[Federal Register Volume 91, Number 125 (Wednesday, July 1, 2026)]
[Notices]
[Pages 40003-40004]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2026-13309]
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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.
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 (HPSA) in a designated status
as of April 30, 2026. The lists are available on the shortage area
topic page on HRSA's data.hrsa.gov website. Federal law requires
publication of an annual Federal Register notice (FRN) not later than
July 1 of each year listing designated HPSAs. This FRN serves as notice
that HPSAs that were placed in a proposed for withdrawal status due to
state primary care office (PCO) actions between October 16, 2024, and
September 21, 2025, will be withdrawn. HPSAs that did not pass the
National Shortage Designation Update conducted in September 2025 will
be maintained in a proposed for withdrawal status after the publication
of this FRN, and the state PCOs will be allowed additional time to
review and update designations. HRSA intends to address those HPSAs
with the publication of the FRN on or before July 1, 2027.
ADDRESSES: Complete lists of HPSAs designated as of April 30, 2026, are
available on the website at https://data.hrsa.gov/topics/health-
workforce/shortage-areas/frn. Frequently updated information on HPSAs
is available at https://data.hrsa.gov/topics/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 Matthew Patterson, Acting Branch Chief, Shortage Designation
Branch, Division of Policy and Shortage Designation, Bureau of Health
Workforce (BHW), HRSA, 5600 Fishers Lane, Rockville, Maryland 20857,
(301) 594-5110, [email protected].
SUPPLEMENTARY INFORMATION:
Background
Section 332 of the Public Health Service (PHS) Act, 42 U.S.C. 254e,
provides that the Secretary of Health and Human Services 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 of Health and Human Services 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 on November 17,
1980 (45 FR 75996), 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
published on October 29, 1987 (52 FR 41594), and revised 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 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. 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.
In 2023, HRSA published two FRNs related to HPSAs. The first in
July 2023 met the statutory requirement to publish an annual FRN and
listed all HPSAs in designated and proposed for withdrawal status. The
FRN publication did not withdraw any HPSAs, rather it served as a
preview to states as to what HPSAs may lose designated status if action
was not taken. HRSA then published a second FRN in November 2023 that
withdrew any HPSA designations not addressed and still in a proposed
for withdrawal status. In 2024, HRSA reverted to a once-annual FRN
posting that served to withdraw any HPSAs that no longer met criteria
for designation. HRSA reviewed statuses of HPSAs on October 15, 2024,
to inform development of the 2024 FRN, posted November 5, 2024, meeting
the statutory requirement. In September 2025, HRSA conducted the
National Shortage Designation Update that applied new data to existing
HPSAs and checked designations against established regulatory criteria.
The status of those HPSAs that did not pass the National Shortage
Designation Update will be maintained in a proposed for withdrawal
status after the publication of this FRN, and the state PCOs will be
allowed additional time to review and update designations. HRSA intends
to address those HPSAs with the publication of the FRN on or before
July 1, 2027.
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, 2026. This notice incorporates the
most recent annual reviews of designated HPSAs and supersedes the HPSA
lists published in the Federal Register on November 5, 2024, (FR/Vol.
89, No. 214, Tuesday, November 5, 2024/Document Number 2024-25624).
[[Page 40004]]
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 (FQHC) 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 in
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
HRSA continuously receives requests for designation or withdrawal
of a particular geographic area, population group, or facility as a
HPSA. Under a Cooperative Agreement between HRSA and the 54 state and
territorial PCOs, PCOs conduct needs assessments and submit
applications to HRSA to designate areas as HPSAs. HRSA 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.
HRSA reviews each recommendation for possible addition,
continuation, revision, or withdrawal. Following review, HRSA notifies
the appropriate agency, individuals, and interested organizations of
each designation of a HPSA, rejection of a 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
HRSA and are updated frequently on the HRSA Data Warehouse 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.
Ann M. Sheehy,
Principal Deputy Administrator.
[FR Doc. 2026-13309 Filed 6-30-26; 8:45 am]
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