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INDIANA SHORTAGE DESIGNATIONS Raymond J. Guest, M.P.H.
 

INDIANA SHORTAGE DESIGNATIONS Raymond J. Guest, M.P.H.

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    INDIANA SHORTAGE DESIGNATIONS Raymond J. Guest, M.P.H. INDIANA SHORTAGE DESIGNATIONS Raymond J. Guest, M.P.H. Presentation Transcript

    • INDIANA SHORTAGE DESIGNATIONS Raymond J. Guest, M.P.H. Primary Care Office Manager Indiana State Department of Health
    • Definitions
      • PCO
      • PCA
      • OSD
      • HRSA
      • NHSC
      • CMS
      National Health Service Corps Centers for Medicare & Medicaid Services Health Resources & Services Administration Primary Care Office (ISDH) Primary Care Association (IPHCA) Agencies Office of Shortage Designation
    • Definitions
      • HPSA
      • MUA
      • MUP
      Health Professional Shortage Area Medically Underserved Area Medically Underserved Population Types of Designations
    • Designations Needed for Selected Federal Programs X X Governor’s Exception MUP X X MUP X X X MUA X X X Facility HPSA X X X X Population HPSA X X X X X Geographic HPSA HPSA Subtypes X Geographic only, ask CMS X X Mental HPSA X X Dental HPSA X X Geographic only X X Primary Care HPSA J-1 Visa Waiver Program CMS Rural Health Clinic Program CMS Medicare Incentive Payment Program FQHC Program SLRP NHSC
    • Application Process
      • Determine Rational Service Area (RSA)
      • Determine Contiguous Service Areas
      • Identify providers ( Local Help Needed )
      • Collect data.
    • Application Process
      • Determine Rational Service Area (RSA)
      • Single County
      • Multi-county or Catchment Area
      • Partial County
      • Census Tracts
      • Townships
    • Application Process
      • Facility Designations
      • HPSA Designation of Facilities
      • Prisons
      • Medical Facilities ( i.e. Community Health Centers)
      • Automatic HPSA Designation of Facilities
      • Federally Qualified Health Centers (FQHC)
      • Rural Health Centers (RHC)
    • Application Process
      • Designation of a geographic area or population?
      • Geographic area
      • Population
    • Application Process
      • Designation of a geographic area or population?
      • Populations that can be designated:
      • Low-income/poor
      • Migrant farm workers
      • Homeless
      • Medicaid eligible
      • et al.
    • Application Process
      • Preliminary Analysis
      • Determine Contiguous Service Areas
      • 20 mile polygon for Primary Care HPSAs
      • 25 mile polygon for Dental & Mental HPSAs
      • No contiguous analysis for MUA/Ps
    •  
    • Application Process
      • Identify Providers
      • Primary Care Physicians
      • Family/General Practice
      • General Internal Medicine
      • General Pediatric Medicine
      • OB/GYN
      • Geriatric Medicine
      • Immediate care physicians
    • Application Process
      • Identify Providers
      • Dentists who provide direct patient care
      • General Dentistry
      • Pediatric Dentistry
    • Application Process
      • Identify Providers
      • Core Mental Health Providers (CMHP)
      • Psychiatrists
      • Clinical Psychologists
      • Clinical Social Workers
      • Psychiatric Nurse Specialists
      • Marriage and Family Therapists
    • Application Process
      • Collect demographic data
      • Race
      • Poverty
      • Infant Mortality Rate
      • Age (65+)
      • Low-Income
    • Application Process
      • Survey providers
      • In RSA
      • In Contiguous Service Areas
    • Application Process
      • Analysis
      • Are all the qualifications met?
    • Application Process
      • Analysis - Qualifications for RSAs
      • PC-HPSA – Geographic
        • 3500:1 pop to provider ratio
      • PC-HPSA – Population
        • 3000:1 pop to provider ratio
        • 30% of population must be at or below 200% of poverty
    • Application Process
      • Analysis - Qualifications for RSAs
      • Dent-HPSA – Geographic
        • 5000:1 pop to provider ratio
      • Dent-HPSA – Population
        • 4000:1 pop to provider ratio
        • 30% of population must be at or below 200% of poverty
    • Application Process
      • Analysis - Qualifications for RSAs
      • Ment-HPSA Geographic
        • 30,000:1 psychiatrists only
        • 9,000:1 CMHP including psychiatrists
        • 6,000:1 CMHP and = or > 20,000:1 psychiatrists
    • Application Process
      • Analysis – Qualifications for RSAs
      • Ment-HPSA Population
        • 20,000:1 psychiatrists only
        • 6,000:1 CMHP including psychiatrists
        • 4,500:1 CMHP and > 15,000:1 psychiatrists
        • 30% of population must be at or below 200% of poverty
    • Application Process
      • Analysis - Qualifications for Contiguous Areas
      • Barriers to access
        • Distance
        • Physical barriers
        • Socio-Economic disparities
        • Contig Area has = or > designation
        • Self Identified neighborhood
        • Overutilization
    • Application Process
      • Analysis – Qualifications for Contiguous Areas
      • For Primary Care HPSAs,
        • no resources within 30 min
      • For Dental & Mental HPSA’s
        • no resources within 40 min.
    •  
    • Application Process
      • Analysis - Qualifications for Contiguous Areas Overutilization
        • Population to provider ratios
          • PC > 2,000:1
          • Dent > 3,000:1
          • Ment > 20,000:1 (psychiatrists) or
          • Ment > 3,000:1 (CMHP) + > 10,000:1 (psychiatrists)
    • Application Process
      • Analysis – Qualifications for MUA/Ps
      • MUA & MUP– Score of 62 or less
        • Variables
          • % of Population in Poverty
          • % of Population 65 & over
          • Infant Mortality Rate
          • Providers per 1000 population
    • Medically Underserved Area (MUA) .151 13.1 12.2% 10.5% Value 61.1 Total Score .5 V4. Prov/1000 pop 21.5 V3. IMR 19.1 V2. > 65 pop 20.0 V1. Poverty WV Variable
    • Application Process
      • Review
      • Identify RSA & Contig Areas
      • Identify providers
      • Survey providers
      • Analysis
      • Submission to OSD
      • Designation
    • Resources
      • ISDH web site
      • http://www.in.gov/isdh/publications/llo/shortages/shortage.htm
      • Official Designation Database
      • http://hpsafind.hrsa.gov/
      • Nat’l Health Service Corps
      • http://nhsc.bhpr.hrsa.gov
    • Contact
      • Natalie Brown, MPH
      • Shortage Designations and National Health Service Corps Program Director
      • Indiana Primary Health Care Assoc.
      • [email_address]
      • (317) 630-0845
    • Contact
      • Raymond J. Guest, MPH
      • Primary Care Office Manager
      • Indiana State Department of Health
      • [email_address]
      • (317) 233-7846