Types of Designations

We use Health Professional Shortage Area (HPSA) designations to identify areas, population groups, or facilities within the United States that are experiencing a shortage of health care professionals.

Geographic HPSAs

Geographic HPSAs have a shortage of services for the entire population within an established geographic area.

Population HPSAs

Population HPSAs have a shortage of services for a specific population subset within an established geographic area.

Frequently Designated Population HPSAs include:

• Medicaid eligible
• Low income
• Migrant farmworker
• Native American/Alaskan Native
• People experiencing homelessness

Facility HPSAs

Facility HPSAs include three categories:

• Other Facility (OFAC)
  Public or non-profit private medical facilities serving a population or geographic area designated as a HPSA with a shortage of health providers.
• Correctional Facility
  Medium to maximum-security federal and state correctional institutions and youth detention facilities with a shortage of health providers.
• State Mental Hospitals
  State or county hospitals with a shortage of psychiatric professionals (mental health designations only).

Automatic Facility HPSAs (Auto-HPSAs)

Some facilities do not have to apply for a designation. They are automatically designated as HPSAs by statute or through regulation. These include:

• Federally Qualified Health Centers (FQHCs)
  Health centers that:
  • Provide primary care to an underserved area or population
  • Offer a sliding fee scale
  • Provide comprehensive services
  • Have an ongoing quality assurance program; and
  • Have a governing board of directors.

  All organizations receiving grants under Health Center Program Section 330 of the Public Health Service Act are FQHCs.

  Medically Underserved Areas (MUAs) and Medically Underserved Populations (MUPs)

  MUAs and MUPs identify geographic areas and populations with a lack of access to primary care services.

  • MUAs have a shortage of primary care health services for residents within a geographic area such as:
    • a whole county;
    • a group of neighboring counties;
    • a group of urban census tracts; or
    • a group of county or civil divisions.
    • People experiencing homelessness
    • Low-income
    • Medicaid-eligible
    • Native American
    • Migrant farmworkers

    Governor’s Designated Secretary Certified Shortage Areas for Rural Health Clinics

    A State Governor or designee designates these areas as having a shortage according to the state-established shortage plan for the establishment of a Rural Health Clinic.

    Which federal programs use shortage designations?

    Many federal programs use different types of shortage designations to determine eligibility. Below is a snapshot:

    Primary Care

    Shortage Designation Option

    National Health Service Corps (NHSC)

    Nurse Corps

    Health Center Program

    IHS Loan Repayment Program

    CMS HPSA Bonus Payment Program

    CMS Rural Health Clinic Program

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