The department shall designate counties, communities, or sections of urban areas as areas of defined need when such county, community or section of an urban area has, but is not limited to, the following:

1. (1) A population to primary care physician ratio of three thousand five hundred to one or more; or

2. (2) A population to primary care physician ratio of less than three thousand five hundred to one, but greater than two thousand five hundred to one; and

   1. (a) Has a twenty percent or greater population fifty-five years of age or over; or
   2. (b) Twenty percent of the population or households are below the poverty level; or
   3. (c) If the largest hospital in the area is approximately thirty miles or more from a comparable or larger facility or if the central community in the area is approximately fifteen miles or more from a hospital having more than four thousand discharges a year or more than four hundred deliveries annually; and
   4. (d) Has a community or city of six thousand or more population plus the surrounding area up to a radius of approximately fifteen miles that serves as the central community or an urban or metropolitan neighborhood located within the central city or cities of a standard metropolitan statistical area having limited interaction with contiguous areas and a minimum population of approximately twenty thousand;
3. (3) Any other community or section of an urban area with unusual circumstances can be evaluated on a case-by-case basis for designation by the department as an area of defined need.

(L. 1988 H.B. 1380 § 3)