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Shortage Designations

Introduction

Areas of need are identified through the PCO's coordination of the federal designation process for Health Professional Shortage Areas (HPSA) and Medically Underserved Areas/Populations (MUA/P). The HPSA designation may be done for geographic areas, population groups or facilities and is required for health care providers to apply for federal and state workforce programs. The MUA/P designation may be done for geographic areas or population groups and is required for safety net sites to apply for Federally Qualified Health Center (FQHC) funding. The PCO also assists in the designation of Governor's Certified Shortage Areas for Rural Health Clinics.

Health Professional Shortage Areas (HPSAs)

The Primary Care Office (PCO) collects and analyzes demographic and provider data to determine areas within Ohio that are underserved according to federal Health Professional Shortage Area (HPSA) criteria. Designation as a HPSA allows Ohio communities to apply for recruitment and retention assistance through various state and federal programs, and is often utilized as a preference factor for other public and private funding opportunities.

The HPSA designation may assess the need for primary medical care, dental health or mental health providers in an area. The PCO works in partnership with local communities for the designation of HPSAs, and works collaboratively with the Ohio Department of Mental Health and Addiction Services and the Ohio Department of Rehabilitation and Correction for the designation of state mental hospital and correctional facility HPSAs.  
 

HPSA Requirements

  • Rational service area – The area must be rational for the delivery of services. Rational service areas may be defined as a whole county (usually rural), a neighborhood (usually urban) or a grouping of townships or census tracts that are demographically and socio-economically similar. 
  • Population-to-provider ratio - Minimum ratios vary with the discipline and type of HPSA being requested, as well as with the demographics of the area. 
  • Contiguous area analysis – Services in neighboring areas must be unavailable to the HPSA based on overutilization, excessive distance or socioeconomic barriers. 

Types of HPSAs 

  • Geographic area designations may be done for whole counties (usually rural), neighborhoods (usually urban) or groupings of townships or census tracts that are demographically and socio-economically similar. 
  • Population groups eligible for designation include low income, Medicaid eligible, homeless and migrant farmworkers within a defined geographic area.

Facilities that may be considered for the designation include public and nonprofit facilities providing primary, dental, or mental healthcare to residents of a designated HPSA; medium- and maximum-security correctional facilities or youth detention centers; and state mental hospitals. Additionally, Federally Qualified Health Centers (FQHC) and FQHC Look-Alikes are considered automatic facility HPSAs. Automatic facility HPSA status is also available for Rural Health Clinics that meet National Health Service Corps site requirements. 

Review Cycle

  • New designations may be requested at any time. 
  • Current designations must be updated periodically following a regular update cycle and may be updated more frequently if significant provider changes occur in the community. 

Visit https://data.hrsa.gov/tools/shortage-area to search for currently designated HPSAs by county or address. 

Governor's Certified Shortage Areas for Rural Health Clinics

Governor's Certified Shortage Area designations are authorized under federal Rural Health Clinic (RHC) legislation and establish areas as underserved for primary care for RHC certification purposes.  Governor’s Certified Shortage Areas are also known as Governor-designated and Secretary-certified shortage areas. 

Background

The RHC program was developed to improve access to primary care services in underserved rural areas.  RHCs use a team approach of physicians and non-physician providers, such as nurse practitioners, physician assistants and certified nurse midwives. 

To meet the location requirements for RHC certification, eligible clinics must be located within both an underserved and rural area.  Areas designated as a geographic or special population Health Professional Shortage Area (HPSA), a Medically Underserved Area (MUA) or a Governor’s Certified Shortage Area within the last four years are considered underserved for purposes of RHC certification.  To be considered rural, eligible clinics must be located outside of U.S. Census Bureau defined urbanized areas.  

The Ohio State Office of Rural Health (SORH) can assist with location requirement information. The SORH also offers an annual statewide conference and other events and resources for rural providers, including RHCs and clinics pursuing RHC certification. Please see the contact information listed on this page or visit the SORH Web page for more information or assistance.

Clinics must also meet staffing and other requirements for RHC certification. For more information on certification, please visit the Centers for Medicare and Medicaid Services web page.

Additional information on RHCs can be found by visiting the Rural Health Information Hub’s RHC Topic Guide

Designation

For designation as a Governor’s Certified Shortage Area, a service area must meet established criteria in Ohio, based upon a review of the local population-to-provider ratio and high-need indicators. If the area meets the criteria for designation, a request for designation is submitted to the Health Resources and Services Administration (HRSA) for review and approval.

A list of designated Governor’s Certified Shortage Areas for RHC purposes in Ohio is available below.  As described above, a designation must be from within the last four years to be considered current for RHC certification purposes. 

Areas can be reviewed for new designation or re-designation if communities request a review and provide assistance with the review process.  Please see the contact information listed below for assistance or more information.

List of Designations