Notice2023-14092
Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas
Primary source
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Published
July 3, 2023
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
This is the first of two notices planned for the coming months informing the public of the availability of the complete lists of all geographic areas, population groups, and facilities designated as primary medical care, dental health, and mental health professional shortage areas (HPSAs). This notice includes the lists of HPSAs in a designated status as of April 28, 2023. The lists are available on the shortage area topic page on HRSA's data.hrsa.gov website and includes HPSAs which are proposed for withdrawal but currently remain designated. HRSA is extending the transition time communicated in the notice published on July 7, 2022, for jurisdictions and facilities to prepare for potential loss of HPSA designations. HPSA designations that are currently proposed for withdrawal will remain in this status until they are re-evaluated in preparation for the publication of the January 2, 2024, HPSA Federal Register notice. If these HPSAs do not meet the requirements for designation by the data pull scheduled for November 15, 2023, they will be withdrawn with the publication of a second Federal Register notice planned for January 2, 2024.
Full Text
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<title>Federal Register, Volume 88 Issue 126 (Monday, July 3, 2023)</title>
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[Federal Register Volume 88, Number 126 (Monday, July 3, 2023)]
[Notices]
[Pages 42725-42726]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-14092]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Lists of Designated Primary Medical Care, Mental Health, and
Dental Health Professional Shortage Areas
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: This is the first of two notices planned for the coming months
informing the public of the availability of the complete lists of all
geographic areas, population groups, and facilities designated as
primary medical care, dental health, and mental health professional
shortage areas (HPSAs). This notice includes the lists of HPSAs in a
designated status as of April 28, 2023. The lists are available on the
shortage area topic page on HRSA's <a href="http://data.hrsa.gov">data.hrsa.gov</a> website and includes
HPSAs which are proposed for withdrawal but currently remain
designated. HRSA is extending the transition time communicated in the
notice published on July 7, 2022, for jurisdictions and facilities to
prepare for potential loss of HPSA designations. HPSA designations that
are currently proposed for withdrawal will remain in this status until
they are re-evaluated in preparation for the publication of the January
2, 2024, HPSA Federal Register notice. If these HPSAs do not meet the
requirements for designation by the data pull scheduled for November
15, 2023, they will be withdrawn with the publication of a second
Federal Register notice planned for January 2, 2024.
ADDRESSES: Complete lists of HPSAs designated as of April 28, 2023, are
available on the website at <a href="https://data.hrsa.gov/tools/health-workforce/shortage-areas/frn">https://data.hrsa.gov/tools/health-workforce/shortage-areas/frn</a>. Frequently updated information on HPSAs
is available at <a href="https://data.hrsa.gov/topics/health-workforce/health-workforce-shortage-areas">https://data.hrsa.gov/topics/health-workforce/health-workforce-shortage-areas</a>. Information on shortage designations is
available at <a href="https://bhw.hrsa.gov/workforce-shortage-areas/shortage-designation">https://bhw.hrsa.gov/workforce-shortage-areas/shortage-designation</a>.
FOR FURTHER INFORMATION CONTACT: For further information on the HPSA
designations listed on the website or to request additional
designation, withdrawal, or reapplication for designation, please
contact Anthony Estelle, Chief, Shortage Designation Branch, Division
of Policy and Shortage Designation, Bureau of Health Workforce (BHW),
HRSA, 5600 Fishers Lane, Room 11W16, Rockville, Maryland 20857,
<a href="/cdn-cgi/l/email-protection#e4978086a48c969785ca838b92"><span class="__cf_email__" data-cfemail="7a091e183a1208091b541d150c">[email protected]</span></a> or (301) 945-0942.
SUPPLEMENTARY INFORMATION:
Background
Section 332 of the Public Health Service (PHS) Act, 42 U.S.C. 254e,
provides that the Secretary shall designate HPSAs based on criteria
established by regulation. HPSAs are defined in section 332 to include
(1) urban and rural geographic areas with shortages of health
professionals, (2) population groups with such shortages, and (3)
facilities with such shortages. Section 332 further requires that the
Secretary annually publish lists of the designated geographic areas,
population groups, and facilities. This notice meets that requirement.
The lists of HPSAs are to be reviewed at least annually and revised as
necessary.
Final regulations (42 CFR part 5) were published in 1980 that
include the criteria for designating HPSAs. Criteria were defined for
seven health professional types: primary medical care, dental,
psychiatric, vision care, podiatric, pharmacy, and veterinary care. The
criteria for correctional facility HPSAs were revised and published on
March 2, 1989 (54 FR 8735). The criteria for psychiatric HPSAs were
expanded to mental health HPSAs on January 22, 1992 (57 FR 2473).
Currently funded PHS Act programs use only the primary medical care,
mental health, or dental HPSA or relevant sub-score designations such
as Maternity Care Target Areas.
HPSA designation offers access to potential Federal assistance.
Public or private nonprofit entities are eligible to apply for
assignment of National Health Service Corps personnel to provide
primary medical care, mental health, or dental health services in or to
these HPSAs. National Health Service Corps health professionals enter
into service agreements to serve in federally designated HPSAs.
Entities with clinical training sites located in HPSAs are eligible to
receive priority for certain residency training program grants
administered by HRSA's BHW. Other Federal programs also utilize HPSA
designations. For example, under authorities administered by the
Centers for Medicare & Medicaid Services, certain qualified providers
in geographic area HPSAs are eligible for increased levels of Medicare
reimbursement.
Content and Format of Lists
The three lists of designated HPSAs are available on the HRSA Data
Warehouse shortage area topic web page and include a snapshot of all
geographic
[[Page 42726]]
areas, population groups, and facilities that were designated HPSAs as
of April 28, 2023. This notice incorporates the most recent annual
reviews of designated HPSAs (including those that have been proposed
for withdrawal but have not yet been withdrawn) which can be located on
HRSA's <a href="http://data.hrsa.gov">data.hrsa.gov</a> website and supersedes the HPSA lists published in
the Federal Register on July 7, 2022, (87 FR 40540-40451).
In addition, all Indian Tribes that meet the definition of such
Tribes in the Indian Health Care Improvement Act of 1976, 25 U.S.C.
1603, are automatically designated as population groups with primary
medical care and dental health professional shortages. Further, the
Health Care Safety Net Amendments of 2002 provides eligibility for
automatic facility HPSA designations for all federally qualified health
centers (FQHCs) and rural health clinics that offer services regardless
of ability to pay. Specifically, these entities include FQHCs funded
under section 330 of the PHS Act, FQHC Look-Alikes, and Tribal and
urban Indian clinics operating under the Indian Self-Determination and
Education Act of 1975 (25 U.S.C. 450) or the Indian Health Care
Improvement Act. Many, but not all, of these entities are included on
this listing. Since they are automatically designated by statute,
absence from this list does not exclude them from HPSA designation;
facilities eligible for automatic designation are included in the
database when they are identified.
Each list of designated HPSAs is arranged by state. Within each
state, the list is presented by county. If only a portion (or portions)
of a county is (are) designated, a county is part of a larger
designated service area, or a population group residing in a county or
a facility located in the county has been designated, the name of the
service area, population group, or facility involved is listed under
the county name. A county that has a whole county geographic or
population group HPSA is indicated by the phrase ``County'' following
the county name.
Development of the Designation and Withdrawal Lists
Requests for designation or withdrawal of a particular geographic
area, population group, or facility as a HPSA are received continuously
by BHW. Under a Cooperative Agreement between HRSA and the 54 state and
territorial Primary Care Offices (PCOs), PCOs conduct needs assessments
and submit applications to HRSA to designate HPSAs. BHW also receives
other requests for designation from other sources and refers them to
PCOs for review. As part of the HPSA designation process, interested
parties, including Governors, state Primary Care Associations, and
state professional associations, are notified of requests so that they
may submit their comments and recommendations.
BHW reviews each recommendation for possible addition,
continuation, revision, or withdrawal. Following review, BHW notifies
the appropriate agency, individuals, and interested organizations of
each designation of a HPSA, rejection of recommendation for HPSA
designation, revision of a HPSA designation, and/or advance notice of
pending withdrawals from the HPSA list. Designations (or revisions of
designations) are effective as of the date on the notification from BHW
and are updated daily on the HRSA Data Warehouse website. While this
list is a snapshot of HPSAs at a point in time, HPSA designations are
regularly being updated so the best source of current designation
status is the HRSA Data Warehouse website at (<a href="https://data.hrsa.gov/tools/shortage-area">https://data.hrsa.gov/tools/shortage-area</a>).
State and territorial PCOs will have additional time to update
their HPSA designations. HPSA designations that are currently proposed
for withdrawal will remain in this status until they are re-evaluated
in mid-November in preparation for the publication of the January 2,
2024, HPSA Federal Register notice. If these HPSAs do not meet the
requirements for designation as of November 15, 2023, they will be
withdrawn with the publication of a second Federal Register notice
planned for January 2, 2024.
Carole Johnson,
Administrator.
[FR Doc. 2023-14092 Filed 6-30-23; 8:45 am]
BILLING CODE 4165-15-P
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