State Primary Care Offices Will Have Additional Time to Review and Update Designations Before Final Withdrawal Decisions
The Health Resources and Services Administration (HRSA) today announced that it will provide State Primary Care Offices (PCOs) additional time to review and update certain Health Professional Shortage Area (HPSA) designations identified through the agency’s 2025 National Shortage Designation Update (NSDU).
As part of the annual Federal Register Notice (FRN) (PDF - 188 KB) publishing the nation’s designated HPSAs, HRSA will maintain the HPSA designations that were identified through the NSDU in a “Proposed for Withdrawal” status rather than withdrawing them on July 1, 2026. This action gives state and territorial PCOs additional time to evaluate updated data, review designation boundaries, and submit revisions where appropriate before HRSA takes final action.
Importantly, this extension applies only to HPSAs identified through the NSDU process. HPSA withdrawals that were specifically requested by State PCOs will continue to move forward and will be withdrawn as planned.
“HPSA designations play a critical role in directing health workforce resources to communities with shortages of primary care, dental, and mental health providers,” said HRSA Administrator Tom Engels. “By providing states additional time to review and update these designations, HRSA is helping ensure that workforce programs continue to reflect local needs and the most accurate data available.”
The affected designations were identified during HRSA’s September 2025 NSDU, which applied updated demographic and provider data, including changes associated with 2020 Census geographies. Rather than immediately withdrawing these designations through the 2026 FRN, HRSA will hold them in a Proposed for Withdrawal status and work with states to address any needed updates before publication of the next annual FRN, scheduled on or before July 1, 2027.
Maintaining the NSDU-affected HPSAs in Proposed for Withdrawal status helps avoid unnecessary disruptions while states complete their reviews. Communities with these designations will continue to be recognized as HPSAs until final withdrawal decisions are made through a future FRN.
HPSA designations help determine eligibility and priority for a range of federal workforce programs, including placement of National Health Service Corps clinicians and certain Medicare incentive payments. HRSA will continue working closely with state PCOs to ensure that HPSA designations accurately reflect current workforce shortages and community needs.
View the complete lists of designated HPSAs as of April 30, 2026.
Learn more about HRSA’s health workforce programs.