1. 1
Government of the District of Columbia
For Official Government Use Only
Department of Health
Health Professional Shortage Area (HPSA)
Designations
November 2014
Lauren Ratner, MPH, MSW
Primary Care Bureau
Community Health Administration
DC Department of Health
2. 2
Government of the District of Columbia
For Official Government Use Only
Department of Health
Presentation Purpose
To orient the membership of the Board of Dentistry to
HPSAs
To discuss collaboration on the BoD’s workforce survey
3. 3
Government of the District of Columbia
For Official Government Use Only
Department of Health
What is a HPSA?
Health Professional Shortage Area (HPSA): federal designation that indicates
a shortage of personal health services in a defined area.
3 designation disciplines
– Primary Care
– Mental Health
– Dental
2 types of designations
– Geographic: Insufficient number of providers to serve the total
population in a defined area
– Population: Insufficient number of providers to serve a specific
population (e.g. low-income, homeless, etc.) in a defined area
4. 4
Government of the District of Columbia
For Official Government Use Only
Department of Health
What is a HPSA?
Standard for eligibility or priority for over 32 federal
programs
Shortage Designation
Option
National Health
Service Corps
Health
Professional
Loan Repayment
Program
Federally
Qualified Health
Center Program
CMS
Medicare
Incentive Payment
J-1 Visa Waiver
Primary Care HPSA X X X X
Dental Care HPSA X X
Mental Health HPSA X X X
Geographic HPSA X X X X
Population HPSA X X X
Facility HPSA X X X
Exceptional MUP X X
Medically Underserved
Area
X X X
Medically Underserved
Population
X X X
5. 5
Government of the District of Columbia
For Official Government Use Only
Department of Health
DC’s HPSAs
Nine (9) HPSAs:
• 6 primary care;
• 1 mental health;
• 2 dental
• Low-Income Anacostia
• Homeless Downtown
6. 6
Government of the District of Columbia
For Official Government Use Only
Department of Health
Dental HPSA Calculations
Dental HPSA calculations based on:
Population-to-Provider Ratios (>5,000:1 or
>4,000:1 if special needs)
Poverty Rates
Flouridated Water
Travel time to nearest available dentist
7. 7
Government of the District of Columbia
For Official Government Use Only
Department of Health
Designation Process
Presently, HPSAs must be reviewed and renewed every
3-5 years.
Dental HPSAs renewals planned for 2016
Renewal and designation of new HPSAs requires
detailed data on all dentists practicing in the District.
541 Dentists in DC (according to NPI)
8. 8
Government of the District of Columbia
For Official Government Use Only
Department of Health
Dental Provider Data
CMS’s National Provider Identifier (NPI)
DOH must augment NPI data by collecting
information on:
– Clinical vs. Non-Clinical Activities
– Practice Locations and Hours
– Medicaid Participation
– Number of Auxiliaries (e.g. Dental Assistants)
– Dentist’s Age
9. 9
Government of the District of Columbia
For Official Government Use Only
Department of Health
DOH Data Collection
Claims data from DHCF
Licensure data from HRLA
Surveys
– BoD Workforce Survey
– Primary Care Bureau Survey
– Phone Follow-Up
10. 10
Government of the District of Columbia
For Official Government Use Only
Department of Health
2011 and 2013 Board of Dentistry
Workforce Surveys
Included Key HPSA Data Points:
Primary/Secondary Practice Area and Hours (e.g. clinical, academics, administration, etc.)
Specialty (e.g. General, Pediatric, Orthodontics, etc.)
Primary/Secondary Clinical Practice Addresses and Hours
Patient Demographics:
– Medicaid (% - 2011; Y/N - 2013)
– Homeless % (2011)
– Language % (2011)
Practice Characteristics:
– Auxiliaries (2013)
– Sliding fee (2011)
– Wait Time (new and existing patients) (2011)
11. 11
Government of the District of Columbia
For Official Government Use Only
Department of Health
Collaboration with Board of Dentistry
2015 BoD Workforce Survey development/deployment
– Questions
– Question Structure
– Response Rates
Workforce Survey Data Analysis
– Cleaning
– Linkage
Findings and Action
– HPSA Designations
– Workforce Reports
12. 12
Government of the District of Columbia
For Official Government Use Only
Department of Health
Questions?
Contact Information:
Lauren Ratner, Primary Care Bureau Chief
202-442-9350
Lauren.Ratner@dc.gov
Additional Resources:
–http://doh.dc.gov/service/shortage-designation
–http://www.hrsa.gov/shortage/
–HPSAFind.hrsa.gov
Editor's Notes
In the interest of time, I’m going to limit my discussion to HPSAs and not Medically Underserved Area designations. MUAs are very similar designations to Primary Care HPSA designations. However, they do not expire as HPSAs do
In DC, “areas” are clusters of census tracts.
In the interest of time, I’m going to limit my discussion to HPSAs and not Medically Underserved Area designations. MUAs are very similar designations to Primary Care HPSA designations. However, they do not expire as HPSAs do
In DC, “areas” are clusters of census tracts.
Low income: There are not enough physicians to provide services for patients insured by Medicaid or for uninsured patients
Designations are ranked on a scale of 1-25 where the higher the score, the higher the need
At least 8 states have implemented this kind of a process for HPSA designations