Wisconsin Primary Care Programs - Shortage Designations

Wisconsin Primary Care Programs
Shortage Designations

Three general categories of federal shortage designations:
- Health Professional Shortage Area (HPSA)
- Medically Underserved Area/Population (MUA/MUP)
- Governor's Shortage Designation for Rural Health Clinics
Document a significant shortage of primary care, dental, or mental health providers in a rural or urban service area;
Are specific to a service area that can be a county, group of towns, group of census tracts in a city, a state or federal correctional facility, a rural health clinic or a community health center; and
Are associated with difficulty or delays in getting basic health care (e.g., long travel distances to providers, long wait times for appointments, or no providers who can serve uninsured or underinsured patients).
The PCO works in partnership with clinics to collect the detailed physician/psychiatrist data that are needed in order for the PCO to submit State HPSA applications to the federal Office of Shortage Designation.

GEOGRAPHIC HPSAs	BENEFITS THAT WILL BE LOST
Beloit central city Coon Valley/Chaseburg Pulaski Sturgeon Bay	Lose Medicare HPSA 10% bonus effective January 1, 2013 Lose Medicare HPSA bonus for general surgeons on January 1, 2013 Lose J-1 visa waiver physician recruitment No development of new Rural Health Clinics effective June 29, 2012. *Existing RHCs are "grandfathered in" and not currently required to be in a designated HPSA.
LOW-INCOME POPULATION HPSAs	BENEFITS THAT WILL BE LOST
Boscobel	[These were not eligible for the Medicare HPSA bonuses.] Lose J-1 visa waiver physician recruitment No development of new Rural Health Clinics effective June 29, 2012. *Existing RHCs are "grandfathered in" and not currently required to be in a designated HPSA.

GEOGRAPHIC HPSAs	BENEFITS THAT WILL BE LOST
Fond du Lac County Pierce County	Lose Medicare HPSA 10% bonus effective January 1, 2013 Lose J-1 visa waiver physician recruitment
CORRECTIONS FACILITIES	BENEFITS THAT WILL BE LOST
Taycheedah	Lose J-1 visa waiver physician recruitment These are already in-eligible for federal loan repayment.

When a Federal Register list of designated HPSAs was published on June 29, 2012, the previous HPSAs listed above were "officially withdrawn" and lost access to HPSA-linked benefits. For more information, visit HRSA's Office of Shortage Designation for the Federal Register. (exit DHS)
Each of the "withdrawn" HPSAs was reviewed by the Wisconsin Primary Care Office, and data for their service area no longer meets federal HPSA requirements for designation.
When your clinic is contacted and asked to update its physician or psychiatrist data, the Wisconsin Primary Care Office needs a timely response. Annual HPSA reviews for which we get a poor response rate from clinics, will be set aside. These HPSAs will be at-risk of losing HPSA designation and at-risk for losing HPSA-linked benefits.
Rural Health Clinics - If the federal Center for Medicare/Medicaid Services (CMS) publishes an updated rule for RHCs which requires that existing RHCs must have a current federal shortage designation, Wisconsin does have a new Governor's Shortage Designation which can help many RHCs retain a federal shortage designation. The PCO will have to review its HPSA work priorities to include this work for at-risk RHCs.
All federally qualified health centers - FQHCs (community health centers and tribal health centers) are eligible for the National Health Service Corps loan repayment, since as FQHCs - they each have an automatic safety net facility HPSA.

Last Revised: April 19, 2013

Wisconsin Department of Health Services