[Federal Register Volume 81, Number 127 (Friday, July 1, 2016)]
[Notices]
[Pages 43214-43215]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-15678]
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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, HHS.
ACTION: Notice.
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SUMMARY: This notice advises the public of the published lists of all
geographic areas, population groups, and facilities designated as
primary medical care, mental health, and dental health professional
shortage areas (HPSAs) as of May 13, 2016, available on the Health
Resources and Services Administration (HRSA) Web site at http://www.hrsa.gov/shortage/. HPSAs are designated or withdrawn by the
Secretary of Health and Human Services (HHS) under the authority of
section 332 of the Public Health Service (PHS) Act and 42 CFR part 5.
FOR FURTHER INFORMATION CONTACT: Requests for further information on
the HPSA designations listed on the HRSA Web site below should be
submitted to Kae Brickerd, Ph.D., Director, Shortage Designation
Branch, Division of Policy and Shortage Designation, Bureau of Health
Workforce (BHW), HRSA, Mail Stop 11SWH03, 5600 Fishers Lane, Rockville,
Maryland 20857, (301) 594-5168 or [email protected].
SUPPLEMENTARY INFORMATION:
Background
Section 332 of the PHS Act, 42 U.S.C. 254e, provides that the
Secretary of HHS 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 a list of the designated geographic areas, population groups,
and facilities. HPSAs are to be reviewed at least annually and revised
as necessary. HRSA's BHW has the responsibility for designating and
updating HPSAs.
Public or private nonprofit entities are eligible to apply for
assignment of National Health Service Corps (NHSC) personnel to provide
primary care, mental, or dental health services in or to these HPSAs.
NHSC health professionals with a service obligation may enter into
service agreements to serve only 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 BHW. Many 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.
Development of the Designation and Withdrawal Lists
Criteria for designating HPSAs were published as final regulations
(42 CFR part 5) in 1980. Criteria then were defined for each of 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 designations.
Individual requests for designation or withdrawal of a particular
geographic area, population group, or a facility as a HPSA are received
and reviewed continuously by BHW. The majority of the requests come
from the Primary Care Offices (PCO) in the State Health Departments,
who have access to the on-line application and review system. Requests
that come from other sources are referred to the PCOs for their review
and concurrence. In addition, interested parties, including the
Governor, the State Primary Care Association and state professional
associations are notified of each request submitted for their comments
and recommendations.
Recommendations for possible additions, continuations, revisions,
or withdrawals from a HPSA list are reviewed by BHW, and the review
findings are provided by letter to the agency or individual requesting
action or providing data, with copies to other interested organizations
and individuals. These letters constitute the official notice of
designation as a HPSA, rejection of recommendations 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 letter
from BHW. Proposed withdrawals become effective only after interested
parties in the area affected have been afforded the opportunity to
submit additional information to BHW in support of its continued or
revised designation. If no new data are submitted, or if BHW review
confirms the proposed withdrawal, the withdrawal becomes effective upon
publication of the lists of designated HPSAs in the Federal Register.
In addition, lists of HPSAs are updated daily on the HRSA Web site,
http://www.hrsa.gov/shortage/, so that interested parties can access
the most accurate and timely information.
Publication and Format of Lists
Due to the large volume of designations, a printed version of the
list is no longer distributed. This notice serves to inform the public
of the availability of the complete listings of designated HPSAs on the
HRSA Web site. The three lists (primary medical care, mental health,
and dental) of designated HPSAs are available at a link on the HRSA Web
site at http://www.hrsa.gov/shortage/ and include a snapshot of all
geographic areas, population groups, and facilities that were
designated HPSAs as of May 13, 2016. This notice incorporates the most
recent annual reviews of designated HPSAs and supersedes the HPSA lists
published in the Federal Register on July 1, 2015 (Federal Register/
Vol. 80,
[[Page 43215]]
No. 126/Wednesday, July 1, 2015/Notices 37637). The lists also include
automatic facility HPSAs, designated as a result of the Health Care
Safety Net Amendments of 2002 (Pub. L. 107-251), not subject to update
requirements. Each list of designated HPSAs (primary medical care,
mental health, and dental) 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, or if the county is part of a larger
designated service area, or if a population group residing in the
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. Counties that have a whole county
geographic HPSA are indicated by the ``Entire county HPSA'' notation
following the county name. Further details on the snapshot of HPSAs
listed can be found on the HRSA Web site: http://www.hrsa.gov/shortage/ shortage/.
In addition to the specific listings included in this notice, all
Indian Tribes that meet the definition of such Tribes in the Indian
Health Care Improvement Act of 1976, 25 U.S.C. 1603(d), are
automatically designated as population groups with primary medical care
and dental health professional shortages. The Health Care Safety Net
Amendments of 2002 also made the following entities eligible for
automatic facility HPSA designations: All federally qualified health
centers (FQHCs) and rural health clinics that offer services regardless
of ability to pay. 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.
Exclusion from this list does not exclude them from HPSA designation;
any facilities eligible for automatic designation will be included in
the HRSA Data Warehouse list of HPSAs as they are identified.
Future Updates of Lists of Designated HPSAs
The lists of HPSAs at http://www.hrsa.gov/shortage/ consist of all
those that were designated as of May 13, 2016. It should be noted that
HPSAs are currently updated on an ongoing basis based on the
identification of new areas, population groups, facilities, and sites
that meet the eligibility criteria or that no longer meet eligibility
criteria and/or are being replaced by another type of designation. As
such, additional HPSAs may have been designated by letter since that
date. The appropriate agencies and individuals have been or will be
notified of these actions by letter. These newly designated HPSAs will
be included in the next publication of the HPSA list and are currently
included in the daily updates posted on the HRSA Web site at http://www.hrsa.gov/shortage/find.html.
Any designated HPSA listed on the HRSA Web site is subject to
withdrawal from designation if new information received and confirmed
by HRSA indicates that the relevant data for the area involved have
significantly changed since its designation. The effective date of such
a withdrawal will be the next publication of a notice regarding this
list in the Federal Register.
All requests for new designations, updates, or withdrawals should
be based on the relevant criteria in regulations published at 42 CFR
part 5.
Electronic Access Address
The complete list of HPSAs designated as of May 13, 2016, are
available on the HRSA Web site at http://www.hrsa.gov/shortage/.
Frequently updated information on HPSAs is also available at http://datawarehouse.hrsa.gov.
Dated: June 24, 2016.
James Macrae,
Acting Administrator.
[FR Doc. 2016-15678 Filed 6-30-16; 8:45 am]
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