Affordable Access

Area designation issues and problems

Publication Date
  • November 1970 - November 1974
  • Design
  • Law


1.0 .. RLP: 9/30/74 Area Designation Issues & Problems Designation of health services areas will be an important, initial steP in the ir.?lementationof the Health Resources planning (H~) Program. Several major issues and problems have been identified in our planning and preliminary implementationefforts to date relative to area designation (AD). Those efforts have been based largely upon H.R. 16204 and the draft House!Committee report. 1. 2. 3. 4. 5. Only two objective AD requirementsare legislativelymandated. They relate to population and SMSAS, and compliancecan be readily determined. To what extent do we want to effectivelylimit the ~ requirements to these and allow governs wide latitudewithin the dynamics at work within their OP States, in waking designations? Waivers to both the minimum population and SMSA requirements,are permitted. It is assumed that relatively few waivers should be granted. TO what extent,however,do w~wa:t to try to “influ~nce” the designations to be made by ~overn~fthrough the criteria employed in reviewing waiver requests, granting or denying them? (For example, we probably want to discourge governors from chipping up existing areas that now have reasonably effective functioningCHP or other a2encies and meet the mandated requirements.) Approval (or disapproval)of proposed designations,including waiver requests, is reserved to the Secretary. Who should exercise ori his behalf the official as opposed to the effective approval authority? (It is assumed that regional offices will work the principal responsibilityfor reviewing proposed designa~iofis, a~~dthat their recommendationswill be tantamount to approval in the great majority of instances.) A small ad hoc review panel consisting of both regional (RO) and central office (CO) Staff, has besn suggested to handle exceptions. What should constitute an exception? For example, all requested ~gaivel-s~or only those where RO staff anclCO staff disagree; a~lY designation that meets the population a

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