FCC Round 2 Telehealth Metrics Walkthrough | April 5, 2021

Video walkthrough here

Schedule a time to discuss with one of our FCC Telehealth specialists here!

Connected Devices and Services Support Page

Steps before applying:

  1. Request an eligibility determination from USAC by filing an FCC Form 460

  2. Obtain an FCC Registration Number (FRN) and an FCC Commission Registration System (CORES) ID

  3. Enroll with System for Awards Management (SAM) and Invoice Processing Platform (IPP) for funding submissions

Round 2 application process

In order to increase transparency in Round 2 of the FCC’s Telehealth Program, the FCC has shared the evaluation metrics USAC will use during the Round 2 application review process. Each metric is assigned its own objective scoring mechanism, which will allow USAC to score applications. 

Applications will be scored to ensure that the providers who need funding the most will be prioritized. A higher score translates to a higher likelihood of receiving funding in Round 2.

Directly below is our team’s reference guide on the Round 2 metrics, resources links, and eligible points.

Factor Resource Links Points
Hardest Hit Area
(Hotspot /
Sustained Hotspot)
                                                    		 HHS Hotspot Guide +15: Sustained Hotspot

+7: Hotspot
                                                                            
Low-Income Area Small Area Income and
Poverty Estimates (SAIPE)

Census Tract		 +15: ≥ 75th percentile of poverty for area
SAIPE (17.5%) OR Census Tract (19.8%)

+7: ≥ median poverty level of
SAIPE (13.5%) OR Census Tract (11.4%),
but <75th percentile

0: Less than the median poverty rate
Round 1
Application
Experience		 Round 1 Awardee? Applicant?
(https://www.fcc.gov/ecfs/
under Docket 20-89)		 +15: Applied, but did not receive,
Round 1 funding

+5: Did not apply for Round 1

0: Received Round 1 Funding
Tribal
Community		 Operate on Tribal Lands
or affiliation with
Indian Health Services?		 +15: Operate on Tribal land or affiliation
with Indian Health Services (IHS)
Critical Access
Hospital		 Critical Access
Hospital eligibility		 +10: Designated Critical
Access Hospital
FQHC,
Look-Alike,
or DSH 		FQHC
FQHC Look-Alike
Disproportionate Share Hospitals 		+10: Designation as an FQHC,
FQHC Look-Alike, or DSH
Healthcare Provider
Shortage Area
(HPSA)		 HPSA database by address
(under “primary care” category)		 +10: HPSA score between 13-25

+5: HPSA score between 1-12
Rural County USAC’s Eligible Rural
Areas Search tool		 +5: If you are located in a rural county

Eligible Items and Invoicing

Supporting invoice documentation and materials to prove eligibility must be submitted.
Examples of these forms can be found through links on this page: www.stel.life/order

The COVID-19 Telehealth Program Request for Reimbursement Form.
Enroll with the Invoice Processing Platform (IPP) and register with the System for Award Management (SAM) to receive funding.
FAQs and details on Invoicing process can be found on “invoices & reimbursements” tab

“Eligible health care providers should not include the cost of ineligible items in their funding application.” #27 on FCC FAQ

(Below: list of Eligible and Ineligible items from the FCC FAQS)

 

Eligible Services And Devices

  • Connected Vitals Devices (Bluetooth / Wifi Blood Pressure Monitors, Scales, etc…)

  • Connected Equipment (Tablets, smart phones, connected vitals devices) to receive connected care services at home

  • Telemedicine Kiosks / carts

  • Telecommunications and Internet Connectivity

  • Information Services (remote patient monitoring, store and forward, async patient data, synchronous video)

  • Recurring Fees (12 months for eligible services)

Ineligible

  • Personnel and Administrative Expenses - e.g., IT staff, project managers, medical professionals, consultant fees, training, customer service, marketing, etc.

  • Technical support, maintenance, warranties, and protection plans, development / implementation of platforms, websites, or systems.

  • Unconnected devices and supplies - Devices patients use and manually enter / report results to professionals, testing strips, lancets, disposable covers, and personal protective equipment, etc.

  • Unconnected accessories - e.g., cases, mouse pads, cable clips, laptop bags, tablet stands, charging stations, back-up batteries, power cords, surge protectors, etc.

  • Consumer Devices and Non-Telehealth Items - e.g., Smartwatches and fitness trackers, office furniture and supplies, security systems, and incidental expenses, etc.

  • Construction: e.g., fiber/ethernet/cable network constructions, facility alterations, and temporary site location structures, etc.

 

Below is a full breakdown of the evaluation metrics from the FCC’s Report & Order and example walkthroughs from our team.

Round2 Report and Order Metrics Diagram.png

Points:

  • +7 points to applications that demonstrate “hotspot” criteria

  • +15 points to applications that demonstrate “sustained hotspot” criteria

Round 2 will continue to prioritize funding to eligible health care providers located in areas that are most-impacted by the COVID-19 pandemic. To limit support only to those areas most affected by the COVID-19 pandemic, “hardest hit” is defined as areas designated as either a “sustained hotspot,” or a “hotspot,” on the COVID-19 Community Profile Report, Area of Concern Continuum by County dataset provided by the U.S. Department of Health and Human Services (HHS).131 [USAC to use the county tab of the report generated on the date of the close of the application filing window for this prioritization factor]

The CDC’s Community Profile Report is located under “Attachments” about halfway down the page. To check a certain county’s status, download the Excel file and under the “Counties” tab, each county and their “Area of Concern Category” will be listed. It’s important to note that the applications will be reviewed against the data from the day the application window closes. 

Low-Income Area:

Resources from FCC Report & Order:
Small Area Income and Poverty Estimates (SAIPE),
American Community Survey: Poverty Status in the Past Twelve MonthsI(Census Tract)

Points: 

  • +7 points to applications that demonstrate greater than or equal to the median poverty level of SAIPE (13.5%) OR Census Tract (11.4%), but less than the 75th percentile.

  • +15 points to applications that demonstrate greater than or equal to 75th percentile of poverty SAIPE (17.5%) OR Census Tract (19.8%).

  • Less than the median poverty rate for both data sets will not receive points. 


The data used to judge this metric comes from two sources of US Census Data -  Small Area Income and Poverty Estimates (SAIPE), and American Community Survey: Poverty Status in the Past Twelve months(Census Tract). When reviewing the applications, the FCC has instructed USAC to use whichever source offers the highest point value. For example, if the poverty rate in your county is less than the national average of 13.4% according to SAIPE data, but is more than the national average of 11.4% according to Census Tract data- applicants will receive an additional 7 points. We recommend searching for your location in both databases to confirm your eligibility for either tier, as there are different averages and percentiles for SAIPE data and Census Tract data.

USAC provided this tool from Texas A&M to locate the Census Tract information. (Under “Best Geocode Output Census Values” ).

Round 1 Unfunded: 

Points: 

  • +15 points to Applicants that applied for, but did not receive, Round 1 funding

  • No additional points in this section for previous Round 1 winners

Round 2 New Applicant

Points

  • +5 points to applicants that have not previously applied during Round 1


Tribal Community 

Resource: https://www.usac.org/lifeline/get-started/enhanced-tribal-benefit/#Eligible

The FCC is prioritizing applications from providers within the Tribal community that are associated with Indian Health Services. Eligible applicants in this category will receive an additional 15 points on their application in hopes of expanding telehealth services to Tribal communities that lack sufficient broadband infrastructure. Applicants must provide supporting documentation as proof of affiliation with Indian Health Services. 

Points:

  • +15 points to applications demonstrating operations on Tribal land and/or are affiliated with Indian Health Services (IHS) 

Critical Access Hospital 

Resource from FCC Report & Order: https://www.flexmonitoring.org/critical-access-hospital-locations-list

Points

  • +10 points to applications that demonstrate designation as a Critical Access Hospital

Critical Access Hospitals receive their designations from the Center for Medicare and Medicaid Services for being a small, rural hospital that provides 24/7 emergency care to patients with no other hospitals within a 36 mile radius. These locations typically do not have the resources to stand up their own telehealth services, and are especially in need of additional funding to expand such services. The FCC has provided a link to check the eligibility here. Applicants must provide proof of their CAH status to receive the additional points. 


FQHC or FQHC Look-Alike or DSH  

Resource from FCC Report & Order: 

Points

  • +10 points to applications that demonstrate designation as an FQHC, FQHC look-alike, or Disproportionate Share Hospital.

In an effort to expand telehealth and connected care services to vulnerable populations served by Federally Qualified Health Centers (FQHC), as well as FQHC look-alikes and Disproportionate Share Hospitals (DSH), applicants with these designations will receive +10 points on their application. These locations primarily care for low-income and minority communities and serve as a community hub for dental, primary care, and mental health services. By prioritizing applicants from these types of facilities, the FCC is doubling down on its commitment to expand telehealth services to challenged communities in hopes of curing the digital divide in healthcare. Applicants must provide proof of status as FQHC, FQHC look-alike, or DSH in order to qualify for the additional points.

Healthcare Provider Shortage Area:

Resource from FCC Report & Order:  

https://data.hrsa.gov/tools/shortage-area/by-address

Points

  • +5 points to applications that demonstrate HPSA scores between 1-12

  • +10 points to applications that demonstrate HPSA scores between 13-25

The Health Resources and Services Administration (HRSA) defines a healthcare provider shortage area as a geographical location in which there are not enough healthcare providers to provide care to the population- thus creating a strain on the providers beyond just the pandemic. The FCC instructed USAC to prioritize applications from these areas in hopes of alleviating some of that burden by expanding telehealth and connected care services. Geographic regions receive a score between 1-25 based on the degree of their provider shortage- 1 being the least burdened, 25 being the most burdened.  To check eligibility, click the link above provided by the FCC to the HRSA website and search the organization’s primary address. There will be options for Mental Health Services, Dental Health Services, and Primary Care. For the sake of this application, the only relevant score is for “Primary Care”.

Rural County

Resource from FCC Report & Order:  

https://apps.usac.org/rhc/tools/Rural/search/search.asp


Points

  • +5 points to applications that demonstrate they are in a rural county

To ensure that providers in remote and rural areas are able to scale up their telehealth capabilities, applicants from these areas will receive additional points. Telehealth services are uniquely beneficial for these patient populations who have long commutes to their physicians offices. To check eligibility as a Rural County provider, click the link provided by the FCC to check your county’s status. To receive the points, you must include proof of your status. 

Walkthrough - Scoring Examples

Yale New Haven Health - New Haven County

  • Hardest Hit Area:Sustained Hotspot +15

  • Low Income Area: Census Trac-42.3% = +15

  • Round 1 unfunded: NA

  • Critical Access Hospital : NA

  • FQHC/DSH: Unknown

  • HPSA Score: 15 (HPSA ID: 1092596360) + 10

  • Round 2 New Applicant: NA

  • Rural County: NA

Estimated Total: 40-50

Sinai Chicago - Cook County

  • Hardest Hit Area: Sustained Hotspot +15

  • Low Income Area:Census Tract-38.9%= +15

  • Round 1 Unfunded Applicant +15

  • Tribal: NA

  • Critical Access: NA

  • FQHC/DSH: Unknown

  • HPSA Score: 20 ((HPSA ID:1178838489) +15

  • Round 2 New Applicant: NA

  • Rural County: NA

Estimated Total: 60-70

University of Michigan Health System - Washtenaw County

  • Hardest Hit Area: Sustained Hotspot +15

  • Low Income Area: Census Tract-69.8%=+15

  • Tribal: NA

  • Critical Access: NA

  • FQHC/DSH: Unknown

  • HPSA Score: 18 (HPSA ID:1263315502) +10

  • Round 2 New Applicant: NA

  • Rural County: NA

Estimated Total: 40-50

MassGeneral (Partners Healthcare) - Suffolk County

  • Hardest Hit: NA

  • Low Income Area: Census Tract-42.3%=+15

  • Round 1 Unfunded: +15

  • Tribal: NA

  • Critical Access: NA

  • FQHC/DSH: Unknown

  • HPSA: NA

  • Round 2 New Applicant: NA

  • Rural County: NA

Estimated Total: 30-40

Tampa General Hospital - Hillsborough County

  • Hardest Hit: +15

  • Low Income Area: SAIPE-13.5% =+7

  • Round 1 Unfunded: +15

  • Tribal: NA

  • Critical Access: NA

  • FQHC/DSH: Unknown

  • HPSA: NA

  • Round 2 New Applicant: NA

  • Rural County: NA

Estimated Total: 37-47

Other notes:

Before the application window opens, prospective applicants MUST register on the Form 460 to confirm eligibility to receive grant funding for Round 2. Once registered, the “HCP” ID can be used to apply. 

All of these resources come directly from the FCC’s Report and Order released on March 30th, 2021. Official scoring may vary from the estimations you may make from this document because of updated COVID data from the CDC at the time the applications are reviewed. If you believe we’ve misinterpreted the metrics outlined by the FCC, please let us know so we can be best prepared to assist applicants through this process.

Reach out to sumner@stel.life with any questions or comments! 

Sumner Sykes