Health Professional Shortage Area Designations
Primary Care Offices (PCOs) in every US state and territory are funded by the federal Health Resources Services Administration, Division of Policy and Shortage Designation (HRSA/DPSD) to support the designation of health professional shortage areas (HPSAs) and Medically Underserved Areas or Populations (MUA/P). These designations leverage federal resources that help states improve access to primary care, dental care, and mental health care.
Resources associated with HPSA designations include loan repayment and scholarship programs through the National Health Service Corps (NHSC), Medicare incentive payments under the Centers for Medicare and Medicaid Services (CMS), the Rural Health Clinic program, and the Conrad 30/J-1 Physician Visa Waiver program.
Resources associated with the MUA/P designation include grant funding under Section 330 of the Public Health Service Act, and increased Medicaid reimbursement rates for Federally Qualified Health Centers.
The main criterion for designation is the ratio of population to provider for a defined geographic area. Depending on the type of designation, other criteria include poverty rates, infant health measures, travel time to access care, fluoridation of public water, population age, and substance abuse rates.
All 17 counties in Nevada have some type of shortage designation, due to very high ratios of population to provider. In urban areas, poverty is also a significant factor in shortage designation, because many providers do not accept Medicaid. In rural and frontier areas, travel time to access a provider can be several hours, which is also a significant factor in shortage designation. Information about designated areas is available online at http://hpsafind.hrsa.gov/.
Clark County is the only Nevada County with fluoridated water; dental HPSA designations for all other counties are impacted based on this oral health deficiency. Washoe County has a relatively high rate of substance abuse, thereby increasing its HPSA score with regard to the need for mental health care providers.
The Nevada PCO works with health care providers and stakeholders to maintain existing designations and establish new designations where appropriate. Surveys are conducted on a periodic basis to document type of practice, location of practice, hours of practice, types of acceptable payment, and acceptance of new patients. Additional data is collected and analyzed as part of the designation process. Please contact staff for more information.