[Federal Register Volume 88, Number 126 (Monday, July 3, 2023)]
[Notices]
[Pages 42725-42726]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-14092]


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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 is the first of two notices planned for the coming months 
informing 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). This notice includes the lists of HPSAs in a 
designated status as of April 28, 2023. The lists are available on the 
shortage area topic page on HRSA's data.hrsa.gov website and includes 
HPSAs which are proposed for withdrawal but currently remain 
designated. HRSA is extending the transition time communicated in the 
notice published on July 7, 2022, for jurisdictions and facilities to 
prepare for potential loss of HPSA designations. HPSA designations that 
are currently proposed for withdrawal will remain in this status until 
they are re-evaluated in preparation for the publication of the January 
2, 2024, HPSA Federal Register notice. If these HPSAs do not meet the 
requirements for designation by the data pull scheduled for November 
15, 2023, they will be withdrawn with the publication of a second 
Federal Register notice planned for January 2, 2024.

ADDRESSES: Complete lists of HPSAs designated as of April 28, 2023, are 
available on the website at https://data.hrsa.gov/tools/health-workforce/shortage-areas/frn. Frequently updated information on HPSAs 
is available at https://data.hrsa.gov/topics/health-workforce/health-workforce-shortage-areas. 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 Anthony Estelle, Chief, Shortage Designation Branch, Division 
of Policy and Shortage Designation, Bureau of Health Workforce (BHW), 
HRSA, 5600 Fishers Lane, Room 11W16, Rockville, Maryland 20857, 
[email protected] or (301) 945-0942.

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. This notice meets that requirement. 
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 or relevant sub-score designations such 
as Maternity Care Target Areas.
    HPSA designation offers access to potential Federal assistance. 
Public or private nonprofit entities are eligible to apply for 
assignment of National Health Service Corps personnel to provide 
primary medical care, mental health, or dental health services in or to 
these HPSAs. National Health Service Corps 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 & 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

[[Page 42726]]

areas, population groups, and facilities that were designated HPSAs as 
of April 28, 2023. This notice incorporates the most recent annual 
reviews of designated HPSAs (including those that have been proposed 
for withdrawal but have not yet been withdrawn) which can be located on 
HRSA's data.hrsa.gov website and supersedes the HPSA lists published in 
the Federal Register on July 7, 2022, (87 FR 40540-40451).
    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. Since they are automatically designated by statute, 
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 HPSAs. BHW also receives 
other requests for designation from other sources and refers them to 
PCOs for review. As part of the HPSA designation process, 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 website. While this 
list is a snapshot of HPSAs at a point in time, HPSA designations are 
regularly being updated so the best source of current designation 
status is the HRSA Data Warehouse website at (https://data.hrsa.gov/tools/shortage-area).
    State and territorial PCOs will have additional time to update 
their HPSA designations. HPSA designations that are currently proposed 
for withdrawal will remain in this status until they are re-evaluated 
in mid-November in preparation for the publication of the January 2, 
2024, HPSA Federal Register notice. If these HPSAs do not meet the 
requirements for designation as of November 15, 2023, they will be 
withdrawn with the publication of a second Federal Register notice 
planned for January 2, 2024.

Carole Johnson,
Administrator.
[FR Doc. 2023-14092 Filed 6-30-23; 8:45 am]
BILLING CODE 4165-15-P