List of primary care health manpower shortage areas designated under Section 332 of the Public Health Service Act

This notice provides a list, updated as of September 30, 1984, of primary care health manpower shortage areas designated by the Secretary of Health and Human Services under the authority of section 332 of the Public Health Service Act.     

List of primary care, dental and psychiatric health manpower shortage areas designated under Section 332 of the Public Health Service Act

This notice provides a list, updated as of December 31, 1982, of primary care, dental, and psychiatric health manpower shortage areas designated by the Secretary of Health and Human Services under the authority of section 332 of the Public Health Service Act.     

List of designated primary medical care health manpower shortage areas (HMSAs); list of withdrawals from primary medical care HMSA designation--PHS. Notice

This notice provides two lists. The first is a list of all areas, population groups, or facilities designated as primary medical care health manpower shortage areas (HMSAs) as of December 31, 1989. Second is a list of previously-designated primary medical care HMSAs that have been found to no longer meet the HMSA criteria and are therefore being withdrawn from the HMSA list. HMSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 332 of the Public Health Service Act.     

Public Health Service-Criteria for designation of health manpower shortage areas. Final regulations

These regulations set forth the criteria for designation of health manpower shortage areas under section 332 of the Public Health Services Act. Entities in these areas are eligible to apply for assignment of National Health Service Corps Personnel. These areas are also eligible areas for certain loan repayment, scholarship, and other Public Health Service programs.     

Public Health Service--assignment of National Health Service Corps personnel; requirements. Final regulation

This regulation sets forth the requirements for the assignment of National Health Service Corps personnel to public or nonprofit private entities to provide health services in or to health manpower shortage areas.     

Criteria for designation of mental health professional shortage areas--PHS. Final rule

This final rule amends the existing regulations governing the criteria for designation of health manpower shortage areas, or HMSAs (now health professional shortage areas, or HPSAs; name changed by Public Law 101-597, the National Health Service Corps Revitalization Amendments of 1990) under section 332 of the Public Health Service Act. Specifically, this amendment revises the existing criteria for designation of HMSAs having shortages of psychiatric manpower, transforming them into criteria for designation of HPSAs having shortages of mental health professionals, to take into account not only psychiatrists but also mental health service providers other than psychiatrists. The intended effect of this amendment is to more accurately assess the supply of mental health service providers when making shortage area determinations. This notice also summarizes the comments received by the Department on the Notice of Proposed Rulemaking published on August 8, 1989, which set forth the proposed methodology for making this and other changes to the HMSA criteria. It also formally changes "HMSA" to "HPSA" throughout the regulation, to conform with Public Law 101-597.     

Public Health Service--Grants for construction of teaching facilities, educational improvements, scholarships and student loans; grants for nurse practitioner traineeship programs. Interim-final regulations

These regulations set forth requirements for grants to schools of nursing, medicine, and public health, to public or nonprofit private hospitals, and to other nonprofit entities to meet the costs of traineeships for the training of nurse practitioners. Trainees must reside in health manpower shortage areas and sign a commitment with the Secretary to practice full-time as nurse practitioners in areas having shortages of primary medical care manpower.     

Withdrawals from list of designated primary care health manpower shortage areas--HRSA

This notice provides a list of those areas that have been withdrawn from designation as having primary care health manpower shortages since the most recent list of all designated Health Manpower Shortage Areas ( HMSAs ) was published in the Federal Register on August 19, 1983 (48 FR 37822). Such areas are designated or withdrawn by the Secretary of Health and Human Services under the authority of section 332 of the Public Health Service Act. A forthcoming notice will list those HMSAs that remain designated or have been newly designated.     

Lists of designated primary medical care, mental health, and dental health professional shortage areas--HRSA. Notice

This notice provides lists of all areas, population groups, and facilities designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of September 30, 1996. HPSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 332 of the Public Health Service (PHS) Act.     

Lists of designated primary medical care, mental health, and dental health professional shortage areas--HRSA. Notice

This notice provides lists of all areas, population groups, and facilities designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of June 15, 1995. HPSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 332 of the Public Health Service (PHS) Act.     

List of designated primary medical care, mental health, and dental health professional shortage areas--HRSA. Notice

This notice provides lists of all areas, population groups, and facilities designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of March 31, 1997. HPSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 322 of the Public Health Service (PHS) Act.     

List of designated primary medical care health professional shortage areas (HPSAs); list of withdrawals from primary medical care HPSA designation--HRSA. Notice

This notice provides two lists. The first is a list of all areas, population groups, or facilities designated as primary medical care health professional shortage areas (HPSAs) as of June 30, 1992. Second is a list of previously-designated primary medical care HPSAs that have been found to no longer meet the HPSA criteria and therefore are being withdrawn from the HPSA list. HPSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 332 of the Public Health Service Act.     

List of designated primary medical care health professional shortage areas (HPSAs); list of withdrawals from primary medical care HPSA designation--HHS. Notice

This notice provides two lists. The first is a list of all areas, population groups, or facilities designated as primary medical care health professional shortage areas (HPSAs) as of August 31, 1993. Second is a list of previously designated primary medical care HPSAs that have been found to no longer meet the HPSA criteria and therefore are being withdrawn from the HPSA list. HPSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 332 of the Public Health Service Act.     

List of designated primary medical care health professional shortage areas (HPSAs); list of withdrawals from primary medical care HPSA designation--PHS. Notice

This notice provides two lists. The first is a list of all areas, population groups, or facilities designated as primary medical care health professional shortage areas (HPSAs) as of June 30, 1991. Second is a list of previously-designated primary medical care HPSAs that have been found to no longer meet the HPSA criteria and are therefore being withdrawn from the HPSA list. HPSAs are designated or withdrawn by the Secretary of Health and Human Services (HHS) under the authority of section 332 of the Public Health Service Act.     

Waiver of the two-year home country physical presence requirement for certain foreign medical graduates--INS. Interim rule with request for comments

This rule amends the Immigration and Naturalization Service (Service) regulations by allowing certain foreign medical graduates who entered the United States in J-1 status, or who acquired J-1 status after arrival in the United States, to obtain a waiver of the 2-year home country residence and physical presence requirement under section 212(e)(iii) of the Immigration and Nationality Act (Act) pursuant to a request by a State Department of Public Health, or its equivalent. The waiver is intended to permit these foreign medical graduates to work at a health care facility in an area designated by the Secretary, Health and Human Services (HHS), as having a shortage of health care professionals ("HHS-designated shortage area"). This interim rule also contains provisions which will permit these foreign medical graduates to change their nonimmigrant status in the United States from J-1 exchange visitor to H-1B specialty occupation worker.     

Grants for nurse practitioner traineeship programs--PHS. Interim final regulations

These regulations set forth requirements for grants to schools of nursing, medicine, and public health, to public or nonprofit private hospitals, and to other public or nonprofit private entities to meet the costs of traineeships for training nurse practitioners. A trainee must sign a commitment with the Secretary to practice full-time as a nurse practitioner in a primary medical care health manpower shortage area, designated under section 332 of the Public Health Service Act (the Act), for a period equal to 1 month for each month of traineeship support, after completion of the training. If this obligation is not fulfilled, a trainee must pay back traineeship support. The purpose of these regulations is to respond to the comments on the 1980 interim final regulations and to conform 42 CFR Part 57, Subpart AA, with the Paperwork Reduction Act of 1980, Pub. L. 96-511, and with the Omnibus Budget Reconciliation Act of 1981, Pub. L. 97-35, which requires, among other provisions, that the Secretary provide, by regulation, for the waiver or suspension of the repayment obligation under certain conditions. In addition, other minor changes have been made and Office of Management and Budget (OMB) numbers are cited in those sections which have approved reporting and recordkeeping requirements.     

Establishment of criteria for determining priorities among designated health professional shortage areas--HRA. Notice

In accordance with the requirement of section 333A(c) of the Public Health Service Act, as amended by Public Law 101-597 (the National Health Service Corps Revitalization Amendments of 1990), this Notice establishes the criteria which the Secretary will use to make determinations under section 333A(a)(1)(A) of the health professional shortage areas (HPSAs) with the greatest shortages, using the exclusive factors specified in section 333A(b).     

Designation of medically underserved populations and health professional shortage areas--HRSA. Proposed rules

The rules proposed below would consolidate the processes for designating medically underserved populations (MUPs) and health professional shortage areas (HPSAs), designations that are used in several DHHS programs. The purpose is to improve the way underserved areas are designated by incorporating up-to-date measures of health status and access barriers and eliminating inconsistencies and duplication of effort. The intended effect is to reduce the effort and data burden on States and communities by simplifying and automating the design process as much as possible, while maximizing the use of technology. The proposed rules involve major changes to both the MUP and the primary care HPSA designation criteria, which have the effect of making primary care HPSAs a subset of the MUPs. No changes are proposed with respect to the criteria for designating dental and mental health HPSAs. Podiatric, vision care, pharmacy, and veterinary care HPSA designations would be abolished under the rules proposed below.     

Responding to the immunoglobulin shortage: a case study

In fall 1997, a shortage of intravenous immunoglobulin (IVIG) developed in the United States because of increased demand for the product, reduced supply, and product recalls. This shortage is a useful model for understanding how our health care system responds to scarcity. Although the U.S. government took steps to inform the medical community of the shortage, with few exceptions, the government did not respond to the shortage in a timely or effective manner. Instead, it took a relatively passive role, leaving IVIG manufacturers and distributors, health care institutions, and clinicians to fend for themselves. The shortage likely had an uneven impact on patients, based on the relative market strength of the health care institutions in which they received care and the individual patient's ability to absorb the increasing out-of-pocket costs of scarce IVIG. Market mechanisms have now largely alleviated the shortage and significantly reduced its detrimental impact on patients. However, future shortages of IVIG or other scarce medical products, such as vaccines and antibiotics, would benefit from more immediate and coordinated efforts not only to make sure that scarce health care resources are distributed in a just manner but also to identify and remedy the sources of health product supply problems.