Health Professional Shortage Areas (HPSA) 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 most. The criteria and guidelines for HPSA Designations are determined by Health Resources and Services Administration (HRSA). Through the National Shortage Designation Modernization Project, HRSA has standardized the process in which designations are determined by the use of a database. To date, there has been two national shortage designation updates, one in 2019 and another in 2021. New statutory guidelines on annual review and updates for HPSAs.

HPSAs may be designated as having a shortage of:​

There are four types of HPSA designations:​

  • Geographic: this designation is a shortage of providers for an entire group of people within a defined geographic area​.
  • Population: This designation indicates that a subpopulation of individuals living in the area of designation has insufficient access to care. Population groups include those below 200% of federal poverty level, groups on Medicaid, migrant farm workers, tribal or homeless populations, among others.​
    • North Dakota does have few low-income population designations​.
  • Facility:  This designation indicates that individuals served by a specific health facility have insufficient access to care.​
    • 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​
  •  Automatic HPSA: Certain types of facilities and population groups receive an automatic HPSA designation from HRSA.​