Health Center Federal Policy, Uncategorized

HRSA Kicks Off Year-Long Negotiated Rulemaking Process to Change Shortage Designation Methodology

This past week, HRSA moved toward the starting line on implementing one piece of the new health reform law – the agency published the first Notice of Proposed Rulemaking to change the shortage designation methodologies for Medically Underserved Populations and Health Professional Shortage Areas.

The Patient Protection and Affordable Care Act required HRSA to use the Negotiated Rulemaking process to start immediately to update the shortage designation for MUPs and HPSAs.  The notice published May 11th starts a year-long process that will include a representative group of stakeholders, and is geared towards reaching consensus in order to ensure the regulation HRSA issues is supported by those most impacted by the changes.  Congress mandated that HRSA use this rulemaking process after the last shortage designation rulemaking in 2008 ended with no agreement.  NACHC has supported negotiated rulemaking as a way to engage stakeholders and make sure any policy changes help and don’t hurt health centers and their patients. This process is designed to do just that.

This notice is an important starting point and NACHC is preparing comments in response to the notice’s three areas of focus.

  1. HRSA proposes a list of issues and questions.  They are requesting feedback on whether these are the right questions and if there are other important points or issues to consider during negotiated rulemaking discussions.
  2. HRSA proposes a list of stakeholders who will make up the Negotiated Rulemaking Committee.  They are requesting feedback on whether this group of stakeholders is appropriate and soliciting nominations of interested and qualified parties who will bring an unrepresented and critically important perspective.
  3. HRSA proposes a timeline for the negotiated rulemaking process and an outline of the way the process, and the Negotiated Rulemaking Committee, will work.  They are requesting feedback on the timeline and policies that will govern the work of the Negotiated Rulemaking Committee.

The feedback HRSA gets will guide them as they build the Committee and navigate the stakeholder-governed rulemaking process.  NACHC’s Regulatory Affairs and Research teams are heading the efforts to write the comments on this initial notice already, which are due on June 10th, 2010.  We will keep health centers, PCAs and advocates informed as we move through this process through updates in the PCA Update, the Hotline, and this blog.  Stay tuned.


  1. May we receive a summary of HRSA’s proposal to change its method of designating HPSAs and if available its rationale for change? If so, please send this summary via e-mail.

  2. I have sent a detailed letter to Dan, Roger and Craig with my thoughts and hopes for the rulemaking process and outcomes. Thank you for your role in this activity and I hope members are kept informed at every step of the way. Let us know how we can help.

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