Health
Professional Shortage Area Designation Criteria
RELEVANT EXCERPTS FROM
42 CODE OF FEDERAL REGULATIONS (CFR), CHAPTER 1, PART 5 (October
1, 1993, pp. 34-48)
DESIGNATION OF HEALTH
PROFESSIONAL(S) SHORTAGE AREAS
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On this page: Purpose
| Definitions | Procedures
| Notification and publication of designations and
withdrawals
Authority: Sec. 215 of the Public
Health Service Act, 58 Stat. 690 (42 U.S.C. 216); sec. 332 of the
Public Health Service Act, 90 Stat. 2270 - 2272 (42 U.S.C. 254e).
Source: 45 FR 76000, Nov. 17, 1980, unless otherwise noted. Editorial
Note: Nomenclature changes to part 5 appear at 57 FR 2480, Jan.
22, 1992.
5.1 Purpose.
These regulations establish criteria
and procedures for the designation of geographic areas, population
groups, medical facilities, and other public facilities, in the
States, as health professional(s) shortage areas.
5.2 Definitions.
Act means the Public Health
Service Act, as amended.
Health professional(s) shortage
area means any of the following which the Secretary determines
has a shortage of health professional(s): (1) An urban or rural
area (which need not conform to the geographic boundaries of a political
subdivision and which is a rational area for the delivery of health
services); (2) a population group; or (3) a public or nonprofit
private medical facility.
Health service area means a
health service area whose boundaries have been designated by the
Secretary, under section 1511 of the Act, for purposes of health
planning activities.
Health systems agency or HSA
means the health systems agency designated, under section 1515 of
the Act, to carry out health planning activities for a specific
health service area.
Medical facility means a facility
for the delivery of health services and includes: (1) A community
health center, public health center, outpatient medical facility,
or community mental health center; (2) a hospital, State mental
hospital, facility for long-term care, or rehabilitation facility;
(3) a migrant health center or an Indian Health service facility;
(4) a facility for delivery of health services to inmates in a U.S.
penal or correctional institution (under section 323 of the Act)
or a State correctional institution; (5) a Public Health Service
medical facility (used in connection with the delivery of health
services under section 320, 321, 322, 324, 325, or 326 of the Act);
or (6) any other Federal medical facility.
Metropolitan area means an area
which has been designated by the Office of Management and Budget
as a standard metropolitan statistical area (SMSA). All other areas
are "non-metropolitan areas."
Poverty level means the poverty
level as defined by the Bureau of the Census, using the poverty
index adopted by a Federal Interagency Committee in 1969, and updated
each year to reflect changes in the Consumer Price Index.
Secretary means the Secretary
of Health and Human Services and any other officer or employee of
the Department to whom the authority involved has been delegated.
State includes, in addition
to the several States, the District of Columbia, the Commonwealth
of Puerto Rico, the Northern Mariana Islands, the Virgin Islands,
Guam, American Samoa, and the Trust Territory of the Pacific Islands.
State health planning and development
agency or SHPDA means a State health planning and development
agency designated under section 1521 of the Act.
5.3
Procedures for designation of health professional(s) shortage areas.
(a) Using data available to the Department
from national, State, and local sources and based upon the criteria
in the appendices to this part, the Department will annually prepare
listings (by State and health service area) of currently designated
health professional(s) shortage areas and potentially designatable
areas, together with appropriate related data available to the Department.
Relevant portions of this material will then be forwarded to each
health systems agency, State health planning and development agency,
and Governor, who will be asked to review the listings for their
State, correct any errors of which they are aware, and offer their
recommendations, if any, within 90 days, as to which geographic
areas, population groups, and facilities in areas under their jurisdiction
should be designated. An information copy of these listings will
also be made available, upon request, to interested parties for
their use in providing comments or recommendations to the Secretary
and/or to the appropriate HSA, SHPDA, or Governor.
(b) In addition, any agency or individual
may request the Secretary to designate (or withdraw the designation
of) a particular geographic area, population group, or facility
as a health professional(s) shortage area. Each request will be
forwarded by the Secretary to the appropriate HSA, SHPDA, and Governor,
who will be asked to review it and offer their recommendations,
if any, within 30 days. An information copy will also be made available
to other interested parties, upon request, for their use in providing
comments or recommendations to the Secretary and/or to the appropriate
HSA, SHPDA, or Governor.
(c) In each case where the designation
of a public facility (including a Federal medical facility) is under
consideration, the Secretary will give written notice of the proposed
designation to the chief administrative officer of the facility,
who will be asked to review it and offer their recommendations,
if any, within 30 days.
(d) After review of the available information
and consideration of the comments and recommendations submitted,
the Secretary will designate health professional(s) shortage areas
and withdraw the designation of any areas which have been determined
no longer to have a shortage of health professional(s).
5.4
Notification and publication of designations and withdrawals.
(a) The Secretary will give written
notice of the designation (or withdrawal of designation) of a health
professional(s) shortage area, not later than 60 days from the date
of the designation (or withdrawal of designation), to:
(1) The Governor of each State in which
the area, population group, medical facility, or other public facility
so designated is in whole or in part located;
(2) Each HSA for a health service area
which includes all or any part of the area, population group, medical
facility, or other public facility so designated;
(3) The SHPDA for each State in which
the area, population group, medical facility, or other public facility
so designated is in whole or in part located; and
(4) Appropriate public or nonprofit
private entities which are located in or which have a demonstrated
interest in the area so designated.
(b) The Secretary will periodically
publish updated lists of designated health professional(s) shortage
areas in the Federal Register, by type of professional(s) shortage.
An updated list of areas for each type of professional(s) shortage
will be published at least once annually.
(c) The effective date of the designation
of an area shall be the date of the notification letter to the individual
or agency which requested the designation, or the date of publication
in the Federal Register, whichever comes first.
(d) Once an area is listed in the Federal
Register as a designated health professional(s) shortage area, the
effective date of any later withdrawal of the area's designation
shall be the date when notification of the withdrawal, or an updated
list of designated areas which does not include it, is published
in the Federal Register.
For
shortage designation inquiries, please call 1-888-275-4772. Press
option 1, then option 2 or contact the Shortage Designation
Branch:
sdb@hrsa.gov
301-594-0816
301-443-4370 fax
5600 Fishers Lane
Room 8C-26
Rockville, MD 20857
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