WASHINGTON — The Department of Health and Human Services (HHS) yesterday withdrew a proposed rule on the designation of Medically Underserved Areas/Populations (MUA/P) and Health Professional Shortage Areas (HPSA) that threatened to disrupt health center funding and jeopardize health care for poor and underserved populations across the nation. (The Federal Register notice announcing this decision is available at http://wp-content/uploads/2013/01/E8-16831.pdf.) The Notice of Proposed Rulemaking (NPRM), issued in the Federal Register on February 29, sought to create a new method to designate HPSAs and MUA/Ps, by creating a three-tier system with new criteria for designation. These designations are used by the federal government to prioritize the distribution of federal and state funds, including clinical resources to vulnerable and underserved communities.
In withdrawing the rule, the Health Resources and Services Administration (HRSA) cited receipt of “many substantive comments on the proposed rule,” a reference to the hundreds of comments submitted during the public comment period, which ended June 30, 2008 after two extensions. A comprehensive analysis of the proposed rule by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative issued in April 2008 provided the first up-to-date estimates of the effects of the proposed regulations on safety net providers and vulnerable populations. The policy brief, “Analysis of the Proposed Rule on Designation of Medically Underserved Populations and Health Professional Shortage Areas” was conducted by faculty at The George Washington University Medical Center’s School of Public Health and Health Services, with analytical help provided by the Robert Graham Center.
The analysis found that only one-third of all health centers would continue to meet Tier 1 status, an indicator of high need for resources. Fewer areas would receive designations of underservice, and one-third would be designated “safety net facilities,” the lowest priority group for funding. The proposed rule would disproportionally affect urban areas, as well as states in the northeast and northwest. A subsequent analysis of grantee-level data, released in May 2008, estimated that more than 300 health centers would need an alternative pathway to reach tier-based designation.
“Our analysis of the expected effects of the proposed regulations demonstrates that there would have been significant adverse consequences for safety net health care services in many areas even though need is increasing,” said Sara Rosenbaum, JD, Hirsh Professor and chair, Department of Health Policy. “While the current designation methodology is over 30 years old and in need of an overhaul, we welcome HRSA’s announcement that the proposed rule has been withdrawn. We look forward to having the opportunity to review a new proposal that will better address documented need.”
“The proposed regulations would have jeopardized the ability of community health centers to provide care to underserved populations nationwide,” said Julio Bellber, president and CEO of the RCHN Community Health Foundation. “The input of hundreds of respondents across the country, coupled with the thorough and timely research by the Collaborative, was crucial in leading HRSA to this important decision.”
About the RCHN Community Health Foundation
The RCHN Community Health Foundation (RCHN CHF) is a New York-based not-for-profit operating foundation dedicated to supporting and benefiting community health centers (CHCs) in New York state and nationally. The Foundation develops and supports programmatic and business initiatives related to community health center access, pharmacy and health information technology through strategic investment, research, outreach, education, and coalition building and advocacy. For more information about RCHN CHF, contact Chief Operating Officer Feygele Jacobs at 212-246-1122 ext. 712 or fjacobs@rchnfoundation.org.
About The George Washington University Medical Center
The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, DC metropolitan area for 176 years. The Medical Center comprises the School of Medicine and Health Sciences, the 11th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation’s capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and a subsidiary of Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit www.gwumc.edu.
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