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HPSA Designation Criteria
Also see:
5.1 Purpose.
These regulations establish criteria and procedures
for the designation of geographic areas, population
groups, medical facilities, and other public facilities,
in the States, as health professional(s) shortage
areas.
5.2 Definitions.
Act means the Public Health Service Act, as
amended.
Health professional(s) shortage area means
any of the following which the Secretary determines
has a shortage of health professional(s): (1) An urban
or rural area (which need not conform to the geographic
boundaries of a political subdivision and which is
a rational area for the delivery of health services);
(2) a population group; or (3) a public or nonprofit
private medical facility.
Health service area means a health service
area whose boundaries have been designated by the
Secretary, under section 1511 of the Act, for purposes
of health planning activities.
Health systems agency or HSA means the health
systems agency designated, under section 1515 of the
Act, to carry out health planning activities for a
specific health service area.
Medical facility means a facility for the
delivery of health services and includes: (1) A community
health center, public health center, outpatient medical
facility, or community mental health center; (2) a
hospital, State mental hospital, facility for long-term
care, or rehabilitation facility; (3) a migrant health
center or an Indian Health service facility; (4) a
facility for delivery of health services to inmates
in a U.S. penal or correctional institution (under
section 323 of the Act) or a State correctional institution;
(5) a Public Health Service medical facility (used
in connection with the delivery of health services
under section 320, 321, 322, 324, 325, or 326 of the
Act); or (6) any other Federal medical facility.
Metropolitan area means an area which has
been designated by the Office of Management and Budget
as a standard metropolitan statistical area (SMSA).
All other areas are "non-metropolitan areas."
Poverty level means the poverty level as defined
by the Bureau of the Census, using the poverty index
adopted by a Federal Interagency Committee in 1969,
and updated each year to reflect changes in the Consumer
Price Index.
Secretary means the Secretary of Health and
Human Services and any other officer or employee of
the Department to whom the authority involved has
been delegated.
State includes, in addition to the several
States, the District of Columbia, the Commonwealth
of Puerto Rico, the Northern Mariana Islands, the
Virgin Islands, Guam, American Samoa, and the Trust
Territory of the Pacific Islands.
State health planning and development agency or
SHPDA means a State health planning and development
agency designated under section 1521 of the Act.
5.3 Procedures for designation
of health professional(s) shortage areas.
- Using data available to the Department from national,
State, and local sources and based upon the criteria
in the appendices to this part, the Department will
annually prepare listings (by State and health service
area) of currently designated health professional(s)
shortage areas and potentially designatable areas,
together with appropriate related data available
to the Department. Relevant portions of this material
will then be forwarded to each health systems agency,
State health planning and development agency, and
Governor, who will be asked to review the listings
for their State, correct any errors of which they
are aware, and offer their recommendations, if any,
within 90 days, as to which geographic areas, population
groups, and facilities in areas under their jurisdiction
should be designated. An information copy of these
listings will also be made available, upon request,
to interested parties for their use in providing
comments or recommendations to the Secretary and/or
to the appropriate HSA, SHPDA, or Governor.
- In addition, any agency or individual may request
the Secretary to designate (or withdraw the designation
of) a particular geographic area, population group,
or facility as a health professional(s) shortage
area. Each request will be forwarded by the Secretary
to the appropriate HSA, SHPDA, and Governor, who
will be asked to review it and offer their recommendations,
if any, within 30 days. An information copy will
also be made available to other interested parties,
upon request, for their use in providing comments
or recommendations to the Secretary and/or to the
appropriate HSA, SHPDA, or Governor.
- In each case where the designation of a public
facility (including a Federal medical facility)
is under consideration, the Secretary will give
written notice of the proposed designation to the
chief administrative officer of the facility, who
will be asked to review it and offer their recommendations,
if any, within 30 days.
- After review of the available information and
consideration of the comments and recommendations
submitted, the Secretary will designate health professional(s)
shortage areas and withdraw the designation of any
areas which have been determined no longer to have
a shortage of health professional(s).
5.4 Notification and publication
of designations and withdrawals.
- The Secretary will give written notice of the
designation (or withdrawal of designation) of a
health professional(s) shortage area, not later
than 60 days from the date of the designation (or
withdrawal of designation), to:
- The Governor of each State in which the area,
population group, medical facility, or other
public facility so designated is in whole or
in part located;
- Each HSA for a health service area which includes
all or any part of the area, population group,
medical facility, or other public facility so
designated;
- The SHPDA for each State in which the area,
population group, medical facility, or other
public facility so designated is in whole or
in part located; and
- Appropriate public or nonprofit private entities
which are located in or which have a demonstrated
interest in the area so designated.
- The Secretary will periodically publish updated
lists of designated health professional(s) shortage
areas in the Federal Register, by type of professional(s)
shortage. An updated list of areas for each type
of professional(s) shortage will be published at
least once annually.
- The effective date of the designation of an area
shall be the date of the notification letter to
the individual or agency which requested the designation,
or the date of publication in the Federal Register,
whichever comes first.
- Once an area is listed in the Federal Register
as a designated health professional(s) shortage
area, the effective date of any later withdrawal
of the area's designation shall be the date when
notification of the withdrawal, or an updated list
of designated areas which does not include it, is
published in the Federal Register.
Relevant Excerpts from 42 Code of Federal Regulations (CFR), Chapter 1, Part 5 (October 1, 1993, pp 34-38)
Authority: Sec. 215 of the Public Health Service Act, 58 Stat. 690 (42 U.S.C. 216); sec. 332 of the Public Health Service Act, 90 Stat. 2270 - 2272 (42 U.S.C. 254e).
Source: 45 FR 76000, Nov. 17, 1980, unless otherwise noted. Editorial Note: Nomenclature changes to part 5 appear at 57 FR 2480, Jan. 22, 1992.
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