Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 540 - RULES AND REGULATIONS FOR THE IDENTIFICATION OF MEDICALLY UNDERSERVED AREAS IN VIRGINIA › Part II - Designating Medically Underserved Areas › Section 12VAC5-540-40 - Application of the criteria

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				  Determining medically underserved cities and counties. The criteria enumerated
				  in 12VAC5-540-30 shall be used to
				  construct a numerical index by which the relative degree of medical
				  underservice shall be calculated for each city and county within the
				  Commonwealth. Observations for each of the criteria will be listed for each
				  Virginia city and county. An interval scale will be used to assign a particular
				  value to each observation. This will be done for each of the criteria. Each
				  interval scale will consist of four ranges or outcomes of observations. The
				  ranges will be numerically equal. The four ranges will be labeled as Level 1,
				  Level 2, Level 3, and Level 4. The numerical difference between the ranges will
				  be established beginning with the Level 2 range.
The Level 2 range shall have the statewide average for
					 each respective criterion, except the population to primary care physician
					 ratio, as its upper limit. The Level 2 upper limit for the primary care
					 physician to population ratio is established by dividing the difference between
					 the Level 4 upper limit for this criterion and the Level 1 upper limit by two.
					 Each observation which is equal to or less than the Level 2 upper limit, but
					 greater than the Level 1 upper limit, will be assigned a numerical value of
					 two.
The Level 1 range shall have an upper limit which is the
					 quotient of the statewide average divided by two. For the ratio of population
					 to primary care physician criterion, the upper limit of Level 1 shall be the
					 ratio 2500:1 as recommended by the American Academy of Family Physicians. Each
					 observation that is equal to or less than the Level 1 upper limit will be
					 assigned a numerical value of one.
The Level 3 range shall have an upper limit that is equal
					 to the sum of the upper limit of the Level 1 range and the upper limit of the
					 Level 2 range. For the ratio of population to primary care physician criterion,
					 the upper limit of level 3 shall be established at 3500:1, the federal standard
					 for designating health manpower shortage areas. Each observation that is equal
					 to or less than the Level 3 upper limit will be assigned a numerical value of
					 three.
The Level 4 range will include any observation greater
					 than the upper limit of Level 3 range. Each observation in the Level 4 range
					 will be assigned a numerical value of four.
The values for each of the ranges of the criteria will be
					 summed for each Virginia city and county. Each Virginia city and county will
					 have an assigned value of five or greater, to a maximum of 20. A statewide
					 average value will be determined by summing the total city and county values
					 and dividing by the number of cities and counties. Any city or county assigned
					 a value that is greater than the statewide average value shall be considered
					 medically underserved.
B.
				  Determining medically underserved areas within cities and counties. Geographic
				  subsections of cities or counties may be designated as medically underserved
				  areas when the entire city or county is not eligible if the subsection has:
(i) a population to primary care physician
				  ratio equal to or greater than 3500:1; and
(ii) a population whose rate of poverty is
				  greater than the statewide average poverty rate; and
(iii) a minimum population of 3,500 persons
				  residing in a contiguous, identifiable, geographic area. The board shall from
				  time to time, on petition of any person, or as a result of its own decision,
				  apply criteria for determining medically underserved subareas of cities and
				  counties. Once determined to be medically underserved, any subarea of a city or
				  county shall appear on the next list of medically underserved areas published
				  by the board. Areas which qualify as medically underserved areas under
				  12VAC5-540-40 A and that are
				  within Standard Metropolitan Areas as defined by the U.S. Department of
				  Commerce, must also qualify under this section for purposes of placement of
				  health professionals.