The Meaning of Frontier
Frontier areas are the most remote and geographically isolated areas in the United States. These areas are usually sparsely populated and in addition to extreme weather, they often face extreme distances and travel time to services of any kind.
Although these general characteristics of Frontier are widely accepted, different organizations use different criteria to determine eligibility for their specific programmatic purposes.
The 1998 Matrix for identifying frontier areas
One widely used set of criteria for identifying frontier areas was developed in 1997-1998 through a consensus process convened by NCFC and funded by the federal Office of Rural Health Policy. A multi-disciplinary group of frontier and rural leaders spent nearly a year developing a matrix that weights population density, distance in miles and travel time in minutes from a market or service area. After nearly a year of work, consensus was achieved in support of a matrix that weights population density, distance in miles and travel time in minutes from a market-service area. This methodology has been formally adopted and used by the National Rural Health Association, National Institute of Mental Health, and the Western Governors' Association.
NCFC applies the 1998 Matrix in consultation with state offices of rural health. The Center believes that states and communities should be involved in decision-making, because local people best understand local conditions. This process is unique in its use of a "bottom-up" feedback loop that acknowledges the diversity among frontier areas.
The 1998 Matrix is used by nearly half of the state offices of rural health. California, Hawaii and Michigan have developed sets of criteria for determining Frontier that are specific to the conditions in those states. Eleven state offices of rural health use population density alone to determine frontier areas. Here is a map of the frontier designation criteria used by various state offices of rural health.
Criteria for Designating Frontier Areas
The 1998 Matrix (NCFC)
The Frontier and Remote Areas (FAR) methodology (ORHP, USDA)
In November 2012, a new methodology for identifying frontier areas was released by USDA and ORHP for public comment. The methodology could be used to determine eligibility for a wide variety of federal funding and grant opportunities, so input from frontier stakeholders is essential. All comments are due by January 4, 2013. Click here for more information on the FAR methodology.
California's Frontier Methodology
Rural-Urban Commuting Area (RUCA) Codes
Rural-Urban Commuting Area Codes, are use the Bureau of Census Urbanized Area and Urban Cluster definitions in combination with work commuting information to characterize all of the nation's Census tracts regarding their rural and urban status and relationships. Census tracts identified as "isolated rural" (RUCA Codes 10.0-10.6) are often considered Frontier.
Office for the Advancement of Telehealth
Methodology for Designating Frontier Areas (2006)
This report established a "Frontier Area" designation process for programs implemented through the Office for the Advancement of Telehealth
Department of Health and Human Services
Definition of Frontier (2008)
"Frontier Area means those areas identified by the Secretary (through the Frontier Work Group of the Office for the Advancement of Telehealth) as frontier areas, or, until an official list of frontier areas is issued, those U.S. counties or county-equivalent units with a population density less than or equal to 6 persons per square mile."
Frontier Extended Stay Clinic Criteria
Criteria for elegibility as a Frontier Extended Stay Clinic
Frontier Community Health Integration Demonstration Program
Defines frontier using population density for the purposes of the Frontier Community Health Integration Demonstration Program.
Revised October 2012