Billing Code: 4165-15-P
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional
Shortage Areas
AGENCY: Health Resources and Services Administration (HRSA), Department of Health and
Human Services.
ACTION: Notice.
SUMMARY: This notice informs the public of the availability of the complete lists of all
geographic areas, population groups, and facilities designated as primary medical care, dental
health, and mental health professional shortage areas (HPSAs) in a designated status as of April
15, 2024. The lists are available on the shortage area topic page on HRSA's data.hrsa.gov
website. All currently designated HPSAs remain designated until final lists are published later
this fall. HPSA designations that are currently proposed for withdrawal will remain in this status
until the publication of the HPSA Federal Register notice on or before November 1, 2024.
HPSAs proposed for withdraw will be re-evaluated before final publication if additional
information is made available to HPSA by states. If these HPSAs do not meet the requirements
for designation at the time of the publication of the HPSA Federal Register on or before
November 1, 2024, they will be withdrawn.
ADDRESSES: Complete lists of currently designated HPSAs as of April 15, 2024, and include
those proposed for withdraw, are available on the website at https://data.hrsa.gov/tools/healthworkforce/shortage-areas/frn. Frequently updated information on HPSAs is available at
https://data.hrsa.gov/topics/health-workforce/health-workforce-shortage-areas. Information on
shortage designations is available at https://bhw.hrsa.gov/workforce-shortage-areas/shortagedesignation.
FOR FURTHER INFORMATION CONTACT: For further information on the HPSA

designations listed on the website or to request additional designation, withdrawal, or
reapplication for designation, please contact Matthew Patterson, Acting Branch Chief, Shortage
Designation Branch, Division of Policy and Shortage Designation, Bureau of Health Workforce
(BHW), HRSA, 5600 Fishers Lane, Rockville, Maryland 20857, sdb@hrsa.gov.
SUPPLEMENTARY INFORMATION:
Background
Section 332 of the Public Health Service (PHS) Act, 42 U.S.C. 254e, provides that the
Secretary shall designate HPSAs based on criteria established by regulation. HPSAs are defined
in section 332 to include (1) urban and rural geographic areas with shortages of health
professionals, (2) population groups with such shortages, and (3) facilities with such shortages.
Section 332 further requires that the Secretary annually publish lists of the designated geographic
areas, population groups, and facilities. The lists of HPSAs are to be reviewed at least annually
and revised as necessary.
Final regulations (42 CFR part 5) were published on November 17, 1980 (45 FR 75996)
that include the criteria for designating HPSAs. Criteria were defined for seven health
professional types: primary medical care, dental, psychiatric, vision care, podiatric, pharmacy,
and veterinary care. The criteria for correctional facility HPSAs were published on October 29,
1987 (52 FR 41594) and revised March 2, 1989 (54 FR 8735). The criteria for psychiatric
HPSAs were expanded to mental health HPSAs on January 22, 1992 (57 FR 2473). Currently
funded PHS Act programs use the primary medical care, mental health, or dental HPSA or
relevant sub-score designations such as Maternity Care Target Areas.
HPSA designation offers access to potential federal assistance. Public or private
nonprofit entities are eligible to apply for assignment of National Health Service Corps personnel
to provide primary medical care, mental health, or dental health services in or to these HPSAs.
National Health Service Corps health professionals enter into service agreements to serve in
federally designated HPSAs. Entities with clinical training sites located in HPSAs are eligible to

receive priority for certain residency training program grants administered by HRSA’s Bureau of
Health Workforce (BHW). Other federal programs also utilize HPSA designations. For
example, under authorities administered by the Centers for Medicare & Medicaid Services,
certain qualified providers in geographic area HPSAs are eligible for increased levels of
Medicare reimbursement.
Content and Format of Lists
The three lists of designated HPSAs are available on the HRSA Data Warehouse shortage
area topic webpage, including those proposed for withdraw, and include a snapshot of all
geographic areas, population groups, and facilities that were designated HPSAs as of April 15,
2024. This notice incorporates the most recent annual reviews of designated HPSAs and
supersedes the HPSA lists published in the Federal Register on January 2, 2024 (FR/Vol. 89,
No. 1, Tuesday, January 2, 2024/Document Number 2023-28844). The proposed for withdraw
HPSAs will remain in that status until the lists are finalized this fall. States have the opportunity
to provide additional information as part of the review of proposed for withdraw HPSAs prior to
the lists being finalized this fall.
In addition, all Indian Tribes that meet the definition of such Tribes in the Indian Health
Care Improvement Act of 1976, 25 U.S.C. 1603, are automatically designated as population
groups with primary medical care and dental health professional shortages. Further, the Health
Care Safety Net Amendments of 2002 provides eligibility for automatic facility HPSA
designations for all federally qualified health centers (FQHCs) and rural health clinics that offer
services regardless of ability to pay. Specifically, these entities include FQHCs funded under
section 330 of the PHS Act, FQHC Look-Alikes, and Tribal and urban Indian clinics operating
under the Indian Self-Determination and Education Act of 1975 (25 U.S.C. 450) or the Indian
Health Care Improvement Act. Many, but not all, of these entities are included on this listing.
Absence from this list does not exclude them from HPSA designation; facilities eligible for
automatic designation are included in the database when they are identified.

Each list of designated HPSAs is arranged by state. Within each state, the list is
presented by county. If only a portion (or portions) of a county is (are) designated, a county is
part of a larger designated service area, or a population group residing in a county or a facility
located in the county has been designated, the name of the service area, population group, or
facility involved is listed under the county name. A county that has a whole county geographic
or population group HPSA is indicated by the phrase “County” following the county name.
Development of the Designation and Withdrawal Lists
Requests for designation or withdrawal of a particular geographic area, population group,
or facility as a HPSA are received continuously by BHW. Under a Cooperative Agreement
between HRSA and the 54 state and territorial Primary Care Offices (PCOs), PCOs conduct
needs assessments and submit applications to HRSA to designate areas as HPSAs. BHW refers
requests that come from other sources to PCOs for review. In addition, interested parties,
including Governors, state Primary Care Associations, and state professional associations, are
notified of requests so that they may submit their comments and recommendations.
BHW reviews each recommendation for possible addition, continuation, revision, or
withdrawal. Following review, BHW notifies the appropriate agency, individuals, and interested
organizations of each designation of a HPSA, rejection of recommendation for HPSA
designation, revision of a HPSA designation, and/or advance notice of pending withdrawals from
the HPSA list. Designations (or revisions of designations) are effective as of the date on the
notification from BHW and are updated daily on the HRSA Data Warehouse website. The
effective date of a withdrawal will be the next publication of a notice regarding the list of
designated HPSAs in the Federal Register.

Carole Johnson,
Administrator.
[FR Doc. 2024-14477 Filed: 6/28/2024 8:45 am; Publication Date: 7/1/2024]