Section 5.4 - Notification and publication of designations and withdrawals(a) The Secretary will give written notice of the designation (or withdrawal of designation) of a health professional(s) shortage area, not later than 60 days from the date of the designation (or withdrawal of designation), to: (1) The Governor of each State in which the area, population group, medical facility, or other public facility so designated is in whole or in part located;(2) Each HSA for a health service area which includes all or any part of the area, population group, medical facility, or other public facility so designated;(3) The SHPDA for each State in which the area, population group, medical facility, or other public facility so designated is in whole or in part located; and(4) Appropriate public or nonprofit private entities which are located in or which have a demonstrated interest in the area so designated.(b) The Secretary will periodically publish updated lists of designated health professional(s) shortage areas in the FEDERAL REGISTER, by type of professional(s) shortage. An updated list of areas for each type of professional(s) shortage will be published at least once annually.(c) The effective date of the designation of an area shall be the date of the notification letter to the individual or agency which requested the designation, or the date of publication in the FEDERAL REGISTER, whichever comes first.(d) Once an area is listed in the FEDERAL REGISTER as a designated health professional(s) shortage area, the effective date of any later withdrawal of the area's designation shall be the date when notification of the withdrawal, or an updated list of designated areas which does not include it, is published in the FEDERAL REGISTER.