Shortage Designations

Terri Lang, Project Coordinator

UND Center for Rural Health

October 12, 2011

Shortage Designations• HPSA

Health Professional Shortage Area• MUA/P

Medically Underserved Area/Population

• What are they:A way to identify areas of greatest

health needs so limited resources can be prioritized and given to those most in need of primary health services

Legislation

• Original legislation enacted by Congress in 1970s, Sections 330 MUA/MUP and 332 (HPSA) of Public Health Service Act as amended.

• Most recently, Health Care Safety Net Amendments authorized automatic facility HPSA designation process for Federally Qualified Health Centers and a simple HPSA application process for Rural Health Clinics.

When you think…HPSA

• Think three health professions– Primary Care– Dental– Mental Health

• Think three sub-types– Geographic– Population– Facility

Primary Care HPSAs

Mental Health HPSAs

Dental Care HPSAs

When you think…MUA

• Think Federally Qualified Health Centers (FQHC) or Community Health Centers and FQHC look-a-likes

Medically Underserved Areas/Populations

Who uses the designations

***Approximately 40 federal programs use MUA/P and HPSA designations as eligibility requirements

Designation Needed for Selected Federal ProgramsShortage Designations Options

National Health Service Corps

Federally Qualified Health Center Programs

CMS Medicare Incentive Payment

CMS Rural Health Clinic Program

J-1Visa Waiver

Primary Care HPSA

X X GeographicHPSA only

X X

Dental Care HPSA X

Mental Health HPSA

X X 7/1/04 Geographic only

X

HPSA Subtypes

Geographic HPSA X X X X

Population HPSA X X X

Facility HPSA X X

Medically Underserved Area (MUA)

X X X

Medically Underserved Population (MUP)

X X X

Primary Benefits• If you are in a HPSA

You can apply for National Health Service Corps (NHSC) loan repayment or a NHSC scholar.

You can apply to be Rural Health ClinicYou can seek a J1 Visa Physician

• If you are in a Geographic HPSAThere are 10% Medicare Incentive Benefits

o Psychiatrists can receive same incentive benefits beginning 7-1-2004 in a Mental Health Geographic HPSA

Primary Benefits

• If you are in a MUA/P::

You can apply to be Federally Qualified Health Center. (FQHC) or a FQHC look alike, who are both Automatic HPSAs.

You can apply to be Rural Health Clinic (RHC) who can obtain a Automatic HPSA.

You can seek a J1 Visa Physician.

How a HPSA/MUA is Designated

• DHHS contracts with State Health Department to analyze local areas to determine shortages.

• The rules are very specific in law and regulation.• If it appears the area meets criteria, application is

submitted to Shortage Designation Branch.

Currently taking approximately 3 months or more to make a determination.

The rules are being more strictly interpreted than they were a few years ago.