82 Federal Register / Vol. 89, No. 1 / Tuesday, January 2, 2024 / Notices 

V. Provisions of the Final Notice 

A. Differences Between CHAP’s 

Standards and Requirements for 

Accreditation and Medicare Conditions 

and Survey Requirements 

We compared CHAP’s HHA 

requirements and survey process with 

the Medicare CoPs and survey process 

as outlined in the State Operations 

Manual (SOM). Our review and 

evaluation of CHAP’s HHA application 

were conducted as described in section 

III. of this notice and have yielded the 

following areas where, as of the date of 

this notice, CHAP has completed 

revising its standards and certification 

processes to meet the standard’s 

requirements of all the following 

regulations: 

• Section 484.50(c)(8), to clarify 

under Patient Right’s that the HHA must 

also comply with the requirements of 42 

CFR 405.1200 through 405.1204 when 

providing the patient with written 

notice, in advance of a specific service 

being furnished. 

• Section 484.75(c)(2), to specify that 

when rehabilitative therapy services are 

provided under the supervision of an 

occupational therapist or physical 

therapist, the qualified professional 

meets the requirements of § 484.115(f) 

or (h), respectively. 

• Section 484.75(c)(3), to specify that 

when medical social services are 

provided under the supervision of a 

social worker, the requirements of 

§ 484.115(m) are met. 

• Section 484.100(a), to appropriately 

cross-reference the Medicare conditions 

of §§ 420.201, 420.202, and 420.206 or 

corresponding comparable CHAP 

standards. 

• Section 484.102(d)(2)(iii), to 

include the requirement for HHAs to 

analyze the HHA’s response to and 

maintain documentation of all drills, 

tabletop exercises, and emergency 

events, and revise the HHA’s emergency 

plan, as needed. 

• Section 484.105(g), to appropriately 

cross-reference the Medicare conditions 

of §§ 485.713, 485.715, 485.719, 

485.723, and 485.727 or corresponding 

comparable CHAP standards. 

In addition to the standards review, 

CMS also reviewed CHAP’s comparable 

survey processes, which were 

conducted as described in section III. of 

this notice, and yielded the following 

areas where, as of the date of this notice, 

CHAP has completed revising its survey 

processes, in order to demonstrate that 

it uses survey processes that are 

comparable to state survey agency 

processes by removing references to 

‘‘blackout dates,’’ by allowing facilities 

to select dates which suggested the 

facility would be unavailable for 

surveys, as CMS expects all Medicareparticipating facilities to be survey 

ready at all times. 

B. Term of Approval 

Based on our review and observations 

described in sections III. and V. of this 

notice, we approve CHAP as a national 

AO for HHAs that request participation 

in the Medicare program. The decision 

announced in this final notice is 

effective March 31, 2024, through March 

31, 2030 (6 years). 

VI. Collection of Information 

Requirements 

This document does not impose 

information collection requirements, 

that is, reporting, recordkeeping, or 

third-party disclosure requirements. 

Consequently, there is no need for 

review by the Office of Management and 

Budget under the authority of the 

Paperwork Reduction Act of 1995 (44 

U.S.C. 3501 et seq.). 

The Administrator of the Centers for 

Medicare & Medicaid Services (CMS), 

Chiquita Brooks-LaSure, having 

reviewed and approved this document, 

authorizes Chyana Woodyard, who is 

the Federal Register Liaison, to 

electronically sign this document for 

purposes of publication in the Federal 

Register. 

Chyana Woodyard, 

Federal Register Liaison, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2023–28831 Filed 12–29–23; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Lists of Designated Primary Medical 

Care, Mental Health, and Dental Health 

Professional Shortage Areas 

AGENCY: Health Resources and Services 

Administration (HRSA), Department of 

Health and Human Services. 

ACTION: Notice. 

SUMMARY: This is the second of two 

planned notices informing the public of 

the availability of the complete lists of 

all geographic areas, population groups, 

and facilities designated as primary 

medical care, dental health, and mental 

health professional shortage areas 

(HPSA). This notice includes the lists of 

HPSAs in a designated status as of 

December 2, 2023. The lists are 

available on the shortage area topic page 

on HRSA’s data.hrsa.gov website. The 

first Federal Register notice was 

published on July 3, 2023, and included 

HPSAs in a designated status and those 

proposed for withdrawal, while 

extending the transition time 

communicated in the prior notice 

published on July 7, 2022. State primary 

care offices had additional time to 

submit HPSA data that was re-evaluated 

in preparation for the publication of this 

notice. This second Federal Register 

notice includes the lists of HPSAs in a 

designated status and withdraws 

designations proposed for withdrawal 

not meeting the requirements for 

designation as of the data pull on 

December 2, 2023. 

ADDRESSES: Complete lists of HPSAs 

designated as of December 2, 2023, are 

available on the website at https://

data.hrsa.gov/tools/health-workforce/ 

shortage-areas/frn. Frequently updated 

information on HPSAs is available at 

https://data.hrsa.gov/topics/healthworkforce/health-workforce-shortageareas. Information on shortage 

designations is available at https://

bhw.hrsa.gov/workforce-shortage-areas/ 

shortage-designation. 

FOR FURTHER INFORMATION CONTACT: For 

further information on the HPSA 

designations listed on the website or to 

request additional designation, 

withdrawal, or reapplication for 

designation, please contact Anthony 

Estelle, Chief, Shortage Designation 

Branch, Division of Policy and Shortage 

Designation, Bureau of Health 

Workforce (BHW), HRSA, 5600 Fishers 

Lane, Room 11W16, Rockville, 

Maryland 20857, sdb@hrsa.gov. 

SUPPLEMENTARY INFORMATION: 

Background 

Section 332 of the Public Health 

Service (PHS) Act, 42 U.S.C. 254e, 

provides that the Secretary shall 

designate HPSAs based on criteria 

established by regulation. HPSAs are 

defined in section 332 to include (1) 

urban and rural geographic areas with 

shortages of health professionals, (2) 

population groups with such shortages, 

and (3) facilities with such shortages. 

Section 332 further requires that the 

Secretary annually publish lists of the 

designated geographic areas, population 

groups, and facilities. The lists of 

HPSAs are to be reviewed at least 

annually and revised as necessary. 

Final regulations (42 CFR part 5) were 

published in 1980 that include the 

criteria for designating HPSAs. Criteria 

were defined for seven health 

professional types: primary medical 

care, dental, psychiatric, vision care, 

podiatric, pharmacy, and veterinary 

care. The criteria for correctional facility 


khammond on DSKJM1Z7X2PROD with NOTICES
Federal Register / Vol. 89, No. 1 / Tuesday, January 2, 2024 / Notices 83 

HPSAs were revised and published on 

March 2, 1989 (54 FR 8735). The criteria 

for psychiatric HPSAs were expanded to 

mental health HPSAs on January 22, 

1992 (57 FR 2473). Currently funded 

PHS Act programs use only the primary 

medical care, mental health, or dental 

HPSA or relevant sub-score designations 

such as Maternity Care Target Areas. 

HPSA designation offers access to 

potential federal assistance. Public or 

private nonprofit entities are eligible to 

apply for assignment of National Health 

Service Corps personnel to provide 

primary medical care, mental health, or 

dental health services in or to these 

HPSAs. National Health Service Corps 

health professionals enter into service 

agreements to serve in federally 

designated HPSAs. Entities with clinical 

training sites located in HPSAs are 

eligible to receive priority for certain 

residency training program grants 

administered by HRSA’s BHW. Other 

federal programs also utilize HPSA 

designations. For example, under 

authorities administered by the Centers 

for Medicare & Medicaid Services, 

certain qualified providers in 

geographic area HPSAs are eligible for 

increased levels of Medicare 

reimbursement. 

Content and Format of Lists 

The three lists of designated HPSAs 

are available on the HRSA Data 

Warehouse shortage area topic web page 

and include a snapshot of all geographic 

areas, population groups, and facilities 

that were designated HPSAs as of 

December 2, 2023. This notice 

incorporates the most recent annual 

reviews of designated HPSAs, which 

can be located on HRSA’s data.hrsa.gov 

website, and supersedes the HPSA lists 

published in the Federal Register on 

July 3, 2023 (88 FR 42725). 

In addition, all Indian Tribes that 

meet the definition of such Tribes in the 

Indian Health Care Improvement Act of 

1976, 25 U.S.C. 1603, are automatically 

designated as population groups with 

primary medical care and dental health 

professional shortages. Further, the 

Health Care Safety Net Amendments of 

2002 provides eligibility for automatic 

facility HPSA designations for all 

federally qualified health centers 

(FQHC) and rural health clinics that 

offer services regardless of ability to 

pay. Specifically, these entities include 

FQHCs funded under section 330 of the 

PHS Act, FQHC Look-Alikes, and Tribal 

and urban Indian clinics operating 

under the Indian Self-Determination 

and Education Act of 1975 (25 U.S.C. 

450) or the Indian Health Care 

Improvement Act. Many, but not all, of 

these entities are included on this 

listing. Since they are automatically 

designated by statute, absence from this 

list does not exclude them from HPSA 

designation; facilities eligible for 

automatic designation are included in 

the database when they are identified. 

Each list of designated HPSAs is 

arranged by state. Within each state, the 

list is presented by county. If only a 

portion (or portions) of a county is (are) 

designated, a county is part of a larger 

designated service area, or a population 

group residing in a county or a facility 

located in the county has been 

designated, the name of the service area, 

population group, or facility involved is 

listed under the county name. A county 

that has a whole county geographic or 

population group HPSA is indicated by 

the phrase ‘‘County’’ following the 

county name. 

Development of the Designation and 

Withdrawal Lists 

Requests for designation or 

withdrawal of a particular geographic 

area, population group, or facility as a 

HPSA are received continuously by 

BHW. Under a Cooperative Agreement 

between HRSA and the 54 state and 

territorial Primary Care Offices (PCO), 

PCOs conduct needs assessments and 

submit applications to HRSA to 

designate HPSAs. BHW also receives 

other requests for designation from 

other sources and refers them to PCOs 

for review. As part of the HPSA 

designation process, interested parties, 

including Governors, state Primary Care 

Associations, and state professional 

associations, are notified of requests so 

that they may submit their comments 

and recommendations. 

BHW reviews each recommendation 

for possible addition, continuation, 

revision, or withdrawal. Following 

review, BHW notifies the appropriate 

agency, individuals, and interested 

organizations of each designation of a 

HPSA, rejection of recommendation for 

HPSA designation, revision of a HPSA 

designation, and/or advance notice of 

pending withdrawals from the HPSA 

list. Designations (or revisions of 

designations) are effective as of the date 

on the notification from BHW and are 

updated daily on the HRSA Data 

Warehouse website. While this list is a 

snapshot of HPSAs at a point in time, 

HPSA designations are regularly being 

updated so the best source of current 

designation status is the HRSA Data 

Warehouse website at (https://

data.hrsa.gov/tools/shortage-area). 

In 2024, BHW will publish two 

Federal Register notices to inform the 

public of the availability of the complete 

lists of all geographic areas, population 

groups, and facilities designated as 

primary medical care, dental health, and 

mental health professional shortage 

areas. The first notice will be on or 

before May 1, 2024, and will list all 

designated HPSAs and those that are 

proposed for withdrawal HPSAs that 

will remain in a designated status until 

the second Federal Register notice 

which will be scheduled on or before 

November 1, 2024. The second Federal 

Register notice will withdraw all HPSAs 

that were proposed for withdrawl and 

do not meet the requirements for 

designation. This two-step process 

provides greater clarity for jurisdictions 

and facilities to prepare for any changes 

in HPSA designation. 

Carole Johnson, 

Administrator. 

[FR Doc. 2023–28844 Filed 12–29–23; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Substance Abuse and Mental Health 

Services Administration 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

Periodically, the Substance Abuse and 

Mental Health Services Administration 

(SAMHSA) will publish a summary of 

information collection requests under 

OMB review, in compliance with the 

Paperwork Reduction Act (44 U.S.C. 

chapter 35). To request a copy of these 

documents, call the SAMHSA Reports 

Clearance Officer on (240) 276–0361. 

Project: Survey of Current and Alumni 

SAMHSA Fellows of the Minority 

Fellowship Program (MFP) (OMB No. 

0930–0304)—REVISION 

In 1973, in response to a substantial 

lack of ethnic and racial minorities in 

the mental health professions, the 

Center for Minority Health at the 

National Institute of Mental Health 

established the MFP. Since the MFP’s 

transition to SAMHSA in 1992, the 

program has continued to facilitate the 

entry of graduate students and 

psychiatric residents into mental health 

careers and has increased the number of 

psychology, psychiatry, nursing, and 

social work professionals trained to 

provide mental health and substance 

abuse services to minority groups. The 

traditional MFP offers sustained grants 

to six national behavioral health 

professional associations: the American 

Association of Marriage and Family 

Therapy (AAMFT), American Nurses 

Association (ANA), American 

Psychiatric Association (APsychA), 


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