1. (1) To be designated a PSA, the Commissioner of the Tennessee Department of Health will consider whether:

   1. (a) The area is a rational area for the delivery of primary medical care.

      1. 1. The following areas will be considered rational areas for the delivery of primary medical care services:
   2. (i) A county, or a group of contiguous counties whose population centers are within 30 minutes travel time of each other.
   3. (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, distinctive population characteristics or other factors, has limited access to contiguous area resources, as measured generally by a travel time greater than 30 minutes to such resources.

   4. (iii) Established neighborhoods and communities within metropolitan areas which displays a strong self-identity (as indicated by a homogeneous socioeconomic or demographic structure and/or a tradition of interaction or interdependency), have limited interaction with contiguous areas, and which, in general, have a minimum population of 20,000.

      1. 2. The following distances will be used as guidelines in determining distance corresponding to 30 minutes travel time:
   5. (i) Under normal conditions with primary roads available: 20 miles.
   6. (ii) In mountainous terrain or in areas with only secondary roads available: 15 miles.
   7. (iii) Within inner portions of metropolitan areas, information on the public transportation system will be used to determine the distance corresponding to 30 minutes travel time.
   8. (b) The area has a population to full-time-equivalent primary care physician ratio of at least 2,300:1:
   9. (c) All Health Manpower Shortage Areas for Primary Care will also be accepted as a PSA for the purposes of the implementation of this act.

Authority: T.C.A. §49-50-106. Administrative History: Original rule filed June 29, 1983.