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INDIANA SHORTAGE DESIGNATIONS

INDIANA SHORTAGE DESIGNATIONS. Raymond J. Guest, M.P.H. Primary Care Office Manager Indiana State Department of Health. Definitions. Agencies. PCO PCA OSD HRSA NHSC CMS. Primary Care Office (ISDH). Primary Care Association (IPHCA). Office of Shortage Designation.

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INDIANA SHORTAGE DESIGNATIONS

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  1. INDIANA SHORTAGE DESIGNATIONS Raymond J. Guest, M.P.H. Primary Care Office Manager Indiana State Department of Health

  2. Definitions Agencies • PCO • PCA • OSD • HRSA • NHSC • CMS Primary Care Office (ISDH) Primary Care Association (IPHCA) Office of Shortage Designation Health Resources & Services Administration National Health Service Corps Centers for Medicare & Medicaid Services

  3. Definitions Types of Designations • HPSA • MUA • MUP Health Professional Shortage Area Medically Underserved Area Medically Underserved Population

  4. Designations Needed for Selected Federal Programs

  5. Application Process Determine Rational Service Area (RSA) Determine Contiguous Service Areas Identify providers (Local Help Needed) Collect data.

  6. Application Process Determine Rational Service Area (RSA) Single County Multi-county or Catchment Area Partial County Census Tracts Townships

  7. Application Process Facility Designations HPSA Designation of Facilities • Prisons • Medical Facilities (i.e. Community Health Centers) Automatic HPSA Designation of Facilities • Federally Qualified Health Centers (FQHC) • Rural Health Centers (RHC)

  8. Application Process Designation of a geographic area or population? Geographic area Population

  9. Application Process Designation of a geographic area or population? Populations that can be designated: Low-income/poor Migrant farm workers Homeless Medicaid eligible et al.

  10. Application Process Preliminary Analysis Determine Contiguous Service Areas 20 mile polygon for Primary Care HPSAs 25 mile polygon for Dental & Mental HPSAs No contiguous analysis for MUA/Ps

  11. Application Process Identify Providers Primary Care Physicians Family/General Practice General Internal Medicine General Pediatric Medicine OB/GYN Geriatric Medicine Immediate care physicians

  12. Application Process Identify Providers Dentists who provide direct patient care General Dentistry Pediatric Dentistry

  13. Application Process Identify Providers Core Mental Health Providers (CMHP) Psychiatrists Clinical Psychologists Clinical Social Workers Psychiatric Nurse Specialists Marriage and Family Therapists

  14. Application Process Collect demographic data Race Poverty Infant Mortality Rate Age (65+) Low-Income

  15. Application Process Survey providers In RSA In Contiguous Service Areas

  16. Application Process Analysis Are all the qualifications met?

  17. Application Process Analysis - Qualifications for RSAs • PC-HPSA – Geographic • 3500:1 pop to provider ratio • PC-HPSA – Population • 3000:1 pop to provider ratio • 30% of population must be at or below 200% of poverty

  18. Application Process Analysis - Qualifications for RSAs • Dent-HPSA – Geographic • 5000:1 pop to provider ratio • Dent-HPSA – Population • 4000:1 pop to provider ratio • 30% of population must be at or below 200% of poverty

  19. Application Process Analysis - Qualifications for RSAs Ment-HPSA Geographic • 30,000:1 psychiatrists only • 9,000:1 CMHP including psychiatrists • 6,000:1 CMHP and = or > 20,000:1 psychiatrists

  20. Application Process Analysis – Qualifications for RSAs • Ment-HPSA Population • 20,000:1 psychiatrists only • 6,000:1 CMHP including psychiatrists • 4,500:1 CMHP and > 15,000:1 psychiatrists • 30% of population must be at or below 200% of poverty

  21. Application Process Analysis - Qualifications for Contiguous Areas • Barriers to access • Distance • Physical barriers • Socio-Economic disparities • Contig Area has = or > designation • Self Identified neighborhood • Overutilization

  22. Application Process Analysis – Qualifications for Contiguous Areas • For Primary Care HPSAs, • no resources within 30 min • For Dental & Mental HPSA’s • no resources within 40 min.

  23. Application Process Analysis - Qualifications for Contiguous Areas Overutilization • Population to provider ratios • PC > 2,000:1 • Dent > 3,000:1 • Ment > 20,000:1 (psychiatrists) or • Ment > 3,000:1 (CMHP) + >10,000:1 (psychiatrists)

  24. Application Process Analysis – Qualifications for MUA/Ps • MUA & MUP– Score of 62 or less • Variables • % of Population in Poverty • % of Population 65 & over • Infant Mortality Rate • Providers per 1000 population

  25. Medically Underserved Area (MUA)

  26. Application Process Review • Identify RSA & Contig Areas • Identify providers • Survey providers • Analysis • Submission to OSD • Designation

  27. Resources ISDH web site http://www.in.gov/isdh/publications/llo/shortages/shortage.htm Official Designation Database http://hpsafind.hrsa.gov/ Nat’l Health Service Corps http://nhsc.bhpr.hrsa.gov

  28. Contact Natalie Brown, MPH Shortage Designations and National Health Service Corps Program Director Indiana Primary Health Care Assoc. nbrown@indianapca.org (317) 630-0845

  29. Contact Raymond J. Guest, MPH Primary Care Office Manager Indiana State Department of Health rguest@isdh.in.gov (317) 233-7846

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