providers Funding Year 2004: July 1, 2004 through June 30, 2005 Voice Grade Broadband Other Service 56K to 200K to 1.5Mb or Speed State 199K 1.49Mb and faster Unknown Total Alabama $0 $0 $0 $0 $0 Alaska 13,059 280,353 326,123 0 619,536 Arizona 0 0 37,450 0 37,450 Arkansas 325 0 11,538 0 11,863 California 1,050 8,477 39,434 0 48,961 Colorado 0 0 8,969 0 8,969 Connecticut 0 0 0 0 0 Delaware 0 0 0 0 0 District of Columbia 0 0 0 0 0 Florida 0 0 0 0 0 Georgia 0 0 27,124 0 27,124 Hawaii 0 0 7,800 0 7,800 Idaho 750 12,911 9,523 0 23,184 Illinois 1,666 0 4,202 0 5,868 Indiana 0 0 0 0 0 Iowa 560 3,222 80,928 0 84,710 Kansas 7,198 0 17,489 0 24,686 Kentucky 36,222 118,511 107,512 0 262,245 Louisiana 0 0 0 0 0 Maine 0 0 0 0 0 Maryland 0 0 0 0 0 Massachusetts 0 0 0 0 0 Michigan 7,749 1,355 10,751 0 19,856 Minnesota 2,279 1,746 173,515 0 177,540 Mississippi 0 2,322 41,980 0 44,302 Missouri 4,406 0 0 0 4,406 Montana 485 0 85,980 0 86,466 Nebraska 1,010 0 10,286 0 11,296 Nevada 0 0 0 0 0 New Hampshire 0 0 1,241 0 1,241 New Jersey 0 0 0 0 0 New Mexico 0 0 9,500 0 9,500 New York 0 0 0 0 0 North Carolina 0 0 9,984 0 9,984 North Dakota 402 101,571 121,925 0 223,898 Ohio 0 0 6,218 16,300 22,518 Oklahoma 0 0 0 0 0 Oregon 0 0 0 0 0 Pennsylvania 0 0 0 0 0 Rhode Island 0 0 0 0 0 South Carolina 0 0 0 0 0 South Dakota 2,362 3,637 277,216 0 283,216 Tennessee 0 0 6,235 0 6,235 Texas 0 0 0 0 0 Utah 0 0 20,600 0 20,600 Vermont 2,400 0 1,705 0 4,105 Virgin Islands 0 0 0 0 Virginia 1,181 0 8,040 0 9,221 Washington 0 0 0 0 0 West Virginia 0 0 0 0 0 Wisconsin 754 0 28,291 0 29,045 Wyoming 0 0 0 0 0 Totals $83,859 $534,105 $1,491,558 $16,300 $2,125,823 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: Disbursements through June 2, 2005. Because of the appeals process, funding commitments and disbursements may be made after the program year ended. 5 - 11 11 USAC Disbursements Disbursements State or on Behalf of Rural Population in Per Person in Jurisdiction Health Care Providers Rural Areas 1 Rural Areas Alabama $24 1,407 $0.017 Alaska 12,670 367 34.556 American Samoa 0 57 0.000 Arizona 997 954 1.046 Arkansas 60 1,435 0.042 California 346 2,521 0.137 Colorado 141 777 0.181 Connecticut 0 334 0.000 Delaware 0 157 0.000 District of Columbia 0 0 NA Florida 220 1,427 0.154 Georgia 43 2,520 0.017 Guam 0 155 0.000 Hawaii 228 335 0.679 Idaho 95 862 0.110 Illinois 112 1,878 0.059 Indiana 15 1,691 0.009 Iowa 158 1,600 0.099 Kansas 220 1,193 0.185 Kentucky 535 2,069 0.258 Louisiana 2 1,111 0.001 Maine 19 854 0.023 Maryland 0 385 0.000 Massachusetts 0 335 0.000 Michigan 591 1,769 0.334 Minnesota 837 1,594 0.525 Mississippi 76 1,821 0.042 Missouri 33 1,799 0.019 Montana 501 705 0.712 Nebraska 524 811 0.646 Nevada 56 305 0.182 New Hampshire 0 380 0.000 New Jersey 0 0 NA New Mexico 235 856 0.274 New York 21 1,537 0.013 North Carolina 171 2,612 0.065 North Dakota 467 367 1.271 Northern Mariana Islands 0 69 0.000 Ohio 125 2,139 0.058 Oklahoma 71 1,378 0.052 Oregon 26 977 0.026 Pennsylvania 12 1,893 0.006 Puerto Rico 0 3,859 0.000 Rhode Island 0 55 0.000 South Carolina 21 1,205 0.017 South Dakota 356 503 0.707 Tennessee 56 1,827 0.031 Texas 21 3,280 0.006 Utah 361 531 0.681 Vermont 0 448 0.000 Virgin Islands 66 109 0.607 Virginia 195 1,503 0.130 Washington 77 1,136 0.068 West Virginia 49 1,043 0.047 Wisconsin 396 1,757 0.225 Wyoming 153 354 0.431 Totals $21,380 58,795 $0.364 1 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: Disbursements through June 2, 2005. Because of the appeals process, funding commitments and disbursements may be made after the program year ended. Population in entirely rural counties as of April 1, 2000 from the Census Bureau. Some commitments were allowed in non- rural counties in areas affected by the Goldsmith Modification. See 47 C. F. R. § 54.5. For those counties, the 2000 rural population has been estimated. Table 5.4 Disbursements per Person for Rural Health Care Support Mechanism, by State Values in Thousands, Except Disbursements per Person in Rural Areas Funding Year 2002: July 1, 2002 through June 30, 2003 5 - 12 12 USAC Disbursements Disbursements State or on Behalf of Rural Population in Per Person in Jurisdiction Health Care Providers Rural Areas 1 Rural Areas Alabama $27 1,407 $0.019 Alaska 11,138 367 30.378 American Samoa 0 57 0.000 Arizona 461 954 0.483 Arkansas 51 1,435 0.036 California 242 2,521 0.096 Colorado 105 777 0.136 Connecticut 0 334 0.000 Delaware 0 157 0.000 District of Columbia 0 0 NA Florida 97 1,427 0.068 Georgia 70 2,520 0.028 Guam 0 155 0.000 Hawaii 212 335 0.632 Idaho 80 862 0.093 Illinois 58 1,878 0.031 Indiana 19 1,691 0.011 Iowa 127 1,600 0.080 Kansas 316 1,193 0.265 Kentucky 450 2,069 0.217 Louisiana 1 1,111 0.001 Maine 2 854 0.002 Maryland 0 385 0.000 Massachusetts 0 335 0.000 Michigan 433 1,769 0.245 Minnesota 748 1,594 0.470 Mississippi 97 1,821 0.054 Missouri 63 1,799 0.035 Montana 463 705 0.658 Nebraska 594 811 0.732 Nevada 21 305 0.070 New Hampshire 0 380 0.000 New Jersey 0 0 NA New Mexico 155 856 0.181 New York 14 1,537 0.009 North Carolina 71 2,612 0.027 North Dakota 390 367 1.060 Northern Mariana Islands 0 69 0.000 Ohio 80 2,139 0.038 Oklahoma 30 1,378 0.022 Oregon 3 977 0.003 Pennsylvania 19 1,893 0.010 Puerto Rico 0 3,859 0.000 Rhode Island 0 55 0.000 South Carolina 4 1,205 0.004 South Dakota 302 503 0.601 Tennessee 9 1,827 0.005 Texas 3 3,280 0.001 Utah 548 531 1.033 Vermont 1 448 0.002 Virgin Islands 114 109 1.043 Virginia 162 1,503 0.108 Washington 38 1,136 0.033 West Virginia 72 1,043 0.069 Wisconsin 739 1,757 0.421 Wyoming 121 354 0.341 Totals $18,752 58,795 $0.319 1 Source: USAC data. Rollups performed by the Industry Analysis and Technology Division, Wireline Competition Bureau, FCC. Note: Disbursements through June 2, 2005. Because of the appeals process, funding commitments and disbursements may be made after the program year ended. Population in entirely rural counties as of April 1, 2000 from the Census Bureau. Some commitments were allowed in non- rural counties in areas affected by the Goldsmith Modification. See 47 C. F. R. § 54.5. For those counties, the 2000 rural population has been estimated. Table 5.4 Disbursements per Person for Rural Health Care Support Mechanism, by State Values in Thousands, Except Disbursements per Person in Rural Areas Funding Year 2003: July 1, 2003 through June 30, 2004 5 - 13 13