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  1. Title: Registered Nurse Shortage Areas, California, 2015

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    Summary: This polygon shapefile contains registered nursing shortage areas (RNSAs) in California for 2014. The Commission uses the RNSA as only one of many factors to determine Song-Brown funding for nursing education programs. The RNSA does not in itself determine funding or funding levels. The method for determining the RNSA is a function of the number of licensed nurses (supply) and patient volume (demand). The analysis performed uses annual data requested from the Board of Registered Nurses and patient count - hospital utilization data from OSHPD HIRC and compiled/analyzed on a county basis. Final designation is determined when a county (1) lacks a general acute care hospital (GAC) and a long-term care (LTC) facility and (2) is above the mean ratio of available nurses to patient volume. The ratio is the total number of bed days for GACs and LTC facilities multiplied by .08 and divided by the number of registered nurses (RNs) in the specific county. Three factors are used in defining nursing shortages: (1) California counties (as the geographic unit for analysis), (2) California registered nurse data of all active licenses by county from the Board of Registered Nursing (BRN), Department of Consumer Affairs , and (3) the patient day and census data from all LTCs and GACs from OSHPD. OSHPD maintains data on patient volume for GACs and LTCs. These data are maintained in the OSHPD Automated Licensing Information and Report Tracking System (ALIRTS) program. These locations employ nearly 70% of the total nursing workforce in California. No current data exist on patient volume for the other 30% of the workforce. OSHPD facility census data for year of evaluation were obtained by county. There are more licensed bed days in LTCs than GACs in California and LTCs only account for 5% of the registered nurse workforce. Therefore, a scale factor representing the percent of the nursing workforce at LTCs in this function was applied to ensure the census data were not skewed. A total census was created by summing the two numbers and a ratio was used of census divided by registered nurses for each of the 58 counties. Ratio Equation: SUM(CensusDaysGAC + [(PatientDaysLTC) * 0.08]) / RNCount. Where: CensusDaysGAC is the number of days a patient is occupying a bed in General Acute Care Hospitals in year of evaluation. PatientDaysLTC is the number of days a patient is occupying a bed in Long-Term Care Facilities in year of evaluation. RNCount is the number of licensed, active registered nurses per county in year of evaluation .These data were collected beginning in October 2014.Data collection begins in October 2014. The data being analyzed are for 2014 (year of evaluation). Total Population was taken from American Community Survery 2010 Estimates.There will always be a lag (of a year or more) due to the availability of the data. The reports to the Commission are usually presented at the public meeting for registered nursing programs every year. This version was presented to the Commission on March 4, 2015. This layer is part of the Healthcare Atlas of California. The Commission requires a quantitative, repeatable and meaningful way of ranking applications whose past graduates and training facilities operate in areas of unmet need (e.g. shortages). Determining nursing shortage areas is extremely different than determining physician shortage areas. Nurses are nearly entirely employed at licensed health facilities, while physicians have multiple practice locations in the field. Therefore, the Commission has adopted a California Registered Nurse Shortage Area (RNSA) as a function of (1) facilities at which nurses are predominantly employed (2) the volume of patients at these facilities and (3) available licensed nurses to work at these locations. This function provides an aggregate ratio of patient demand to nurse availability. For this designation, counties are used as the analytical unit. California. Office of Statewide Health Planning and Development. (2015). Registered Nurse Shortage Areas, California, 2015. California. Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/rd839bd7735. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  2. Title: Primary Care Health Professional Shortage Areas, California, 2015

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    Summary: This polygon shapefile contains primary health care professional shortage areas (HPSAs) in California. On January 26, 2004, the California Healthcare Workforce Policy Commission (Commission) formally adopted a means to create the PCSA map. The process for identifying PCSAs uses the rule base listed below. In March, 2015, the OSHPD staff presented the Commission with information suggesting an update to the map to include current data on (1) physicians, (2) poverty and (3) population. Percent below Poverty Level (100%) Value Range Weighted Score 5.0 or Less 0 5.1 - 10.0 1 10.1 - 15.0 2 15.1 - 20.0 3 20.1 - 25.0 4 25.1 or Greater 5 (maximum) Physician-to-Population Ratio Value Range Weighted Score Lower than 1:1,000 0 1:1,000 to 1:1,500 1 1:1,500 to 1:2,000 2 1:2,000 to 1:2,500 3 1:2,500 to 1:3,000 4 Higher than 1:3,000 5 (maximum) * Any MSSA with a score of 5 or greater is defined as a PCSA. PCSAs are used as a means to help the Commission rank applications based on the number of program graduates and training sites inside areas of unmet need. PCSAs are the only consistently applied rule base to defining shortages of physicians, as the other designations are applicant based and require prior knowledge that a shortage might exist. This data is aggregated by Medical Service Study Area (MSSA) to obtain a count of primary care physicians by MSSA. Primary Care Shortage Areas are updated Annually and are used in the Song-Brown Grant Program for Family Medicine, Family Nurse Practitioner-Physician Assistant and Primary Care Residency programs. This update to data for the PCSA was approved by the California Healthcare Workforce Policy Commission on March 4, 2015. This layer is part of the Healthcare Atlas of California. This data for Primary Care Shortage Area (PCSA) was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce Development Division (HWDD). The data is used to support the following programatic areas: 1) encourage demographically underrepresented groups to pursue healthcare careers 2) identifies geographic areas of unmet need, and 3) encourages primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. O'Neill, M. and California Office of Statewide Health Planning and Development. (2015). Primary Care Health Professional Shortage Areas, California, 2015. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/zr629js5551. 1. The recipient will not distribute copies of the data or make the DATA available to a third party. The recipient may transmit to a third party colleague in hard copy or electronically, minimal amounts of the California Healthcare Workforce Catalog (CWHC) data for scholarly, educational, or scientific research or professional use bit in no case for re-sale. In addition, the recipient has the right to use, with appropriate credit, maps, figures, tables and excerpts derived from the CHWC in the recipients own scientific, scholarly and educational works. 2. The recipient will not resell the data or portions of the data 3. Maps, figures, tables and data from the CHWC should be appropriately attributed trough the use of the following citation: California Healthcare Workforce Catalog (CWHC). April 2005. California Health and Human Services Agency, Office of Statewide Health Planning and Development, Healthcare Workforce and Development Division, Sacramento CA. 4. Whenever, HWDD has knowledge or reason to believe that the recipient has failed to observe the terms and conditions of this agreement, HWDD will notify the recipient of the concerns. The recipient is required to provide adequate documentation or information to establish HWDD's satisfaction that the concerns are without merit, or to remedy the situation within 30 days or within a reasonable timeframe agreed to by both parties. Use Constraints: The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  3. Title: Dental Health Professional Shortage Areas, California, 2014

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    Summary: This polygon shapefile contains dental health professional shortage areas (HPSAs) in California. The federal Dental HPSA designation (formerly Health Manpower Shortage Areas) identifies areas as having a shortage of dental providers on the basis of availability of dentists and dental auxiliaries. To qualify for designation as a Dental HPSA, an area must be: 1. A rational service area, [the Federal Shortage Designation Branch recognizes Medical Services Study Areas as rational service areas.] 2. Population to general practice dentist ratio: 5,000:1 or 4,000:1 plus population features demonstrating "unusually high need." 3. A lack of access to dental care in surrounding areas because of distance, overutilization, or access barriers. Benefits of designation as a Dental HPSA include: Student loan repayment and personnel placement through the National Health Service Corps (NHSC); Eligibility for the California State Loan Repayment Program; Scholarships for dental training in return for service in a shortage area; and Funding priorities for training in general practice dentistry in programs that provide substantial training in shortage areas. This is version 7 of the data. (Updated: July 2014). This layer is part of the Healthcare Atlas of California. This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: to encourage demographically underrepresented groups to pursue healthcare careers, to identify geographic areas of unmet need, and to encourage primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2014). Dental Health Professional Shortage Areas, California, 2014. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/kp852tr6927. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  4. Title: Primary Care Health Professional Shortage Areas, California, 2014

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    Summary: This polygon shapefile contains primary health care professional shortage areas (HPSAs) in California. The federal HPSA designation identifies areas as having a shortage of health care providers on the basis of availability of primary care physicians. To qualify for designation as a HPSA, an area must be: 1. A rational service area, [the Federal Shortage Designation Branch recognizes Medical Service Study Areas in California as rational service areas.] 2. Population to primary care physician ratio: 3,500:1 or 3,000:1 plus population features demonstrating "unusually high need". 3. A lack of access to health care in surrounding areas because of excessive distance, over-utilization, or access barriers. Benefits of designation as a HPSA include: Student loan repayment and personnel placement through the National Health Service Corps (NHSC); Improved Medicare reimbursement. Physicians in geographic HPSAs are automatically eligible for a 10% increase in Medicare reimbursement; Eligibility for Rural Health Clinics (a prospective payment method designed to enhance access to primary health care in rural underserved areas); Eligibility for the California State Loan Repayment Program; Enhanced federal grant eligibility; and Funding preference for primary care physician, physician assistant, nurse practitioner, and nurse midwife programs that provide substantial training experience in HPSAs. The original legislation was enacted by Congress in the 1970s, Section 332 of the U.S. Public Health Service Act (as amended); Health Care Safety Net Amendments authorized automatic facility HPSA process for Federally Qualified Health Centers (FQHC), and Rural Health Centers (RHC). Authorizes the Secretary of U.S. Department of Health and Human Services to designate shortage areas delegated to Health Resources and Services Administration/Bureau of Health Professions/ National Center for Health Workforce Analysis/Shortage Designation Branch. This is version 7 of this data (updated: July 2014). This layer is part of the Healthcare Atlas of California. This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Development Division (HWDD). The data is used to support the following programatic areas: 1) encourage demographically underrepresented groups to pursue healthcare careers 2) identifies geographic areas of unmet need, and 3) encourages primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2014). Primary Care Health Professional Shortage Areas, California, 2014. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/qr661sz3557. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  5. Title: Mental Health Professional Shortage Areas, California, 2014

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    Summary: This polygon shapefile contains mental health professional shortage areas (HPSAs) in California. The federal HPSA designation (formerly Health Manpower Shortage Areas) identifies areas as having a shortage of mental health providers on the basis of availability of psychiatrist and mental health professionals. To qualify for designation as a Mental HPSA, an area must be: 1. A rational service area for the delivery of mental health services, 2. A lack of access to care provided by Core Mental Health Professionals (CMHP) in the area, and 3. One of the following conditions prevails in the area: a. The population to CMHP ratio is > 6,000:1, and the population to psychiatrist ratio is > 20,000:1, OR b. The population to CMHP ratio is > 9,000:1 OR c. The population to psychiatrist ratio is > 30,000:1. Benefits of designation as a HPSA include: student loan repayment and personnel placement through the National Health Service Corps (NHSC) improved Medicare reimbursement enhanced federal grant eligibility. This is version 7 of this data (updated July 2014). This layer is part of the Healthcare Atlas of California. This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: 1) encourage demographically underrepresented groups to pursue healthcare careers 2) identifies geographic areas of unmet need, and 3) encourages primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2014). Mental Health Professional Shortage Areas, California, 2014. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/pw937gd8367. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  6. Title: Rural Clinics, California, 2013

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    Summary: This point shapefile represents rural healthcare clinics in California as of August 27, 2013. This layer is part of the Healthcare Atlas of California. This layer provides location information for mapping rural healthcare clinics in California. California Office of Statewide Health Planning and Development. (2013). Rural Clinics, California, 2013. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/jk311kt1550. Licensed healthcare facility address data are extracted from the the Automated Licensing Information and Report Tracking System (ALIRTS), an OSHPD information system. All address data are validated against a U.S. Postal Service address database and geocoded using ArcInfo Desktop 9.x against Tele Atlas (GDT) Dynamap/2000 reference data sets, v13, 14, 15. The State of California, Health and Human Services Agency, and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State or the Department liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the Office of Statewide Health Planning and Development as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users. However, users are encouraged to refer others to the Office of Statewide Health Planning and Development to acquire the data, in case updated data become available. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  7. Title: Medically Underserved Areas, California, 2012

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    Summary: This polygon shapefile represents medically underserved areas (MUA) in California. The federal MUA designation identifies medically underserved areas on the basis of demographic data. Criteria: To qualify for designation the area or population is scored on the basis of four criteria: 1. percentage of population below 100% poverty 2. percentage of population age 65 and over 3. infant mortality rate 4. primary care physicians per 1,000 population The four resulting scores are added and the sum is identified as the Index of Medical Underservice (IMU). An area with a score less than 62 is generally eligible for designation as an MUA. Benefits of designation as an MUA: Eligibility to develop community health centers, migrant health centers, federally qualified health centers (FQHCs) and FQHC look-alikes, and rural health clinics (RHCs). The cost-based reimbursement of these programs is designed to enhance access to primary health care in medically underserved areas. Enhance federal grant eligibility. Legislation: Original legislation enacted by Congress in 1970s, Section 330 of the U.S. Public Health Service Act (as amended); 2002 Health Care Safety Net Amendments authorized automatic facility HPSA process for Federally Qualified Health Centers (FQHC), and Rural Health Centers (RHC). Authorizes the Secretary of U.S. Department of Health and Human Services to designate shortage areas delegated to Health Resources and Services Administration/Bureau of Health Professions/National Center for Health Workforce Analysis/Shortage Designation Branch. This is version 7 of this data (updated: August 2012). This layer is part of the Healthcare Atlas of California. This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce Development Division (HWDD). The data is used to support the following programatic areas: to encourage demographically underrepresented groups to pursue healthcare careers, to identify geographic areas of unmet need, and to encourage primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2012). Medically Underserved Areas, California, 2012. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/jw555pq9558. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  8. Title: Medically Underserved Populations, California, 2012

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    Summary: This polygon shapefile represents medically underserved populations (MUP) in California. The federal MUP designation is used when an area does not meet the established medically underserved area (MUA) criteria. The process involves assembling the same data elements and carrying out the same computational steps as stated for MUAs (for V1, V2 and V3). The difference is the population to physician ratio (V4) as follows: 1) For V4, the population is now the population of the requested group within the area rather than the total resident civilian population of the area. 2) The number of FTE primary care physicians would include only those serving the requested population group (V4). If the total of weighted values V1 - V4 is 62.0 or less, the population group qualifies for designation as a MUP and you complete the process as for the MUA. Benefits of MUP designation: 1) Eligibility to develop community health centers, migrant health centers, federally qualified health centers (FQHCs) and FQHC look-alikes. The cost-based reimbursement of these programs is designed to enhance access to primary health care in medically underserved areas. 2) Enhanced federal grant eligibility. Legislation: Original legislation enacted by Congress in 1970s, Section 330 of the U.S. Public Health Service Act (as amended); 2002 Health Care Safety Net Amendments authorized automatic facility HPSA process for Federally Qualified Health Centers (FQHC), and Rural Health Centers (RHC). Authorizes the Secretary of U.S. Department of Health and Human Services to designate shortage areas delegated to Health Resources and Services Administration/Bureau of Health Professions/ National Center for Health Workforce Analysis/Shortage Designation Branch. This is version 7 of this data (updated: August 2012). This layer is part of the Healthcare Atlas of California. This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: to encourage demographically underrepresented groups to pursue healthcare careers, to identify geographic areas of unmet need, and to encourage primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2012). Medically Underserved Populations, California, 2012. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/wt491xy4893. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  9. Title: Census Zip Code Tabulation Areas, California, 2010

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    Summary: This polygon shapefile represents zip code tabulation areas (ZCTAs) for the state of California. These data were gathered from the 2010 Census demographics update and contain keys for ZCTAs, centroid coordinates, demographic fields for age, gender, race and ethnicity, and housing information including living quarters, institutionalized populations, households and housing units. For the 2010 Census, there were no “XX” or “HH” ZCTAs assigned. Only five-digit ZCTAs were produced, and large unpopulated areas were excluded from the delineations. For the 2010 Census, there is no wall-to-wall national coverage for ZCTAs. Large water bodies and unpopulated land area such as national parks were excluded from the 2010 delineations, and for this reason the Census 2010 product does not have complete national coverage. This dataset is intended for researchers, students, policy makers, and the general public for reference and mapping purposes, and may be used for basic applications such as viewing, querying, and map output production, or to provide a basemap to support graphical overlays and analysis with other spatial data O'Neill, M. and California Office of Statewide Health Planning and Development. (2010). Census Zip Code Tabulation Areas, California, 2010. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/dc841dq9031. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  10. Title: Primary Care Health Professional Shortage Areas, California, 2010

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    Summary: This polygon shapefile contains primary health care professional shortage areas (HPSAs) in California. The federal HPSA designation identifies areas as having a shortage of health care providers on the basis of availability of primary care physicians. To qualify for designation as a HPSA, an area must be: 1. A rational service area, [the Federal Shortage Designation Branch recognizes Medical Service Study Areas in California as rational service areas.] 2. Population to primary care physician ratio: 3,500:1 or 3,000:1 plus population features demonstrating "unusually high need". 3. A lack of access to health care in surrounding areas because of excessive distance, over-utilization, or access barriers. Benefits of designation as a HPSA include: Student loan repayment and personnel placement through the National Health Service Corps (NHSC); Improved Medicare reimbursement. Physicians in geographic HPSAs are automatically eligible for a 10% increase in Medicare reimbursement; Eligibility for Rural Health Clinics (a prospective payment method designed to enhance access to primary health care in rural underserved areas); Eligibility for the California State Loan Repayment Program; Enhanced federal grant eligibility; and Funding preference for primary care physician, physician assistant, nurse practitioner, and nurse midwife programs that provide substantial training experience in HPSAs. The original legislation was enacted by Congress in the 1970s, Section 332 of the U.S. Public Health Service Act (as amended); Health Care Safety Net Amendments authorized automatic facility HPSA process for Federally Qualified Health Centers (FQHC), and Rural Health Centers (RHC). Authorizes the Secretary of U.S. Department of Health and Human Services to designate shortage areas delegated to Health Resources and Services Administration/Bureau of Health Professions/ National Center for Health Workforce Analysis/Shortage Designation Branch. This is version 6 of this data (updated: 2010). This layer is part of the Healthcare Atlas of California.This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: 1) encourage demographically underrepresented groups to pursue healthcare careers 2) identifies geographic areas of unmet need, and 3) encourages primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California.

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  11. Title: Medical Service Study Areas, Census Tract Detail. California, 2007

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    Summary: The 2007 MSSA Detail layer (developed during July 2009 - July 2010) is an update to the 2005 version. The 2000 Medical Service Study Area (MSSA) Census Tract Detail polygon layer represents all California census tract boundaries used in the construction of the 2000 MSSA Boundaries. Each of the state's 7,049 census tracts was assigned to a medical service study area, as identified in this data layer. The 2000 MSSA Census Tract Detail data is aggregated by OSHPD, to create the 2000 MSSA data layer. This layer is part of the Healthcare Atlas of California. The 2007 MSSA Detail layer (developed during July 2009 - July 2010) was developed to update fields affected by population change. The Claritas 2007 population data pertaining to total, group quarter, race, ethnicity, and age was used in the update. Some geometry updates were also included in this version. In July of 2010 updates were made to the poverty data to correct a miscalculation of poverty percentages and to remove "2007" from field names. The 2000 MSSA Census Tract Detail map layer was developed to support geographic information systems (GIS) applications, representing 2000 census tract geography that is the foundation of 2000 medical service study area (MSSA) boundaries. InfoUSA, U.S. Census Bureau, and California Office of Statewide Health Planning and Development. (2007). Medical Service Study Areas, Census Tract Detail. California, 2007. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/qn014cr7123. The 2007 (developed during July 2009 - July 2010) version contains the following geographic corrections: 1) MSSA 1.1 and 1.2 IDs (and associated MSSA Names) were swapped. 2) MSSA 175.1 and 175.2 IDs (and associated MSSA Names) were swapped. 3) MSSA 247 and 248 MSSA Names were swapped. The 2007 (developed during July 2009 - July 2010) version contains the following field calculation updates: 1) an update of fields affected by demographic changes reported in the Claritas 2007 data, except Poverty (at the 100 and 200% levels) were updated with Claritas 2007 data. Poverty values were updated by holding the percent levels constant from 2000 and calculating the population numbers based on the total populations 2) Hispanic population and percentages were directly calculated from the Claritas 2007 data (the sum total of columns EX through FD ('Current Year Hispanic or Latino:...race) from table SELCAT01.xls). 3) Race fields were calculated from 'Current Year...' race figures that include Hispanics or Latinos. It was confirmed that the sum total from columns EJ through EP in SELCAT01.xls ('Current Year...' race figures that include Hispanics or Latinos) equals the total population count (column M, POP_C, 'Current Year Population'). This might not be a change from the 2005 methodology, but it is important to note. 4) In January of 2010, Race fields for population count and percent population were added to the template feature class and calculated from "Current Year Not Hispanic or Latino." race figures from the Claritas 2007 data. 5) In July of 2010, povery percentages were corrected with re-calculated numbers developed by OSHPD. Poverty percentages were updated from the re-calculated US Census 2000 data. The population in poverty numbers were calculated on the civilian (non-group quarter) populations. Also "2007" was removed from field names. California, like several other Western states, has a large total area, but relatively few counties. As a result, county-based statistical systems mask significant disparities in population density between the urban and rural portions of many counties, and mask disparities in the socioeconomic status of the population within metropolitan areas. In 1976, California enacted legislation requiring the development of a geographic framework for determining which parts of the state were rural and which were urban, and for determining which parts of counties and cities had adequate health care resources and which were "medically underserved". Thus, sub-city and sub-county geographic units called "medical service study areas [MSSAs]" were developed, using combinations of census-defined geographic units, established following General Rules promulgated by a statutory commission. After each subsequent census the MSSAs were revised. In the scheduled revisions that followed the 1990 census, community meetings of stakeholders (including county officials, and representatives of hospitals and community health centers) were held in larger metropolitan areas. The meetings were designed to develop consensus as how to draw the sub-city units so as to best display health care disparities. The importance of involving stakeholders was heightened in 1992 when the United States Department of Health and Human Services' Health and Resources Administration entered a formal agreement to recognize the state-determined MSSAs as "rational service areas" for federal recognition of "health professional shortage areas" and "medically underserved areas". After the 2000 census, two innovations transformed the process, and set the stage for GIS to emerge as a major factor in health care resource planning in California. First, the Office of Statewide Health Planning and Development [OSHPD], which organizes the community stakeholder meetings and provides the staff to administer the MSSAs, entered into an Enterprise GIS contract. Second, OSHPD authorized at least one community meeting to be held in each of the 58 counties, a significant number of which were wholly rural or frontier counties. For populous Los Angeles County, 11 community meetings were held. As a result, health resource data in California are collected and organized by 541 geographic units. The boundaries of these units were established by community healthcare experts, with the objective of maximizing their usefulness for needs assessment purposes. The most dramatic consequence was introducing a process by which all local stakeholders could see relevant socioeconomic and healthcare resource data simultaneously displayed in a GIS format. A two-person team, incorporating healthcare policy and GIS expertise, conducted the series of meetings, and supervised the development of the 2000-census configuration of the MSSAs. William H. Burnett, Senior Advisor Healthcare Workforce and Community Development Division California Office of Statewide Health Planning and Development MSSA Configuration Guidelines (General Rules): - Each MSSA is composed of one or more complete census tracts. - As a general rule, MSSAs are deemed to be "rational service areas [RSAs]" for purposes of designating health professional shortage areas [HPSAs], medically underserved areas [MUAs] or medically underserved populations [MUPs]. - MSSAs will not cross county lines. - To the extent practicable, all census-defined places within the MSSA are within 30 minutes travel time to the largest population center within the MSSA, except in those circumstances where meeting this criterion would require splitting a census tract. - To the extent practicable, areas that, standing alone, would meet both the definition of an MSSA and a Rural MSSA, should not be a part of an Urban MSSA. - Any Urban MSSA whose population exceeds 200,000 shall be divided into two or more Urban MSSA Subdivisions. - Urban MSSA Subdivisions should be within a population range of 75,000 to 125,000, but may not be smaller than five square miles in area. If removing any census tract on the perimeter of the Urban MSSA Subdivision would cause the area to fall below five square miles in area, then the population of the Urban MSSA may exceed 125,000. - To the extent practicable, Urban MSSA Subdivisions should reflect recognized community and neighborhood boundaries and take into account such demographic information as income level and ethnicity. - Rural Definitions: A rural MSSA is an MSSA adopted by the Commission, which has a population density of less than 250 persons per square mile, and which has no census defined place within the area with a population in excess of 50,000. Only the population that is located within the MSSA is counted in determining the population of the census defined place. A frontier MSSA is a rural MSSA adopted by the Commission which has a population density of less than 11 persons per square mile. Any MSSA which is not a rural or frontier MSSA is an urban MSSA. The State of California and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State or the Department liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the Office of Statewide Health Planning and Development as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users. However, users are encouraged to refer others to the Office of Statewide Health Planning and Development to acquire the data, in case updated data become available. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  12. Title: Medically Underserved Populations, California, 2010

    Contributors:

    Summary: This polygon shapefile contains areas of medically underserved populations (MUP) in California. The federal MUP designation is used when an area does not meet the established medicall underserved areas (MUA) criteria. The process involves assembling the same data elements and carrying out the same computational steps as stated for MUAs (for V1, V2 and V3). The difference is the population to physician ratio (V4) as follows: 1) For V4, the population is now the population of the requested group within the area rather than the total resident civilian population of the area. 2) The number of FTE primary care physicians would include only those serving the requested population group (V4). If the total of weighted values V1 - V4 is 62.0 or less, the population group qualifies for designation as a MUP and you complete the process as for the MUA. Benefits of MUP designation: 1) Eligibility to develop community health centers, migrant health centers, federally qualified health centers (FQHCs) and FQHC look-alikes. The cost-based reimbursement of these programs is designed to enhance access to primary health care in medically underserved areas. 2) Enhanced federal grant eligibility. Legislation: Original legislation enacted by Congress in 1970s, Section 330 of the U.S. Public Health Service Act (as amended); 2002 Health Care Safety Net Amendments authorized automatic facility HPSA process for Federally Qualified Health Centers (FQHC), and Rural Health Centers (RHC). Authorizes the Secretary of U.S. Department of Health and Human Services to designate shortage areas delegated to Health Resources and Services Administration/Bureau of Health Professions/ National Center for Health Workforce Analysis/Shortage Designation Branch. This is version 6 of this data (updated: 2010). This layer is part of the Healthcare Atlas of California. This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: to encourage demographically underrepresented groups to pursue healthcare careers, to identify geographic areas of unmet need, and to encourage primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2010). Medically Underserved Populations, California, 2010. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/rj446mz9523. These poloygons represent all MUP's; it is the appended dataset for California, based on the source geography definition of MCD, Tract and Whole County. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  13. Title: Mental Health Profesional Shortage Areas, California, 2010

    Contributors:

    Summary: This polygon shapefile contains mental health professional shortage areas (HPSAs) in California. The federal HPSA designation (formerly Health Manpower Shortage Areas) identifies areas as having a shortage of mental health providers on the basis of availability of psychiatrist and mental health professionals. To qualify for designation as a Mental HPSA, an area must be: 1. A rational service area for the delivery of mental health services, 2. A lack of access to care provided by Core Mental Health Professionals (CMHP) in the area, and 3. One of the following conditions prevails in the area: a. The population to CMHP ratio is > 6,000:1, and the population to psychiatrist ratio is > 20,000:1, OR b. The population to CMHP ratio is > 9,000:1 OR c. The population to psychiatrist ratio is > 30,000:1. Benefits of designation as a HPSA include: student loan repayment and personnel placement through the National Health Service Corps (NHSC) improved Medicare reimbursement enhanced federal grant eligibility. This is version 6 of this data (updated 2010). This layer is part of the Healthcare Atlas of California This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: 1) encourage demographically underrepresented groups to pursue healthcare careers 2) identifies geographic areas of unmet need, and 3) encourages primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2010). Mental Health Professional Shortage Areas, California, 2010. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/fb325dg9259. Manually edited several records according to HRSA website by direction from staff in Shortage Designation Program. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  14. Title: Medical Service Study Areas, California, 2010

    Contributors:

    Summary: This polygon shapefile represents medical service study areas (MSSA) in California for 2010. MSSAs are the defined geographic analysis unit for the Office of Statewide Health Planning and Development (OSHPD). MSSAs are a principal component for display of large data bases through OSHPD's and State of California's Geographic Information Systems. MSSAs have the potential for assisting in needs assessment, health planning, and health policy development. MSSA's are reproduced on the decadal census and the boundaries are formally approved by the Health Manpower Policy Commission. Moreover, the US Department of Health and Human Services, Health Resources Serviced Administration (HRSA) formally recognizes California MSSA's as the Rational Service Area (RSA) for medical service for California.The 2007 MSSA layer (developed during July 2009 - July 2010) is an update to the 2005 version and represents the boundaries constructed following the census. The MSSA layer is the unique MSSA boundaries composed of aggregated census tracts. This layer is created by dissolving all census tracts on a common MSSA Name/ID. MSSA's are maintained by OSHPD and used by multiple agencies to administer a variety of state and federal health-related programs. This represents the final MSSA Reconfiguration based on U.S. Census 2010, public meetings held throughout California with stakeholder input and approved by the California Healthcare Workforce Policy Commission on May 29, 2013. Revised October, 2013 to add Farallon Island in San Francisco County, CT 9804.01 to MSSA 162d. This layer is part of the Healthcare Atlas of California. The MSSA ACS layer is an update using 2010 U.S. Census data. This is an update to geometries and demographics. The Medical Service Study Area (MSSA) Census Tract Detail polygon layer represents all California census tract boundaries used in the construction based on U.S. Census Tracts 2010. Each of the state's 8,035 census tracts (shoreline buffer census tracts were removed) was assigned to a medical service study area, as identified in this data layer. The MSSA Census Tract Detail data is aggregated by OSHPD, to create this MSSA data layer. This represents the final MSSA Reconfiguration based on U.S. Census 2010 and public meetings held throughout California. California Office of Statewide Health Planning and Development. (2010). Medical Service Study Areas, California, 2010. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/ph637gq9746. Source of update: American Community Survey 5 year 2006-2010 data for poverty. For source tables refer to InfoUSA update procedural documentation. The 2012 MSSA Detail layer was developed to update fields affected by population change. The American Community Survey 5 year 2006-2010 population data pertaining to total, in households, race, ethnicity, age, and poverty was used in the update. The 2012 MSSA Census Tract Detail map layer was developed to support geographic information systems (GIS) applications, representing 2010 census tract geography that is the foundation of 2012 medical service study area (MSSA) boundaries. ***This version is the finalized MSSA reconfiguration boundaries based on the US Census Bureau 2010 Census. In 1976 Garamendi Rural Health Services Act, required the development of a geographic framework for determining which parts of the state were rural and which were urban, and for determining which parts of counties and cities had adequate health care resources and which were "medically underserved". Thus, sub-city and sub-county geographic units called "medical service study areas [MSSAs]" were developed, using combinations of census-defined geographic units, established following General Rules promulgated by a statutory commission. After each subsequent census the MSSAs were revised.In the scheduled revisions that followed the 1990 census, community meetings of stakeholders (including county officials, and representatives of hospitals and community health centers) were held in larger metropolitan areas. The meetings were designed to develop consensus as how to draw the sub-city units so as to best display health care disparities.The importance of involving stakeholders was heightened in 1992 when the United States Department of Health and Human Services' Health and Resources Administration entered a formal agreement to recognize the state-determined MSSAs as "rational service areas" for federal recognition of "health professional shortage areas" and "medically underserved areas".After the 2000 census, two innovations transformed the process, and set the stage for GIS to emerge as a major factor in health care resource planning in California. First, the Office of Statewide Health Planning and Development [OSHPD], which organizes the community stakeholder meetings and provides the staff to administer the MSSAs, entered into an Enterprise GIS contract. Second, OSHPD authorized at least one community meeting to be held in each of the 58 counties, a significant number of which were wholly rural or frontier counties. For populous Los Angeles County, 11 community meetings were held.As a result, health resource data in California are collected and organized by 541 geographic units. The boundaries of these units were established by community healthcare experts, with the objective of maximizing their usefulness for needs assessment purposes. The most dramatic consequence was introducing a data simultaneously displayed in a GIS format.A two-person team, incorporating healthcare policy and GIS expertise, conducted the series of meetings, and supervised the development of the 2000-census configuration of the MSSAs. MSSA Configuration Guidelines (General Rules):- Each MSSA is composed of one or more complete census tracts.- As a general rule, MSSAs are deemed to be "rational service areas [RSAs]" for purposes of designating health professional shortage areas [HPSAs], medically underserved areas [MUAs] or medically underserved populations [MUPs].- MSSAs will not cross county lines.- To the extent practicable, all census-defined places within the MSSA are within 30 minutes travel time to the largest population center within the MSSA, except in those circumstances where meeting this criterion would require splitting a census tract.- To the extent practicable, areas that, standing alone, would meet both the definition of an MSSA and a Rural MSSA, should not be a part of an Urban MSSA.- Any Urban MSSA whose population exceeds 200,000 shall be divided into two or more Urban MSSA Subdivisions.- Urban MSSA Subdivisions should be within a population range of 75,000 to 125,000, but may not be smaller than five square miles in area. If removing any census tract on the perimeter of the Urban MSSA Subdivision would cause the area to fall below five square miles in area, then the population of the Urban MSSA may exceed 125,000.- To the extent practicable, Urban MSSA Subdivisions should reflect recognized community and neighborhood boundaries and take into account such demographic information as income level and ethnicity. Rural Definitions:A rural MSSA is an MSSA adopted by the Commission, which has a population density of less than 250 persons per square mile, and which has no census defined place within the area with a population in excess of 50,000. Only the population that is located within the MSSA is counted in determining the population of the census defined place.A frontier MSSA is a rural MSSA adopted by the Commission which has a population density of less than 11 persons per square mile.Any MSSA which is not a rural or frontier MSSA is an urban MSSA. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  15. Title: Dental Health Professional Shortage Areas, California, 2010

    Contributors:

    Summary: This polygon shapefile contains dental health professional shortage areas (HPSAs) in California. The federal Dental HPSA designation (formerly Health Manpower Shortage Areas) identifies areas as having a shortage of dental providers on the basis of availability of dentists and dental auxiliaries. To qualify for designation as a Dental HPSA, an area must be: 1. A rational service area, [the Federal Shortage Designation Branch recognizes Medical Services Study Areas as rational service areas.] 2. Population to general practice dentist ratio: 5,000:1 or 4,000:1 plus population features demonstrating "unusually high need." 3. A lack of access to dental care in surrounding areas because of distance, overutilization, or access barriers. Benefits of designation as a Dental HPSA include: Student loan repayment and personnel placement through the National Health Service Corps (NHSC); Eligibility for the California State Loan Repayment Program; Scholarships for dental training in return for service in a shortage area; and Funding priorities for training in general practice dentistry in programs that provide substantial training in shortage areas. This is version 6 of the data (updated: 2010). This layer is part of the Healthcare Atlas of California. This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: 1) encourage demographically underrepresented groups to pursue healthcare careers 2) identifies geographic areas of unmet need, and 3) encourages primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California Office of Statewide Health Planning and Development. (2010). Dental Health Professional Shortage Areas, California, 2010. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/cs568tr5005. Manually edited several records according to HRSA website by direction from staff in Shortage Designation Program. The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  16. Title: Medical Service Study Areas, California, 2007

    Contributors:

    Summary: This polygon shapefile represents medical service study areas (MSSA) in California for 2007. MSSAs are the defined geographic analysis unit for the Office of Statewide Health Planning and Development (OSHPD). MSSAs are a principal component for display of large data bases through OSHPD's and State of California's Geographic Information Systems. MSSAs have the potential for assisting in needs assessment, health planning, and health policy development. MSSA's are reproduced on the decadal census and the boundaries are formally approved by the Health Manpower Policy Commission. Moreover, the US Department of Health and Human Services, Health Resources Serviced Administration (HRSA) formally recognizes California MSSA's as the Rational Service Area (RSA) for medical service for California.The 2007 MSSA layer (developed during July 2009 - July 2010) is an update to the 2005 version and represents the boundaries constructed following the census. The MSSA layer is the unique MSSA boundaries composed of aggregated census tracts. This layer is created by dissolving all census tracts on a common MSSA Name/ID. MSSA's are maintained by OSHPD and used by multiple agencies to administer a variety of state and federal health-related programs. This layer is part of the Healthcare Atlas of California. The 2007 MSSA layer (developed during July 2009 - July 2010) was developed to update fields affected by population change, to update the practioner count and ratio fields, and to correct the poverty fields. The Claritas 2007 population data pertaining to total, group quarter, race, ethnicity, and age was used in the update. InfoUSA 2009 data was used for physician, dentist, and psych counts. Some geometry updates were also included in this version. In July of 2010 updates were made to the poverty data to correct a miscalculation of poverty percentages. Also "2007" was removed from field names. California Office of Statewide Health Planning and Development. (2007). Medical Service Study Areas, California, 2007. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/br080kw9577. The 2007 (developed during July 2009 - July 2010) version contains the following geographic corrections: 1) MSSA 1.1 and 1.2 IDs (and associated MSSA Names) were swapped. 2) MSSA 175.1 and 175.2 IDs (and associated MSSA Names) were swapped. 3) MSSA 247 and 248 names were swapped. The 2007 (developed during July 2009 - July 2010) version contains the following field calculation updates: 1) an update of fields affected by demographic changes reported in the Claritas 2007 data, except Poverty (at the 100 and 200% levels) were updated with Claritas 2007 data. Poverty values were updated by holding the percent levels constant from 2000 and calculating the population numbers based on the total populations 2) Hispanic population and percentages were directly calculated from the Claritas 2007 data (the sum total of columns EX through FD ('Current Year Hispanic or Latino:...race) from table SELCAT01.xls). 3) Race fields were calculated from 'Current Year...' race figures that include Hispanics or Latinos. It was confirmed that the sum total from columns EJ through EP in SELCAT01.xls ('Current Year...' race figures that include Hispanics or Latinos) equals the total population count (column M, POP_C, 'Current Year Population'). This might not be a change from the 2005 methodology, but it is important to note. 4) Practioner count fields were updated with InfoUSA data from 2009 and for psych counts InfoUSA data from 2007. 5) Practioner ratios were re-calculated with updated practitioner and population counts. 6) In January of 2010, Race fields for population count, percent population, and percent civilian population were added to the template feature class and calculated from "Current Year Not Hispanic or Latino." race figures from the Claritas 2007 data. 7) In March of 2010, Civilian percentage fields related to race, ethnicity, and age were removed from the template feature class which carried through to the MSAA2007 feature class. The thought process was that the Claritas data concerning race, ethnicity and age is not disaggregated into those that live in group quarters. It was determined that this information could be revealed at the application level (Dashboard) and not at the feature class/table level. 8) Also during the March of 2010 revisions, psych data was used from 2009 InfoUSA data, similar to physician and dentist data. 9) In July of 2010, povery percentages were corrected with re-calculated numbers developed by OSHPD. Poverty values were updated from the re-calculated US Census 2000 data summarized census tract data. The population in poverty numbers were calculated on the civilian (non-group quarter) populations. Also "2007" was removed from field names. LEGISLATIVE AUTHORITY FOR MSSAs Song Brown Family Physician Training Act (1973) creates California Health Manpower Policy Commission (CHMPC), which divides state into sub-city and sub-county areas to determine areas of unmet need for physicians. Garamendi Rural Health Services Act (1976) requires Commission to determine which areas of the state are rural and which urban, and which rural areas are deficient in medical services. MSSA Reconfiguration Adoption Process Changes to the boundaries of MSSAs can only be made through motions adopted by the CHMPC. Any such motions will be agenda items of CHMPC and should be accompanied by letters of support from community officials and stakeholders. MSSA ADPOTION GUIDELINES 1. Each MSSA is composed of one or more complete census tracts. 2. As a general rule, MSSAs are deemed to be "rational service areas [RSAs]" for purposes of designating health professional shortage areas [HPSAs], medically underserved areas [MUAs] or medically underserved populations [MUPs]. Notwithstanding the general rule, an applicant for a HPSA, MUA or MUP designation, for purposes of determining an RSA, may substitute Minor Civil Divisions [MCDs] for MSSAs in any of the following circumstances: (a) Where an MSSA is comprised of a whole county with a single census tract and where the county contains more than one MCD. (b) Where an MSSA is based on a single 2000 census tract which comprises all or part of two or more previous MSSAs whose boundaries were based on 1990 census tracts, block groups, or any other geographical unit established by the United States Census Bureau. (c) Where the California Health Manpower Policy Commission has established any other rule for substituting MCDs for MSSAs. 3. MSSAs will not cross county lines. 4. To the extent practicable, all census-defined places within the MSSA are within 30 minutes travel time to the largest population center within the MSSA, except in those circumstances where meeting this criterion would require splitting a census tract. 5. To the extent practicable, areas that, standing alone, would meet both the definition of an MSSA and a Rural MSSA, should not be a part of an Urban MSSA. 6. Any Urban MSSA whose population exceeds 200,000 shall be divided into two or more Urban MSSA Subdivisions. 7. Urban MSSA Subdivisions should be within a population range of 75,000 to 125,000, but may not be smaller than five square miles in area. If removing any census tract on the perimeter of the Urban MSSA Subdivision would cause the area to fall below five square miles in area, then the population of the Urban MSSA may exceed 125,000. 8. To the extent practicable, Urban MSSA Subdivisions should reflect recognized community and neighborhood boundaries and take into account such demographic information as income level and ethnicity. 9. Rural Definitions: A rural MSSA is an MSSA adopted by the Commission, which has a population density of less than 250 persons per square mile, and which has no census defined place within the area with a population in excess of 50,000. Only the population that is located within the MSSA is counted in determining the population of the census defined place. A frontier MSSA is a rural MSSA adopted by the Commission which has a population density of less than 11 persons per square mile. Any MSSA which is not a rural or frontier MSSA is an urban MSSA. Purpose This data was developed by the Office of Statewide Health Planning and Development's (OSHPD) Healthcare Workforce and Community Development Division (HWCDD). The data is used to support the following programatic areas: 1) encourage demographically underrepresented groups to pursue healthcare careers 2) identifies geographic areas of unmet need, and 3) encourages primary care physicians and non-physician practitioners to provide healthcare in medically underserved areas in California. California, like several other Western states, has a large total area, but relatively few counties. As a result, county-based statistical systems mask significant disparities in population density between the urban and rural portions of many counties, and mask disparities in the socioeconomic status of the population within metropolitan areas. In 1976, California enacted legislation requiring the development of a geographic framework for determining which parts of the state were rural and which were urban, and for determining which parts of counties and cities had adequate health care resources and which were "medically underserved". Thus, sub-city and sub-county geographic units called "medical service study areas [MSSAs]" were developed, using combinations of census-defined geographic units, established following General Rules promulgated by a statutory commission. After each subsequent census the MSSAs were revised. In the scheduled revisions that followed the 1990 census, community meetings of stakeholders (including county officials, and representatives of hospitals and community health centers) were held in larger metropolitan areas. The meetings were designed to develop consensus as how to draw the sub-city units so as to best display health care disparities. The importance of involving stakeholders was heightened in 1992 when the United States Department of Health and Human Services' Health and Resources Administration entered a formal agreement to recognize the state-determined MSSAs as "rational service areas" for federal recognition of "health professional shortage areas" and "medically underserved areas". After the 2000 census, two innovations transformed the process, and set the stage for GIS to emerge as a major factor in health care resource planning in California. First, the Office of Statewide Health Planning and Development [OSHPD], which organizes the community stakeholder meetings and provides the staff to administer the MSSAs, entered into an Enterprise GIS contract. Second, OSHPD authorized at least one community meeting to be held in each of the 58 counties, a significant number of which were wholly rural or frontier counties. For populous Los Angeles County, 11 community meetings were held. As a result, health resource data in California are collected and organized by MSSA geographic units. The boundaries of these units were established by community healthcare experts, with the objective of maximizing their usefulness for needs assessment purposes. The most dramatic consequence was introducing a process by which all local stakeholders could see relevant socioeconomic and healthcare resource data simultaneously displayed in a GIS format. A two-person team, incorporating healthcare policy and GIS expertise, conducted the series of meetings, and supervised the development of the 2000-census configuration of the MSSAs. William H. Burnett, Senior Advisor Healthcare Workforce and Community Development Division California Office of Statewide Health Planning and Development The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  17. Title: Licensed Healthcare Facilities, California, 2006

    Contributors:

    Summary: This point shapefile represents healthcare facilities licensed by the State of California, Department of Health Services (DHS), as of1997. Facility address information is maintained and provided by the Office of Statewide Health Planning and Development (OSHPD). Facility types include hospitals, nursing homes, clinics, etc. This layer is part of the Healthcare Atlas of California.This layer provides location information for mapping healthcare facilities in California.

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  18. Title: Registered Nurse Shortage Areas, California, 2005

    Contributors:

    Summary: This polygon shapefile contains registered nursing shortage areas (RNSAs) in California for 2005. The Commission uses the RNSA as only one of many factors to determine Song-Brown funding for nursing education programs. The RNSA does not in itself determine funding or funding levels. The method for determining the RNSA is a function of the number of licensed nurses (supply) and patient volume (demand). The analysis performed uses annual data requested from the Board of Registered Nurses and patient count - hospital utilization data from OSHPD HIRC and compiled/analyzed on a county basis. Final designation is determined when a county (1) lacks a general acute care hospital (GAC) and a long-term care (LTC) facility and (2) is above the mean ratio of available nurses to patient volume. The ratio is the total number of bed days for GACs and LTC facilities multiplied by .08 and divided by the number of registered nurses (RNs) in the specific county. Three factors are used in defining nursing shortages: (1) California counties (as the geographic unit for analysis), (2) California registered nurse data of all active licenses by county from the Board of Registered Nursing (BRN), Department of Consumer Affairs , and (3) the patient day and census data from all LTCs and GACs from OSHPD. OSHPD maintains data on patient volume for GACs and LTCs. These data are maintained in the OSHPD Automated Licensing Information and Report Tracking System (ALIRTS) program. These locations employ nearly 70% of the total nursing workforce in California. No current data exist on patient volume for the other 30% of the workforce. OSHPD facility census data for year of evaluation were obtained by county. There are more licensed bed days in LTCs than GACs in California and LTCs only account for 5% of the registered nurse workforce. Therefore, a scale factor representing the percent of the nursing workforce at LTCs in this function was applied to ensure the census data were not skewed. A total census was created by summing the two numbers and a ratio was used of census divided by registered nurses for each of the 58 counties. Ratio Equation: SUM(CensusDaysGAC + [(PatientDaysLTC) * 0.08]) / RNCount. Where: CensusDaysGAC is the number of days a patient is occupying a bed in General Acute Care Hospitals in year of evaluation . PatientDaysLTC is the number of days a patient is occupying a bed in Long-Term Care Facilities in year of evaluation .RNCount is the number of licensed, active registered nurses per county in year of evaluation .This layer is part of the Healthcare Atlas of California The Commission requires a quantitative, repeatable and meaningful way of ranking applications whose past graduates and training facilities operate in areas of unmet need (e.g. shortages). Determining nursing shortage areas is extremely different than determining physician shortage areas. Nurses are nearly entirely employed at licensed health facilities, while physicians have multiple practice locations in the field. Therefore, the Commission has adopted a California Registered Nurse Shortage Area (RNSA) as a function of (1) facilities at which nurses are predominantly employed (2) the volume of patients at these facilities and (3) available licensed nurses to work at these locations. This function provides an aggregate ratio of patient demand to nurse availability. For this designation, counties are used as the analytical unit. California Office of Statewide Health Planning and Development. (2005). Dental Health Professional Shortage Areas, California, 2005. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/bw151vd6725. This designation uses three factors in defining nursing shortage. (1) County boundaries (as the geographic unit for analysis), (2) The Board of Registered Nursing (BRN) licensee data and (3) the patient day or census data from all long term care facilities and general acute care hospitals . The BRN data, where each record is an individual licensed nurse, was summarized to obtain a count of Registered Nurses by county. 2006 California registered nurse data of all licensees were obtained from the Board of Registered Nursing (BRN) and geocoded. Next, licensee addresses were used to determine a specific location on commercial road data. This data was then summed by each county to obtain a count of nurses in each county. OSHPD maintains data on patient volume for general acute care (GAC) hospitals and skilled nursing facilities. These data are maintained in the OSHPD Automated Licensing Information and Report Tracking System (ALIRTS) program. These locations employ nearly 70% of the total nursing workforce in California. No current data exists on patient volume for the other 30% of the workforce. OSHPD facility census data, where each facility contained a census day total for 2005, was summarized to obtain a total census of long term care and hospitals (each) by county. There are significantly more (on average more than 2:1 more) license bed days in skilled nursing facilities than general acute care hospitals in California. Moreover, skilled nursing facilities only account for 5% of the registered nurse workforce . Therefore a scale factor representing the percent of the nursing workforce at skilled nursing facilities in this function was applied to ensure the census data were not skewed . We then created a total census by summing these two numbers. Finally, we created a ratio of census divided by registered nurses for each county. The formula for determining the ratio is: Equation 1 (BedDaysGAC + (BedDaysSNF * 0.8) ) / RNCount Where: BedDaysGAC is the 2005 patient bed days for General Acute Care Hospitals BedDaysSNF is the 2005 patient bed days for Skilled Nursing Facilities RNCount is the number of licensed nurses per county Discussion The Commission needs a rubric to assist in evaluating nursing education grant applications. In particular, it needs to determine the extent to which applicants have training sites, and past graduates practicing in shortage areas. This designation meets these needs. The shortage method adopted is quantitative, repeatable, reflects current science and meaningful. It is the responsibility of the Commission to ensure that the most critical areas are designated and therefore receive the most benefit of the Song-Brown program. The Commission feels that the most meaningful method of determining shortage should be a function of not only available nurses, but also volume of patients served. Unlike the other methods, this designation provides a meaningful indicator of workload (e.g. average facility census). This designation has two limitations. First, only about 70% of the nursing workforce is accounted for in this function. The remaining 30% of the workforce is employed at schools, home health agencies and other facilities, for which no ratio of average daily census or population served can readily be analyzed. Second, nurses and patients both travel outside county boundaries to give and receive care. Adopted Areas The Commission formally defines RNSAs as those areas (1) lacking any hospital AND long-term care facility and (2) above the mean ratio shown in Equation 1, where mean is the average of all counties in California. The Commission further proposes that this method be reviewed in one year and every 2 years thereafter to provide insight to the latest science and current literature affecting the nursing workforce. The Commission bases their decision on the following: (1) There is a shortage of nurses statewide. The enabling legislation finds "that nurses are in very short supply in California" , and the number of nurses per 100,000 in the state is significantly below the national number of nurses per 100,000 population. However, the majority of nurses are employed at hospitals and long term care facilities. Those regions with above average census to nurse populations are hit the hardest by this statewide shortage and therefore should be given priority. (2) In the proposed evaluation process, every applicant program and past graduate who falls into an area without any facilities (e.g. hospital or long-term care) is also deemed to be in a shortage area. (3) Research on nursing workforce shortage areas is currently being produced. No leading theory has been established to date, but a simple ratio like the one presented here is the most effective at a repeatable, quantitative, and meaningful designation. The Commission believes preparing the current method, without revisiting it for revision in the near future would hinder the scope of recommendations the Commission makes. The resulting shortage designation map is presented in Figure 2. This RNSA designates 31,311,830 people (84% of the 37,444,385) based on 2006 provisional Department of Finance population estimates. 27 of the 58 counties are listed as Registered Nurse Shortage Areas The State of California, the California Health and Human Services Agency and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State, the Agency or the Office liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the California Health and Human Services Agency and/or the Office as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  19. Title: Federal NO2, SO2, and CO Area Designations: California, 2003

    Contributors:

    Summary: This polygon shapefile displays federal Nitrogen Oxide (NO2), Sulfur Dioxide (SO2), and Carbon Monoxide (CO) area designations contained in 40CFR81.305, the federal National Ambient Air Quality Standard (NAAQS) which monitors each pollutant as per the Clean Air Act. There are three designation categories: nonattainment, unclassifiable and attainment areas. Non-attainment areas are those which are in violation of the standard. This data layer is current as of November 2003. Projection: Teale Albers, NAD83. This shapefile can be used to identify designation areas that are defined pursuant to the corresponding federal national ambient air quality standard for each pollutant as per the Clean Air Act. California Office of Statewide Health Planning and Development. (2003). Federal NO2, SO2, and CO2 Area Designations: California, 2003. California Air Resources Board. Available at: http://purl.stanford.edu/ny073ny2890. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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  20. Title: Medical Service Study Areas, California, 2000

    Contributors:

    Summary: The 2000 Medical Service Study Area (MSSA) Census Tract Detail polygon layer represents all California census tract boundaries used in the construction of the 2000 MSSA Boundaries. Each of the state's 7,049 census tracts was assigned to a medical service study area, as identified in this data layer. The 2000 MSSA Census Tract Detail data is aggregated by OSHPD, to create the 2000 MSSA data layer. This layer is part of the Healthcare Atlas of California. The 2000 MSSA Census Tract Detail map layer was developed to support geographic information systems (GIS) applications, representing 2000 census tract geography that is the foundation of 2000 medical service study area (MSSA) boundaries. California Office of Statewide Health Planning and Development. (2000). Medical Service Study Areas, California, 2000. California Office of Statewide Health Planning and Development. Available at: http://purl.stanford.edu/cw298nk7833. The State of California and the Office of Statewide Health Planning and Development make no representations or warranties regarding the accuracy of data or maps. The user will not seek to hold the State or the Department liable under any circumstances for any damages with respect to any claim by the user or any third party on account of or arising from the use of data or maps. The user will cite the Office of Statewide Health Planning and Development as the original source of the data, but will clearly denote cases where the original data have been updated, modified, or in any way altered from the original condition. There are no restrictions on distribution of the data by users. However, users are encouraged to refer others to the Office of Statewide Health Planning and Development to acquire the data, in case updated data become available. This layer is presented in the WGS84 coordinate system for web display purposes. Downloadable data are provided in native coordinate system or projection.

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