Transcript Automatic Facility HPSAs and IHP Sites

Shortage Designation Update
State Office of Rural Health Orientation Meeting
Rockville, Maryland
September 11, 2013
Objectives
 Become familiar
Shortage Designation
Branch
 Gain an understanding
of Shortage Designation
Types
 Gain an understanding
of Shortage Partners
and Stakeholders
2
Organizational Structure
 October 2012, Shortage Designation Function Transferred to BCRS
 Increased alignment with National Health Service Corps and NURSE
Corps Scholarship and Loan Repayment Programs
Office of the Associate Administrator
Associate Administrator
Deputy Associate Administrator
Administrative
Management Services
Office of
Legal and
Compliance
Division of
National
Health
Service
Corps
Division of
Nursing and
Public
Health
Senior Advisor
Division of
External
Affairs
Division of
Policy and
Shortage
Designation
Division of
Program
Operations
Division of
Regional
Operations
Office of
Business
Operations
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Division of Policy
and Shortage
Designation
 Improve access to health care
services for individuals and
communities that are
underserved by designating
and addressing health
professional shortages areas
(HPSAs) and Medically
Underserved Areas and
Populations (MUA/Ps)
 State Primary Care Offices
 Public Health Service Act, Title
III, Sections 330 and 333
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HPSA Designations:
Health Discipline Shortages

Health Professional Shortage Area (HPSA) designations are used to identify areas and
population groups within the United States that are experiencing a shortage of health
professionals

There are three categories of HPSAs based on health discipline:
1. primary medical care
2. dental
3. mental health

For each discipline category, there are three types of HPSAs
1. geographic area
2. population group
3. facility

The primary factor used to determine a HPSA designation is the number of health
professionals relative to the population with consideration of high need.

These HPSA Designations are required to be updated on a regular basis
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Automatic Health
Professional Shortage
Area (HPSA) Statute
 Legislation in 2002 created a
separate type of HPSA
designation, not based on
geographic or population data
but based on status as a certain
type of facility
 This legislation created
“Automatic Facility (Auto)
HPSAs”
 Auto HPSAs are automatically
designated by statute
 Auto HPSAs are manually scored
by the BCRS Shortage
Designation Branch
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Entities Covered under Auto HPSA Statute
 Certified Rural Health
Clinics (RHCs) meeting
NHSC-Site Requirement
 Federally Qualified
Health
Centers/Community
Health Centers
 FQHC Look-A-Likes
(LALs)
 Federal Indian Health
Service Clinics
 Tribally-run Health
Clinics
 Urban Indian Health
Clinics
 Dual-funded
Community Health
Centers/Tribal Health
Clinics
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Shortage
Designations and
Medicare
Certification as a
Rural Health Clinic
 Primary Care Medical
Geographic HPSA
 Primary Care Medical
Population-Group HPSA
 Medically Underserved
Area
 Governor-designated and
Secretary-certified
shortage area
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What is as HPSA
Score?
 HPSA Scores are developed for
use by the National Health
Service Corps in determining
priorities for assignment of
clinicians.
 Scores range from 1 to 25 for
primary care and mental health,
1 to 26 for dental.
 The higher the score, the greater
the chance of obtaining a
provider.
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Auto HPSA Scores
 A score of “0” can
mean two different
things:
• Data was provided and
calculated score is “0”
• Or, the site has not been
scored, that is no data
has been presented and
thus not scored
• “0” means “null” in the
latter case
 Auto HPSA Scores are
not required to be
updated and only
updated on request
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MUAs/Ps
Health Services Shortages

MUAs may be a whole county, a group of contiguous counties, a group of county or
civil divisions, or a group of urban census tracts in which residents have a shortage of
personal health services

MUPs may include groups of persons who face economic, cultural or linguistic
barriers leading to a shortage of personal health services

MUA/Ps use an Index of Medical Underservice (IMU) with a scale of 0 to 100

The IMU involves four variables which are summed and weighted to obtain an area’s
score:
• ratio of primary medical care physicians per 1,000 population
• infant mortality rate
• percentage of the population with incomes below the poverty level
• percentage of the population age 65 or over

An IMU of 62.0 or less qualifies for designation as an MUA/P
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HPSA Find Website
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HPSA Find Website
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HPSA Find Website
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HPSA Find Website
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State Primary Care Offices: PCOs

HRSA-PCO Cooperative Agreement addresses the needs of underserved areas and
populations

Coordinate and oversee HPSA and MUA/P needs assessment and application process

Pending FY 14 Competing Continuation Funding Opportunity Announcement

Retain its historic focus to support states and territories in:
1. their statewide primary care needs assessments
2. shortage designation coordination
3. technical assistance and collaborations that seek expand access to primary care

FOA will strongly encourage needs assessments be based on pre-defined Rational Service
Area plans or Primary Care Service Areas (PCSAs) and serve as the basis for shortage
designation applications

Discussion of past and/or future plans to coordinate the collection of provider data with
all licensing boards for health professionals in the state or other appropriate organizations
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How Shortage Designations are used
National Health
Shortage Designation Option
Service Corps
Federally
Qualified Health
Center Program
CMS
Medicare
Incentive
Payment
CMS Rural
Health Clinic
Program
J-1 Visa
Waiver
X
X
X
Primary Care HPSA
X
Dental Care HPSA
X
Mental Health HPSA
X
X
Geographic HPSA
X
X
Population HPSA
X
Facility HPSA
X
X
X
X
X
X
Exceptional MUP
X
Medically Underserved Area
X
Medically Underserved
Population
State Governor's Certified
Shortage Area
X
X
X
X
X
X
X
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Division of Policy and
Shortage Designation
CAPT Phil Budashewitz, Director:
[email protected]
301-443-1372
Q&A