Required FCC Project Participant Documentation
All sites participating in the FCC Rural Health Care Pilot Program are required to complete a Letter of Agency (LOA). The LOA designates the University of Wyoming to negotiate with the FCC for contracts with vendor for network deployment. Additionally, the FCC requires Community Mental Centers and Substance Abuse Centers to complete a checklist to confirm their eligibility for participation. Entities claiming not-for-profit status must provide appropriate documentation.
This documentation must be submitted by September 12, 2008, at the address below.
Dr. Dorothy C. Yates
Associate Vice President for Research and Economic Development
University of Wyoming
1000 E. University Avenue, Department 3355
Laramie WY 82071
LETTERS OF AGENCY(LOA)
LOAs are required for each participating site. Those entities with multiple participating sites may complete one letter covering all affiliated sites.
LOAs address the following for each entity:
• Confirms its intent to participate in the Wyoming Network for Telehealth (WyNETTE), Wyoming's project in the FCC Rural Health Care Pilot Program.
• Authorizes the University of Wyoming, as the fiscal and contracting agency for the WyNETTE project, to act on its behalf before the Federal Communications Commission (FCC) in matters related to the Rural Health Care Pilot Program.
• Authorizes the University of Wyoming to submit FCC Form 465, FCC Form 466-A, FCC Form 467 and any other Rural Health Care Pilot Program forms and attachments to the Rural Health Care Division of the Universal Service Administrative Company on its behalf.
• Confirms the entity is a participant in the Wyoming Network for Telehealth (WyNETTE) consortium.
The LOA is effective from the date of this letter to the network build-out deadline as defined by the FCC. Note: See In the Matter of Rural Health Care Support Mechanism, WC Docket 02-60, Order, 22 FCC Rcd 20360, ¶¶ 35, 94 (2007) (defining the network build-out deadline as five years from the Pilot Program Participant's receipt of the initial Funding Commitment Letter).
LOA template (single site)- download the file at the bottom of the page
LOA Template (multiple sites)- download the file at the bottom of the page
COMMUNITY MENTAL HEALTH CENTER QUESTIONNAIRE
The Questionnaire helps the FCC determine that facilities provide "health care" (not social services). The following guidance for the FCC explains their concern.
With regard to Community Mental Health Centers (CMHC), they are generally eligible to participate and receive funding under the Rural Health Care programs. However, because certain factions used the CMHC too broadly (to include a very high level of social service programs at the expense of true health care providers/activities), the program developed a questionnaire to be completed by CMHCs to aid in determining eligibility. The program now requires all CMHCs to complete the questionnaire. This is in addition to the entity being either a public or a non-profit organization.
Community Mental Health and Behavioral Services Checklist - download the file at the bottom of the page
NOT-FOR-PROFIT STATUS
Entities should submit proof of their not-for-profit status. This could include state or local license/charter/registration stating non-profit status and types of medical services performed
Files: