Section 590.410  Criteria for Designating Shortage Areas

a)         Shortage areas may include the following:

1)         An urban or rural area which is a rational area for the delivery of health services;

2)         A population group;

3)         A public or nonprofit private medical facility.

(Section 3.04 of the Act)

b)         Areas and population groups designated by the U.S. Department of Health and Human Services (See 42 CFR 5) as having shortages of primary care physicians shall qualify for purposes described in this Part.

c)         Additional areas shall be designated using the following criteria:

1)         Urban service areas with a population-to-primary care physician ratio of at least 3000:1;

2)         Rural service areas with a population-to-primary care physician ratio of at least 2400:1;

3)         Rural service areas with a population-to-primary care physician ratio between 1800:1 and 2399:1, and where one-third of the primary care physicians are 60 years of age or older;

4)         Urban or rural areas where board certified pediatricians or obstetrician/gynecologists are not practicing within the service area, and where there is sufficient need to support a full-time practice.  Sufficient need, for the purposes of this subsection may be documented in the following manner:

A)        at least 80% of the non-pediatrician (or obstetrician) physicians agreeing that there is a sufficient need.

B)        At least 80% of the pediatricians (or obstetrician) physicians agreeing that there is sufficient need.

C)        Agreement by the hospitals and local health department administrators.

5)         Rural service areas where the obstetricians having admitting privileges at a hospital with an obstetrical unit perform more deliveries per year than the statewide average obtained by dividing the number of obstetricians providing patient care in Illinois into the number of births in Illinois in a year; and where the existing obstetricians and family physicians providing obstetrical care express, in writing, their need for additional obstetricians.

d)         Facilities whose mission is to provide care to underserved populations will be designated for purposes of this Part. Such facilities include:

1)         Local health departments which establish primary care clinics, offering direct patient care on either a full or part-time basis;

2)         Any community health center or its satellite in Illinois which is funded through Section 330 of the Public Health Service Act;

3)         Health clinics which can document that at least 75 percent of their patients are a combination of the following:

A)        Medicaid eligible, or

B)        Qualify for reduced fees based on a sliding fee scale using as an upper limit 200 percent of the federal poverty level, as published annually in the Federal Register.