Health Workforce Shortage Designations
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Shortage designations are used to identify geographic areas, population groups, and health care facilities that lack access to health care providers. The Health Resources and Service Administration’s Office of Shortage Designation reviews shortage designation requests which include Health Professional Shortage Areas (HPSAs), Medically Underserved Areas (MUAs), and Medically Underserved Populations (MUPs). These designations are used to determine eligibility for a variety of federal and state health workforce programs, including the Federally Qualified Health Centers program (MUA/Ps) and the National Health Service Corps programs (HPSAs). Three distinct HPSA categories identify shortages of primary medical care, dental, and mental health providers. HPSAs may cover urban or rural areas, population groups, or medical or other public facilities.
According the HRSA’s Office of Shortage Designation, there are currently 5,500+ primary care HPSAs requiring more than 16,000 providers, 4,500+ dental HPSAs requiring more than 9,000 providers, and 3,000+ mental health HPSAs requiring more than 5,000 providers to achieve target ratios of providers. MUAs and MUPs are determined based on the ratio of primary medical care physicians per 1,000 people, infant mortality rate, percent of the population with incomes below the poverty level, and percent of the population age 65 or older. Information about this process is available on the Office of Shortage Designation web site, http://www.hrsa.gov/shortage.
The Patient Protection and Affordable Care Act of 2010 requires HRSA to develop new criteria for shortage areas through the use of negotiated rulemaking. The Negotiated Rulemaking Committee on the Designation on MUPs and HPSAs met monthly from September 2010 through October 2011. While the Committee did not reach a unanimous consensus, it issued a final report to the Secretary of the Department of Health and Human Services in October 2011 that provides recommendations for consideration by the Secretary. The Department of Health and Human Services is examining several options for improving designation methodologies, and the report submitted by the Negotiated Rulemaking Committee provides valuable information for consideration. The Affordable Care Act requires the Department to publish an interim final rule on the issue and that work is continuing. The timeframe for issuing the regulation has not been finalized.
Page last updated March 6, 2013