Medical Service Study Areas, California, 2010

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.