Wisconsin Primary Care Programs
What are Shortage Designations?
Three basic categories of shortage designations:
- Health Professional Shortage Area (HPSA) designation
- Indicates a significant shortage of health providers in the service
area and in surrounding areas, and it is measured by a population to provider ratio.
- Three different types of HPSAs - each type indicates a
shortage of either primary care, dental, or mental health providers.
- HPSA service areas can be based on geographic areas, a population or a
facility (community health centers, rural health clinics, tribal
health centers, correctional facilities).
- Each HPSA must be reviewed for re-designation every 3 years.
criteria, guidelines and process for HPSA designation (exit
- Medically Underserved Area/population (MUA/P) designation
- Indicates significant underservice for an area and is measured by an
Index of Medical Underservice (IMU). The score is calculated by
combining weighted values for four indicators of access to care
barriers: population below the federal poverty level, population
age 65 or older, infant mortality rate, and population to primary care
provider ratio. NOTE: It is frequently more difficult for
an area to qualify for a MUA/MUP than for a HPSA.
- Three different types - MUA is calculated for an entire service
area, MUP is calculated for a specific population in an area, an
Exceptional/Governor's MUP for populations with documented unusual
- MUA/Ps currently do not need to be re-designated.
- Federal criteria,
guidelines and process for MUA/MUP designation (exit
- Governor's Shortage Designation for Rural Health Clinics (RHCs)
- Indicates a significant shortage of providers and high needs for
the population in a "rural area" which does not meet federal
criteria for a HPSA designation.
- A Governor's Shortage Designation for RHCs can help a rural
clinic meet the federal certification requirement that a RHC must be
located in a federally designated shortage area (e.g., HPSA, MUA,
- The federal Office of Shortage Designation has approved the
State's process and criteria for designating a shortage area for
Rural Health Clinic purposes, and must also approve State
applications for individual RHC service areas to be designated as a
Governor's Shortage Area for RHCs.
- Existing certified Rural Health Clinics and new rural clinics
which do not have a current HPSA designation can request that the
Wisconsin Primary Care Office review their area to see if they
qualify for a Governor's Designation for RHCs
- Each Governor's Designations for a RHC must be reviewed for
re-designation every 4 years.
- State process and criteria for a Governor's Shortage Designation
for RHCs (PDF, 81 KB)
- Governor Designated and DHHS Secretary
Certified Shortage Areas for RHCs
Federal Negotiated Rulemaking
Process to Review Criteria for the Designation of MUAs and HPSAs
Federal and State Partnership:
- Federal Shortage Designation Bureau (exit
DHS) in DHHS/HRSA is responsible for
reviewing and making final decisions on shortage designation
applications per federal regulations, and maintaining a web-searchable
database of designations.
- State health departments are responsible for: coordinating
with clinics that
request shortage designations,
collecting and analyzing provider FTE and other designation data, and
submitting state applications for federal designation of shortage areas.
The Wisconsin Primary Care Office is responsible for shortage designation applications in
Shortage Designations in Wisconsin:
- HPSAs in Wisconsin (June 2012) = 106 primary care, 74 dental, and 109
searchable database (exit DHS) -- Select state,
then select county and specialty, and select "show me the HPSAs"
- MUA/Ps in Wisconsin (2012) = 76
- MUA/P searchable database
-- Select state, then select county and "show me the
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June 19, 2013