[Senate Report 114-368]
[From the U.S. Government Publishing Office]
Calendar No. 659
114th Congress } { Report
SENATE
2d Session } { 114-368
_______________________________________________________________________
RURAL HEALTH CARE CONNECTIVITY ACT OF 2015
__________
R E P O R T
of the
COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION
on
S. 1916
October 27, 2016.--Ordered to be printed
Filed, under authority of the order of the Senate of September 29, 2016
_________
U.S. GOVERNMENT PUBLISHING OFFICE
69-010 WASHINGTON : 2016
SENATE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION
one hundred fourteenth congress
second session
JOHN THUNE, South Dakota, Chairman
ROGER F. WICKER, Mississippi BILL NELSON, Florida
ROY BLUNT, Missouri MARIA CANTWELL, Washington
MARCO RUBIO, Florida CLAIRE McCASKILL, Missouri
KELLY AYOTTE, New Hampshire AMY KLOBUCHAR, Minnesota
TED CRUZ, Texas RICHARD BLUMENTHAL, Connecticut
DEB FISCHER, Nebraska BRIAN SCHATZ, Hawaii
JERRY MORAN, Kansas ED MARKEY, Massachusetts
DAN SULLIVAN, Alaska CORY BOOKER, New Jersey
RON JOHNSON, Wisconsin TOM UDALL, New Mexico
DEAN HELLER, Nevada JOE MANCHIN, West Virginia
CORY GARDNER, Colorado GARY PETERS, Michigan
STEVE DAINES, Montana
Nick Rossi, Staff Director
Adrian Arnakis, Deputy Staff Director
Jason Van Beek, General Counsel
Kim Lipsky, Democratic Staff Director
Christopher Day, Democratic Deputy Staff Director
Clint Odom, Democratic General Counsel
Calendar No. 659
114th Congress } { Report
SENATE
2d Session } { 114-368
======================================================================
RURAL HEALTH CARE CONNECTIVITY ACT OF 2015
_______
October 27, 2016.--Ordered to be printed
Filed, under authority of the order of the Senate of September 29, 2016
_______
Mr. Thune, from the Committee on Commerce, Science, and Transportation,
submitted the following
R E P O R T
[To accompany S. 1916]
The Committee on Commerce, Science, and Transportation, to
which was referred the bill (S. 1916) to include skilled
nursing facilities as a type of health care provider under
section 254(h) of the Communications Act of 1934, having
considered the same, reports favorably thereon (without
amendment) and recommends that the bill do pass.
Purpose of the Bill
The purpose of S. 1916, the Rural Health Care Connectivity
Act of 2015, is to include skilled nursing facilities (SNFs)
among the types of health care providers that may obtain
support from the Universal Service Fund's (USF) Rural Health
Care Program (RHCP).
Background and Needs
Americans living in rural areas face acute shortages of
primary care physicians and specialists, and often must travel
long distances to obtain medical care. SNFs are particularly
well-suited to improve patient outcomes in these rural areas,
providing some of the same post-acute services that are
traditionally provided at hospitals, such as the management,
observation, and evaluation of patient care. As the Federal
Communications Commission (FCC) has noted, by their nature,
SNFs are often remote from doctors and sophisticated laboratory
and testing facilities, making the availability of electronic
health records and telehealth an especially valuable benefit to
rural convalescents or patients for whom traveling to see a
doctor, diagnostician, or specialist would be especially
difficult.
The RHCP provides USF funding for telecommunications and
broadband services used to provide health care services to
rural Americans. Section 254(h) of the Communications Act of
1934 (47 U.S.C. 254(h)) specifies which types of health care
providers are eligible to receive RHCP support. These include:
post-secondary educational institutions offering healthcare
instruction, teaching hospitals, and medical schools; community
health centers or health centers providing health care to
migrants; local health departments or agencies; community
mental health centers; not-for-profit hospitals; rural health
clinics; and a consortia of health care providers consisting of
one or more of the aforementioned entities. SNFs, however, are
not included in that Act.
In 2012, the FCC proposed to include not-for-profit SNFs
within the definition of ``not-for-profit hospital'' under the
Communications Act of 1934 (47 U.S.C. 151 et seq.), and it also
proposed to establish a pilot program to provide limited RHCP
support to those SNFs beginning in 2014. That pilot program was
later deferred pending FCC action on other issues related to
the RHCP, and the FCC has not implemented the expanded
definition of ``non-for-profit hospitals.'' Thus, SNFs remain
ineligible today to receive RHCP support.
Summary of Provisions
S. 1916 would amend the Communications Act of 1934 to
include SNFs among the types of health care providers that are
eligible for RHCP support and may request from a
telecommunications carrier under the USF the necessary
telecommunications and information services to serve persons
who reside in rural areas at rates that are reasonably
comparable to rates charged for similar services in urban
areas.
Legislative History
On August 3, 2015, Chairman Thune introduced the Rural
Health Care Connectivity Act of 2015. The legislation is
cosponsored by Senators Klobuchar, Hoeven, and Fischer. Similar
legislation (H.R. 4111) was introduced in the House of
Representatives by Representative Leonard Lance on November 19,
2015.
On November 18, 2015, the Committee ordered that S. 1916 be
reported favorably without amendment.
Estimated Costs
In accordance with paragraph 11(a) of rule XXVI of the
Standing Rules of the Senate and section 403 of the
Congressional Budget Act of 1974, the Committee provides the
following cost estimate, prepared by the Congressional Budget
Office:
S. 1916--Rural Health Care Connectivity Act of 2015
Summary: S. 1916 would make certain skilled nursing
facilities eligible for grants under the Universal Service
Fund's (USF's) Rural Health Care (RHC) program. The Universal
Service program is administered by the Federal Communications
Commission (FCC) and is intended to promote the availability of
telecommunications services at affordable rates. The cash flows
of the USF appear in the budget as direct spending (for amounts
distributed from the fund) and as revenues (for fund
collections).
CBO estimates that enacting S. 1916 would increase direct
spending by $197 million over the 2017-2026 period and result
in increased revenue collections of $215 million over the same
period, resulting in an estimated net reduction in the deficit
of $18 million. CBO estimates that implementing the bill would
have no significant discretionary costs. Pay-as-you-go
procedures apply because enacting the legislation would affect
direct spending and revenues.
CBO estimates that enacting the legislation would not
increase net direct spending or on-budget deficits by more than
$5 billion in one or more of the four consecutive 10-year
periods beginning in 2027.
S. 1916 contains no intergovernmental mandates as defined
in the Unfunded Mandates Reform Act (UMRA). CBO expects the FCC
would increase fee collections associated with the USF to
offset some of the costs of expanding the Rural Health Care
program. As a result, the bill would increase the cost of an
existing mandate on private entities required to pay those
fees. Based on information from the FCC, CBO estimates that the
cost of the mandate would amount to no more than $25 million in
any of the next five years. Thus, the aggregate cost of the
mandate would fall below the annual threshold established in
UMRA for private-sector mandates ($154 million in 2016,
adjusted annually for inflation).
Estimated cost to the Federal Government: The estimated
budgetary effect of S. 1916 is shown in the following table.
The costs of this legislation fall within budget function 370
(commerce and housing credit).
--------------------------------------------------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------------------------------------------------------------
2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2017-2021 2017-2026
--------------------------------------------------------------------------------------------------------------------------------------------------------
INCREASE IN DIRECT SPENDING
Estimated Budget Authority........................ 5 10 15 20 25 25 25 30 30 30 75 215
Estimated Outlays................................. 3 7 12 17 22 24 25 28 29 30 61 197
INCREASE IN REVENUES
Estimated Revenues................................ 5 10 15 20 25 25 25 30 30 30 75 215
NET DECREASE IN THE DEFICIT
Impact on Deficit................................. -2 -3 -3 -3 -3 -1 0 -2 -1 0 -14 -18
--------------------------------------------------------------------------------------------------------------------------------------------------------
Basis of estimate: Current law authorizes the Universal
Service program to collect and spend up to $400 million a year
for Rural Health Care (RHC) programs, which provide reduced
rates for telecommunications services for certain rural public
and nonprofit health care providers. Expanding the eligibility
criteria to include skilled nursing facilities (SNFs) would
increase direct spending and revenues because the RHC programs
currently operate below the statutory cap on total spending.
CBO estimates that enacting the program over the 2017-2026
period would increase direct spending and revenues by $197
million and $215 million, respectively, resulting in a net
reduction in the deficit of $18 million over that period. CBO
estimates that an average of 1,650 public and nonprofit SNFs in
rural areas would be eligible for grants during that period and
that participation rates and grant awards would be similar to
those for existing RHC programs. Based on information from the
FCC, CBO estimates that participation rates would reach 75
percent over a period of several years and that certain non-
rural entities affiliated with those participants also would
receive funding. Grant awards would vary in size depending on
the recipient's location and choice of benefits. In 2015, most
RHC grantees received an average of about $14,000 for
telecommunications services; by contrast, payments to entities
in Alaska averaged roughly $140,000 because of the higher cost
of services in that state. CBO estimates that grants would
average about $18,000 a year over the next 10 years, reflecting
the historical growth in payments for other RHC programs.
Finally, based on information from the FCC, CBO estimates
that the administrative activities needed to implement the new
program would not have a significant effect on the agency's
operating costs. Moreover, under current law, the FCC is
authorized to collect fees sufficient to offset the cost of its
regulatory activities each year.
Pay-As-You-Go considerations: The Statutory Pay-As-You-Go
Act of 2010 establishes budget-reporting and enforcement
procedures for legislation affecting direct spending or
revenues. The net changes in outlays and revenues that are
subject to those pay-as-you-go procedures are shown in the
following table.
CBO ESTIMATE OF PAY-AS-YOU-GO EFFECTS FOR S. 1916, AS ORDERED REPORTED BY THE SENATE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION ON NOVEMBER 18,
2015
--------------------------------------------------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-------------------------------------------------------------------------------------------------------------
2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2016-2021 2016-2026
--------------------------------------------------------------------------------------------------------------------------------------------------------
DECREASE IN THE DEFICIT
Statutory Pay-As-You-Go Impact............ 0 -2 -3 -3 -3 -3 -1 0 -2 -1 0 -14 -18
Memorandum:
Changes in Outlays.................... 0 3 7 12 17 22 24 25 28 29 30 61 197
Changes in Revenues................... 0 5 10 15 20 25 25 25 30 30 30 75 215
--------------------------------------------------------------------------------------------------------------------------------------------------------
Increase in long-term direct spending and deficits: CBO
estimates that enacting the legislation would not increase net
direct spending or on-budget deficits by more than $5 billion
in any of the four consecutive 10-year periods beginning in
2027.
Estimated impact on state, local, and tribal governments:
S. 1916 contains no intergovernmental mandates as defined in
UMRA.
Estimated impact on the private sector: CBO expects the FCC
to increase fee collections to offset the costs associated with
expanding the USF's Rural Health Care program to cover skilled
nursing facilities. As a result, the bill would increase the
cost of an existing mandate on some telecommunications
companies required to pay those fees. Based on information from
the FCC, CBO estimates that the cost of the mandate would
amount to about $5 million in 2017, increasing to about $25
million in 2021. Therefore, the incremental cost of the mandate
would fall below the annual threshold established in UMRA for
private-sector mandates ($154 million in 2016, adjusted
annually for inflation). CBO expects that telecommunications
companies would generally pass most of the cost of the fee
increase on to consumers.
Estimate prepared by: Federal costs: Kathleen Gramp; impact
on state, local, and tribal governments: Melisa Merrell; impact
on the private sector: Logan Smith.
Estimate approved by: Theresa Gullo, Assistant Director for
Budget Analysis.
Regulatory Impact
In accordance with paragraph 11(b) of rule XXVI of the
Standing Rules of the Senate, the Committee provides the
following evaluation of the regulatory impact of the
legislation, as reported:
number of persons covered
There are approximately 1,650 public and nonprofit SNFs in
rural areas, many of which would be eligible to participate in
the RHCP if S. 1916 is enacted.
economic impact
This legislation would not have an adverse economic impact
on the Nation. The bill would promote rural health care by
making SNFs eligible to receive telecommunications and
information services to serve persons who reside in rural areas
at rates that are reasonably comparable to rates charged for
similar services in urban areas.
privacy
The bill would not have any adverse impact on the personal
privacy of individuals.
paperwork
The Committee does not anticipate a major increase in
paperwork burdens resulting from the passage of this
legislation.
Congressionally Directed Spending
In compliance with paragraph 4(b) of rule XLIV of the
Standing Rules of the Senate, the Committee provides that no
provisions contained in the bill, as reported, meet the
definition of congressionally directed spending items under the
rule.
Section-by-Section Analysis
Section 1. Short title.
Section 1 would designate this Act as the ``Rural Health
Care Connectivity Act of 2015.''
Section 2. Telecommunications services for skilled nursing facilities.
Section 2 would amend section 254(h) of the Communications
Act of 1934 (47 U.S.C. 254) to include SNFs in the definition
of health care providers under that subsection.
Changes in Existing Law
In compliance with paragraph 12 of rule XXVI of the
Standing Rules of the Senate, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
material is printed in italic, existing law in which no change
is proposed is shown in roman):
COMMUNICATIONS ACT OF 1934
[47 U.S.C. 151 et seq.]
SEC. 254. UNIVERSAL SERVICE.
* * * * * * *
(h) Telecommunications Services for Certain Providers.--
(1) In general.--
(A) Health care providers for rural areas.--A
telecommunications carrier shall, upon
receiving a bona fide request, provide
telecommunications services which are necessary
for the provision of health care services in a
State, including instruction relating to such
services, to any public or nonprofit health
care provider that serves persons who reside in
rural areas in that State at rates that are
reasonably comparable to rates charged for
similar services in urban areas in that State.
A telecommunications carrier providing service
under this paragraph shall be entitled to have
an amount equal to the difference, if any,
between the rates for services provided to
health care providers for rural areas in a
State and the rates for similar services
provided to other customers in comparable rural
areas in that State treated as a service
obligation as a part of its obligation to
participate in the mechanisms to preserve and
advance universal service.
(B) Educational providers and libraries.--All
telecommunications carriers serving a
geographic area shall, upon a bona fide request
for any of its services that are within the
definition of universal service under
subsection (c)(3), provide such services to
elementary schools, secondary schools, and
libraries for educational purposes at rates
less than the amounts charged for similar
services to other parties. The discount shall
be an amount that the Commission, with respect
to interstate services, and the States, with
respect to intrastate services, determine is
appropriate and necessary to ensure affordable
access to and use of such services by such
entities. A telecommunications carrier
providing service under this paragraph shall--
(i) have an amount equal to the
amount of the discount treated as an
offset to its obligation to contribute
to the mechanisms to preserve and
advance universal service, or
(ii) notwithstanding the provisions
of subsection (e) of this section,
receive reimbursement utilizing the
support mechanisms to preserve and
advance universal service.
(2) Advanced services.--The Commission shall
establish competitively neutral rules--
(A) to enhance, to the extent technically
feasible and economically reasonable, access to
advanced telecommunications and information
services for all public and nonprofit
elementary and secondary school classrooms,
health care providers, and libraries; and
(B) to define the circumstances under which a
telecommunications carrier may be required to
connect its network to such public
institutional telecommunications users.
(3) Terms and conditions.--Telecommunications
services and network capacity provided to a public
institutional telecommunications user under this
subsection may not be sold, resold, or otherwise
transferred by such user in consideration for money or
any other thing of value.
(4) Eligibility of users.--No entity listed in this
subsection shall be entitled to preferential rates or
treatment as required by this subsection, if such
entity operates as a for-profit business, is a school
described in paragraph (7)(A) with an endowment of more
than $50,000,000, or is a library or library consortium
not eligible for assistance from a State library
administrative agency under the Library Services and
Technology Act.
(5) Requirements for certain schools with computers
having internet access.--
(A) Internet safety.--
(i) In general.--Except as provided
in clause (ii), an elementary or
secondary school having computers with
Internet access may not receive
services at discount rates under
paragraph (1)(B) unless the school,
school board, local educational agency,
or other authority with responsibility
for administration of the school--
(I) submits to the Commission
the certifications described in
subparagraphs (B) and (C);
(II) submits to the
Commission a certification that
an Internet safety policy has
been adopted and implemented
for the school under subsection
(l); and
(III) ensures the use of such
computers in accordance with
the certifications.
(ii) Applicability.--The prohibition
in clause (i) shall not apply with
respect to a school that receives
services at discount rates under
paragraph (1)(B) only for purposes
other than the provision of Internet
access, Internet service, or internal
connections.
(iii) Public notice; hearing.--An
elementary or secondary school
described in clause (i), or the school
board, local educational agency, or
other authority with responsibility for
administration of the school, shall
provide reasonable public notice and
hold at least 1 public hearing or
meeting to address the proposed
Internet safety policy. In the case of
an elementary or secondary school other
than an elementary or secondary school
as defined in section 14101 of the
Elementary and Secondary Education Act
of 1965 (20 U.S.C. 8801), the notice
and hearing required by this clause may
be limited to those members of the
public with a relationship to the
school.
(B) Certification with respect to minors.--A
certification under this subparagraph is a
certification that the school, school board,
local educational agency, or other authority
with responsibility for administration of the
school--
(i) is enforcing a policy of Internet
safety for minors that includes
monitoring the online activities of
minors and the operation of a
technology protection measure with
respect to any of its computers with
Internet access that protects against
access through such computers to visual
depictions that are--
(I) obscene;
(II) child pornography; or
(III) harmful to minors;
(ii) is enforcing the operation of
such technology protection measure
during any use of such computers by
minors; and
(iii) as part of its Internet safety
policy is educating minors about
appropriate online behavior, including
interacting with other individuals on
social networking websites and in chat
rooms and cyberbullying awareness and
response.
(C) Certification with respect to adults.--A
certification under this paragraph is a
certification that the school, school board,
local educational agency, or other authority
with responsibility for administration of the
school--
(i) is enforcing a policy of Internet
safety that includes the operation of a
technology protection measure with
respect to any of its computers with
Internet access that protects against
access through such computers to visual
depictions that are--
(I) obscene; or
(II) child pornography; and
(ii) is enforcing the operation of
such technology protection measure
during any use of such computers.
(D) Disabling during adult use.--An
administrator, supervisor, or other person
authorized by the certifying authority under
subparagraph (A)(i) may disable the technology
protection measure concerned, during use by an
adult, to enable access for bona fide research
or other lawful purpose.
(E) Timing of implementation.--
(i) In general.--Subject to clause
(ii) in the case of any school covered
by this paragraph as of the effective
date of this paragraph under section
1721(h) of the Children's Internet
Protection Act, the certification under
subparagraphs (B) and (C) shall be
made--
(I) with respect to the first
program funding year under this
subsection following such
effective date, not later than
120 days after the beginning of
such program funding year; and
(II) with respect to any
subsequent program funding
year, as part of the
application process for such
program funding year.
(ii) Process.--
(I) Schools with internet
safety policy and technology
protection measures in place. A
school covered by clause (i)
that has in place an Internet
safety policy and technology
protection measures meeting the
requirements necessary for
certification under
subparagraphs (B) and (C) shall
certify its compliance with
subparagraphs (B) and (C)
during each annual program
application cycle under this
subsection, except that with
respect to the first program
funding year after the
effective date of this
paragraph under section 1721(h)
of the Children's Internet
Protection Act [note to this
section], the certifications
shall be made not later than
120 days after the beginning of
such first program funding
year.
(II) Schools without internet
safety policy and technology
protection measures in place.--
A school covered by clause (i)
that does not have in place an
Internet safety policy and
technology protection measures
meeting the requirements
necessary for certification
under subparagraphs (B) and
(C)--
(aa) for the first
program year after the
effective date of this
subsection in which it
is applying for funds
under this subsection,
shall certify that it
is undertaking such
actions, including any
necessary procurement
procedures, to put in
place an Internet
safety policy and
technology protection
measures meeting the
requirements necessary
for certification under
subparagraphs (B) and
(C); and
(bb) for the second
program year after the
effective date of this
subsection in which it
is applying for funds
under this subsection,
shall certify that it
is in compliance with
subparagraphs (B) and
(C).
Any school that is unable to
certify compliance with such
requirements in such second
program year shall be
ineligible for services at
discount rates or funding in
lieu of services at such rates
under this subsection for such
second year and all subsequent
program years under this
subsection, until such time as
such school comes into
compliance with this paragraph.
(III) Waivers.--Any school
subject to subclause (II) that
cannot come into compliance
with subparagraphs (B) and (C)
in such second year program may
seek a waiver of subclause
(II)(bb) if State or local
procurement rules or
regulations or competitive
bidding requirements prevent
the making of the certification
otherwise required by such
subclause. A school, school
board, local educational
agency, or other authority with
responsibility for
administration of the school
shall notify the Commission of
the applicability of such
subclause to the school. Such
notice shall certify that the
school in question will be
brought into compliance before
the start of the third program
year after the effective date
of this subsection in which the
school is applying for funds
under this subsection.
(F) Noncompliance.--
(i) Failure to submit
certification.--Any school that
knowingly fails to comply with the
application guidelines regarding the
annual submission of certification
required by this paragraph shall not be
eligible for services at discount rates
or funding in lieu of services at such
rates under this subsection.
(ii) Failure to comply with
certification.--Any school that
knowingly fails to ensure the use of
its computers in accordance with a
certification under subparagraphs (B)
and (C) shall reimburse any funds and
discounts received under this
subsection for the period covered by
such certification.
(iii) Remedy of noncompliance.--
(I) Failure to submit.--A
school that has failed to
submit a certification under
clause (i) may remedy the
failure by submitting the
certification to which the
failure relates. Upon submittal
of such certification, the
school shall be eligible for
services at discount rates
under this subsection.
(II) Failure to comply.--A
school that has failed to
comply with a certification as
described in clause (ii) may
remedy the failure by ensuring
the use of its computers in
accordance with such
certification. Upon submittal
to the Commission of a
certification or other
appropriate evidence of such
remedy, the school shall be
eligible for services at
discount rates under this
subsection.
(6) Requirements for certain libraries with computers
having internet access.--
(A) Internet safety.--
(i) In general.--Except as provided
in clause (ii), a library having one or
more computers with Internet access may
not receive services at discount rates
under paragraph (1)(B) unless the
library--
(I) submits to the Commission
the certifications described in
subparagraphs (B) and (C); and
(II) submits to the
Commission a certification that
an Internet safety policy has
been adopted and implemented
for the library under
subsection (l); and
(III) ensures the use of such
computers in accordance with
the certifications.
(ii) Applicability.--The prohibition
in clause (i) shall not apply with
respect to a library that receives
services at discount rates under
paragraph (1)(B) only for purposes
other than the provision of Internet
access, Internet service, or internal
connections.
(iii) Public notice; hearing.--A
library described in clause (i) shall
provide reasonable public notice and
hold at least 1 public hearing or
meeting to address the proposed
Internet safety policy.
(B) Certification with respect to minors.--A
certification under this subparagraph is a
certification that the library--
(i) is enforcing a policy of Internet
safety that includes the operation of a
technology protection measure with
respect to any of its computers with
Internet access that protects against
access through such computers to visual
depictions that are--
(I) obscene;
(II) child pornography; or
(III) harmful to minors; and
(ii) is enforcing the operation of
such technology protection measure
during any use of such computers by
minors.
(C) Certification with respect to adults.--A
certification under this paragraph is a
certification that the library--
(i) is enforcing a policy of Internet
safety that includes the operation of a
technology protection measure with
respect to any of its computers with
Internet access that protects against
access through such computers to visual
depictions that are--
(I) obscene; or
(II) child pornography; and
(ii) is enforcing the operation of
such technology protection measure
during any use of such computers.
(D) Disabling during adult use.--An
administrator, supervisor, or other person
authorized by the certifying authority under
subparagraph (A)(i) may disable the technology
protection measure concerned, during use by an
adult, to enable access for bona fide research
or other lawful purpose.
(E) Timing of implementation.--
(i) In general.--Subject to clause
(ii) in the case of any library covered
by this paragraph as of the effective
date of this paragraph under section
1721(h) of the Children's Internet
Protection Act [note to this section],
the certification under subparagraphs
(B) and (C) shall be made--
(I) with respect to the first
program funding year under this
subsection following such
effective date, not later than
120 days after the beginning of
such program funding year; and
(II) with respect to any
subsequent program funding
year, as part of the
application process for such
program funding year.
(ii) Process.--
(I) Libraries with internet
safety policy and technology
protection measures in place.--
A library covered by clause (i)
that has in place an Internet
safety policy and technology
protection measures meeting the
requirements necessary for
certification under
subparagraphs (B) and (C) shall
certify its compliance with
subparagraphs (B) and (C)
during each annual program
application cycle under this
subsection, except that with
respect to the first program
funding year after the
effective date of this
paragraph under section 1721(h)
of the Children's Internet
Protection Act [note to this
section], the certifications
shall be made not later than
120 days after the beginning of
such first program funding
year.
(II) Libraries without
internet safety policy and
technology protection measures
in place.--A library covered by
clause (i) that does not have
in place an Internet safety
policy and technology
protection measures meeting the
requirements necessary for
certification under
subparagraphs (B) and (C)--
(aa) for the first
program year after the
effective date of this
subsection in which it
is applying for funds
under this subsection,
shall certify that it
is undertaking such
actions, including any
necessary procurement
procedures, to put in
place an Internet
safety policy and
technology protection
measures meeting the
requirements necessary
for certification under
subparagraphs (B) and
(C); and
(bb) for the second
program year after the
effective date of this
subsection in which it
is applying for funds
under this subsection,
shall certify that it
is in compliance with
subparagraphs (B) and
(C).
Any library that is unable to
certify compliance with such
requirements in such second
program year shall be
ineligible for services at
discount rates or funding in
lieu of services at such rates
under this subsection for such
second year and all subsequent
program years under this
subsection, until such time as
such library comes into
compliance with this paragraph.
(III) Waivers.--Any library
subject to subclause (II) that
cannot come into compliance
with subparagraphs (B) and (C)
in such second year may seek a
waiver of subclause (II)(bb) if
State or local procurement
rules or regulations or
competitive bidding
requirements prevent the making
of the certification otherwise
required by such subclause. A
library, library board, or
other authority with
responsibility for
administration of the library
shall notify the Commission of
the applicability of such
subclause to the library. Such
notice shall certify that the
library in question will be
brought into compliance before
the start of the third program
year after the effective date
of this subsection in which the
library is applying for funds
under this subsection.
(F) Noncompliance.--
(i) Failure to submit
certification.--Any library that
knowingly fails to comply with the
application guidelines regarding the
annual submission of certification
required by this paragraph shall not be
eligible for services at discount rates
or funding in lieu of services at such
rates under this subsection.
(ii) Failure to comply with
certification.--Any library that
knowingly fails to ensure the use of
its computers in accordance with a
certification under subparagraphs (B)
and (C) shall reimburse all funds and
discounts received under this
subsection for the period covered by
such certification.
(iii) Remedy of noncompliance.--
(I) Failure to submit.--A
library that has failed to
submit a certification under
clause (i) may remedy the
failure by submitting the
certification to which the
failure relates. Upon submittal
of such certification, the
library shall be eligible for
services at discount rates
under this subsection.
(II) Failure to comply.--A
library that has failed to
comply with a certification as
described in clause (ii) may
remedy the failure by ensuring
the use of its computers in
accordance with such
certification. Upon submittal
to the Commission of a
certification or other
appropriate evidence of such
remedy, the library shall be
eligible for services at
discount rates under this
subsection.
(7) Definitions.--For purposes of this subsection:
(A) Elementary and secondary schools.--The
term ``elementary and secondary schools'' means
elementary schools and secondary schools, as
defined in section 9101 of the Elementary and
Secondary Education Act of 1965.
(B) Health care provider.--The term ``health
care provider'' means--
(i) post-secondary educational
institutions offering health care
instruction, teaching hospitals, and
medical schools;
(ii) community health centers or
health centers providing health care to
migrants;
(iii) local health departments or
agencies;
(iv) community mental health centers;
(v) not-for-profit hospitals;
(vi) rural health clinics; [and]
(vii) skilled nursing facilities;
[(vii)](viii) consortia of health
care providers consisting of one or
more entities described in [clauses (i)
through (vi)] clauses (i) through
(vii).\1\
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\1\Nothing in the amendment to subsection (h)(7)(B) would be
construed to affect the aggregate annual cap on Federal universal
service support for health care providers under section 54.675 of title
47, Code of Federal Regulations, or any successor regulation.
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(C) Public institutional telecommunications
user.--The term ``public institutional
telecommunications user'' means an elementary
or secondary school, a library, or a health
care provider as those terms are defined in
this paragraph.
(D) Minor.--The term ``minor'' means any
individual who has not attained the age of 17
years.
(E) Obscene.--The term ``obscene'' has the
meaning given such term in section 1460 of
title 18, United States Code.
(F) Child pornography.--The term ``child
pornography'' has the meaning given such term
in section 2256 of title 18, United States
Code.
(G) Harmful to minors.--The term ``harmful to
minors'' means any picture, image, graphic
image file, or other visual depiction that--
(i) taken as a whole and with respect
to minors, appeals to a prurient
interest in nudity, sex, or excretion;
(ii) depicts, describes, or
represents, in a patently offensive way
with respect to what is suitable for
minors, an actual or simulated sexual
act or sexual contact, actual or
simulated normal or perverted sexual
acts, or a lewd exhibition of the
genitals; and
(iii) taken as a whole, lacks serious
literary, artistic, political, or
scientific value as to minors.
(H) Sexual act; sexual contact.--The terms
``sexual act'' and ``sexual contact'' have the
meanings given such terms in section 2246 of
title 18, United States Code.
(I) Technology protection measure.--The term
``technology protection measure'' means a
specific technology that blocks or filters
Internet access to the material covered by a
certification under paragraph (5) or (6) to
which such certification relates.
* * * * * * *