[Federal Register Volume 86, Number 127 (Wednesday, July 7, 2021)]
[Notices]
[Pages 35808-35809]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-14408]


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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, dental health, and 
mental health professional shortage areas (HPSAs) as of April 30, 2021. 
The lists are available on the shortage area topic page on HRSA's 
data.hrsa.gov website.

ADDRESSES: Complete lists of HPSAs designated as of April 30, 2021, 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/workforce-shortage-areas/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 (BHW), HRSA, 5600 Fishers Lane, Room 11W14, 
Rockville, Maryland 20857, [email protected].

SUPPLEMENTARY INFORMATION:

[[Page 35809]]

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 that 
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 access to potential 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 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 shortage area topic web page and include a snapshot of all 
geographic areas, population groups, and facilities that were 
designated HPSAs as of April 30, 2021. This notice incorporates the 
most recent annual reviews of designated HPSAs and supersedes the HPSA 
lists published in the Federal Register on June 15, 2020 (Federal 
Register/Vol. 85, No. 115/Monday, June 15, 2020/Notices 36219).
    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, 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. Many, but not all, of these entities 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 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 a Cooperative Agreement between HRSA and the 54 state and 
territorial Primary Care Offices (PCOs), PCOs conduct needs assessments 
and submit applications to HRSA to designate areas as 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 HRSA Data Warehouse Find Shortage Area 
website. The effective date of a withdrawal will be the next 
publication of a notice regarding the list of designated HPSAs in the 
Federal Register.

Diana Espinosa,
Acting Administrator.
[FR Doc. 2021-14408 Filed 7-6-21; 8:45 am]
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