Health Professional Shortage Areas (HPSAs)

Health Professional Shortage Areas (HPSAs) are designations that indicate health care provider shortages in primary care, dental health; or mental health.

These shortages may be geographic-, population-, or facility-based:

  • Geographic Area
    • A shortage of providers for the entire population within a defined geographic area.
  • Population Groups
    • A shortage of providers for a specific population group(s) within a defined geographic area (e.g., low income, migrant farmworkers, and other groups)
  • Facilities
    • Other Facility (OFAC)
      Public or non-profit private medical facilities serving a population or geographic area designated as a HPSA with a shortage of health providers
    • Correctional Facility
      Medium to maximum security federal and state correctional institutions and youth detention facilities with a shortage of health providers
    • State Mental Hospitals
      State or county hospitals with a shortage of psychiatric professionals (mental health designations only)
    • Automatic Facility HPSAs (Auto HPSAs)
      Automatically designated as a HPSA by statute or through regulation without having to apply for a designation:
      • Federally Qualified Health Centers (FQHCs)
        Health centers that provide primary care to an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors. All organizations receiving grants under Health Center Program Section 330 of the Public Health Service Act are FQHCs. Find additional information and requirements (PDF - 259 KB) from the Centers for Medicare and Medicaid Services (CMS).
      • FQHC Look-A-Likes (LALs)
        Community-based health care providers that meet the requirements of the HRSA Health Center Program, but do not receive Health Center Program funding. 
      • Indian Health Facilities
        Federal Indian Health Service (IHS), Tribally-run, and Urban Indian health clinics that provide medical services to members of federally recognized tribes and Alaska Natives. 
      • IHS and Tribal Hospitals
        Federal Indian Health Service (IHS), Tribally-run hospitals that provide inpatient and outpatient medical services to members of federally recognized tribes and Alaska Natives.
      • Dual-funded Community Health Centers/Tribal Clinics
        Health centers that receive funding from tribal entities and HRSA to provide medical services to members of federally recognized tribes and Alaska Natives. 
      • CMS-Certified Rural Health Clinics (RHCs) that meet National Health Service Corps (NHSC) site requirements
        Outpatient clinics located in non-urbanized areas that are certified as RHCs by CMS and meet NHSC Site requirements including accepting Medicaid, CHIP, and providing services on a sliding fee scale.

How we designate HPSAs

Aside from Auto HPSAs and HPSAs for federal correctional facilities, state Primary Care Offices (PCOs) must submit applications to designate all HPSAs.  

HRSA reviews these applications to determine if they meet the eligibility criteria for designation. The main eligibility criterion is that the proposed designation meets a threshold ratio for population to providers.

Once designated, HRSA scores HPSAs on a scale of 0-25 for primary care and mental health, and 0-26 for dental health, with higher scores indicating greater need.

Find out more about the HPSA designation process.

Date Last Reviewed:  May 2019