Proposed Rule: Designation of Medically Underserved Populations & Health Professional Shortage Areas

HRSA Announces HPSA Clarifications

Comment Period Extended to May 29, 2008.

Extension of public comment period and clarification (Federal Register Notice, 4-21-08)

We were recently asked for additional information regarding the proposed rule for the designation of medically underserved populations and areas and health professional shortage areas (HPSA), published in the Federal Register on February 29, 2008. We were also asked to extend the comment period.

The Health Resources and Services Administration (HRSA) is committed to working with its constituents to develop and implement this rule. The recently published proposed rule reflects the thoughts, ideas, and suggestions of many state partners including State Primary Care Offices, State Offices of Rural Health, and State Primary Care Associations. In addition, HRSA made presentations as the methodology was being developed at a variety of venues and national meetings.

Where are the data sources HRSA used to develop the proposed HPSA rule?

Data sources are identified in the tables in the proposed rule.
Additional tools have been made available for state partners to assist in the testing of the methodology, including population data for the required age/gender groupings, and the preprogrammed spreadsheets that complete the calculations.

Did HRSA analyze the impact of the proposed regulation on the health center grantees?

HRSA recently updated its analysis of the proposed regulation on health center grantees by applying the National Data Calculations for Geographic Areas combined with Estimates of Low Income Populations, and also the Safety Net Facility Option using 2006 UDS data . From this analysis, it appears that as few as 16 health center grantees may lose their designation under these two combined approaches.

In response, HRSA has initiated contact with the 16 specific grantees to determine if there are additional state and local data that could be used to achieve designation under the proposed rule.
However, if an entity does not meet the designation criteria, the proposed regulation offers the possibility of permissible MUP designation at the request of the Governor.

Did HRSA analyze the impact of the proposed regulation on other safety net providers?

HRSA does not have a national data set to evaluate safety net providers that are not health center grantees using the Safety Net Facility Option. We would, however, encourage these safety net providers to compare their individual site specific patient data to the Safety Net Facility Option defined in the proposed rule.
In addition, safety net providers may work with their State Primary Care Office, State Office of Rural Health, and State Primary Care Association for additional assistance.

Will HRSA extend the comment period beyond the regular 60-day period?

We believe that since many states assisted in the early development and testing of the proposed methodology, 60 days is adequate time for review.
Given that there may be only 16 affected health center grantees, we do not believe an extension is warranted.

We remain committed to working with affected entities to assist in understanding the proposed rule and encourage them to contact their State Primary Care Office, State Office of Rural Health, and State Primary Care Association for additional assistance.

Please continue to provide comments pertaining to the methodology, implementation, and potential impact of this proposed rule on or before the close of the 60-day comment period (April 29, 2008). Information on submitting comments is included in the Federal Register notice.

We look forward to working with our national, state, and local partners in the development of the proposed rule.

sent as Listserv message, March 31, 2008