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Exceptional Designation
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There are instances when an area or population may not meet the traditional criteria needed to qualify for one of the preceding designations. As a result, the government has provided two exceptional designations, which include the following: 1) the Governor’s Exceptional MUP designation; and 2) Governor’s Certified Areas for RHCs. These requests must include a written recommendation for designation from the Governor or other chief executive officer of the State and local health official. Please click on the header for more information.


A primary purpose for applying for the MUP designation is to develop a Federally Qualified Health Center (FQHC) ‘look-alike’ or apply for FQHC grant funding. When a community does not meet the criteria for a traditional MUP, authorization for the Governor's Exceptional MUP is pending decision from the current administration. Scroll down to find a list of past approved exceptional MUP designations.

Exceptional MUP Designations (Governor's Exceptional MUP)

Under the provisions of Public law 99-280, enacted in 1986, a population group which does not meet the established criteria of an IMU less than 62.0 can nevertheless be considered for designation if "unusual local conditions which are a barrier to access to or the availability of personal health services" exist and are documented, and if such a designation is recommended by the chief executive officer and local officials of the State where the requested population resides.

  • Requests for designation under these exceptional procedures should describe in detail the unusual local conditions/access barriers/availability indicators which led to the recommendation for exceptional designation and include any supporting data.
  • Such requests must also include a written recommendation for designation from the Governor or other chief executive officer of the State (or State-equivalent) and local health official.

Communities that are interested in pursuing a Governor’s recommended Exceptional MUP designation should submit a request to the Michigan Department of Community Health. This request should be in the form of a compelling two to five page narrative that describes and documents the unusual local conditions that necessitate consideration for designation.

  • The following factors should be considered when describing the unusual local conditions that support the designation request:
    • Unusual local conditions which lead to a barrier in accessing primary medical care or that indicate medical under service is present. (i.e. shift in employment/unemployment, immigration, loss of service, linguistic isolation.) Document that the unusual local condition has impacted access to care.
    • Documented data showing statistically significant higher rates for morbidity and mortality measures, as compared to State and National data. (i.e. chronic and infectious disease and mortality rates, prenatal care measures.) Include data sources.
    • Demonstrated inadequate access to care for the low-income uninsured or publicly insured. This may be demonstrated through a high population to provider ratio, a high percentage of emergency room visits for primary care, and/or other compelling information specific to community conditions.
    • The request should also include documentation that the area or population does not qualify for a traditional MUA/P designation by providing the Index of Medical Underservice (IMU) calculation for the area. It is anticipated that communities seeking Governor’s Exceptional MUP designation will also be partnering with the Michigan Department of Community Health and/or the Michigan Primary Care Association to expand local access to primary care. Primary care community development assistance is available to interested communities.

To request assistance with a Governor’s MUP request, please contact Joe Tran, Michigan Primary Care Association.

Past Approved Governor's Exceptional MUPs

  • Barry and Eaton County- Barry/Eaton Service Area- Designated June 2005
  • Berrien County- Designated September 2008
  • Emmet County- Designated February 2007
  • Jackson County- Designated September 1996
  • Portion of Kent County- Designated April 2011
  • Lenawee County- Morenci City Service Area- Designated July 1996
  • Portion of Macomb County- Designated March 1988
  • Marquette County- Designated January 2010
  • Montcalm County- Designated June 2005
  • Portion of Muskegon County- Designated January 1993
  • St. Clair County- Designated April 2010
  • Shiawassee County- Designated February 2007
  • Portion of Washtenaw County- Designated September 2010
  • Wexford County- Designated July 2005

For more information on these designations, click here.



Current Designations in Michigan

Primary Care Health Professional Shortage Area

Statewide Map of HPSAs
List by County

Mental Health Professional Shortage Area

Statewide Map of HPSAs
List by County

Dental Health Professional Shortage Area

Statewide Map of HPSAs
List by County

Medically Underserved Area/Population

Map of MUA/MUP
List by County

Detroit Medically Underserved Area/Population

Map of Detroit's MUA/Ps

Governor’s Certified Shortage Area for RHC

Statewide Map of RHCs
List by County

More Information & Designation Inquiries

J. Ryan Grinnell-Ackerman, MPA
Policy and Workforce Development Manager


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