Shortage Designation Management System

Bureau of Health Workforce
Shortage Designation Mapping Tool User Guide

Mapping Tool: Shortage
Designation Management

User Guide

December 2014

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Bureau of Health Workforce
Primary Care Portal: Shortage Designation Management System User Guide

TABLE OF CONTENTS
SHORTAGE DESIGNATION MANAGEMENT SYSTEM (OVERVIEW) ...............................................................................4
SECTION 1: ACCESSING THE SHORTAGE DESIGNATION MAIN PAGE...........................................................................5
SECTION 2: CREATING A NEW DESIGNATION (OVERVIEW) .........................................................................................6
SECTION 2A: NAMING AND SELECTING DESIGNATION TYPE .......................................................................................7
SECTION 2B: APPLICATION PROCESS STEPS ...............................................................................................................10
TAKING STEPS BACK ............................................................................................................................................10
SECTION 2C: MAP TOOLS ............................................................................................................................................11
SECTION 2D: BASEMAP ...............................................................................................................................................12
SECTION 2E: CONTENT PANEL (LAYERS, LEGEND, DATA)...........................................................................................13
LAYERS ...................................................................................................................................................................13
LEGEND ..................................................................................................................................................................14
DATA .......................................................................................................................................................................14
SECTION 2F: CREATING A RATIONAL SERVICE AREA (RSA) ........................................................................................15
BUISINESS RULES FOR PRIMARY CARE GEOGRAP HIC HIGH NEEDS INSUFFICENT CAPACITY TAB ....18
BUSINESS RULES FOR DENTAL HEALTH GEOGRAPHIC HIGH NEEDS INSUFFICIENT CAPACITY TAB: 19
SECTION 2G: SAVED RATIONAL SERVICE AREA AND ACCESSING THE DATA PANEL .................................................22
SECTION 2H: SELECTING POPULATION CENTER .........................................................................................................23
SECTION 2I: SAVED POPULATION CENTER .................................................................................................................26
SECTION 2J: TRAVEL P OLYGON ...........................................................................................................................27
SECTION 2K: CONTIGIOUS AREA (CA) ANALYSIS ............................................................................................29
CREATING CONTIGUOUS AREAS ..............................................................................................................................29
EDITING CONTIGUOUS AREAS .................................................................................................................................32
ANALYZING CONTIGUOUS AREAS ............................................................................................................................33
VIEWING DETAILS OF CONTIGUOUS AREAS ............................................................................................................34
COMPLETING THE CONTIGUOUS AREA ANALYSIS SECTION ....................................................................................37
SECTION 2L: NEAREST NON-DESIGNATED PROVIDER (NND) ......................................................................39
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SYSTEM DEFAULT NEAREST NON-DESIGNATED PROVIDER .....................................................................................39
USER SELECTED NEAREST NON-DESIGNATED PROVIDER ........................................................................................40
REVERTING FROM USER NND TO SYSTEM DEFAULT NND .......................................................................................42
SECTION 2M: APPLICAT ION SUBMISSION CHECK S ........................................................................................43
SECTION 2N: SUPPLEMENTAL INFORMATION FORM ....................................................................................44
RSA RELATED INFORMATION FOR PRIMARY CARE ......................................................................................44
RSA RELATED INFORMATION FOR DENTAL HEALTH ...................................................................................45
RSA RELATED INFORMATION FOR MENTAL HEALTH...................................................................................46
CA ANALYSIS INFORMATION .............................................................................................................................47
NND INFORMATION ............................................................................................................................................48
SUPPORTING DOCUMENTS ...............................................................................................................................49
SECTION 2O: SCORING ..........................................................................................................................................51
PRIMARY CARE DESIGNATION SCORE .....................................................................................................................51
DENTAL HEALTH DESIGNATION SCORE ...................................................................................................................51
MENTAL HEALTH DESIGNATION SCORE ..................................................................................................................52
MUA/P SCORE ..........................................................................................................................................................53
SECTION 2P: SUBMIT .............................................................................................................................................54

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SHORTAGE DESIGNATION MANAGEMENT SYSTEM (OVERVIEW)
Goal: The Shortage Designation Management System is used to manage, apply, and update designation
applications. The foundation of the Shortage Designation Management System comes from nationally
sourced data and the policies and procedures of the Division of Shortage Designation and Policy (DPSD).
PCOs are able to complete the following:
-

Search for existing designations
View information about existing designations
Create and Submit new designations
Update existing designations
Copy designations
Create and Manage inquiries

Roles: The shortage designation role is required to be part of the PCO user account in order to have the
access to the Shortage Designation Management System for Designations for their state. Please refer to
the Create Account Section in the Primary Care Portal User Guide to gain the role and permission to
perform the Designation Management functions.

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SECTION 1: ACCESSING THE SHORTAGE DESIGNATION MAIN PAGE
The purpose of the Shortage Designation Main Page is for the PCO to view important updates, helpful resources
and access designations, provider management, inquiries and report functionalities.

1.
2.
3.

Updates: This section will provide the user with new information and updates pertaining to Shortage Designation
Management.
My Profile: This section will list the name and email address of the user.
Helpful Resources: This section will provide the user with resources on the policies and procedures of the new
Shortage Designation Management System.

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SECTION 2: CREATING A NEW DESIGNATION (OVERVIEW)
Once the Designation Homepage has been accessed, the user has the option to create a new HPSA or MUAP
designation application by selecting the

tab.

1

1.

: The user should select this button to access the mapping tool and create a new mapping
application. Once selected, the user will be directed to the mapping tool landing page, displayed in the
next section.

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Primary Care Portal: Shortage Designation Management System User Guide

SECTION 2A: NAMING AND SELECTING DESIGNATION TYPE
Once the Mapping Tool button is selected on the Designation homepage, the user will be directed to the Mapping
Tool landing page
There are four required fields on the Mapping Tool Landing Page
 Application Name
 Discipline
 Designation Type
 Designation Option

1
2
3
4

1.
2.

Application Name: The user should enter the Application name in the text field. The field is limited to 60
characters or less.
Discipline: The user will select one of the following options for their new Designation application

Business Rules:
 If the user selects Mental Health, the system will display the option for the PCO to classify the application
as a mental health catchment area.

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3.

4.

Designation Type: The user will select an option from the drop down. Please note, the selections are dynamic
based on the discipline type.
Buisness Rules:
 The selections under the Designation Type drop down are dynamic based on the discipline type selected.
 The system displays the following Designation Type options if the PCO selects Primary Care discipline:
o MUA
o MUP
o HPSA Population
o HPSA Geographic
o HPSA Geographic High Needs
 The system displays the following Designation Type options if the PCO selects Dental or Mental health
discipline:
o HPSA Population
o HPSA Geographic
o HPSA Geographic High Needs
Designation Option: The user will select an option from the drop down. Please note, the selections are dynamic
based on the discipline and designation type selected.
Buisness Rules:
 The system displays the following Designation Option selections if the PCO selects Primary Care
(Discipline) and MUA (Type):
o Medically Underserved Area
 The system displays the following Designation Option selections if the PCO selects Primary Care
(Discipline) and MUP (Type):
o MUP Low Income
o MUP Medicaid Eligible
o MUP Migrant Worker
o MUP Migrant Seasonal Worker
o MUP Native American
o MUP Homeless
o MUP Low Income Homeless
o MUP Low Income Migrant Farmworker
o MUP Low Income Homeless Migrant Farmworker
o MUP Low Income Migrant Seasonal Worker
o MUP Low Income Migrant Seasonal Worker Homeless
o MUP Migrant Farmworker and Homeless
o MUP Migrant Seasonal Worker and Homeless
o MUP Other Population
 The system displays the following Designation Option selections if the PCO selects Primary Care, Dental
Health or Mental Health (Discipline) and HPSA Population (Type):
o Low Income Population HPSA
o Medicaid Eligible Population HPSA
o Migrant Farmworker Population HPSA
o Migrant Seasonal Worker Population HPSA
o Native American Population HPSA
o Low Income Homeless Population HPSA
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o
o
o
o
o
o
o
o



5.

Low Income Migrant Farmworker Population HPSA
Low Income Homeless Migrant Farmworker Population HPSA
Low Income Migrant Seasonal Worker Population HPSA
Low Income Homeless Migrant Seasonal Worker Population HPSA
Homeless Population HPSA
Migrant Farmworker and Homeless Population HPSA
Migrant Seasonal Worker and Homeless Population HPSA
Other Population HPSA
 If the user selects Other Population HPSA, the system will display the following error
message. Other Population HPSA applications are required to be discussed with DPSD
and applied outside the system.

The system defaults to the following Designation Option selection if the user selects Primary Care, Dental
Health or Mental Health (Discipline) and HPSA Geographic and HPSA Geographic High Needs (Type):
o Geographic Population

: Once all the fields are completed, the user should select this button to begin the new designation
application.
Buisness Rules:


All fields are required in order for the

button to be enabled

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Primary Care Portal: Shortage Designation Management System User Guide

SECTION 2B: APPLICATION PROCESS STEPS
The Application Process Steps is located on the left panel.
Clicking on the “X” on the upper right corner will close this panel. To open it again, click on the “Steps” button
located on the horizontal navigation bar.
The Steps panel contains instructions and detailed information that
will automatically update when user moves along the application
process steps.
There are three main steps to the application: (1) “Create RSA” that
includes locating the Population Center and generating the Travel
Polygon; (2) “CA Analysis” which requires filling the Travel Polygon
with passing Contiguous Areas; and (3) “Find NND” that selects the
Nearest Non-Designated provider.
Steps are dependent on each other, because of that; subsequent
steps will be inactive until depended steps have been completed. For
example, user can only start the 2nd step (CA Analysis) after
completing the 1st step (Create RSA).
The Supplemental Information form link can be accessed at the
bottom of the Steps panel at any time after user saves the RSA.

TAKING STEPS BACK
Users can take steps back during different steps of the application, as long as final submission has not been
concluded yet.
There are two options to take steps back:
(1) Click on “Go Back” located within the steps to make
modifications to saved information; or
(2) Click on “View” located within the steps to see more
details and not modify anything.

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SECTION 2C: MAP TOOLS
The Map Tools menu is available under the second button on the horizontal
navigation bar. These tools are used to select areas on the map or to show
more information about selected areas on the map.
Map Tool Options:
Pan: Use this tool to navigate the map. Click on the map and hold the
mouse until seeing the area where you want work on.
Select by Point: Use this tool to select a single area component (county,
census tract, or MCD) on the map with one click.
Select by Line: Use this tool to select a multiple components (county, census
tract, or MCD) on the map. Start with single clicks to form lines and use
double-click to complete a selection.
Select by Rectangle: Use this tool to select a multiple components (county,
census tract, or MCD) on the map. Click on the map and drag down the mouse until the visible rectangle covers the
area you want to select.
Select by Polygon: Use this tool to select multiple components (county, census tract, or MCD) on the map. Start
with single clicks to form lines and use double-click to close the visible polygon.
Identify: Use this tool to click on an active layer component (county, census tract, or MCD) and see more
information about the selected area. Information will include Geo ID, State FP, County FP, Name of Component,
Total Population, Percent Population Below 100% FPL, and Percent Population Below 200% FPL.

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Primary Care Portal: Shortage Designation Management System User Guide

SECTION 2D: BASEMAP
The Basemap menu is located on the right side of the screen,
next to the Content panel. It contains multiple cartographic
styles that offer different views.
Basemap Options:
Imagery: This view presents satellite imagery for the world
and high-resolution imagery for the United States
Imagery Labels: This option shows satellite and highresolution aerial imagery for the world with political
boundaries and place names.
Streets: This comprehensive street map includes highways,
major roads, minor roads, railways, water features, cities,
parks, landmarks, building footprints, and administrative
boundaries.
Topo: The topographic map includes cities, water features, physiographic features, parks, landmarks, highways,
roads, railways, airports, and administrative boundaries.
Gray Canvas: This is the default basemap, which is the simplest and most neutral background with minimal colors,
labels, and features. It facilitates visibility for seeing layers and saving components on the map.
National Geographic: This basemap features the National Geographic World Map, which is a cartographically rich
and distinctive. It includes administrative boundaries, cities, protected areas, highways, roads, railways, water
features, buildings and landmarks, overlaid on shaded relief and land cover imagery.
Ocean: This basemap includes bathymetry, marine water body names, undersea feature names, and derived depth
values in meters. Land features include administrative boundaries, cities, inland waters, roads, overlaid on land
cover and shaded relief imagery.
Open Street Map: This basemap references the live service from the OpenStreetMap (OSM) project, which is a
collaborative initiative to create a free editable map of the world. It includes data about roads, trails, cafés, railway
stations, and much more.

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SECTION 2E: CONTENT PANEL (LAYERS, LEGEND, DATA)
The Content panel is located on the right side of the screen. Click on the Content button on the horizontal
navigation bar to open it.
This panel includes the following tabs:
1.
2.
3.

Layers
Legend
Data

LAYERS
The Layers tab provides the following content:
Components: This allows user to select only one active
layer (county, census tract, or MCD) to save RSA and CAs. It
also provides optional visibility for county, census tract,
and MCD through the checkbox selection.
Health Statistics: This contains optional visible layers for
Fertility Rate, Infant Mortality Rate, and Infant Low Birth
Weight Rate.
Providers: This shows Usable and Non Usable providers on
the map based on updates made on the Provider
Management application.
Designations: This includes layers to see existing Auto HPSA locations, HPSAs, MUA/Ps, Prisons, and Other
Facilities.
Demographics: This includes layers with statistics for African American Population, Asian Population, Caucasian
Population, Hispanic Population, Native American / Alaska Native, Pacific Islander Population, 100% Federal
Poverty Level, 200% Federal Poverty Level, Elderly Ratio, Youth Ratio, and Percent Population Elderly.

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LEGEND
The Legend tab is the second of three tabs inside the Content panel. It
automatically updates when user selects layers to show on the map.
In this example, user has selected the following layers to show: Usable
providers, Auto HPSAs, HPSAs, Counties, and 100% Federal Poverty Level.

DATA
The Data tab is the last tab in the Content panel. It only shows content when user has saved a RSA or a CA on the
map. If the user receives an invalid RSA message upon trying to save an RSA, the data panel will also display
content for that invalid RSA. In this example, the user saved an RSA which information is showing on the Data tab.

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SECTION 2F: CREATING A RATIONAL SERVICE AREA (RSA)
The first step of the mapping designation application is to create a Rational Service Area (RSA). The content panel
explained in section 2E will be helpful in selecting the active layer and provide visuals and data on the map to help
formulate an appropriate area to create the RSA.

1

1.

Tools: The user should select an option from map tools in order to select a RSA component on the map. Once the
tool is selected the user should click on the desired component(s) on the map.

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1.
2.

3.

Edit RSA Pop Up: This appears after the user makes a component selection on the map. The pop up provides
useful information about the component (s) selected for the RSA.
Discipline, Designation Type and Designation Option: The user is able to change the Designation Type and Option
by way of the drop downs.
Business Rules:
 Discipline is a non-editable column.
 Designation Type and Option are dynamic based on discipline and include the same options as the
selections on the New Mapping Tool landing page (see section 2A).
 If the Designation Type is changed to HPSA Population or MUP Population, the user is required to select a
new designation option.
 Changing from a HPSA to a MUA or MUP or vice versa within the Edit RSA box is not applicable. The user
must create a new application if switching between the two types is desired.

4.
5.
6.

The user uses this icon to select or deselect the component(s) of the RSA. If deselected, the color will be
removed from the component(s) on the map to indicate that it will not be included in the saved RSA.
Business Rules:
 The user must have at least one component selected in order to save the RSA.
 The darker red color indicates that the component(s) are not saved.
Name: Represents the name of each component.
CompID: Represents the component ID.
CNTY: Represents the county each component falls under.

7.

Info: Hover over

to see the following information.

Important Information to Note: Total Population is representative of the Total Resident Civilian population.
8.

Enter Adjusted Population: Hover over

to receive the following tips for what to enter in this field.

Business Rules:
 Enter Adjusted Population field appears only for HPSA Geographic and Geographic High needs application
and is not required.
 This field is numeric where the user can enter a max of 6 digits.
 A similar required field will appear with the following population type HPSAs and MUPs and will be
dynamic based on the population type selected.
o Migrant Farmworker Population

o

Migrant Seasonal Worker Population

o

Low Income Homeless Population*

o

Low Income Migrant Farmworker Population*

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9.

o

Low Income Homeless Migrant Farmworker Population*

o

Low Income Migrant Seasonal Worker Population*

o

Low Income Homeless Migrant Seasonal Worker Population*

o

Homeless Population HPSA

o

Migrant Farmworker and Homeless Population*

o

Migrant Seasonal Worker and Homeless Population*

*Important Information to Note: Hover over
to receive guidance on what should be entered in each
specific field.
 This field will not appear for the following HPSA and MUP types because the system sources the correct
population data used for these types:
o Low Income Population
o Medicaid Eligible Population
o Native American Population
Insufficient Capacity Tab: This tab should be used for Primary Care and Dental Health Geographic High Needs
HPSA applications.

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BUISINESS RULES FOR PRIMARY CARE GEOGRAP HIC HIGH NEEDS INSUFFICENT CAPACITY TAB





This tab is only required if the RSA does not pass the following system checks:
o More than 20% of the population has incomes at or below 100% FPL
o More than 100 births per year per 1,000 women ages 15-44
o More than 20 infant deaths per 1,000 live births
If the Insufficient Capacity is required to be completed, the RSA must meet at least 2 of the following
criteria:
o More than 8,000 office or outpatient visits per year per FTE primary care physician serving the
area
 Numeric field-Integer
o More than 7 days for appointment wait times for existing patients
 Numeric field-Decimal to the hundredth
o More than 14 days for appointment wait times for new patients
 Numeric field-Decimal to the hundredth
o More than 1 hour wait time for patients with appointments
 Numeric field-Decimal to the hundredth
o More than 2 hours wait time for patients who are treated on a first come, first served basis
 Numeric field-Decimal to the hundredth
o Abnormally low utilization of health services, as indicated by an average of two or fewer office
visits per year on the part of the area's population
 Numeric field-Decimal to the hundredth
o Evidence of excessive use of emergency room facilities for routine primary care
 User should choose between Yes or No radio buttons
o Two-thirds or more of area physicians do not accept new patients
 User should choose between Yes or No radio buttons



The
button on the Insufficeint capacity tab is enabled when the user completes at least one field on
the form



The PCO should select the



Once the

button after completing desired field(s).

button is selected, the PCO will receive the following message:

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Important Information to Note: The system will verify the Insufficient capacity buiness rules upon Saving the RSA
not when the PCO selects the

button on the Insufficient Capacity tab.

BUSINESS RULES FOR DENTAL HEALTH GEOGRAPHIC HIGH NEEDS INSUFFICIENT CAPACITY TAB:





This tab is only required if the RSA does not pass the following system checks:
o More than 20% of the population has incomes at or below 100% FPL
o More than 50% of the population has no fluoridated water
If the Insufficient Capacity is required to be completed, the RSA must meet at least 1 of the following
criteria:
o More than 5,000 visits per year per FTE dentist serving the area
 Numeric field-integar
o More than six weeks wait time for appoitments for routine dental services
 Numeric field-Decimal to the hundredth
o Two-Thirds or more of the area’s dentists do not accept new patients
 User should choose between Yes or No radio buttons



The
button on the Insufficeint capacity tab is enabled when the user completes at least one field on
the form



The user should select the



Once the

button after completing desired field(s).

button is selected, the user will receive the following message:

Important Information to Note: The system will verify the Insufficient capacity buiness rules upon Saving the RSA
not when the user selects the

button on the Insufficient Capacity tab.

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10. Enter RSA Name: The user must enter a name for the RSA.
Buisness Rules:
 This field can include alphanumeric and symbols.
 This field accomodates a maximum of 40 characters.
11.

Button: The user selects this to Save the RSA. The system will display the following pop up when the RSA is
successfully saved:

Buiness Rules:


The user must enter a RSA name before the



The system will perform the following checks upon the selection of the
button:
o The population type of the HPSA in the RSA is greater than or equal to 250,000 if a whole or
multiple county for Primary Care and Dental Health
o The population type of the HPSA in the RSA is greater and or equal to 999,999 if a whole or
multiple county for Mental health
o The population for all HPSA and MUA/P types must be greater than 0



The system will display the following message when the RSA does not qualify. The user should click on the
to reveal more information about why the RSA does not qualify.



The system will display the following message under
the population exceeds the maximum population allowed.

button is enabled

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when the RSA does not qualify because

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Primary Care Portal: Shortage Designation Management System User Guide



The system will display the following message under
when the RSA does not qualify because
the population type is not greater than 0. The error will usually occur if the user does not put in the
population number for HPSA and MUAP population types not sourced by the system.



The system will display the following message under
when the RSA does not qualify because
the area selected overlaps with an existing HPSA or MUAP. This error can be avioded by turning on the
Designation layers before selecting a component.

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SECTION 2G: SAVED RATIONAL SERVICE AREA AND ACCESSING THE DATA PANEL

Saved RSA Pop Up: This shows the user that the RSA has been successfully completed.
Data Tab: As a result of the RSA being saved, the user can view certain health and demographic data for the RSA by
selecting the
panel and selecting the
tab. The data points vary based on discipline of the
application. Please refer to the Shortage Designation Management System Manual for Policies and Procedures,
located on the Designation Portal Homepage, for specific information on the statistical methodology for each
health and demographic data point.

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SECTION 2H: SELECTING POPULATION CENTER
Once the RSA is successfully saved, the next step of the application is selecting the population center.

1.

Save RSA: This indicates that the status of the RSA status is Done.

2.

Population Center: This indicates that the population center step has not been completed yet.

3.

Travel Polygon: This indicates that the travel polygon step has not been completed yet.

4.

Link: This link can be used to edit the RSA. If clicked on, the user will be directed back to the Edit RSA pop up to
add or delete componets.

5.

Button:The user should select this button to continue on to the population center step.

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Once the user selects the Continue button, the system will display the following Population Center Pop up.

Population Center Pop Up: This pop up will display the RSA name as well as the longitude and latitude coordinates
for the system default population center. If the user is satisfied with this location, select
Default population center.

to save the

Business Rules:


The system will display the population center as the Geographic center of the most populous Census Tract
or Minor Civil Division within the RSA.
Important Information to Note: There might be times where the population center pop up will be
covering the actual population center on the map. The user should drag the pop up to another area of the
map so they can view the population center (Please see image below).

Moving the Population Center: The user can move the population center by dragging the icon to another point on
the map.

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Business Rules:





The system will display the population center as the Geographic center of the most populous Census Tract
or Minor Civil Division within the RSA.
The population center must be within the boundaries of the RSA.
The user is required to enter a justification for moving the population center on the Supplemental
Information Form
The user will receive the following warning message if the user moves the population center outside of
the RSA

Important Information to Note: The system will automatically display the pan tool to drag the population
center. The user should not select a tool to move the population center.

Accepting the non-default location Population Center: Once the user has dragged the population center to
another location within the RSA, the system will display the read only latitude and longitude coordinates for both
the Default location and the new location. The user can either select
go back to the Default population center location.

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to save the new location or

to

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Primary Care Portal: Shortage Designation Management System User Guide

SECTION 2I: SAVED POPULATION CENTER
Once the user selects the Population Center, the system will update the Application Process steps to reflect that
the population center step is now Done (See Screenshot below). The user can select
next to Population center
to get back to the Population Center pop up. The system will direct user to the next step, Travel Polygon, indicated
by the Pending status.

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SECTION 2J: TRAVEL POLYGON
After saving the population center, the user can now complete the Travel Polygon step.

1
2

1.

Select Mode of Transportation: The user should use this feature to pick which travel polygon type is
desired. The user can choose either Private Car or Public Transit by selecting the radio button ( ).
Important Information to Note: The system will automatically default the radio button to Private Car.

2.

Button: The user should select this button once the mode of transportation has been selected.
Once the save button is selected, the system will create the Travel Polygon on the map (Please see screen
shot below)

Business Rules:


For Private Car the following rules apply:

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O



The system will generate the travel polygon covering 30 minutes, for Primary Care, and 40
minutes, for Dental and Mental Health, using the shortest path network analysis originating at
the population center and stemming out in all directions.
For Public Transit the following rules apply:
O In order to use Public Transit, the area must have at least 20% of the population with an income
at or below 100% of the Federal Poverty level.
O If the area does not pass the check mentioned above the user must provide evidence on the
Supplemental Information form that more than 30% of the population in the area is dependent
on public transportation. The user will see the following warning message as guidance but the
system won’t prevent the user from choosing Public Transit.

o

The system will generate the travel polygon covering 5 miles, for Primary Care, and 7 miles, for
Dental and Mental Health, originating at the population center and stemming out in all
directions.

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SECTION K: CONTIGIOUS AREA (CA) ANALYSIS

CREATING CONTIGUOUS AREAS
The first step of the Contiguous Area analysis section of the HPSA designation application is to view the area that
will need to be analyzed. Regardless of HPSA type or discipline, all application must create valid Contiguous Areas
each with a status of “Passed” that completely cover the land area covered by the travel polygon.

2.
3.

Tools: The PCO should select an option from map tools in order to select a CA component on the map. Once the
tool is selected the PCO should click on the desired component(s) on the map.
Components: The user may select as many components as desired in order to create the CA. The user is
encouraged to use the data layers to create a CA that is valid.

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1
2

5
4

3

6

1.

Edit CA Pop Up: This appears after the PCO makes a component selection on the map. The pop up provides useful
information about the component (s) selected for the CA.

2.

3.
4.
5.

The PCO uses this icon to select or deselect the component(s) of the CA. If deselected, the color will be
removed from the component(s) on the map to indicate that it will not be included in the saved CA.
Business Rules:
 The PCO must have at least one component selected in order to save the CA.
 The darker red color indicates that the component(s) are not saved.
Name: Represents the name of each component.
CompID: Represents the component ID.
CNTY: Represents the county each component falls under.

6.

Info: Hover over

to see the following information.

Important Information to Note: Total Population is representative of the Total Resident Civilian population.
Business Rules:
 Enter the Contiguous Area name prior to selecting “Save and Analyze”
o This field can include alphanumeric and symbols.
o This field accomodates a maximum of 40 characters.

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

7.

The system will not allow the user to select components that are currently part of the RSA. If the user
wishes to add a component that is currently part of the RSA, the user must unselect this component by
using the ‘Go Back’ functionality, editing the RSA, Saving, and returning to the Contiguous Area step.

Button: The PCO selects the Save and Analyze button. The system will display the following pop up
when the CA is successfully saved and analyzed:

Buiness Rules:


The PCO must enter a CA name before the



The system will perform the following checks upon the selection of the
button. These
checks are referred to as the CA Validity checks:
o The system will check if the population of the CA is greater than or equal to 250,000 if a whole or
multiple county for Primary Care and Dental Health
o The system will check if the population of the CA is greater and or equal to 999,999 if a whole or
multiple county for Mental health
o The system will check if the CA is a Whole County
 If so, then the user is not required to enter supporting documentation for the rationality
of the CA, as whole counties that meet the population threshold are by definition
rational
 If the CA is made of multiple whole counties, then the user is required to enter
supporting evidence on the Supplemental Information form that the population centers
of the counties are within 30 minutes travel time
 If the CA is a sub-county, then the user is required to enter supporting evidence of the
area’s rationality on the Supplemental Information form. Refer to the latest Manual for
Policy and Procedures (MPPS) document for more information on the guiding regulation
and policy for CA rationality.
o The system will check if the CA components are contiguous and adjacent.
o The system will proceed to the Analysis step if the Validity has been Passed.



The system will display the following message when the CA does not qualify.
The user should click on the
to reveal more information about
why the CA does not qualify.
If the Validity has a status of “Not Passed,” then the Analysis will always
have a status of “Not Run.”



button is enabled

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EDITING CONTIGUOUS AREAS
Contiguous Area Colors
1.
2.

3.

Light Blue: This color is used to indicate a Contiguous Area that has passed the analysis. All Contiguous
Areas must be light blue in order for the user to continue onto the NND step.
Dark Blue: This color is used to indicate that the Contiguous Area has not yet been saved. It is also used
when a previously saved area is currently being edited. The user must save these changes in order to have
the area checked for validity and analyzed with the edited configuration.
Light Yellow: A Contiguous Area that is Not Valid or has Not Passed the analysis will be displayed in a
yellow color. The user may edit the configuration of the area, or can use the “Not Passed” drop down
described below to change the status. This will create a Light Blue Contiguous Area.

The user is able to edit the formation
of a saved Contiguous Area,
regardless if it has been found to pass
the analysis. In order to edit the area,
the user must use the “Saved CA” pop
over. If this is not currently visible on
the screen, the user should select the
“View” link for the appropriate
Contiguous Area on the Application
Process Steps panel.

The system will display the “Saved
CA” pop over box. The user should
select the “Edit” link on this box on
the map.

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The user should un-select the
components to be removed from the
Contiguous Area using the multi-select
check boxes in the table on the pop up
box on the map. To add components,
the user can select a Tool from the Tools
menu and select the desired
components. These will be added to the
open box and can be removed using the
check boxes.

When the user un-selects the check box
next to component, the color from the
component will be removed from the
map. In the image below, the user has
removed census tracts from the
southwestern side of the Contiguous
Area.

In order to save the changes, the user
must select the
button.
The system will re-run the validity
checks and the analysis tests for the new
configuration.

ANALYZING CONTIGUOUS AREAS
Once the user has created a Contiguous Area that has a Validity status of “Passed,”
the system will automatically run the Analysis step. This process is initiated when
the PCO selects the

button.

The Analysis step is fully described in the MPPS guide. The result of the analysis is
captured in the Saved CA pop-over. The pop-over indicating that the RSA has been

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saved will include the Analysis status, as seen below.
If the Validity has not passed, then the analysis will not be run. The Saved CA popover in this case, will display a message as seen below.
A third possible scenario occurs when the Validity has passed, the analysis has
been run, but the system has been unable to pass the Analysis. This message will
be similarly displayed on the Saved CA pop-over.
When this scenario occurs, but the PCO has a rationale for why this Contiguous
Area should be considered “Passed” for the analysis, this can be addressed on the
side panel. The user may select the “Passed” status from the drop down that will
be created on the Application Process Steps panel.

The user will be prompted to enter an explanation on the Supplemental
Information form prior to submitting the application to explain the reason that the
Contiguous Area Analysis should be considered as Passed, thus ruling the area
inaccessible to the population of the RSA.

VIEWING DETAILS OF CONTIGUOUS AREAS
All Contiguous Areas are saved, whether valid or not. The user may edit the components making up the Contiguous
Area, as described in the sections below. Once saved, supporting summary data for the Contiguous Area is
available on the data section of the content
panel. The user may view this information by
selecting the

drop down, and the

tab.
This will display a table showing demographic,
socio-economic and provider information for the
population making up the Contiguous Area. The
panel will always display the most recently saved
Contiguous Area. Different statistics will show
based on the HPSA discipline, such as the Infant
Mortality Rate and Infant Low Birth Weight Rate
information for Primary Care.
If the user has created a Contiguous Area that

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has a Validity status of “Passed,” the system will automatically run the Analysis. While the status is available on the
“Saved CA” pop over on the map, the statuses of the Contiguous Areas are available viewable in the Application
Process Steps panel.
The user may view the details of any saved Contiguous Area that has been
analyzed by the system by selecting the details link on the panel. This will
expand the section for that Contiguous Area with the results of the systemrun Contiguous Analysis
The system will indicate one of the following statuses for each test:
1.
2.
3.

Not Run
Not Passed
Passed

The rules for each of these tests can be found in MPPS. The system will
show which tests have been run, and which test the Contiguous Area has
passed. Once the area passes a test, the system will not run the remaining
tests. The possible test results are shown in the screenshots below.

Current Designation

Over Utilized

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Excessively Distant

Bureau of Health Workforce
Primary Care Portal: Shortage Designation Management System User Guide
Inaccessible Economic
Access

Demographic Disparity

Other Access Barriers

Important Information to Note: Population type HPSAs that include a user-entered population for the RSA will not
have the Over Utilized check run. This includes Homeless HPSAs, Migrant Farmworker HPSAs, and Migrant
Seasonal Worker HPSAs. Should this test be appropriate for the analysis of the Contiguous Area, the user may
indicate this value on the Supplemental Information panel.
The system will also not run the Other Access Barriers test for any Contiguous Areas. Therefore, the status for this
test will always be set to “Not Run.” The user may indicate the result and reason for this test on the Supplemental
Information panel.
For any Contiguous Area that the user has elected to
“Force Pass” by using the drop down available on the
Application Process Steps panel, the user will be
required to indicate the reason for passing the analysis
on the Supplemental Information form.

The user will also be required to enter an explanation
justifying the reason for passing the Contiguous Area.

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COMPLETING THE CONTIGUOUS AREA ANALYSIS SECTION
The system requires that the travel polygon’s boundary is completely covered by Contiguous Areas and the RSA in
order to consider the Contiguous Area analysis step completed. This can be achieved in two ways.
1.

Travel Polygon is completely within the RSA: If the travel polygon is completely held within the RSA, the
user is not required by the system to analyze any areas outside of the RSA. In order to progress to the
next section of the application, the user should select the

2.

button.

Travel Polygon is covered by valid Contiguous Areas with Analysis “Passed” status: If the user has
completed the process of covering the Travel Polygon area with Contiguous Areas, and these areas have
all been found valid, and have a status of passed, then the user should select the
button located on
the Application Process Steps panel. The system will run a check to confirm that the boundary of the
Travel Polygon is completely covered by the RSA and Contiguous Areas with a passing status.

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If the system identifies that the Travel Polygon has not been
sufficiently covered, or that any of the Contiguous Areas do
not have an Analysis status of “Passed,” then the following
error message will appear on the Application Process Steps
panel.
The user should create and analyze any additional
Contiguous Areas, and then select the
button again
to have the system check that the Travel Polygon is now
covered.
Once this check has been satisfied, the system will
automatically move the user on to the Nearest NonDesigned Provider step.

Contiguous Area Business Rules:



The user is required to analyze all areas covered by the Travel Polygon boundary.
All Contiguous Areas must have a Validity status of “Passed” and an Analysis status of “Passed,” either by
the system or by the user in order for the Contiguous Area Analysis to be considered complete.

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SECTION 2L: NEAREST NON-DESIGNATED PROVIDER (NND)
Upon advancing the user to the
Nearest Non-Designated Provider step,
the system performs an initial analysis.
The user should expect to view the
spinning icon as the system analyzes all
of the providers in the surrounding
areas that are both located in a nondesignated area and also serve the
population of the RSA.
The full details of the search radius,
qualifying providers and designated
areas that cannot include the provider
can be found in the MPPS document.

SYSTEM DEFAULT NEAREST NON-DESIGNATED PROVIDER
If the system has been able to locate a provider that meets the requirements
of a Nearest Non-Designated Provider, then the system will identify this
provider with the
icon. The system will display the Provider Name,
Address, Serves SFS? status, Serves Medicaid? status, Distance from the
Population Center, and Travel Time. The system will also display the road path
used to generate the travel distance and time. The user can view the route
with the road labels by using the Street basemap.
The name, address and populations served statuses can be updated through
Provider Management. If the user agrees with the System Default NND provider location, then the user should
select the

button.

The user will have an opportunity to provide alternate travel distance and time through the Supplemental
Information. At this point, the user should proceed to the Supplemental Information form to complete any
necessary explanations in order to view the score. If no further explanations are required at this point, the system
will generate the score, described in the 5M Scoring section.

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USER SELECTED NEAREST NON-DESIGNATED PROVIDER
In certain cases, the system may be unable to identify a suitable provider to serve as the NND, or the user may
wish to select an alternate NND. This can occur for several reasons.
1.

There are no providers in the search radius that serve the RSA population: If the system cannot locate a
provider within the search radius, the user will be prompted to use the Usable Provider layer on the map

to select the provider. The user should use the standard cursor, not a “Select By” tool to select the
provider. When the user clicks on the Provider icon, the system will calculate the distance and travel time
to the provider. The user may proceed to select potential NNDs in the area by using the “X” in the top
right corner of the Provider pop over to close the window in order to see the map. If the user wishes to
use a chosen provider in the application, the user should select the
selects this button, the system will reassign the

button. Once the user

icon to the user selected NND.

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In certain cases, the system may not be able to calculate the Distance and Travel Time due to inaccessible
roads in the road data. If this occurs, the system will display an error message on the Provider pop over on
the map. The user should enter the travel time and distance on the Supplemental Information form in
order to receive a score for this section.
2.

There are no providers in Provider Management that serve the RSA population: If the system cannot
identify any providers in Provider Management that serve the RSA population, then the provider will
assign the maximum number of points for the NND. The system will automatically move the application to
the Supplemental Information completion step, or scoring if the required information has already been
provided through Supplemental Information. However, this case is very rare, and it is recommended that
the user reviews the Provider Management data for the state to ensure that the appropriate providers
have been surveyed and updated with the latest data for populations served.

3.

The system default NND is not the best choice for the RSA: If the user has reason to believe that the
system identified NND is not the best choice for the designation, then the user may select an alternate
NND. An explanation will be required on Supplemental Information to justify the PCO’s rationale in this
case. The user should use the standard cursor, not a “Select By” tool to select the provider. When the user
clicks on the Provider icon, the system will calculate the distance and travel time to the provider. The user
may proceed to select potential NNDs in the area by using the “X” in the top right corner of the Provider
pop over to close the window in order to see the map. If the user wishes to use a chosen provider in the
application, the user should select the

button. Once the user selects this button, the system will

reassign the
icon to the user selected NND. The PCO selected NND’s name will appear on the
Application Process Steps panel to the left.
In certain cases, the system may not be able to calculate the Distance and Travel Time due to inaccessible
roads in the road data. If this occurs, the system will display an error message on the Provider pop over on
the map. The user should enter the travel time and distance on the Supplemental Information form in
order to receive a score for this section.

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REVERTING FROM USER NND TO SYSTEM DEFAULT NND
After selecting a User NND, the PCO may wish to view information
about the Default NND or User NND. In order to view the NND
information on the map, the user can select the “View” link on the
Application Process Steps panel.
If the PCO wishes to revert to the system NND, the “Remove” link next
to the User NND provider’s name can be selected. This will update the
NND back to the Default NND. Upon selecting
will be used in Scoring.

the Default NND

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SECTION 2M: APPLICATION SUBMISSION CHECKS
Once the user saves the NND section, the system will automatically direct the user to an Application Submission
message. If information is required to be completed in the Supplemental Information form before submission, the
user will be notified with a red warning message. If information is required to be completed in Supplemental
Information, the Designation scoring value will not appear until the form is completed.

If the user has not changed any system information on the application, they will not be required to complete the
Supplemental Information Form and will be directed right to scoring and submit.

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SECTION 2N: SUPPLEMENTAL INFORMATION FORM
The Supplemental Information Form is available to the user at any time of the application after an RSA is saved.
The form is intended for the user to enter information and justification specific to the designation. Some of the
information of the supplemental information form varies by the Discipline used. The form can be accessed by
selecting
at the bottom of the Application Process Steps panel. The form is divided into the
following sections:
1.
2.
3.
4.

RSA Related Information
CA Analysis Information
NND Related Information
Supporting Documents

RSA RELATED INFORMATION FOR PRIMARY CARE

1. RSA Related Information: This is the first section of the Supplemental Information Form. The user should
complete all required fields, indicated by . Once the desired information is entered, the user should
select the
button to save the responses.
Business Rules:




The text boxes in this section are an alpha-numeric field and have a 500 character maximum.
The user can edit these fields at any point during the application.

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

The fields displaying are dynamic based on what has been completed on the application and
will guide the user on where a justification or explanation must be entered before submitting the
application.

RSA RELATED INFORMATION FOR DENTAL HEALTH

1. RSA Related Information: For Dental Health, this section has all the fields as Primary Care with the
additional field where the user must enter the Fluoridation Rate for that RSA. The user should complete
all required fields, indicated by . Once the desired information is entered, the user should select the
button to save the responses.
Business Rules:





The text boxes in this section are an alpha-numeric field and have a 500 character maximum.
The Fluoridation Rate field should be less than 3 digits.
Please refer to the Shortage Designation Management System Manual for Policies and
Procedures for more detailed policy information about the Fluoridation Rate.

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RSA RELATED INFORMATION FOR MENTAL HEALTH

1. RSA Related Information: For Mental Health, this section has all the fields as Primary Care with the
additional field where the user must answer the following questions about the substance abuse rate and
alcohol abuse rate in the RSA (Please see screen shot above). The user should complete all required fields,
indicated by . Once the desired information is entered, the user should select the
the responses.
Business Rules:




button to save

The text boxes in this section are an alpha-numeric field and have a 500 character maximum.
If the user selects Yes for the substance abuse and/or alcohol abuse questions, a document is
required to be uploaded on the Supplemental Information form. Please refer to the Shortage
Designation Management System Manual for Policies and Procedures for more detailed policy
information about the substance and alcohol abuse rate.

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CA ANALYSIS INFORMATION
The CA Analysis Information section pictured below will only appear to the user if a CA group selected does not
pass the system analysis.

1. Reason: The user should use this drop down to select a reason why the area selected is a valid Contiguous
Area group. The user will choose from the following options in the drop down:
 Current Designation
 Overutilized
 Excessively Distant
 Inaccessible Economic Access
 Demographic Disparity
 Other Access Barriers
Business Rules:




The user is required to select a reason indicated by the .
The user is required to enter an explanation about why the CA group passes based on the
selected reason.
The user is required to upload supporting documentation to prove the reason and justification
for why the CA group qualifies.

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NND INFORMATION
The NND Related Information section will always appear on the Supplemental Information form but will only be
required, as indicated by the , if the user has selected a non-Default NND provider.

: This field can be used to input a different miles value for the distance from

1.

the population center to the accepted NND. The user will be required to upload evidence in the
supporting documents section if a mile value is inputted.

: This field can be used to input a different minute value for the travel time

2.

from the population center to the accepted NND. The user will be required to upload evidence in the
supporting documents section if a minute value is inputted.
3. The miles and minutes fields can be used for both default system NND and also User NND. The user must
select
on the supplemental information form in order to have the score recalculated to reflect the
user entered travel time and distance.
Business Rules:





The user is required to complete all fields indicated by .
The text boxes in this section are an alpha-numeric field and have a 500 character maximum.
The miles and minutes fields are numeric and limited to 3 characters.
The user is required to upload justification in the supporting documents section if a value is
entered in the miles and/or minutes field.

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SUPPORTING DOCUMENTS
The Supporting Documents section allows the user to upload document justifications to the Mapping Tool.

1. File Classification: The user should select the radio button (

) for the justification desired to upload.

Important Information to Note: The user can only select one radio button (

) at a time.

2.

: Once the user has selected a file classification, the browse button will be enabled for the user to
search for a document to upload
3. Saved Files: Once the user has successfully uploaded a document, it will appear under this section.

The user can view the document by selecting the hyperlink (
also remove a file from the form by selecting

) on the document name. The user can

.

ADDITIONAL DOCUMENTS AND SCREENSHOTS
The Supplemental Information document upload section also provides the user with the ability to upload
additional, optional documents prior to submitting the application. The PCO may use this document option to
upload any additional information that is important to understand the designation being submitted.
It is recommended that the user takes a screenshot of the final map screen and attaches it to the Supplemental
Information “other” document to provide the DPDS analyst with additional information for reviewing the
designation.
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PC users can use the “PrtSc” button to the right of the space on most standard keyboards to take a screenshot of
the map. This image can be pasted in a Word document, or saved as a .pdf and then uploaded.
Depending on the user’s organization’s guidelines, the user can also use a free screen capture such as Jing
(http://www.techsmith.com/snagit.html) to take and save screenshot in .jpg format.

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SECTION 2O: SCORING
Upon completion of the Rational Service Area, Contiguous Area Analysis, Nearest Non-Designated Provider
sections and Supplemental Information Form, the system will generate a Designation score. If the user is creating
an MUA/P, the score will be generated after the Rational Service Area step is completed. The following sections
describe the system process for scoring a designation by type and discipline. The full description of the data used
and guiding policy can be found in MPPS.

PRIMARY CARE DESIGNATION SCORE
The Primary Care HPSA score will include sub-scores for the following components: Population:Provider Ratio of
the RSA, Percent of the Population at 100% of the Federal Poverty Level for the RSA, the Infant Mortality Rate or
Low Birth Weight Rate for the RSA, and the Travel Time from the population center of the RSA to the Nearest NonDesignated Provider. The system will use the statistic that provides the higher number of sub-score points when
determining the use of the Infant Mortality Rate versus the Low Birth Weight Rate.
The score will be generated when
the user has completed all steps
of the application and has
completed the required text entry
for the application on the
Supplemental Information form.
Once these conditions have been
satisfied, the system will generate
the overall Designation score.
The user is not required to upload
all documents in order to view a
score.
If the user elects to Go Back in the
application, all steps must be
completed again to receive an
updated score. If the user changes
the Travel Time or Distance for the NND on the Supplemental Information form, the NND justification must be
provided, the user should select “Save” on the Supplemental Information form, and the system will be prompted
to recalculate the score based on the updated travel time and distance.

DENTAL HEALTH DESIGNATION SCORE
The Dental Designation score will include sub-scores for the following components: Population:Provider Ratio of
the RSA, Percent of the Population at 100% of the Federal Poverty Level for the RSA, the Percent of the Population
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Designated Provider. The system will use the statistic
provided on the Supplemental Information form for
the Fluoridated Water in order to complete the score.
The PCO may update the population with access to
fluoridated water on the Supplemental Information
form at any time during the application.
If the value entered is 50% or less, then the
Fluoridation Rate sub-score will be generated with 1
point. If the value is greater than 50%, then this subscore will remain as a 0.
The score will be generated when the user has
completed all steps of the application and has
completed the required text entry for the application
on the Supplemental Information form. The user isn’t
required to upload all documents in order to view a
score. Once these conditions have been satisfied, the
system will generate the overall Designation score.
If the user elects to Go Back in the application, all steps must be completed again to receive an updated score. If
the user changes the Travel Time or Distance for
the NND on the Supplemental Information form,
the NND justification must be provided, the user
should select “Save” on the Supplemental
Information form, and the system will be
prompted to recalculate the score based on the
updated travel time and distance.

MENTAL HEALTH DESIGNATION SCORE
The Mental Designation score will include sub-scores for the following components: Population:Provider Ratio of
the RSA, Percent of the Population at 100% of the Federal Poverty Level for the RSA, the Elderly Ratio, the Youth
Ratio, the Prevalence of Alcohol Abuse in the RSA, the Prevalence of Substance Abuse in the RSA, and the Travel
Time from the population center of the RSA to the Nearest Non-Designated Provider. The system will use the
statistic provided on the Supplemental Information form for the Fluoridated Water in order to complete the score.

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Bureau of Health Workforce
Primary Care Portal: Shortage Designation Management System User Guide
The score will be generated when the user has completed all
steps of the application and has completed the required text
entry for the application on the Supplemental Information form.
The user isn’t required to upload all documents in order to view a
score. Once these conditions have been satisfied, the system will
generate the overall Designation score, as shown in the image

below.
If the user elects to Go Back in the application, all steps must be completed again to receive an updated score. If
the user changes the Travel Time or Distance for the NND on the Supplemental Information form, the NND
justification must be provided, the user should select “Save” on the Supplemental Information form, and the
system will be prompted to recalculate the score based on the updated travel time and distance.

MUA/P SCORE
The MUA/P score will include
sub-scores for the following
components: Providers Per
Thousand Population of the RSA,
Percent of the Population at
100% of the Federal Poverty
Level for the RSA, the Infant
Mortality Rate for the RSA, and
the Percent of the Population Age
65 and Over of the RSA.
The score is generated when the
PCO has successfully created a
valid RSA.

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Bureau of Health Workforce
Primary Care Portal: Shortage Designation Management System User Guide

SECTION 2P: SUBMIT
Once the user has completed all required information in the Supplemental Information Form, the system will
enable the

button and display a green message to the user that the supplemental form has been

completed. Once the user selects the
button, the system will automatically direct the user to the General
Information section of the profile for the designation submitted (See Primary Care Portal User Guide).

Important Information to Note: Once the user selects submit and is directed to the profile, the user will no longer
be able to access the map for that specific designation. Until the view map functionality is implemented in the
future, the user might want to take a screen shot of the finished map before submitting it to DPSD for review.

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