Shortage Designations HPSA Health Professional Shortage Area MUAP

Shortage Designations • HPSA Health Professional Shortage Area • MUA/P Medically Underserved Area/Population • What are they: A way to identify areas of greatest health needs so limited resources can be prioritized and given to those most in need of primary health services General Information on designations: HRSA/Shortage Designation Branch: http: //bhpr. hrsa. gov/shortage/index. htm

Designation Needed for Selected Federal Programs Shortage Designations Options National Health Service Corps Federally Qualified Health Center Programs CMS Medicare Incentive Payment CMS Rural Health Clinic Program J-1 Visa Waiver Primary Care HPSA X X Geographic HPSA only X HPSA not older than 3 years X Dental Care HPSA X Mental Health HPSA X X Geographic only, ask CMS Geographic HPSA X X Population HPSA X Facility HPSA X X HPSA Subtypes X X X Medically Underserved Area (MUA) X Indiana MUAs too old to qualify for RHC X Medically Underserved Population (MUP) X X Governor’s Exceptional MUP X X

HPSA/MUA Process 1. Contact Indiana Primary Health Care Association (IPHCA) on what to do. 2. Due to demand there may be a waiting list. 3. You may need to put together a list of primary care physicians for your area. 4. Very possibly the physicians will need to be surveyed to determine Full Time Equivalent (FTE) number available. 5. Neighboring areas within 25 miles need to be examined to see if there is a shortage of physicians.

When there is enough information, the HPSA staff at IPHCA will see if area appears to qualify. The designation information will be entered into ASAPS (the on line designation program). The ISDH Primary Care Office will review the documentation and forward the information to the US Department of Health & Human Services Shortage Designation Branch for a final determination.

For inquiries contact Natalie Brown, MPH Shortage Designations and National Health Service Corps Program Director Indiana Primary Health Care Association 1006 E. Washington Street, Suite 200 Indianapolis, IN 46202 Ph: (317) 630 -0845 / Fax: (317) 630 -0849 nbrown@indianapca. org http: //www. indianapca. org

Types of HPSAs • Primary Care • Dental • Mental Health Subgroups Geographic Low Income (30% of population at 200% of poverty)

Providers HPSAs consider Primary Care Physicians: Family/General Practice General Internal Medicine General Pediatric Medicine General OB/GYN Geriatric Medicine Dentistry, General & Pediatric Mental Health Psychiatrists or Psychiatrists and Core Mental Health Providers

Provider Ratios for Shortages • Primary Care Geographic 3500 pop to 1 FTE Low income 3000 pop to 1 FTE (30% of population at 200% of poverty) All Contiguous areas 2000 pop to 1 FTE • Dental Geographic 5000 pop to 1 FTE Contiguous areas 3000 pop to 1 FTE • Mental Health Geographic 30, 000 pop to 1 FTE psychiatrists or 9, 000 pop to Core Mental Health Professionals and psychiatrists.

HPSA Benefits Eligible for National Health Service Corps loan repayment or scholar. Prerequisite for Rural Health Clinic if designation is less than 3 years old. Geographic HPSAs get 10% Medicare Incentive Benefits. You can seek a J 1 Visa Physician.

Most if not all Indiana counties will not qualify for a new MUA today MUAs are based on a point system based on • 100% of poverty • Percent of population age 65+ • Infant Mortality Rates • Primary Care Physicians per 1000 population All Indiana MUAs are older than 3 years and do not qualify for new Rural Health Clinics.

MUA/P Benefits Prerequisite for Federally Qualified Health Centers (FQHC). (Federally funded clinics) Eligible for a J 1 Visa Waiver Physician. Indiana MUAs are older than 3 years and thereby do not qualify for Rural Health Clinics. MUPs also do not qualify for Rural Health Clinics.