Sending Office: Honorable Rosa L. DeLauro
Sent By:

Dear Colleague,

This letter calls on the Health Resources Services Administration (HRSA) to delay implementation of the update to the auto-HPSA (Health Professional Shortage Area) calculation that will lead Community Health Centers in states like Connecticut, Wisconsin,
Nebraska, Alaska, Wisconsin, South Dakota, and Maine to lose opportunities to recruit and retain providers that are eligible for national health services corps (NHSC) loan repayment. The proposed changes are scheduled to go into effect beginning January 1,
2020, despite the process lacking transparency and creating confusion because of fluctuating scores.

If you have any questions or would like to join this letter, please contact Caitlin Peruccio ( in my office.


Rosa L. DeLauro 

Member of Congress

Text of the Letter:

Dear Administrator Padilla,

We write with regard to the implementation of Shortage Designation Modernization Project’s national update of automatically designated Health Profession Shortage Areas (auto-HPSA) scores, and the adverse impact it will have on many Federally Qualified Health
Centers (FQHCs) across the country.  With the update of auto-HPSAs scores quickly approaching, we are concerned that far too many FQHCs will lose opportunities to recruit providers that are eligible for National Health Services Corps (NHSC) support, as a result
of the Shortage Designation Modernization Project.  We urge HRSA to delay implementation of the national auto-HPSA updates for one year to ensure states have the time necessary to update their data set to accurately reflect their state’s provider capacity. 

Federally Qualified Health Centers provide comprehensive, high-quality, and cost-effective health care to our most underserved communities, and serve more than 28 million individuals nationwide each year. As you know, NHSC support is a key recruitment tool
to strengthen the FQHC workforce, and losing the ability to recruit NHSC providers would have a devastating impact on many FQHCs.

We believe the Health Resources and Services Administration (HRSA) is currently implementing the auto-HPSA aspects of the Shortage Designation Modernization Project without a thorough recognition of the potential impact of the revised HPSA scores on states.
Because two of the largest scoring criteria rely on data about nearby primary care providers who accept Medicaid or offer patients a sliding fee scale, inaccurate provider data can cause many FQHCs to see their scores drop inappropriately to levels that do
not allow them to continue to successfully recruit NHSC participants.

We are deeply concerned that without a delay, many of our constituents will be harmed by the implementation of the auto-HPSA national update, as our states need more time to update and ensure the accuracy of their provider data. The auto-HPSA national update
should only move forward once all states have completed the process of updating their provider data. Thank you for your consideration of this delay request.

Related Legislative Issues

Selected legislative information: HealthCare

icon eDC logo e-Dear Colleague version 2.0
e-Dear Colleagues are intended for internal House use only.