HPSA Statute - Attachment A

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245

PUBLIC HEALTH SERVICE ACT

Sec. 332

(i) double the period of obligated service that would
otherwise be required; or
(ii) in the case of contracts entered into under section
338B, accept a minimum service obligation of 2 years with
an award amount equal to 50 percent of the amount that
would otherwise be payable for full-time service; and
(F) the Corps member agrees in writing that if the Corps
member begins providing half-time service but fails to begin or
complete the period of obligated service, the method stated in
338E(c) for determining the damages for breach of the individual’s written contract will be used after converting periods of
obligated service or of service performed into their full-time
equivalents.
(3) In evaluating waivers issued under paragraph (1), the Secretary shall examine the effect of multidisciplinary teams.
(j) For the purposes of this subpart and subpart III:
(1) The term ‘‘Department’’ means the Department of
Health and Human Services.
(2) The term ‘‘Loan Repayment Program’’ means the National Health Service Corps Loan Repayment Program established under section 338B.
(3) The term ‘‘Scholarship Program’’ means the National
Health Service Corps Scholarship Program established under
section 338A.
(4) The term ‘‘State’’ includes, in addition to the several
States, only the District of Columbia, the Commonwealth of
Puerto Rico, the Commonwealth of the Northern Mariana Islands, the Virgin Islands, Guam, American Samoa, and the
Trust Territory of the Pacific Islands.
(5) The terms ‘‘full time’’ and ‘‘full-time’’ mean a minimum
of 40 hours per week in a clinical practice, for a minimum of
45 weeks per year.
(6) The terms ‘‘half time’’ and ‘‘half-time’’ mean a minimum of 20 hours per week (not to exceed 39 hours per week)
in a clinical practice, for a minimum of 45 weeks per year.
DESIGNATION OF HEALTH PROFESSIONAL SHORTAGE AREAS

SEC. 332. ø254e¿ (a)(1) For purposes of this subpart the term
‘‘health professional shortage area’’ means (A) an area in an urban
or rural area (which need not conform to the geographic boundaries
of a political subdivision and which is a rational area for the delivery of health services) which the Secretary determines has a health
manpower shortage, (B) a population group which the Secretary determines has such a shortage, or (C) a public or nonprofit private
medical facility or other public facility which the Secretary determines has such a shortage. All Federally qualified health centers
and rural health clinics, as defined in section 1861(aa) of the Social
Security Act (42 U.S.C. 1395x(aa)), that meet the requirements of
section 334 shall be automatically designated as having such a
shortage. The Secretary shall not remove an area from the areas
determined to be health professional shortage areas under subparagraph (A) of the preceding sentence until the Secretary has afforded interested persons and groups in such area an opportunity
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to provide data and information in support of the designation as a
health professional shortage area or a population group described
in subparagraph (B) of such sentence or a facility described in subparagraph (C) of such sentence, and has made a determination on
the basis of the data and information submitted by such persons
and groups and other data and information available to the Secretary.
(2) For purposes of this subsection, the term ‘‘medical facility’’
means a facility for the delivery of health services and includes—
(A) a hospital, State mental hospital, public health center,
outpatient medical facility, rehabilitation facility, facility for
long-term care, community mental health center, migrant
health center, facility operated by a city or county health department, and community health center and which is not reasonably accessible to an adequately served area;
(B) such a facility of a State correctional institution or of
the Indian Health Service, and a health program or facility operated by a tribe or tribal organization under the Indian SelfDetermination Act;
(C) such a facility used in connection with the delivery of
health services under section 321 (relating to hospitals), 322
(relating to care and treatment of persons under quarantine
and others), 323 (relating to care and treatment of Federal
prisoners), 324 (relating to examination and treatment of certain Federal employees), 325 (relating to examination of
aliens), 326 (relating to services to certain Federal employees),
320 (relating to services for persons with Hansen’s disease), or
330(h) (relating to the provision of health services to homeless
individuals); and
(D) a Federal medical facility.
(3) Homeless individuals (as defined in section 330(h)(5)), seasonal agricultural workers (as defined in section 330(g)(3)) and migratory agricultural workers (as so defined)), and residents of public housing (as defined in section 3(b)(1) of the United States Housing Act of 1937 (42 U.S.C. 1437a(b)(1))) may be population groups
under paragraph (1).
(b) The Secretary shall establish by regulation criteria for the
designation of areas, population groups, medical facilities, and
other public facilities, in the States, as health professional shortage
areas. In establishing such criteria, the Secretary shall take into
consideration the following:
(1) The ratio of available health manpower to the number
of individuals in an area or population group, or served by a
medical facility or other public facility under consideration for
designation.
(2) Indicators of a need, notwithstanding the supply of
health manpower, for health services for the individuals in an
area or population group or served by a medical facility or
other public facility under consideration for designation.
(3) The percentage of physicians serving an area, population group, medical facility, or other public facility under consideration for designation who are employed by hospitals and
who are graduates of foreign medical schools.
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(c) In determining whether to make a designation, the Secretary shall take into consideration the following:
(1) The recommendations of the Governor of each State in
which the area, population group, medical facility, or other
public facility under consideration for designation is in whole
or part located.
(2) The extent to which individuals who are (A) residents
of the area, members of the population group, or patients in
the medical facility or other public facility under consideration
for designation, and (B) entitled to have payment made for
medical services under title XVIII, XIX, or XXI of the Social
Security Act, cannot obtain such services because of suspension
of physicians from the programs under such titles.
(d)(1) In accordance with the criteria established under subsection (b) and the considerations listed in subsection (c), the Secretary shall designate health professional shortage areas in the
States, publish a descriptive list of the areas, population groups,
medical facilities, and other public facilities so designated, and at
least annually review and, as necessary, revise such designations.
(2) For purposes of paragraph (1), a complete descriptive list
shall be published in the Federal Register not later than July 1 of
1991 and each subsequent year.
(e)(1) Prior to the designation of a public facility, including a
Federal medical facility, as a health professional shortage area, the
Secretary shall give written notice of such proposed designation to
the chief administrative officer of such facility and request comments within 30 days with respect to such designation.
(2) Prior to the designation of a health professional shortage
area under this section, the Secretary shall, to the extent practicable, give written notice of the proposed designation of such area
to appropriate public or private nonprofit entities which are located
or have a demonstrated interest in such area and request comments from such entities with respect to the proposed designation
of such area.
(f) The Secretary shall give written notice of the designation of
a health professional shortage area, not later than 60 days from
the date of such designation, to—
(1) the Governor of each State in which the area, population group, medical facility, or other public facility so designated is in whole or part located; and
(2) appropriate public or nonprofit private entities which
are located or which have a demonstrated interest in the area
so designated.
(g) Any person may recommend to the Secretary the designation of an area, population group, medical facility, or other public
facility as a health professional shortage area.
(h) The Secretary may conduct such information programs in
areas, among population groups, and in medical facilities and other
public facilities designated under this section as health professional
shortage areas as may be necessary to inform public and nonprofit
private entities which are located or have a demonstrated interest
in such areas of the assistance available under this title by virtue
of the designation of such areas.
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(i) DISSEMINATION.—The Administrator of the Health Resources and Services Administration shall disseminate information
concerning the designation criteria described in subsection (b) to—
(1) the Governor of each State;
(2) the representative of any area, population group, or facility selected by any such Governor to receive such information;
(3) the representative of any area, population group, or facility that requests such information; and
(4) the representative of any area, population group, or facility determined by the Administrator to be likely to meet the
criteria described in subsection (b).
(j)(1) The Secretary shall submit the report described in paragraph (2) if the Secretary, acting through the Administrator of the
Health Resources and Services Administration, issues—
(A) a regulation that revises the definition of a health professional shortage area for purposes of this section; or
(B) a regulation that revises the standards concerning priority of such an area under section 333A.
(2) On issuing a regulation described in paragraph (1), the Secretary shall prepare and submit to the Committee on Energy and
Commerce of the House of Representatives and the Committee on
Health, Education, Labor, and Pensions of the Senate a report that
describes the regulation.
(3) Each regulation described in paragraph (1) shall take effect
180 days after the committees described in paragraph (2) receive
a report referred to in such paragraph describing the regulation.
(k)(1) The Secretary, acting through the Administrator of the
Health Resources and Services Administration, shall identify,
based on the data collected under paragraph (3), maternity care
health professional target areas that satisfy the criteria described
in paragraph (2) for purposes of, in connection with receipt of assistance under this title, assigning to such identified areas maternity care health professionals who, without application of this subsection, would otherwise be eligible for such assistance. The Secretary shall distribute maternity care health professionals within
health professional shortage areas using the maternity care health
professional target areas so identified.
(2) For purposes of paragraph (1), the Secretary shall establish
criteria for maternity care health professional target areas that
identify geographic areas within health professional shortage areas
that have a shortage of maternity care health professionals.
(3) For purposes of this subsection, the Secretary shall collect
and publish in the Federal Register data comparing the availability
and need of maternity care health services in health professional
shortage areas and in areas within such health professional shortage areas.
(4) In carrying out paragraph (1), the Secretary shall seek
input from relevant provider organizations, including medical societies, organizations representing medical facilities, and other organizations with expertise in maternity care.
(5) For purposes of this subsection, the term ‘‘full scope maternity care health services’’ includes during labor care, birthing, prenatal care, and postpartum care.
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(6) Nothing in this subsection shall be construed as—
(A) requiring the identification of a maternity care health
professional target area in an area not otherwise already designated as a health professional shortage area; or
(B) affecting the types of health professionals, without application of this subsection, otherwise eligible for assistance,
including a loan repayment or scholarship, pursuant to the application of this section.
ASSIGNMENT OF CORPS PERSONNEL

SEC. 333. ø254f¿ (a)(1) The Secretary may assign members of
the Corps to provide, under regulations promulgated by the Secretary, health services in or to a health professional shortage area
during the assignment period only if—
(A) a public or private entity, which is located or has a
demonstrated interest in such area, makes application to the
Secretary for such assignment;
(B) such application has been approved by the Secretary;
(C) the entity agrees to comply with the requirements of
section 334; and
(D) the Secretary has (i) conducted an evaluation of the
need and demand for health professional shortage area, the intended use of Corps members to be assigned to the area, community support for the assignment of Corps members to the
area, the area’s efforts to secure health professional shortage
area, and the fiscal management capability of the entity to
which Corps members would be assigned and (ii) on the basis
of such evaluation has determined that—
(I) there is a need and demand for health manpower
for the area;
(II) there has been appropriate and efficient use of any
Corps members previously assigned to the entity for the
area;
(III) there is general community support for the assignment of Corps members to the entity;
(IV) the area has made unsuccessful efforts to secure
health manpower for the area;
(V) there is a reasonable prospect of sound fiscal management, including efficient collection of fee-for-service,
third-party, and other appropriate funds, by the entity
with respect to Corps members assigned to such entity;
and
(VI) 39 the entity demonstrates willingness to
support or facilitate mentorship, professional development, and training opportunities for Corps
members.
An application for assignment of a Corps member to a health professional shortage area shall include a demonstration by the applicant that the area or population group to be served by the applicant has a shortage of personal health services and that the Corps
member will be located so that the member will provide services to
39 Margin

so in law.

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