83 FR 30941 - 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 83, Issue 127 (July 2, 2018)

Page Range		30941-30942
FR Document		2018-14115

This notice informs the public of the availability of the complete 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 1, 2018. The lists are available on HRSA's HPSAFind website.

Federal Register, Volume 83 Issue 127 (Monday, July 2, 2018)

[Federal Register Volume 83, Number 127 (Monday, July 2, 2018)]
[Notices]
[Pages 30941-30942]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-14115]


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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 (HRSA), Department 
of Health and Human Services (HHS).

ACTION: Notice.

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SUMMARY: This notice informs the public of the availability of the 
complete lists of all geographic areas, population groups, and 
facilities designated as primary medical care, mental health, and 
dental health professional shortage

[[Page 30942]]

areas (HPSAs) as of May 1, 2018. The lists are available on HRSA's 
HPSAFind website.

ADDRESSES: Complete lists of HPSAs designated as of May 1, 2018, are 
available on the HPSAFind website at https://datawarehouse.hrsa.gov/tools/analyzers/hpsafind.aspx. Frequently updated information on HPSAs 
is available at http://datawarehouse.hrsa.gov. Information on shortage 
designations is available at https://bhw.hrsa.gov/shortage-designation.

FOR FURTHER INFORMATION CONTACT: For further information on the HPSA 
designations listed on the HPSAFind website or to request additional 
designation, withdrawal, or reapplication for designation, please 
contact Melissa Ryan, Acting Director, Division of Policy and Shortage 
Designation, Bureau of Health Workforce, HRSA, 11SWH03, 5600 Fishers 
Lane, Rockville, Maryland 20857, (301) 594-5168 or [email protected].

SUPPLEMENTARY INFORMATION:

Background

    Section 332 of the Public Health Service (PHS) Act, 42 U.S.C. 254e, 
provides that the Secretary 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 lists of the designated geographic areas, 
population groups, and facilities. The lists of HPSAs are to be 
reviewed at least annually and revised as necessary.
    Final regulations (42 CFR part 5) were published in 1980 that 
include the criteria for designating HPSAs. Criteria were defined for 
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.
    HPSA designation offers access to potential federal assistance. 
Public or private nonprofit entities are eligible to apply for 
assignment of National Health Service Corps (NHSC) personnel to provide 
primary medical care, mental health, or dental health services in or to 
these HPSAs. NHSC health professionals enter into service agreements to 
serve 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 HRSA's Bureau of 
Health Workforce (BHW). 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.

Content and Format of Lists

    The three lists of designated HPSAs are available on the HPSAFind 
website and include a snapshot of all geographic areas, population 
groups, and facilities that were designated HPSAs as of May 1, 2018. 
This notice incorporates the most recent annual reviews of designated 
HPSAs and supersedes the HPSA lists published in the Federal Register 
on June 26, 2017 (Federal Register/Vol. 82, No. 121/Monday, June 26, 
2017/Notices 28863).
    In addition, 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. Further, the 
Health Care Safety Net Amendments of 2002 provides eligibility for 
automatic facility HPSA designations for all federally qualified health 
centers (FQHCs) and rural health clinics that offer services regardless 
of ability to pay. Specifically, 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. Absence from this list does not exclude them from HPSA 
designation; facilities eligible for automatic designation are included 
in the database when they are identified.
    Each list of designated HPSAs 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, a county is part of a larger 
designated service area, or a population group residing in a 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. A county that has a whole county geographic HPSA is 
indicated by the phrase ``Entire county HPSA'' following the county 
name.

Development of the Designation and Withdrawal Lists

    Requests for designation or withdrawal of a particular geographic 
area, population group, or a facility as a HPSA are received 
continuously by BHW. Under a Cooperative Agreement between HRSA and the 
54 state and territorial Primary Care Offices (PCOs), PCOs conduct 
needs assessments and submit the majority of the applications to HRSA 
to designate areas as HPSAs. BHW refers requests that come from other 
sources to PCOs for review. In addition, interested parties, including 
Governors, State Primary Care Associations, and state professional 
associations, are notified of requests so that they may submit their 
comments and recommendations.
    BHW reviews each recommendation for possible addition, 
continuation, revision, or withdrawal. Following review, BHW notifies 
the appropriate agency, individuals, and interested organizations of 
each designation of a HPSA, rejection of recommendation 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 from BHW 
and are updated daily on the HPSAFind website. The effective date of a 
withdrawal will be the next publication of a notice regarding the list 
in the Federal Register.

    Dated: June 26, 2018.
George Sigounas,
Administrator.
[FR Doc. 2018-14115 Filed 6-29-18; 8:45 am]
BILLING CODE 4165-15-P

Federal Register / Vol. 83, No. 127 / Monday, July 2, 2018 / Notices 30941

utility; (2) the accuracy of FDA’s makeup, cleansing shampoos, • Buildings and Equipment—
estimate of the burden of the proposed permanent waves, hair colors, including facility space, pest control,
collection of information, including the deodorants, and tattoo inks, as well as practices ensuring the cleanliness and
validity of the methodology and any substance intended for use as a sanitation, water usage and treatment,
assumptions used; (3) ways to enhance component of a cosmetic product. Some and the proper functioning and
the quality, utility, and clarity of the cosmetic products are also regulated as operation of equipment.
information to be collected; and (4) drugs. • Materials and Manufacturing—
ways to minimize the burden of the As with other commodities FDA including practices for inventory
collection of information on regulates, the safety of cosmetic management, labeling and storage of
respondents, including through the use products can be ensured in part through raw materials, closures, and in process
of automated collection techniques, a manufacturer’s approach to the materials; and in process standard
when appropriate, and other forms of management of cosmetic quality. To operating procedures.
information technology. date, FDA has not identified in the • Quality Control/Product Testing—
published literature any systematic, including the scope of the quality
Survey of Current Manufacturing
detailed study of the diversity of the control unit, laboratory testing, dealing
Practices for the Cosmetics Industry—
practices and standards employed with rejected or returned products and
OMB Control Number 0910—New
across the cosmetic industry to ensure complaints, and corrective actions.
FDA has the responsibility to protect product quality and safety. This study is In addition, FDA will obtain the
public health and, as part of this broad intended to fill this gap. FDA proposes characteristics of surveyed
mandate, oversees the safety of the to conduct a voluntary survey of establishments such as the types of
nation’s cosmetic products. The Federal cosmetics establishments to identify the cosmetics produced, published
Food, Drug, and Cosmetic Act (FD&C current quality management and safety standards and guidelines followed, the
Act) prohibits the introduction into practices in the cosmetic industry. number of employees, the volume of
interstate commerce of any cosmetic production, and the approximate
that is adulterated or misbranded. The survey instrument will collect revenue. The survey will be
The FD&C Act defines cosmetics as data, on a voluntary basis, from administered by web or by mail
articles intended to be rubbed, poured, cosmetic product manufacturers on the (respondent choice) and it will be
sprinkled, or sprayed on, introduced following topics: directed to the Plant Manager of the
into, or otherwise applied to the human • Written Procedures and cosmetics establishment.
body for cleansing, beautifying, Documentation—including written This is a new, one-time data
promoting attractiveness, or altering the procedures and records for collection. FDA does not plan to collect
appearance. Among the products manufacturing involving personnel, raw this data from the cosmetics industry on
included in this definition are skin materials, processing, cleaning, an ongoing basis.
moisturizers, perfumes, lipsticks, maintenance, finished products, and FDA estimates the burden of this
fingernail polishes, eye and facial training. collection of information as follows:

TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN 1
Number of
Number of Total annual Average burden
Activity responses per Total hours
respondents responses per response
respondent

Survey Invitation ......................................................... 898 1 898 0.08 (5 minutes) ...... 71.84
Survey ........................................................................ 564 1 564 0.5 (30 minutes) ...... 282.00

Total .................................................................... ........................ ........................ ........................ ................................. 353.84
1 There are no capital costs or operating and maintenance costs associated with this collection of information.

We will select a sample of 898 burden for this collection of information DEPARTMENT OF HEALTH AND
establishments. After adjusting for to be 353.84 hours. HUMAN SERVICES
ineligibility (i.e., firms that do not Dated: June 26, 2018.
produce cosmetic products and those no Health Resources and Services
longer in operation) and a response rate Leslie Kux, Administration
of 70 percent, we expect 564 completed Associate Commissioner for Policy.
surveys. [FR Doc. 2018–14158 Filed 6–29–18; 8:45 am] Lists of Designated Primary Medical
BILLING CODE 4164–01–P
Care, Mental Health, and Dental Health
We expect each individual survey Professional Shortage Areas
invitation to take 5 minutes (0.08 hour)
to complete. Multiplying by the 898 AGENCY: Health Resources and Services
establishments that will receive the Administration (HRSA), Department of
survey invitation, we estimate the time Health and Human Services (HHS).
burden of the survey invitation to be ACTION: Notice.
daltland on DSKBBV9HB2PROD with NOTICES

71.84 hours. We expect each individual
survey to take 30 minutes (0.5 hour) to SUMMARY: This notice informs the public
complete. Multiplying by the estimated of the availability of the complete lists
564 establishments that will complete of all geographic areas, population
the survey, we estimate the time burden groups, and facilities designated as
of the survey to be 282 hours. We primary medical care, mental health,
estimate the total hourly reporting and dental health professional shortage

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30942 Federal Register / Vol. 83, No. 127 / Monday, July 2, 2018 / Notices

areas (HPSAs) as of May 1, 2018. The health, or dental health services in or to listed under the county name. A county
lists are available on HRSA’s HPSAFind these HPSAs. NHSC health that has a whole county geographic
website. professionals enter into service HPSA is indicated by the phrase ‘‘Entire
ADDRESSES: Complete lists of HPSAs agreements to serve in federally county HPSA’’ following the county
designated as of May 1, 2018, are designated HPSAs. Entities with clinical name.
available on the HPSAFind website at training sites located in HPSAs are
Development of the Designation and
https://datawarehouse.hrsa.gov/tools/ eligible to receive priority for certain
Withdrawal Lists
analyzers/hpsafind.aspx. Frequently residency training program grants
updated information on HPSAs is administered by HRSA’s Bureau of Requests for designation or
available at http:// Health Workforce (BHW). Other federal withdrawal of a particular geographic
datawarehouse.hrsa.gov. Information on programs also utilize HPSA area, population group, or a facility as
shortage designations is available at designations. For example, under a HPSA are received continuously by
https://bhw.hrsa.gov/shortage- authorities administered by the Centers BHW. Under a Cooperative Agreement
designation. for Medicare and Medicaid Services, between HRSA and the 54 state and
certain qualified providers in territorial Primary Care Offices (PCOs),
FOR FURTHER INFORMATION CONTACT: For PCOs conduct needs assessments and
geographic area HPSAs are eligible for
further information on the HPSA submit the majority of the applications
increased levels of Medicare
designations listed on the HPSAFind to HRSA to designate areas as HPSAs.
reimbursement.
website or to request additional BHW refers requests that come from
designation, withdrawal, or Content and Format of Lists other sources to PCOs for review. In
reapplication for designation, please The three lists of designated HPSAs addition, interested parties, including
contact Melissa Ryan, Acting Director, are available on the HPSAFind website Governors, State Primary Care
Division of Policy and Shortage and include a snapshot of all geographic Associations, and state professional
Designation, Bureau of Health areas, population groups, and facilities associations, are notified of requests so
Workforce, HRSA, 11SWH03, 5600 that were designated HPSAs as of May that they may submit their comments
Fishers Lane, Rockville, Maryland 1, 2018. This notice incorporates the and recommendations.
20857, (301) 594–5168 or MRyan@ most recent annual reviews of BHW reviews each recommendation
hrsa.gov. designated HPSAs and supersedes the for possible addition, continuation,
SUPPLEMENTARY INFORMATION: HPSA lists published in the Federal revision, or withdrawal. Following
Register on June 26, 2017 (Federal review, BHW notifies the appropriate
Background agency, individuals, and interested
Register/Vol. 82, No. 121/Monday, June
Section 332 of the Public Health 26, 2017/Notices 28863). organizations of each designation of a
Service (PHS) Act, 42 U.S.C. 254e, In addition, all Indian Tribes that HPSA, rejection of recommendation for
provides that the Secretary shall meet the definition of such Tribes in the HPSA designation, revision of a HPSA
designate HPSAs based on criteria Indian Health Care Improvement Act of designation, and/or advance notice of
established by regulation. HPSAs are 1976, 25 U.S.C. 1603(d), are pending withdrawals from the HPSA
defined in section 332 to include (1) automatically designated as population list. Designations (or revisions of
urban and rural geographic areas with groups with primary medical care and designations) are effective as of the date
shortages of health professionals, (2) dental health professional shortages. on the notification from BHW and are
population groups with such shortages, Further, the Health Care Safety Net updated daily on the HPSAFind
and (3) facilities with such shortages. Amendments of 2002 provides website. The effective date of a
Section 332 further requires that the eligibility for automatic facility HPSA withdrawal will be the next publication
Secretary annually publish lists of the designations for all federally qualified of a notice regarding the list in the
designated geographic areas, population health centers (FQHCs) and rural health Federal Register.
groups, and facilities. The lists of clinics that offer services regardless of Dated: June 26, 2018.
HPSAs are to be reviewed at least ability to pay. Specifically, these entities George Sigounas,
annually and revised as necessary. include FQHCs funded under section
Administrator.
Final regulations (42 CFR part 5) were 330 of the PHS Act, FQHC Look-Alikes,
[FR Doc. 2018–14115 Filed 6–29–18; 8:45 am]
published in 1980 that include the and Tribal and urban Indian clinics
BILLING CODE 4165–15–P
criteria for designating HPSAs. Criteria operating under the Indian Self-
were defined for seven health Determination and Education Act of
professional types: Primary medical 1975 (25 U.S.C. 450) or the Indian
DEPARTMENT OF HEALTH AND
care, dental, psychiatric, vision care, Health Care Improvement Act. Many,
HUMAN SERVICES
podiatric, pharmacy, and veterinary but not all, of these entities are included
care. The criteria for correctional facility on this listing. Absence from this list [Document Identifier: OS–0990—new]
HPSAs were revised and published on does not exclude them from HPSA
March 2, 1989 (54 FR 8735). The criteria designation; facilities eligible for Agency Information Collection
for psychiatric HPSAs were expanded to automatic designation are included in Request; 60-Day Public Comment
mental health HPSAs on January 22, the database when they are identified. Request
1992 (57 FR 2473). Currently-funded Each list of designated HPSAs is AGENCY: Office of the Secretary, HHS.
PHS Act programs use only the primary arranged by state. Within each state, the ACTION: Notice.
medical care, mental health, or dental list is presented by county. If only a
daltland on DSKBBV9HB2PROD with NOTICES

HPSA designations. portion (or portions) of a county is (are) SUMMARY: In compliance with the
HPSA designation offers access to designated, a county is part of a larger requirement of the Paperwork
potential federal assistance. Public or designated service area, or a population Reduction Act of 1995, the Office of the
private nonprofit entities are eligible to group residing in a county or a facility Secretary (OS), Department of Health
apply for assignment of National Health located in the county has been and Human Services, is publishing the
Service Corps (NHSC) personnel to designated, the name of the service area, following summary of a proposed
provide primary medical care, mental population group, or facility involved is collection for public comment.

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Document Created: 2018-06-30 00:17:20
Document Modified: 2018-06-30 00:17:20

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Contact		For further information on the HPSA designations listed on the HPSAFind website or to request additional designation, withdrawal, or reapplication for designation, please contact Melissa Ryan, Acting Director, Division of Policy and Shortage Designation, Bureau of Health Workforce, HRSA, 11SWH03, 5600 Fishers Lane, Rockville, Maryland 20857, (301) 594-5168 or [email protected]
FR Citation		83 FR 30941

83 FR 30941 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas

DEPARTMENT OF HEALTH AND HUMAN SERVICESHealth Resources and Services Administration

Federal Register Volume 83, Issue 127 (July 2, 2018)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration