[Federal Register Volume 84, Number 122 (Tuesday, June 25, 2019)]
[Notices]
[Pages 29869-29870]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-13395]


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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 notice informs the public of the availability of the 
complete 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 1, 2019. 
The lists are available on HRSA's HPSAFind website.

ADDRESSES: Complete lists of HPSAs designated as of May 1, 2019, are 
available on the website at https://data.hrsa.gov/topics/health-workforce/shortage-areas. Frequently updated information on HPSAs is 
available at https://data.hrsa.gov/tools/shortage-area. Information on 
shortage designations is available at https://bhw.hrsa.gov/shortage-designation.

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 Janelle D. McCutchen, DHEd, MPH, CHES, Chief, Shortage 
Designation Branch, Division of Policy and Shortage Designation, Bureau 
of Health Workforce, HRSA, 5600 Fishers Lane, Room 11W14, Rockville, 
Maryland 20857, [email protected] or phone at (301) 594-5168.

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. 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 and 
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 designations.
    HPSA designation offers potential access to federal assistance. 
Public or private nonprofit entities are eligible to apply for 
assignment of National Health Service Corps (NHSC) personnel to provide 
primary medical care, mental health, or dental health services in or to 
these HPSAs. NHSC 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 Bureau of 
Health Workforce (BHW). Other federal programs also utilize HPSA 
designations. For example, under authorities administered by the 
Centers for Medicare and 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 HPSAFind website and include a snapshot of all geographic 
areas, population groups, and facilities that were designated HPSAs as 
of May 1, 2019. This notice incorporates the most recent annual reviews 
of designated HPSAs and supersedes the HPSA lists published in the 
Federal Register on July 2, 2018 (Federal Register/Vol. 83, No. 127/
Monday, July 2, 2018/Notices 30941).
    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(d), 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. All of these entities identified by May 1, 2019 are 
included on this listing. 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

[[Page 29870]]

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 cooperative agreements 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 refers requests 
that come from other sources to PCOs for review. In addition, 
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 HPSAFind website. The effective date of a 
withdrawal will be the next publication of a notice regarding the list 
in the Federal Register.

    Dated: June 17, 2019.
George Sigounas,
Administrator.
[FR Doc. 2019-13395 Filed 6-24-19; 8:45 am]
BILLING CODE 4165-15-P