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400 R Street, Suite 330
Sacramento, CA 95811-6213
Phone: (916) 326-3700
Fax: (916) 322-2588
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Healthcare Workforce Development Division
Shortage Designation Program FAQs
Frequently Asked Questions:
- What is an Automatic Facility HPSA Designation?
- How is an Automatic Designation different from the conventional process?
- Is there a drawback to Automatic Designation?
- Are facilities with Automatic Designation eligible for all of the same program assistance as sites with a conventional HPSA score?
- How do HPSA scores affect a practice site's personnel recruitment or funding?
- What scores should NHSC Scholarship Program participants look for when researching placement opportunities?
- How do HPSA scores affect Federal Loan Repayment Programs?
- I think our site qualifies for Automatic Designation. Whom do we contact?
- I received an Automatic Facility HPSA Designation under the Health Care Safety Amendments of 2002. How long does the designation last?
- What happens when the Automatic Designation expires?
- Are language barriers for linguistically isolated groups examined to demonstrate need?
- I heard there are new designation criteria that will be replacing the current criteria. When will they be in effect?
- How will the new criteria affect current designations?
- How do I find out what my census tract is?
- How do I get verification of MUA/MUP status for the Expanded Access to Primary Care (EAPC) grant application?
- What are the benefits of a MUA/MUP?
- How do I apply for a MUA/MUP?
- What are the benefits of a HPSA?
- How do I apply for a HPSA (Primary Care, Dental, and Mental Health)?
- What is an MSSA?
- How many MSSAs are there in California?
- What MSSA am I located in?
- How do I find out if a MSSA is HPSA designated?
- Can I get a map of different counties or MSSAs?
- How do I conduct a physician survey?
- How do I find my demographic & socioeconomic data?
- How do I calculate my provider to population ratio?
- How do I find out the low-birth weight data for a Primary Care HPSA?
- Does the total civilian population include Migrant Farmworkers?
- Are State Correctional Facilities eligible for HPSA designations?
- What types of State Correctional Facilities are eligible for designation?
Q1. What is an Automatic Facility HPSA Designation?
A. The federal government grants a temporary HPSA designation to HRSA funded clinics and health centers that agree to provide care to patients regardless of their ability to pay. Automatic Designation allows the provider sites to recruit NHSC scholars and Loan Repayment recipients and other types of federal assistance.
Q2. How is an Automatic Designation different from the conventional process?
A. Automatic designation is not obtained through a formal application process. You and your satellite sites are eligible as long as you are a HRSA funded or Rural Health Clinic site as described in the Heath Care Safety Net Amendments. To access these amendments, please visit the following Web site: http://bhpr.hrsa.gov/shortage/autoscore.htm.
Q3. Is there a drawback to Automatic Designation?
A. The lack of a detailed analysis determined by a conventional score may not accurately reflect the actual population(s) and medical needs being served and therefore may negatively affect the level and type of assistance for which the practice site qualifies. While it uses similar variables - populations-to-provider ratios, distance/travel time to nearest site, poverty rates, and infant mortality/low birth weight rate - to establish need, it is not site-specific and the automatic score draws from the status of the established, neighboring "parent" site. (For more information go to the federal Bureau of Health Professions at: http://bhpr.hrsa.gov/shortage/autoscore.htm)
Q4. Are facilities with Automatic Designation eligible for all of the same program assistance as sites with a conventional HPSA score?
A. State administered programs, such as State Loan Repayment and Conrad J-1 Visa, do not require a conventional HPSA score for their placements. However, federally administered HRSA programs, such as National Scholars, and Federal Loan Repayment, J1-Visa Waiver, and Ready Responders rely on HPSA scores to prioritize resource allocation and level of assistance.
Q5. How do HPSA scores affect a practice site's personnel recruitment or funding?
A. HRSA administered placement programs, such as the NHSC/Scholarship and Loan Repayment Program, J1 Visa Waiver Program, and NHSC Ready Responders Program all require minimum scores for certain personnel placements. Additionally, higher HPSA scores are prioritized for continued funding, increasing the likelihood that the site can maintain its personnel through ongoing service commitments.
Q6. What scores should NHSC Scholarship Program participants look for when researching placement opportunities?
A. Providing that they are NHSC Scholarship Program participants: Primary care physicians may apply or practice at sites with a Primary Care HPSA score of 14 or higher. (Primary Care includes family medicine, internal medicine, obstetrics/gynecology and pediatrics). Family Nurse Practitioners and Physician Assistants may apply or practice at sites with a minimum Primary Care HPSA score of 13. Certified Nurse Midwives may apply or practice at sites with a minimum Primary Care HPSA score of 8. Physician Psychiatrists may apply or practice at sites with a minimum Mental HPSA score of 20. Dentists may apply or practice at sites with a minimum Dental HPSA score of 20.
Q7. How do HPSA scores affect Federal Loan Repayment Programs?
A. HPSA scores determine the funding priorities and longevity for ongoing NSHC/LRP awards. Clinician applications for Primary Care, Dental, and Mental HPSA sites with scores of 14 and higher receive priority for ongoing support over HPSA sites with scores of 13 or lower. HPSAs with scores of 13 or lower are awarded in descending order, until available funds are exhausted.
Q8. I think our site qualifies for Automatic Designation. Whom do we contact?
A. Send your written request that includes your site's name and physical address, Uniform Data System # of the corporate site, and all of the corporate satellite site addresses to:
Andy Jordan, Chief
Shortage Designation Branch
Office of Workforce Evaluation and Quality Assurance
Bureau of Health Professions
Parklawn Building, Room 8A-08
5600 Fishers Lane
Rockville, MD 20857
Phone: 301-594-0816 ajordan@hrsa.gov
Web site: http://bhpr.hrsa.gov/shortage/autoscore.htm
Q9. I received an Automatic Facility HPSA Designation under the Health Care Safety Amendments of 2002. How long does the designation last?
A. All Automatic Facility HPSA designations expire 6 years from the initial designation date. For example, if an automatic designation began on October of 2003, the designation will end in October of 2009.
Q10. What happens when the Automatic Designation expires?
A. Sites will have to reapply through the conventional process. Sites may have to contact the state's Primary Care Office (PCO) at (916) 326-3732 or (916) 326-3733 or (916) 326-3734 or (916) 326-3782 for Technical Assistance.
Q11. Are language barriers for linguistically isolated groups examined to demonstrate need?
A. No. There are no provisions to demonstrate the inaccessibility of linguistically isolated groups as a barrier to healthcare access for a Geographic or low-income population designation.
Q12. I heard there are new designation criteria that will be replacing the current criteria. When will they be in effect?
A. No effective date has been announced as of December 1, 2005. Once authorized and adopted, the Federal Register publishes revised regulations as a Public Notice.
Q13. How will the new criteria affect current designations?
A. HPSA designations are updated every three years and stay in effect until the new regulations are implemented. It is anticipated there will be a phase-in period to update data conforming to new criteria (including MUAs/MUPs).
Q14. How do I find out what my census tract is?
A. Before you verify whether your clinic site is in a HPSA, begin by matching the physical address to a census tract using the following Web site: http://www.ffiec.gov/Geocode/default.aspx. To match your address to a census tract displayed on a map, please use the following U.S. Census Bureau site: http://factfinder.census.gov/home/saff/main.html?_lang=en - Click on the "Street Address" link in the white "Address Search" box then enter a street address to find Census 2000 data.
Q15. How do I get verification of MUA/MUP status for the Expanded Access to Primary Care (EAPC) grant application?
A. Visit the following Web site http://www.muafind.hrsa.gov/ and enter in the appropriate county information and search for your census tract number or MSSA. A copy of the MUA/MUP list is sufficient verification of MUA/MUP status.
Q16. What are the benefits of a MUA/MUP?
A. The major benefits are: 1) qualify to apply for Section 330 Federal Grant for New Start and Expansion of community health clinics, and 2) eligibility to apply for a Rural Health Clinic Certification for prospective payment method.
Q17. How do I apply for a MUA/MUP?
A. Visit the Shortage Designation Web site for instructions: http://www.oshpd.ca.gov/HWCDD/cooperative/Process.htm - for further information on this process, the PCO may be contacted at (916) 326-3732 or (916) 326-3733 or (916) 326-3734 or (916) 326-3782.
Q18. What are the benefits of a HPSA?
A. For a Geographic HPSA, you qualify for the 10% Medicare incentive payment for Physician Services and recruitment and retention for providers through the NHSC/Scholar Placement and Loan Repayment Programs, NHSC/State Loan Repayment Program (SLRP), and through the California Health Professions Education Foundation's Scholarship and Loan Repayment Programs (www.healthprofessions.ca.gov).
Q19. How do I apply for a HPSA (Primary Care, Dental, and Mental Health)?
A. Contact the PCO at (916) 326-3732 or (916) 326-3733, and they will provide you with federal guidelines, 2005 Claritas population data, Maps, Worksheets, and a sample of a provider list survey.
Q20. What is an MSSA?
A. Each MSSA is composed of one or more complete census tracts. As a general rule, MSSAs are recognized by the Federal Shortage Designation Branch to be "rational service areas (RSAs)" for purposes of designating health professional shortage areas (HPSAs), medically underserved areas (MUAs) or medically underserved populations (MUPs).
Q21. How many MSSAs are there in California?
A. 541 total: 56 Frontier, 299 Urban, and 186 Rural.
Q22. What MSSA am I located in?
A. 1) Provide the physical address to identify the census tract using the following Web site: http://www.ffiec.gov/Geocode/default.aspx, and 2) contact the Shortage Designation Program at (916) 326-3732 or (916) 326-3733 for detailed instructions.
Q23. How do I find out if a MSSA is HPSA designated?
A. After locating the site's census tract, visit the Federal Bureau of Health Professions site: http://bhpr.hrsa.gov/shortage/ to see if the site is located in a Health Professional Shortage Area (HPSA). Select the "Search the HPSA data base (updated weekly)" link, then choose the "Advanced search by HPSA Type, Score, Metro, and Status" link. Now begin your query choosing the appropriate State, County, Discipline, and for "status," select "Designated". Once you have entered all of your data, click on the "Show me the HPSAs" button on the bottom of the page.
Q24. Can I get a map of different counties or MSSAs?
A. Yes, maps are available by request at (916) 326-3732 or (916) 326-3733 or (916) 326-3782 or (916) 326-3734.
Q25. How do I conduct a physician survey?
A. Use the Switchboard Web site to locate physicians in your MSSA: http://cobrand.switchboard.com
Q26. How do I find my demographic & socioeconomic data?
A. Download and save the "Medical Service Study Area (MSSA) Census Tract Detail" document at: http://gis.ca.gov/catalog/BrowseCatalog.epl?id=1044 - the file will download as a Zip and is available in Access once the file is Unzipped.
Q27. How do I calculate my population to provider ratio?
A. 40 hours equals 1 Full-Time Equivalent (FTE). Find the total number of FTEs for the area you are researching by conducting a provider survey and divide the total population by the FTEs to get population to provider ratio.
Q28. How do I find out the low-birth weight data for a Primary Care HPSA?
A. Use the following Web site to find out the low birth weight for your county: http://www.cfpa.net/ - go to the white box on the bottom of the page and enter your county name. The first link given should be "County Nutrition Profile," and you will find all appropriate data on this site.
Q29. Does the total civilian population include Migrant Farmworkers?
A. No, the civilian population does not include Migrant Farmworkers and excludes the non-institutionalized population.
Q30. Are State Correctional Facilities eligible for HPSA designations?
A. Yes, Primary Care, Dental, and Mental Facility HPSAs.
Q31: What types of State Correctional Facilities are eligible for designation?
A: The Facility must be medium and maximum security to qualify. Exceptions to this rule have previously been made if supported by a reasonable argument, with arguments being evaluated on a case-by-case basis.