State Office of Rural Health Orientation Meeting Rockville Maryland September 11 2013 Become familiar Shortage Designation Branch Gain an understanding of Shortage Designation Types Gain an understanding of ID: 721092
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Shortage Designation Update
State Office of Rural Health Orientation Meeting
Rockville, Maryland
September 11, 2013Slide2
Become familiar Shortage Designation BranchGain an understanding of Shortage Designation Types
Gain an understanding of Shortage Partners and Stakeholders Objectives2Slide3
3
Organizational Structure
October 2012, Shortage Designation Function Transferred to BCRS
Increased alignment with National Health Service Corps and NURSE Corps Scholarship and Loan Repayment ProgramsSlide4
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 333Division of Policy and Shortage Designation 4Slide5
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 professionalsThere are three categories of HPSAs based on health
discipline:primary medical caredentalmental healthFor each discipline category, there are three types of HPSAsgeographic areapopulation groupfacilityThe 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 basisHPSA Designations:Health
Discipline Shortages5Slide6
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 facilityThis legislation created “Automatic Facility (Auto) HPSAs”Auto HPSAs are automatically designated by statuteAuto HPSAs are manually scored by the BCRS Shortage Designation BranchAutomatic Health Professional Shortage Area (HPSA) Statute6Slide7
Federal Indian Health Service ClinicsTribally-run Health Clinics
Urban Indian Health ClinicsDual-funded Community Health Centers/Tribal Health ClinicsEntities Covered under Auto HPSA Statute 7
Certified Rural Health Clinics (RHCs) meeting NHSC-Site RequirementFederally Qualified Health Centers/Community Health Centers FQHC Look-A-Likes (LALs)Slide8
Primary Care Medical Geographic HPSAPrimary Care Medical Population-Group HPSA
Medically Underserved Area Governor-designated and Secretary-certified shortage areaShortage Designations and Medicare Certification as a Rural Health Clinic 8Slide9
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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.Slide10
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 caseAuto HPSA Scores are not required to be updated and only updated on requestAuto HPSA Scores10Slide11
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 servicesMUPs may include groups of persons who face economic, cultural or linguistic barriers leading to a shortage of personal health servicesMUA/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 populationinfant mortality ratepercentage of the population with incomes below the poverty levelpercentage of the population age 65 or overAn IMU
of 62.0 or less qualifies for designation as an MUA/PMUAs/PsHealth Services Shortages11Slide12
HPSA Find Website12Slide13
HPSA Find Website13Slide14
HPSA Find Website14Slide15
HPSA Find Website15Slide16
HRSA-PCO Cooperative Agreement addresses the needs of underserved areas and populations
Coordinate and oversee HPSA and MUA/P needs assessment and application processPending FY 14 Competing Continuation Funding Opportunity AnnouncementRetain its historic focus to support states and territories in:their statewide primary care needs assessmentsshortage designation coordinationtechnical assistance and collaborations that seek expand access to primary
careFOA 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 applicationsDiscussion 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 organizationsState Primary Care Offices: PCOs16Slide17
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How Shortage Designations are used
Shortage Designation OptionNational Health Service CorpsFederally Qualified Health Center Program
CMS Medicare Incentive PaymentCMS Rural Health Clinic ProgramJ-1 Visa Waiver
Primary Care HPSA
X
X
X
X
Dental Care HPSA
X
Mental Health HPSA
X
X
X
Geographic HPSA
X
X
X
X
Population HPSA
X
X
X
Facility HPSA
X
X
Exceptional MUP
X
X
Medically Underserved Area
X
X
X
Medically Underserved Population
X
X
State Governor's Certified Shortage Area
X
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Division of Policy and Shortage
DesignationCAPT Phil Budashewitz, Director: pbudashewitz@hrsa.gov301-443-1372Slide19
Q&A