Shortage Designations


Health Professional Shortage Area (HPSA) designations are geographic areas, populations, and facilities with too few primary care providers, dental health providers, and/or mental health providers and services. HPSAs are assigned by the federal government to identify areas of greatest health care needs throughout the United States in order to prioritize the distribution of limited resources.

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Health Professional Shortage Areas

Health Professional Shortage Areas (HPSAs) are federal designations that apply to areas, population groups, or facilities in which there are unmet health care needs. Designations help prioritize limited federal resources to the areas that need them the most. The criteria and guidelines for HPSA designations are determined by the Health Resources and Services Administration (HRSA). HPSA designations are broken down into four types of designations and three disciplines including primary care, dental health, and mental health as listed below.

HPSAs May Be Designated as Having a Shortage Of:


There are Four Types of HPSA Designations:​

  1. Geographic: This designation indicates a shortage of providers for the population within a defined geographic area.
  2. Population: This designation indicates that a subpopulation of individuals living in a defined geographic has insufficient access to care. Population groups include those considered to be low-income (at or below 200% of the federal poverty level), groups on Medicaid, migrant farm workers, and tribal, or homeless populations, among others.​
    • North Dakota does have few low-income population designations.
  3. Facility: This designation indicates that a specific facility has a shortage of providers, they serve as a safety-net facility, and/or serves populations that are considered underserved.​
    • Federally Qualified Health Centers (FQHCs)​
    • National Health Service Corps (NHSC) certified Rural Health Clinics (RHC)​
    • Federal Indian Health Service Clinics and Tribal Health Units (ITUs)​
    • FQHC Look-a-Likes​
    • Correctional Facilities​
    • State/County Mental Health Hospital​
    • Other facilities​
  4. Automatic HPSA: Certain types of facilities receive an automatic HPSA (Auto-HPSA) designation from HRSA.

Medically Underserved Area or Population

Medically underserved areas (MUAs) and populations (MUP) identify geographic areas with a lack of access to primary care services. These designations help establish health maintenance organizations or community health centers. These designations never expire.

Scoring Criteria:

Provider per 1,000 population ratio: 0 – 28.7 points
Percent of population at 100% of the federal poverty level: 0 – 25.1 points
Percent of population age 65 and over: 0 – 20.2 points
Infant mortality rate: 0 – 26 points

MUA/P Score Scale 0-100

0 represents completely underserved, 100 represents best served
Score must be 62.0 or LESS in order to qualify for a MUA/P designation

Additional MUA/P Resources