Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas, 82-83 [2023-28844]
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Federal Register / Vol. 89, No. 1 / Tuesday, January 2, 2024 / Notices
khammond on DSKJM1Z7X2PROD with NOTICES
V. Provisions of the Final Notice
A. Differences Between CHAP’s
Standards and Requirements for
Accreditation and Medicare Conditions
and Survey Requirements
We compared CHAP’s HHA
requirements and survey process with
the Medicare CoPs and survey process
as outlined in the State Operations
Manual (SOM). Our review and
evaluation of CHAP’s HHA application
were conducted as described in section
III. of this notice and have yielded the
following areas where, as of the date of
this notice, CHAP has completed
revising its standards and certification
processes to meet the standard’s
requirements of all the following
regulations:
• Section 484.50(c)(8), to clarify
under Patient Right’s that the HHA must
also comply with the requirements of 42
CFR 405.1200 through 405.1204 when
providing the patient with written
notice, in advance of a specific service
being furnished.
• Section 484.75(c)(2), to specify that
when rehabilitative therapy services are
provided under the supervision of an
occupational therapist or physical
therapist, the qualified professional
meets the requirements of § 484.115(f)
or (h), respectively.
• Section 484.75(c)(3), to specify that
when medical social services are
provided under the supervision of a
social worker, the requirements of
§ 484.115(m) are met.
• Section 484.100(a), to appropriately
cross-reference the Medicare conditions
of §§ 420.201, 420.202, and 420.206 or
corresponding comparable CHAP
standards.
• Section 484.102(d)(2)(iii), to
include the requirement for HHAs to
analyze the HHA’s response to and
maintain documentation of all drills,
tabletop exercises, and emergency
events, and revise the HHA’s emergency
plan, as needed.
• Section 484.105(g), to appropriately
cross-reference the Medicare conditions
of §§ 485.713, 485.715, 485.719,
485.723, and 485.727 or corresponding
comparable CHAP standards.
In addition to the standards review,
CMS also reviewed CHAP’s comparable
survey processes, which were
conducted as described in section III. of
this notice, and yielded the following
areas where, as of the date of this notice,
CHAP has completed revising its survey
processes, in order to demonstrate that
it uses survey processes that are
comparable to state survey agency
processes by removing references to
‘‘blackout dates,’’ by allowing facilities
to select dates which suggested the
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15:59 Dec 29, 2023
Jkt 262001
facility would be unavailable for
surveys, as CMS expects all Medicareparticipating facilities to be survey
ready at all times.
B. Term of Approval
Based on our review and observations
described in sections III. and V. of this
notice, we approve CHAP as a national
AO for HHAs that request participation
in the Medicare program. The decision
announced in this final notice is
effective March 31, 2024, through March
31, 2030 (6 years).
VI. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting, recordkeeping, or
third-party disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 3501 et seq.).
The Administrator of the Centers for
Medicare & Medicaid Services (CMS),
Chiquita Brooks-LaSure, having
reviewed and approved this document,
authorizes Chyana Woodyard, who is
the Federal Register Liaison, to
electronically sign this document for
purposes of publication in the Federal
Register.
Chyana Woodyard,
Federal Register Liaison, Centers for Medicare
& Medicaid Services.
[FR Doc. 2023–28831 Filed 12–29–23; 8:45 am]
BILLING CODE 4120–01–P
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
Health Resources and Services
Administration (HRSA), Department of
Health and Human Services.
ACTION: Notice.
AGENCY:
This is the second of two
planned notices informing the public of
the availability of the complete lists of
all geographic areas, population groups,
and facilities designated as primary
medical care, dental health, and mental
health professional shortage areas
(HPSA). This notice includes the lists of
HPSAs in a designated status as of
December 2, 2023. The lists are
available on the shortage area topic page
on HRSA’s data.hrsa.gov website. The
SUMMARY:
PO 00000
Frm 00040
Fmt 4703
Sfmt 4703
first Federal Register notice was
published on July 3, 2023, and included
HPSAs in a designated status and those
proposed for withdrawal, while
extending the transition time
communicated in the prior notice
published on July 7, 2022. State primary
care offices had additional time to
submit HPSA data that was re-evaluated
in preparation for the publication of this
notice. This second Federal Register
notice includes the lists of HPSAs in a
designated status and withdraws
designations proposed for withdrawal
not meeting the requirements for
designation as of the data pull on
December 2, 2023.
ADDRESSES: Complete lists of HPSAs
designated as of December 2, 2023, are
available on the website at https://
data.hrsa.gov/tools/health-workforce/
shortage-areas/frn. Frequently updated
information on HPSAs is available at
https://data.hrsa.gov/topics/healthworkforce/health-workforce-shortageareas. Information on shortage
designations is available at https://
bhw.hrsa.gov/workforce-shortage-areas/
shortage-designation.
FOR FURTHER INFORMATION CONTACT: For
further information on the HPSA
designations listed on the website or to
request additional designation,
withdrawal, or reapplication for
designation, please contact Anthony
Estelle, Chief, Shortage Designation
Branch, Division of Policy and Shortage
Designation, Bureau of Health
Workforce (BHW), HRSA, 5600 Fishers
Lane, Room 11W16, Rockville,
Maryland 20857, sdb@hrsa.gov.
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
E:\FR\FM\02JAN1.SGM
02JAN1
Federal Register / Vol. 89, No. 1 / Tuesday, January 2, 2024 / Notices
khammond on DSKJM1Z7X2PROD with NOTICES
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 or relevant sub-score designations
such as Maternity Care Target Areas.
HPSA designation offers access to
potential federal assistance. Public or
private nonprofit entities are eligible to
apply for assignment of National Health
Service Corps personnel to provide
primary medical care, mental health, or
dental health services in or to these
HPSAs. National Health Service Corps
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 BHW. Other
federal programs also utilize HPSA
designations. For example, under
authorities administered by the Centers
for Medicare & 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 HRSA Data
Warehouse shortage area topic web page
and include a snapshot of all geographic
areas, population groups, and facilities
that were designated HPSAs as of
December 2, 2023. This notice
incorporates the most recent annual
reviews of designated HPSAs, which
can be located on HRSA’s data.hrsa.gov
website, and supersedes the HPSA lists
published in the Federal Register on
July 3, 2023 (88 FR 42725).
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, 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
(FQHC) 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
VerDate Sep<11>2014
15:59 Dec 29, 2023
Jkt 262001
listing. Since they are automatically
designated by statute, 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 or
population group HPSA is indicated by
the phrase ‘‘County’’ following the
county name.
Development of the Designation and
Withdrawal Lists
Requests for designation or
withdrawal of a particular geographic
area, population group, or facility as a
HPSA are received continuously by
BHW. Under a Cooperative Agreement
between HRSA and the 54 state and
territorial Primary Care Offices (PCO),
PCOs conduct needs assessments and
submit applications to HRSA to
designate HPSAs. BHW also receives
other requests for designation from
other sources and refers them to PCOs
for review. As part of the HPSA
designation process, 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 HRSA Data
Warehouse website. While this list is a
snapshot of HPSAs at a point in time,
HPSA designations are regularly being
updated so the best source of current
designation status is the HRSA Data
Warehouse website at (https://
data.hrsa.gov/tools/shortage-area).
In 2024, BHW will publish two
Federal Register notices to inform the
public of the availability of the complete
lists of all geographic areas, population
groups, and facilities designated as
PO 00000
Frm 00041
Fmt 4703
Sfmt 4703
83
primary medical care, dental health, and
mental health professional shortage
areas. The first notice will be on or
before May 1, 2024, and will list all
designated HPSAs and those that are
proposed for withdrawal HPSAs that
will remain in a designated status until
the second Federal Register notice
which will be scheduled on or before
November 1, 2024. The second Federal
Register notice will withdraw all HPSAs
that were proposed for withdrawl and
do not meet the requirements for
designation. This two-step process
provides greater clarity for jurisdictions
and facilities to prepare for any changes
in HPSA designation.
Carole Johnson,
Administrator.
[FR Doc. 2023–28844 Filed 12–29–23; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Substance Abuse and Mental Health
Services Administration
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Periodically, the Substance Abuse and
Mental Health Services Administration
(SAMHSA) will publish a summary of
information collection requests under
OMB review, in compliance with the
Paperwork Reduction Act (44 U.S.C.
chapter 35). To request a copy of these
documents, call the SAMHSA Reports
Clearance Officer on (240) 276–0361.
Project: Survey of Current and Alumni
SAMHSA Fellows of the Minority
Fellowship Program (MFP) (OMB No.
0930–0304)—REVISION
In 1973, in response to a substantial
lack of ethnic and racial minorities in
the mental health professions, the
Center for Minority Health at the
National Institute of Mental Health
established the MFP. Since the MFP’s
transition to SAMHSA in 1992, the
program has continued to facilitate the
entry of graduate students and
psychiatric residents into mental health
careers and has increased the number of
psychology, psychiatry, nursing, and
social work professionals trained to
provide mental health and substance
abuse services to minority groups. The
traditional MFP offers sustained grants
to six national behavioral health
professional associations: the American
Association of Marriage and Family
Therapy (AAMFT), American Nurses
Association (ANA), American
Psychiatric Association (APsychA),
E:\FR\FM\02JAN1.SGM
02JAN1
]]>Agencies
[Federal Register Volume 89, Number 1 (Tuesday, January 2, 2024)]
[Notices]
[Pages 82-83]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-28844]
-----------------------------------------------------------------------
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.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This is the second of two planned notices informing the public
of the availability of the complete lists of all geographic areas,
population groups, and facilities designated as primary medical care,
dental health, and mental health professional shortage areas (HPSA).
This notice includes the lists of HPSAs in a designated status as of
December 2, 2023. The lists are available on the shortage area topic
page on HRSA's data.hrsa.gov website. The first Federal Register notice
was published on July 3, 2023, and included HPSAs in a designated
status and those proposed for withdrawal, while extending the
transition time communicated in the prior notice published on July 7,
2022. State primary care offices had additional time to submit HPSA
data that was re-evaluated in preparation for the publication of this
notice. This second Federal Register notice includes the lists of HPSAs
in a designated status and withdraws designations proposed for
withdrawal not meeting the requirements for designation as of the data
pull on December 2, 2023.
ADDRESSES: Complete lists of HPSAs designated as of December 2, 2023,
are available on the website at https://data.hrsa.gov/tools/health-workforce/shortage-areas/frn. Frequently updated information on HPSAs
is available at https://data.hrsa.gov/topics/health-workforce/health-workforce-shortage-areas. Information on shortage designations is
available at https://bhw.hrsa.gov/workforce-shortage-areas/shortage-designation.
FOR FURTHER INFORMATION CONTACT: For further information on the HPSA
designations listed on the website or to request additional
designation, withdrawal, or reapplication for designation, please
contact Anthony Estelle, Chief, Shortage Designation Branch, Division
of Policy and Shortage Designation, Bureau of Health Workforce (BHW),
HRSA, 5600 Fishers Lane, Room 11W16, Rockville, Maryland 20857,
[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
[[Page 83]]
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 or
relevant sub-score designations such as Maternity Care Target Areas.
HPSA designation offers access to potential federal assistance.
Public or private nonprofit entities are eligible to apply for
assignment of National Health Service Corps personnel to provide
primary medical care, mental health, or dental health services in or to
these HPSAs. National Health Service Corps 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 BHW. Other federal programs also utilize HPSA
designations. For example, under authorities administered by the
Centers for Medicare & 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 HRSA Data
Warehouse shortage area topic web page and include a snapshot of all
geographic areas, population groups, and facilities that were
designated HPSAs as of December 2, 2023. This notice incorporates the
most recent annual reviews of designated HPSAs, which can be located on
HRSA's data.hrsa.gov website, and supersedes the HPSA lists published
in the Federal Register on July 3, 2023 (88 FR 42725).
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, 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 (FQHC) 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. Since they are automatically designated by statute,
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 or
population group HPSA is indicated by the phrase ``County'' following
the county name.
Development of the Designation and Withdrawal Lists
Requests for designation or withdrawal of a particular geographic
area, population group, or facility as a HPSA are received continuously
by BHW. Under a Cooperative Agreement between HRSA and the 54 state and
territorial Primary Care Offices (PCO), PCOs conduct needs assessments
and submit applications to HRSA to designate HPSAs. BHW also receives
other requests for designation from other sources and refers them to
PCOs for review. As part of the HPSA designation process, 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 HRSA Data Warehouse website. While this
list is a snapshot of HPSAs at a point in time, HPSA designations are
regularly being updated so the best source of current designation
status is the HRSA Data Warehouse website at (https://data.hrsa.gov/tools/shortage-area).
In 2024, BHW will publish two Federal Register notices to inform
the public of the availability of the complete lists of all geographic
areas, population groups, and facilities designated as primary medical
care, dental health, and mental health professional shortage areas. The
first notice will be on or before May 1, 2024, and will list all
designated HPSAs and those that are proposed for withdrawal HPSAs that
will remain in a designated status until the second Federal Register
notice which will be scheduled on or before November 1, 2024. The
second Federal Register notice will withdraw all HPSAs that were
proposed for withdrawl and do not meet the requirements for
designation. This two-step process provides greater clarity for
jurisdictions and facilities to prepare for any changes in HPSA
designation.
Carole Johnson,
Administrator.
[FR Doc. 2023-28844 Filed 12-29-23; 8:45 am]
BILLING CODE 4165-15-P
