By: Alex Sange, Public Policy Associate
After more than a year of meetings, the Negotiated Rule Making (NRM) process to develop new methodologies for designations of Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas/Populations (MUAs/Ps) came to a close last month – without reaching the desired full consensus on proposed new methodologies for both HPSA and MUA/P designations. These designations are intended to measure the degree to which a community is medically underserved (not enough providers to serve the population) and used to determine a community, area or facility’s eligibility for federal programs including the National Health Service Corps. The methodology has not been updated in decades and as required under the Affordable Care Act, a committee of 26 members including representatives from the health center community has convened since last September with the goal of identifying, and reaching consensus on, a new process to designating HPSAs and MUA/MUPs. If the group reached consensus (defined in this process as a unanimous vote), their recommendations to HHS Secretary Kathleen Sebelius about updating the designation process would be binding; without consensus, the Secretary may use the committee’s report for guidance in developing a new rule but it is nonbinding.
The final report was approved by the Committee with 2 dissenting votes out of 26 (5 members not present). Despite total unanimity, the group did reach agreement on a number of fronts and they have urged the Secretary to seriously consider each of their recommendations. We expect to see a rule published from HHS late next spring or early summer (2012). A summary of the Committee’s recommendations to the Secretary is here. Additional information on the Committee’s process and product is here.
Where in all of the rule-making detail are oral health and dental providers? Is there a change in establishing dentally underserved areas or is oral health not in the health field once again?
Mr/Ms Salyk – your point is well-taken; however, the charge to this Negotiated Rulemaking Committee was to revise and update the criteria and methodologies for only PRIMARY MEDICAL CARE HPSA and MUA/P designations. COmmittee members asked early on if we would be asked to provide guidance on Oral Health and mental health designations, and we were told that it was beyond our purview. I remain hopeful that, if this effort undertaken by the NRM Committee succeeds, we may soon see proposed updates to those designations as well.
Dan Hawkins
You’ve got to be kidding meit’s so tanrpsraently clear now!