Internal Government Review and Implementation of Revised HPSA/MUA/P Designation Methods

Dates: 2011-2013

Geographic Scope: Nationwide

Client(s): HRSA

Services: Health Care & Public Health Planning, Applied Research & Evaluation, Health Systems Transformation

Technical Expertise: Health Care Reform, Health Disparities, Population Health, Primary Care, Rural Health, Safety Net, State and Local Public Health


The process of revising the key federal regulations governing the designation of areas of the country as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas/Populations (MUA/MUPs), which underly much of the nation's safety net, has been a long and complex task.

JSI worked closely with HRSA and a negotiated rulemaking committee, under a previous contract, to support the rulemaking process and the report to the Secretary of HHS. This project covered the next phases of the regulatory process. As the formal rulemaking committee did not reach full consensus, the first tasks involved working with HRSA to complete the outstanding areas of the regulation.

Once completed, JSI assisted with internal governmental review and implementation of the revised rules. This included addressing HRSA/HHS/CMS/OMB questions and modifications, as well as issues raised by public comment, and exploring policy alternatives and their potential impact on the results using data and analytic methodologies to inform the process. The implementation phase involved working with the state primary care offices and the contractor for the web-based designation submission tool (ASAPS) to conduct a baseline designation assessment and roll-out the new rule.