80_FR_37763 80 FR 37637 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas

80 FR 37637 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration

Federal Register Volume 80, Issue 126 (July 1, 2015)

Page Range37637-37638
FR Document2015-16168

This notice advises the public of the published lists of all geographic areas, population groups, and facilities designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of May 29, 2015, available on the Health Resources and Services Administration (HRSA) Web site at http:// www.hrsa.gov/shortage/. HPSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 332 of the Public Health Service (PHS) Act and 42 CFR part 5.

Federal Register, Volume 80 Issue 126 (Wednesday, July 1, 2015)
[Federal Register Volume 80, Number 126 (Wednesday, July 1, 2015)]
[Notices]
[Pages 37637-37638]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-16168]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Lists of Designated Primary Medical Care, Mental Health, and 
Dental Health Professional Shortage Areas

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: This notice advises the public of the published lists of all 
geographic areas, population groups, and facilities designated as 
primary medical care, mental health, and dental health professional 
shortage areas (HPSAs) as of May 29, 2015, available on the Health 
Resources and Services Administration (HRSA) Web site at http://www.hrsa.gov/shortage/. HPSAs are designated or withdrawn by the 
Secretary of Health and Human Services (HHS) under the authority of 
section 332 of the Public Health Service (PHS) Act and 42 CFR part 5.

FOR FURTHER INFORMATION CONTACT: Requests for further information on 
the HPSA designations listed on the HRSA Web site and requests for 
additional designations, withdrawals, or reapplication for designations 
should be submitted to Kae Brickerd, Ph.D., Director, Shortage 
Designation Branch, Division of Policy and Shortage Designation, Bureau 
of Health Workforce, Health Resources and Services Administration, Mail 
Stop 11SWH03, Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 
20857, (301) 594-5168.

SUPPLEMENTARY INFORMATION: 

Background

    Section 332 of the PHS Act, 42 U.S.C. 254e, provides that the 
Secretary of HHS shall designate HPSAs based on criteria established by 
regulation. HPSAs are defined in section 332 to include (1) urban and 
rural geographic areas with shortages of health professionals, (2) 
population groups with such shortages, and (3) facilities with such 
shortages. Section 332 further requires that the Secretary annually 
publish a list of the designated geographic areas, population groups, 
and facilities. The lists of HPSAs are to be reviewed at least annually 
and revised as necessary. HRSA's Bureau of Health Workforce (BHW) has 
the responsibility for designating and updating HPSAs.
    Public or private nonprofit entities are eligible to apply for 
assignment of National Health Service Corps (NHSC) personnel to provide 
primary care, mental, or dental health services in or to these HPSAs. 
NHSC health professionals with a service obligation may enter into 
service agreements to serve only in federally designated HPSAs. 
Entities with clinical training sites located in HPSAs are eligible to 
receive priority for certain residency training program grants 
administered by the BHW. Many other federal programs also utilize HPSA 
designations. For example, under authorities administered by the 
Centers for Medicare and Medicaid Services, certain qualified providers 
in geographic area HPSAs are eligible for increased levels of Medicare 
reimbursement.

Development of the Designation and Withdrawal Lists

    Criteria for designating HPSAs were published as final regulations 
(42 CFR part 5) in 1980. Criteria then were defined for each of seven 
health professional types (primary medical care, dental, psychiatric, 
vision care, podiatric, pharmacy, and veterinary care). The criteria 
for correctional facility HPSAs were revised and published on March 2, 
1989 (54 FR 8735). The criteria for psychiatric HPSAs were expanded to 
mental health HPSAs on January 22, 1992 (57 FR 2473). Currently funded 
PHS Act programs use only the primary medical care, mental health, or 
dental HPSA designations.
    Individual requests for designation or withdrawal of a particular 
geographic area, population group, or a facility as a HPSA are received 
and reviewed continuously by BHW. The majority of the requests come 
from the Primary Care Offices (PCO) in the State Health Departments, 
who have access to the on-line application and review system. Requests 
that come from other sources are referred to the PCOs for their review 
and concurrence. In addition, interested parties, including the 
Governor, the State Primary Care Association and state professional 
associations are notified of each request submitted for their comments 
and recommendations.

[[Page 37638]]

    Annually, lists of designated HPSAs are made available to all PCOs, 
state medical and dental societies and others, with a request to review 
and update the data on which the designations are based. Emphasis is 
placed on updating those designations that are more than 3 years old or 
where significant changes relevant to the designation criteria have 
occurred.
    Recommendations for possible additions, continuations, revisions, 
or withdrawals from a HPSA list are reviewed by BHW, and the review 
findings are provided by letter to the agency or individual requesting 
action or providing data, with copies to other interested organizations 
and individuals. These letters constitute the official notice of 
designation as a HPSA, rejection of recommendations for HPSA 
designation, revision of a HPSA designation, and/or advance notice of 
pending withdrawals from the HPSA list. Designations (or revisions of 
designations) are effective as of the date on the notification letter 
from BHW. Proposed withdrawals become effective only after interested 
parties in the area affected have been afforded the opportunity to 
submit additional information to BHW in support of its continued or 
revised designation. If no new data are submitted, or if BHW review 
confirms the proposed withdrawal, the withdrawal becomes effective upon 
publication of the lists of designated HPSAs in the Federal Register. 
In addition, lists of HPSAs are updated daily on the HRSA Web site at 
http://www.hrsa.gov/shortage/, so that interested parties can access 
the most accurate and timely information.

Publication and Format of Lists

    Due to the large volume of designations, a printed version of the 
list is no longer distributed. This notice serves to inform the public 
of the availability of the complete listings of designated HPSA on the 
HRSA Web site. The three lists (primary medical care, mental health, 
and dental) of designated HPSAs are available at a link on the HRSA Web 
site at http://www.hrsa.gov/shortage/ and include a snapshot of all 
geographic areas, population groups, and facilities that were 
designated HPSAs as of May 29, 2015. This notice incorporates the most 
recent annual reviews of designated HPSAs and supersedes the HPSA lists 
published in the Federal Register on June 25, 2014 (Federal Register/
Vol. 79, No. 122/Wednesday, June 25, 2014/Notices 36075). The lists 
also include automatic facility HPSAs, designated as a result of the 
Health Care Safety Net Amendments of 2002 (Pub. L. 107-251), not 
subject to update requirements. Each list of designated HPSAs (primary 
medical care, mental health, and dental) is arranged by state. Within 
each state, the list is presented by county. If only a portion (or 
portions) of a county is (are) designated, or if the county is part of 
a larger designated service area, or if a population group residing in 
the county or a facility located in the county has been designated, the 
name of the service area, population group, or facility involved is 
listed under the county name. Counties that have a whole county 
geographic HPSA are indicated by the ``Entire county HPSA'' notation 
following the county name. Further details on the snapshot of HPSAs 
listed can be found on the HRSA Web site at http://www.hrsa.gov/shortage/.
    In addition to the specific listings included in this notice, all 
Indian Tribes that meet the definition of such Tribes in the Indian 
Health Care Improvement Act of 1976, 25 U.S.C. 1603(d), are 
automatically designated as population groups with primary medical care 
and dental health professional shortages. The Health Care Safety Net 
Amendments of 2002 also made the following entities eligible for 
automatic facility HPSA designations: All federally qualified health 
centers (FQHCs) and rural health clinics that offer services regardless 
of ability to pay. These entities include: FQHCs funded under section 
330 of the PHS Act, FQHC Look-Alikes, and Tribal and urban Indian 
clinics operating under the Indian Self-Determination and Education Act 
of 1975 (25 U.S.C. 450) or the Indian Health Care Improvement Act. 
Many, but not all, of these entities are included on this listing. 
Exclusion from this list does not exclude them from HPSA designation; 
any facilities eligible for automatic designation will be included in 
the database as they are identified.

Future Updates of Lists of Designated HPSAs

    The lists of HPSAs on the HRSA Web site consist of all those that 
were designated as of May 29, 2015. It should be noted that HPSAs are 
currently updated on an ongoing basis based on the identification of 
new areas, population groups, facilities, and sites that meet the 
eligibility criteria or that no longer meet eligibility criteria and/or 
are being replaced by another type of designation. As such, additional 
HPSAs may have been designated by letter since that date. The 
appropriate agencies and individuals have been or will be notified of 
these actions by letter. These newly designated HPSAs will be included 
in the next publication of the HPSA list and are currently included in 
the daily updates posted on the HRSA Web site at http://www.hrsa.gov/shortage/find.html.
    Any designated HPSA listed on the HRSA Web site is subject to 
withdrawal from designation if new information received and confirmed 
by HRSA indicates that the relevant data for the area involved have 
significantly changed since its designation. The effective date of such 
a withdrawal will be the next publication of a notice regarding this 
list in the Federal Register.
    All requests for new designations, updates, or withdrawals should 
be based on the relevant criteria in regulations published at 42 CFR 
part 5.

Electronic Access Address

    The complete list of HPSAs designated as of May 29, 2015, are 
available on the HRSA Web site at http://www.hrsa.gov/shortage/. 
Frequently updated information on HPSAs is also available at http://datawarehouse.hrsa.gov.

    Dated: June 25, 2015.
James Macrae,
Acting Administrator.
[FR Doc. 2015-16168 Filed 6-30-15; 8:45 am]
BILLING CODE 4165-15-P



                                                                                      Federal Register / Vol. 80, No. 126 / Wednesday, July 1, 2015 / Notices                                                                                              37637

                                              are also subject to state laws and                                           Based on the number of 351(k)                                             into account, among other things, the
                                              regulations. Under the BPCI Act, a                                         applications FDA received through FY                                        expiration dates of patents that relate to
                                              biological product that has been                                           2014, we estimate that we will receive                                      potential reference products and general
                                              approved as an ‘‘interchangeable’’ may                                     approximately five 351(k) applications                                      market interest in biological products
                                              be substituted for the reference product                                   annually. The number of respondents                                         that could be candidates for 351(k)
                                              without the intervention of the health                                     submitting 351(k) applications is based                                     applications.
                                              care provider who prescribed the                                           on the number of sponsors submitting
                                                                                                                                                                                                       FDA estimates the burden of this
                                              reference product.                                                         351(k) applications through FY 2014. In
                                                                                                                         making these estimates, FDA has taken                                       collection of information as follows:

                                                                                                            TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN 1
                                                                                                                                                                        Number of                                                Average
                                                                                                                                             Number of                                            Total annual
                                                             351(k) Applications (42 U.S.C. 262(k))                                                                   responses per                                            burden per              Total hours
                                                                                                                                            respondents                                            responses
                                                                                                                                                                        respondent                                              response

                                              351(k)(2)(A)(i) and 351(k)(2)(A)(iii) Biosimilar Product Ap-
                                                plications ...........................................................................                          5                          1                           5                      860             4,300
                                              351(k)(2)(B) and (k)(4) Interchangeable Product Applica-
                                                tions or Supplements .......................................................                                     2                          1                         2                       860             1,720
                                              351(l)(6)(C) Patent Infringement Notifications .....................                                               5                          1                         5                         2                10

                                                    Total ..............................................................................   ........................   ........................   ........................   ........................          6,030
                                                 1 There     are no capital costs or operating and maintenance costs associated with this collection of information.


                                                Dated: June 25, 2015.                                                    Division of Policy and Shortage                                             administered by the Centers for
                                              Leslie Kux,                                                                Designation, Bureau of Health                                               Medicare and Medicaid Services,
                                              Associate Commissioner for Policy.                                         Workforce, Health Resources and                                             certain qualified providers in
                                              [FR Doc. 2015–16128 Filed 6–30–15; 8:45 am]                                Services Administration, Mail Stop                                          geographic area HPSAs are eligible for
                                              BILLING CODE 4164–01–P
                                                                                                                         11SWH03, Parklawn Building, 5600                                            increased levels of Medicare
                                                                                                                         Fishers Lane, Rockville, Maryland                                           reimbursement.
                                                                                                                         20857, (301) 594–5168.
                                                                                                                                                                                                     Development of the Designation and
                                              DEPARTMENT OF HEALTH AND                                                   SUPPLEMENTARY INFORMATION:
                                                                                                                                                                                                     Withdrawal Lists
                                              HUMAN SERVICES                                                             Background
                                                                                                                                                                                                        Criteria for designating HPSAs were
                                              Health Resources and Services                                                 Section 332 of the PHS Act, 42 U.S.C.                                    published as final regulations (42 CFR
                                              Administration                                                             254e, provides that the Secretary of HHS                                    part 5) in 1980. Criteria then were
                                                                                                                         shall designate HPSAs based on criteria
                                              Lists of Designated Primary Medical                                                                                                                    defined for each of seven health
                                                                                                                         established by regulation. HPSAs are
                                              Care, Mental Health, and Dental Health                                                                                                                 professional types (primary medical
                                                                                                                         defined in section 332 to include (1)
                                              Professional Shortage Areas                                                                                                                            care, dental, psychiatric, vision care,
                                                                                                                         urban and rural geographic areas with
                                                                                                                                                                                                     podiatric, pharmacy, and veterinary
                                                                                                                         shortages of health professionals, (2)
                                              AGENCY: Health Resources and Services                                                                                                                  care). The criteria for correctional
                                                                                                                         population groups with such shortages,
                                              Administration, HHS.                                                                                                                                   facility HPSAs were revised and
                                                                                                                         and (3) facilities with such shortages.
                                              ACTION: Notice.                                                                                                                                        published on March 2, 1989 (54 FR
                                                                                                                         Section 332 further requires that the
                                                                                                                                                                                                     8735). The criteria for psychiatric
                                                                                                                         Secretary annually publish a list of the
                                              SUMMARY:   This notice advises the public                                                                                                              HPSAs were expanded to mental health
                                                                                                                         designated geographic areas, population
                                              of the published lists of all geographic                                   groups, and facilities. The lists of                                        HPSAs on January 22, 1992 (57 FR
                                              areas, population groups, and facilities                                   HPSAs are to be reviewed at least                                           2473). Currently funded PHS Act
                                              designated as primary medical care,                                        annually and revised as necessary.                                          programs use only the primary medical
                                              mental health, and dental health                                           HRSA’s Bureau of Health Workforce                                           care, mental health, or dental HPSA
                                              professional shortage areas (HPSAs) as                                     (BHW) has the responsibility for                                            designations.
                                              of May 29, 2015, available on the Health                                   designating and updating HPSAs.                                                Individual requests for designation or
                                              Resources and Services Administration                                         Public or private nonprofit entities are                                 withdrawal of a particular geographic
                                              (HRSA) Web site at http://                                                 eligible to apply for assignment of                                         area, population group, or a facility as
                                              www.hrsa.gov/shortage/. HPSAs are                                          National Health Service Corps (NHSC)                                        a HPSA are received and reviewed
                                              designated or withdrawn by the                                             personnel to provide primary care,                                          continuously by BHW. The majority of
                                              Secretary of Health and Human Services                                     mental, or dental health services in or                                     the requests come from the Primary Care
                                              (HHS) under the authority of section                                       to these HPSAs. NHSC health                                                 Offices (PCO) in the State Health
                                              332 of the Public Health Service (PHS)                                     professionals with a service obligation                                     Departments, who have access to the on-
                                              Act and 42 CFR part 5.                                                     may enter into service agreements to                                        line application and review system.
                                              FOR FURTHER INFORMATION CONTACT:                                           serve only in federally designated                                          Requests that come from other sources
tkelley on DSK3SPTVN1PROD with NOTICES




                                              Requests for further information on the                                    HPSAs. Entities with clinical training                                      are referred to the PCOs for their review
                                              HPSA designations listed on the HRSA                                       sites located in HPSAs are eligible to                                      and concurrence. In addition, interested
                                              Web site and requests for additional                                       receive priority for certain residency                                      parties, including the Governor, the
                                              designations, withdrawals, or                                              training program grants administered by                                     State Primary Care Association and state
                                              reapplication for designations should be                                   the BHW. Many other federal programs                                        professional associations are notified of
                                              submitted to Kae Brickerd, Ph.D.,                                          also utilize HPSA designations. For                                         each request submitted for their
                                              Director, Shortage Designation Branch,                                     example, under authorities                                                  comments and recommendations.


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                                              37638                         Federal Register / Vol. 80, No. 126 / Wednesday, July 1, 2015 / Notices

                                                 Annually, lists of designated HPSAs                  not subject to update requirements.                    of the HPSA list and are currently
                                              are made available to all PCOs, state                   Each list of designated HPSAs (primary                 included in the daily updates posted on
                                              medical and dental societies and others,                medical care, mental health, and dental)               the HRSA Web site at http://
                                              with a request to review and update the                 is arranged by state. Within each state,               www.hrsa.gov/shortage/find.html.
                                              data on which the designations are                      the list is presented by county. If only                  Any designated HPSA listed on the
                                              based. Emphasis is placed on updating                   a portion (or portions) of a county is                 HRSA Web site is subject to withdrawal
                                              those designations that are more than 3                 (are) designated, or if the county is part             from designation if new information
                                              years old or where significant changes                  of a larger designated service area, or if             received and confirmed by HRSA
                                              relevant to the designation criteria have               a population group residing in the                     indicates that the relevant data for the
                                              occurred.                                               county or a facility located in the county             area involved have significantly
                                                 Recommendations for possible                         has been designated, the name of the                   changed since its designation. The
                                              additions, continuations, revisions, or                 service area, population group, or                     effective date of such a withdrawal will
                                              withdrawals from a HPSA list are                        facility involved is listed under the                  be the next publication of a notice
                                              reviewed by BHW, and the review                         county name. Counties that have a                      regarding this list in the Federal
                                              findings are provided by letter to the                  whole county geographic HPSA are                       Register.
                                              agency or individual requesting action                  indicated by the ‘‘Entire county HPSA’’                   All requests for new designations,
                                              or providing data, with copies to other                 notation following the county name.                    updates, or withdrawals should be
                                              interested organizations and                            Further details on the snapshot of                     based on the relevant criteria in
                                              individuals. These letters constitute the               HPSAs listed can be found on the HRSA                  regulations published at 42 CFR part 5.
                                              official notice of designation as a HPSA,               Web site at http://www.hrsa.gov/
                                              rejection of recommendations for HPSA                                                                          Electronic Access Address
                                                                                                      shortage/.
                                              designation, revision of a HPSA                            In addition to the specific listings                  The complete list of HPSAs
                                              designation, and/or advance notice of                   included in this notice, all Indian Tribes             designated as of May 29, 2015, are
                                              pending withdrawals from the HPSA                       that meet the definition of such Tribes                available on the HRSA Web site at
                                              list. Designations (or revisions of                     in the Indian Health Care Improvement                  http://www.hrsa.gov/shortage/.
                                              designations) are effective as of the date              Act of 1976, 25 U.S.C. 1603(d), are                    Frequently updated information on
                                              on the notification letter from BHW.                    automatically designated as population                 HPSAs is also available at http://
                                              Proposed withdrawals become effective                   groups with primary medical care and                   datawarehouse.hrsa.gov.
                                              only after interested parties in the area               dental health professional shortages.                    Dated: June 25, 2015.
                                              affected have been afforded the                         The Health Care Safety Net                             James Macrae,
                                              opportunity to submit additional                        Amendments of 2002 also made the
                                                                                                                                                             Acting Administrator.
                                              information to BHW in support of its                    following entities eligible for automatic
                                                                                                                                                             [FR Doc. 2015–16168 Filed 6–30–15; 8:45 am]
                                              continued or revised designation. If no                 facility HPSA designations: All federally
                                                                                                                                                             BILLING CODE 4165–15–P
                                              new data are submitted, or if BHW                       qualified health centers (FQHCs) and
                                              review confirms the proposed                            rural health clinics that offer services
                                              withdrawal, the withdrawal becomes                      regardless of ability to pay. These
                                                                                                                                                             DEPARTMENT OF HEALTH AND
                                              effective upon publication of the lists of              entities include: FQHCs funded under
                                                                                                                                                             HUMAN SERVICES
                                              designated HPSAs in the Federal                         section 330 of the PHS Act, FQHC Look-
                                              Register. In addition, lists of HPSAs are               Alikes, and Tribal and urban Indian                    Health Resources and Services
                                              updated daily on the HRSA Web site at                   clinics operating under the Indian Self-               Administration
                                              http://www.hrsa.gov/shortage/, so that                  Determination and Education Act of
                                              interested parties can access the most                  1975 (25 U.S.C. 450) or the Indian                     Agency Information Collection
                                              accurate and timely information.                        Health Care Improvement Act. Many,                     Activities: Submission to OMB for
                                                                                                      but not all, of these entities are included            Review and Approval; Public Comment
                                              Publication and Format of Lists
                                                                                                      on this listing. Exclusion from this list              Request
                                                 Due to the large volume of                           does not exclude them from HPSA
                                              designations, a printed version of the                  designation; any facilities eligible for               AGENCY: Health Resources and Services
                                              list is no longer distributed. This notice              automatic designation will be included                 Administration, HHS.
                                              serves to inform the public of the                      in the database as they are identified.                ACTION: Notice.
                                              availability of the complete listings of
                                              designated HPSA on the HRSA Web                         Future Updates of Lists of Designated                  SUMMARY:   In compliance with Section
                                              site. The three lists (primary medical                  HPSAs                                                  3507(a)(1)(D) of the Paperwork
                                              care, mental health, and dental) of                        The lists of HPSAs on the HRSA Web                  Reduction Act of 1995, the Health
                                              designated HPSAs are available at a link                site consist of all those that were                    Resources and Services Administration
                                              on the HRSA Web site at http://                         designated as of May 29, 2015. It should               (HRSA) has submitted an Information
                                              www.hrsa.gov/shortage/ and include a                    be noted that HPSAs are currently                      Collection Request (ICR) to the Office of
                                              snapshot of all geographic areas,                       updated on an ongoing basis based on                   Management and Budget (OMB) for
                                              population groups, and facilities that                  the identification of new areas,                       review and approval. Comments
                                              were designated HPSAs as of May 29,                     population groups, facilities, and sites               submitted during the first public review
                                              2015. This notice incorporates the most                 that meet the eligibility criteria or that             of this ICR will be provided to OMB.
                                              recent annual reviews of designated                     no longer meet eligibility criteria and/or             OMB will accept further comments from
                                              HPSAs and supersedes the HPSA lists                     are being replaced by another type of                  the public during the review and
                                                                                                                                                             approval period.
tkelley on DSK3SPTVN1PROD with NOTICES




                                              published in the Federal Register on                    designation. As such, additional HPSAs
                                              June 25, 2014 (Federal Register/Vol. 79,                may have been designated by letter                     DATES: Comments on this ICR should be
                                              No. 122/Wednesday, June 25, 2014/                       since that date. The appropriate                       received no later than July 31, 2015.
                                              Notices 36075). The lists also include                  agencies and individuals have been or                  ADDRESSES: Submit your comments,
                                              automatic facility HPSAs, designated as                 will be notified of these actions by                   including the Information Collection
                                              a result of the Health Care Safety Net                  letter. These newly designated HPSAs                   Request Title, to the desk officer for
                                              Amendments of 2002 (Pub. L. 107–251),                   will be included in the next publication               HRSA, either by email to OIRA_


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Document Created: 2015-12-15 13:18:56
Document Modified: 2015-12-15 13:18:56
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice.
ContactRequests for further information on the HPSA designations listed on the HRSA Web site and requests for additional designations, withdrawals, or reapplication for designations should be submitted to Kae Brickerd, Ph.D., Director, Shortage Designation Branch, Division of Policy and Shortage Designation, Bureau of Health Workforce, Health Resources and Services Administration, Mail Stop 11SWH03, Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857, (301) 594-5168.
FR Citation80 FR 37637 

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