Appendix F to Part 5 - Criteria for Designation of Areas Having Shortages of Pharmacy Professional(s)
42:1.0.1.1.6.0.1.5.6 : Appendix F
Appendix F to Part 5 - Criteria for Designation of Areas Having
Shortages of Pharmacy Professional(s) Part I - Geographic Areas
A. Criteria.
A geographic area will be designated as having a shortage of
pharmacy professional(s) if the following three criteria are
met:
1. The area is a rational area for the delivery of pharmacy
services.
2. The number of pharmacists serving the area is less than the
estimated requirement for pharmacists in the area, and the computed
pharmacist shortage is at least 0.5.
3. Pharmacists in contiguous areas are overutilized or
excessively distant from the population of the area under
consideration.
B. Methodology.
In determining whether an area meets the criteria established by
paragraph A of this Part, the following methodology will be
used:
1. Rational Areas for the Delivery of Pharmacy
Services.
(a) The following areas will be considered rational areas for
the delivery of pharmacy services:
(i) A county, or a group of contiguous counties whose population
centers are within 30 minutes travel time of each other; and
(ii) A portion of a county, or an area made up of portions of
more than one county, whose population, because of topography,
market or transportation patterns or other factors, has limited
access to contiguous area resources, as measured generally by a
travel time of greater than 30 minutes to these resources.
(b) The following distances will be used as guidelines in
determining distances corresponding to 30 minutes travel time:
(i) Under normal conditions with primary roads available: 20
miles.
(ii) In mountainous terrain or in areas with only secondary
roads available: 15 miles.
(iii) In flat terrain or in areas connected by interstate
highways: 25 miles.
Within inner portions of metropolitan areas, information on the
public transportation system will be used to determine the area
corresponding to 30 minutes travel time.
2. Counting of Pharmacists.
All active pharmacists within the area will be counted, except
those engaged in teaching, administration, or pharmaceutical
research.
3. Determination of Estimated Requirement for
Pharmacists.
(a) Basic estimate. The basic estimated requirement for
pharmacists will be calculated as follows:
Basic pharmacist requirement = .15 × (resident civilian
population/1,000) + .035 × (total number of physicians engaged in
patient care in the area).
(b) Adjusted estimate. For areas with less than 20,000
persons, the following adjustment is made to the basic estimate to
compensate for the lower expected productivity of small
practices.
Estimated pharmacist requirement = (2 − population/20,000) × basic
pharmacist requirement.
4. Size of Shortage Computation.
The size of the shortage will be computed as follows:
Pharmacist shortage = estimated pharmacist requirement − number of
pharmacists available.
5. Contiguous Area Considerations.
Pharmacists in areas contiguous to an area being considered for
designation will be considered excessively distant or overutilized
if either:
(a) Pharmacy professional(s) in contiguous areas are more than
30 minutes travel time from the center of the area under
consideration, or
(b) The number of pharmacists in each contiguous area is less
than or equal to the estimated requirement for pharmacists for that
contiguous area (as computed above).
C. Determination of Degree-of-Shortage.
Designated areas will be assigned to degree-of-shortage groups,
based on the proportion of the estimated requirement for
pharmacists which is currently available in the area, as
follows:
Group 1 - Areas with no pharmacists.
Group 2 - Areas where the ratio of available pharmacists to
pharmacists required is less than 0.5.
Group 3 - Areas where the ratio of available pharmacists to
pharmacists required is between 0.5 and 1.0.