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| Links 2/29/08 Federal Register Proposed Changes 4/21/08 Federal Register clarifications National Rural Health Association (NRHA) Regulatory Guide: HPSA/MUP Methodology Powerpoint we did at May, 2008 NRHA conference NRHA response California State Rural Health Association Letter Memo we wrote for CARHC Where you can submit public comments 4/18/08 OSHPD meeting materials Further OSHPD Analysis and Response to HRSA |
On February 29th, 2008, the Federal Register published long-awaited changes to
the current system of designating primary care Health Professional Shortage Areas
(HPSAS), Medically Underserved Areas (MUAs) and Medically Underserved
Populations (MUPs). The Federally Qualified Health Center (FQHC) and National
Health Service Corps (NHSC) programs, among others, use these designations to
allocate scarce resources.
HPSA, MUA and MUP designations will remain but the proposed changes will
designate communities using an Index of Primary Care Underservice (IPCU). The
main differences between the current and proposed systems is that weighted
midlevel time will be counted; age and gender demographics will be weighed to
determine the “barrier-free” population-to-provider ratio; population density, death
rate, unemployment rate, non-white population percentage, Hispanic population
percentage and percentage of population over age 65 will all be added and the
distance from the nearest source of accessible care will no longer be counted.
There will also be Tier 1 and Tier 2 designations that count (or not) federally-
sponsored primary care providers like NHSC, J-1 Visa holders and FQHC staff.
In addition, the Health Resources and Services Administration (HRSA) will
automatically designate HPSAs/MUAs/MUPs and allow for a state and community
appeal process. The current system is more responsive and less proactive.
This page is meant to serve as a reference for the impact of those changes on
California.
the current system of designating primary care Health Professional Shortage Areas
(HPSAS), Medically Underserved Areas (MUAs) and Medically Underserved
Populations (MUPs). The Federally Qualified Health Center (FQHC) and National
Health Service Corps (NHSC) programs, among others, use these designations to
allocate scarce resources.
HPSA, MUA and MUP designations will remain but the proposed changes will
designate communities using an Index of Primary Care Underservice (IPCU). The
main differences between the current and proposed systems is that weighted
midlevel time will be counted; age and gender demographics will be weighed to
determine the “barrier-free” population-to-provider ratio; population density, death
rate, unemployment rate, non-white population percentage, Hispanic population
percentage and percentage of population over age 65 will all be added and the
distance from the nearest source of accessible care will no longer be counted.
There will also be Tier 1 and Tier 2 designations that count (or not) federally-
sponsored primary care providers like NHSC, J-1 Visa holders and FQHC staff.
In addition, the Health Resources and Services Administration (HRSA) will
automatically designate HPSAs/MUAs/MUPs and allow for a state and community
appeal process. The current system is more responsive and less proactive.
This page is meant to serve as a reference for the impact of those changes on
California.