[Federal Register Volume 77, Number 126 (Friday, June 29, 2012)]
[Notices]
[Pages 38838-38840]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-15819]


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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, Department of 
Health and Human Services.

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 April 1, 2012, available on the Health 
Resources and Services Administration (HRSA) Web site at http://bhpr.hrsa.gov/shortage/index.html. HPSAs are designated or withdrawn by 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 and requests 
for additional designations, withdrawals, or reapplication for 
designation should be submitted to Andy Jordan, Office of Shortage 
Designation, Bureau of Health Professions, Health Resources and 
Services Administration, Room 9A-55, Parklawn Building, 5600 Fishers 
Lane, Rockville, Maryland 20857; (301) 594-0816.

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. The lists of HPSAs 
are to be reviewed at least annually and revised as necessary. HRSA's 
Bureau of Health Professions (BHPr) 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, dental, or mental health services in these HPSAs. NHSC 
health

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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 
BHPr. Many other Federal programs also utilize HPSA designations. For 
example, under authorities administered by the Centers for Medicare and 
Medicaid Services, certain qualified providers in 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, in Federal Register (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 BHPr. The majority of the requests come 
from the Primary Care Office (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, applicants are expected to share copies of 
the requests with other interested parties, including the Governor, the 
State Primary Care Association and State professional associations for 
their comments and recommendations.
    Annually, lists of designated HPSAs are made available to all PCOs, 
state medical and dental societies and others, with a request to review 
and update the data on which the designations are based. Emphasis is 
placed on updating those designations that are more than three years 
old or where significant changes relevant to the designation criteria 
have occurred.
    Recommendations for possible additions, continuations, revisions or 
withdrawals from a HPSA list are reviewed by BHPr, 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 of the notification letter 
from BHPr. Proposed withdrawals become effective only after interested 
parties in the area affected have been afforded the opportunity to 
submit additional information to BHPr in support of its continued or 
revised designation. If no new data are submitted, or if BHPr 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 continuously available on the HRSA Web 
site, http://bhpr.hrsa.gov/shortage/index.html, so that interested 
parties can access the most accurate and timely information.
    Publication and Format of Lists: Due to the large volume of 
designations, this notice serves to inform the public of the 
availability of the complete listings of the designated HPSAs on the 
HRSA Web site. The three lists of designated HPSAs are available at a 
link on the Office of Shortage Designation Web site at http://bhpr.hrsa.gov/shortage/index.html. Each list (primary medical care, 
mental health, and dental) includes all those geographic areas, 
population groups, and facilities that were designated HPSAs as of 
April 1, 2012. This notice incorporates the most recent annual reviews 
of designated HPSAs and supersedes the HPSA lists published in the 
Federal Register on November 3, 2011 (76 FR 68198). The lists include 
those automatic facility HPSAs that have been entered into the HPSA 
data base. Automatic facility HPSAs, designated as a result of the 
Health Care Safety Net Amendments of 2002 (Pub. L. 107-251), are not 
subject to the updating requirements. The lists are constantly changing 
based on the identification of new sites that meet the eligibility 
criteria or current sites that lose their eligibility and need to be 
removed. 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 for the HPSAs listed can be found on the HRSA Web 
site: http://bhpr.hrsa.gov/shortage/index.html.
    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 the list of HPSAs; 
all will be included in the data base as they are identified.
    Future Updates of Lists of Designated HPSAs: The lists of HPSAs on 
the HRSA Web site below consist of all those that were designated as of 
April 1, 2012. It should be noted that 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 on the HRSA Web site at 
http://hpsafind.hrsa.gov/.
    Any designated HPSA listed on the HRSA Web site below 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 April 1, 2012, are available on the HRSA Web site at http://bhpr.hrsa.gov/shortage/index.html. Frequently updated information on 
HPSAs is also

[[Page 38840]]

available at http://datawarehouse.hrsa.gov.

    Dated: June 19, 2012.
Mary K. Wakefield,
Administrator.
[FR Doc. 2012-15819 Filed 6-28-12; 8:45 am]
BILLING CODE 4165-15-P