Frequently Asked Questions

State Loan Repayment Program FAQs

What is the NHSC/SLRP?

The National Health Service Corps (NHSC) State Loan Repayment Program (SLRP) provides cost-sharing grants to more than 30 states to operate their own loan repayment programs. These state programs offer loan repayment to primary care providers working in Health Professional Shortage Areas (HPSAs) for a minimum of two years.


Do clinicians have to be a U.S. citizen to apply for the SLRP?

Yes. They must be a U.S. citizen to apply for the NHSC State Loan Repayment Program.


Can clinicians still apply for the SLRP if they currently owe an existing service obligation?

No. If they owe an existing service obligation to another entity, they cannot apply for the State Loan Repayment Program until they have completed their existing obligation. This includes, but is not limited to, the NHSC Loan Repayment Program (LRP), NHSC Scholarship Program (NHSC SP), Nursing Education Loan Repayment Program (NELRP), Faculty Loan Repayment Program (FLRP) and the Health Professions Education Foundation programs.


Can clinicians apply for more than one scholarship or loan repayment program at a time?

Yes. If clinicians qualify, clinicians are encouraged to apply for as many scholarship or loan repayment programs as available. However, clinicians may not accept more than one award for, or sign a contract for, more than one service obligation simultaneously. Clinicians must complete one service obligation at a time.


Do all applicants of the SLRP receive a loan repayment award?

The State Loan Repayment Program is a competitive program. The number of awards will depend on the amount of funding available and number of applications received by each individual state program. You may contact your SLRP Program Administrator to determine the current amount of funding available for the upcoming cycle. You can find your individual SLRP state program office by visiting the website.


What types of loans are eligible for the SLRP?

Government and commercial loans incurred to obtain a health profession education qualify for the program. Qualifying commercial lending institutions are those that are subject to examination and supervision, in their capacity as lenders, by an agency of the United States or of the State in which the institutions have their place of business. The State Loan Repayment Program does not include interest accrued on an educational loan as an eligible source for loan repayment.


What types of loans are NOT eligible for the SLRP?

The following loans do not qualify for the State Loan Repayment Program:

  • Loans for which the associated documentation does not identify the loan as applicable to undergraduate or graduate education.
  • Loans not obtained from a Government entity or commercial lending institution. Most loans made by private foundations to individuals are not eligible for repayment
  • Loans that have been repaid in full.
  • PLUS Loans (made to parents).
  • Personal lines of credit.
  • Residency relocation loans.
  • Credit Cards

How many grantees are awarded each cycle for the SLRP?

Each State Loan Repayment Program applications cycle is unique, and the number of applicants awarded depends on the number of applications received as well as the availability of funding.


Do clinicians have to be licensed in order to apply for our state SLRP?

Yes. You must have a valid, unrestricted health care license or certificate to apply for this program.


What health professions qualify for the SLRP?

Qualified professions for the State Loan Repayment Program include the following:

  • Allopathic or Osteopathic Physicians specializing in Family Medicine, General Pediatrics, General Internal Medicine, Gerontology, General Psychiatry or Obstetrics/Gynecology
  • Primary Care Nurse Practitioners
  • Primary Care Physician Assistants
  • Certified Nurse-Midwives
  • Dentists (DMD/DDS)
  • Dental Hygienists
  • Licensed Mental Health or Behavioral Health Professionals: Clinical or Counseling Psychologists, Clinical Social Workers, Professional Counselors, Marriage and Family Therapists, or Psychiatric Nurse Specialists.
  • Registered Nurses
  • Pharmacists

Why are pharmacists now included as an eligible profession in the SLRP?

The NHSC aims to support health care providers who will increase access to care in underserved communities. Pharmacists are often an important source of information and counsel in their communities and are increasingly a key member of the primary care team. Providing states additional flexibility to meet the unique needs of their underserved communities benefits the patients the State Loan Repayment Program is designed to serve.


What requirements must clinicians meet in order to apply for our state SLRP?

To qualify for the State Loan Repayment Program, they must meet the following criteria:

  • Be a U.S. citizen, with a valid, unrestricted health care license or certificate for the state in which you practice
  • Have no other existing service commitment
  • Be free of judgments arising from federal debt
  • Be current on all child support payments
  • Be currently employed or have accepted employment at a designated Health Professional Shortage Area (HPSA) site
  • Commit to providing full-time (40 hours per week) direct patient care in a designated Health Professional Shortage Area

When is the annual application filing period for the SLRP?

The application grant cycle for the State Loan Repayment Program through HRSA is now closed; however, individual state applications vary from state to state. Each state is permitted to have its own application cycle, and it is not required to coincide with the NHSC application cycle.


What documents must a clinician submit in order to make their SLRP application complete?

Required documents for the State Loan Repayment Program are based on each state’s individual application. However, the following information may be requested:

  • Application: Clinicians must sign and date the application and have enclosed all required documentation.
  • Educational Debt Reporting Form: Clinicians should refer to their lender statements when filling out this form.
  • Lender Statements: These must be current and dated within 30 days of application submission. They must also include the clinician’s name, the name and payment address of the lender, account number, and the current principal balance.
  • Personal Statement: Clinicians should refer to the application for these predetermined questions. Personal statements should be typed in a question and answer format.
  • Letter of Recommendation: This should come from the clinician’s supervisor and explain why he or she feels that they are a good candidate for the program. The letter should be on letterhead and include an original signature.
  • Certification of Practice Site Form: This form verifies their employer’s agreement to participate in the program.


If any of the required documents listed above are either incomplete or missing, the application packet will not be reviewed. The State Program Administrator may contact the clinician if they are missing required document or if they requested to be notified of a complete packet.

 

What are the terms of a SLRP contractual obligation?

NHSC State Loan Repayment award recipients are required to serve in a designated Health Professional Shortage Area (HPSA) site for a minimum of two years. NHSC State Loan Repayment award recipients must work 40 hours a week, 32 hours of which must be spent providing direct patient care.

However, states may choose to require longer periods of time for an initial contract (more than two years) or negotiate individual contracts with loan repayors with different contract time periods (e.g., two years for physicians, three years for dentists, four years for physician assistants) to meet community needs. States may also offer less than full repayment of all eligible educational loans. If a clinician chooses to apply for a contract extension, they must continue to meet the same program requirements for the duration of the contract.


If the state is selected to be a grantee of the SLRP, will the clinician’s employer be required to sign a contract with them or the state office where the program resides?

Whether or not an employer will be required to sign a contract with the clinician or the state office where the program resides is based on the arrangement each state has with the designated Health Professional Shortage Area (HPSA) site. The contract should specify the duration of the clinician’s commitment and outline the loan repayment payment schedule.


How is the SLRP funded?

The NHSC State Loan Repayment Program is funded by a grant received from the U.S. Health Resources and Services Administration. These funds support the loan repayment awards distributed by the program. Historically, the SLRP awards have been funded by each fiscal year appropriations. A $10 million investment from the Affordable Care Act will support the FY 2012 SLRP grants. Approximately $10 million was available to fund an estimated 34 FY 2010 awards. States must also agree to make available (directly or through donations from public or private entities) non-Federal contributions in cash toward SLRP contracts in an amount not less than $1 for each $1 of Federal funds provided in the grant.


What happens if a clinician is unable to fulfill the terms of their contractual obligation and complete their service obligation?

If they breach the State Loan Repayment Program obligation, they will be responsible for repaying an amount equal to the sum of the following:

  • All loan repayments received
  • $7,500 for each month of service not completed according to the contract
  • Interest on the above amounts
  • Learn more about state SLRP contract requirements and the Contract Breach and Default Provision (PDF-52 KB).

How does a facility qualify for the SLRP?

To be qualified to participate as an approved service site, a site must:

  • Be located in a “Designated” HPSA;
  • Provide outpatient, ambulatory, primary medical, mental and behavioral, and/or dental services;
  • Ensure access to ancillary, inpatient, and specialty referrals;
  • Provide services on a free or reduced fee schedule basis to individuals at or below 200% of the federal poverty level and post signage advertising this statement (in the waiting room and online if applicable);
  • Accept patients covered by Medicare, Medicaid, and the Children's Health Insurance Program (CHIP);
  • Agree not to discriminate in the provision of services to individuals based on their ability to pay, race, color, sex, national origin, disability, religion, or sexual orientation. The site must prominently post signage, provided to sites by the NHSC, advertising the previous statement (in the waiting room and online if applicable) and the statement should be translated into the appropriate language and/or dialect for the service area;
  • Use a clinician credentialing process including reference review, licensure verification, and a query of the National Practitioner Data Bank (NPDB).
  • Agree not to reduce a clinician’s salary due to NHSC support;
  • Provide a supportive environment for NHSC clinicians, facilitating mentorship, professional development and training opportunities for clinicians;
  • Have general community support for the assignment of Corps members; and
  • Provide sound fiscal management.


 

How does a facility get a Health Professional Shortage Area designation and does the facility need to submit an application?

To be designated as a HPSA, communities or facilities must apply to the HRSA Office of Shortage Designation and provide data indicating that a shortage exists in the area or for the population or facility. These applications are submitted through the State Primary Care Offices (PCO). An area or site interested in a HPSA designation should contact their PCO directly. State PCO contacts can be found at http://bhpr.hrsa.gov/shortage/hpsas/primarycareoffices.html. Applicants may also search for this information using the following links:

Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes, and Indian Health Service (IHS) sites are automatically designated as being a facility HPSA, and some Rural Health Clinics that meet additional criteria may be automatically designated as a facility HPSA.

There are three HPSA categories – primary, dental, and mental health. To recruit an NHSC clinician, NHSC-approved sites must have a “Designated” HPSA for the specific category under which an NHSC clinician would serve. For example, to recruit for an internal medicine physician, an NHSC-approved site must have a designated “Primary Care” HPSA. To recruit a psychiatrist, the site must be in a designated “Mental Health” HPSA.


Are consolidated and/or refinanced loans eligible for SLRP loan repayment?

Yes. Consolidated Loans may also be eligible within the following guidelines.

If loans are consolidated, the consolidated/refinanced loan must be from a Government (Federal, State, or local) or commercial lender and must include only your qualifying educational loans. If an eligible educational loan is consolidated/refinanced with ineligible (non-qualifying) debt, no portion of the consolidated/refinanced loan will be eligible for loan repayment.

For loans to remain eligible for SLRP loan repayment, eligible educational loans must be kept segregated from all other debts. Eligible educational loans consolidated with loans owed by any other person, such as a spouse or child, are ineligible for repayment.


What if loans are in forbearance?

If loans are in forbearance, the clinician is required to fill out any paperwork required by the state to verify the status of the loan at the time of application and must include a recent copy of the corresponding lender statements.


What if loans are in default?

Loans which are currently in default are not eligible for the NHSC State Loan Repayment Program.


What is a “service obligation?”

A “service obligation” means the contractual commitment in which the clinician agrees to practice for a specified period of time in or through a designated facility.


What happens if a clinician needs to change jobs during their service obligation?

They have the option to change jobs during the term of their service commitment. However, to comply with the terms of their contract, they must remain employed with a designated Health Professional Shortage Area (HPSA) site who also meets all of the program criteria and the requirements of your state SLRP contract.


How many hours are considered “full-time & half-time” for the NHSC/SLRP?

Full-time service for Physicians, Dentists, Mental Health Providers, Nurse Practitioners, and Physician Assistants is defined as a minimum of 40 hours per week, of which 32 hours is spent providing direct patient care and up to eight hours in practice-related activities (e.g., precepting, chart review, meetings, Continuing Medical Education, etc.) Full-time service for Obstetricians/Gynecologists and Certified Nurse-Midwives is defined as a minimum of 21 hours per week providing direct patient care, with the remaining hours providing inpatient care to patients, and/or in practice-related activities. Other practice-related activities (e.g., precepting, chart review, meetings, Continuing Medical Education, etc.) cannot exceed eight hours per week. Time spent “on-call” cannot be counted toward the 40-hour week.

Half-time service is defined, for the purposes of the NHSC State Loan Repayment Program, as a minimum of 20 hours per week (not to exceed 39 hours per week), for a minimum of 45 weeks per service year. The 20 hours per week may be compressed into no less than 2 work days per week, with no more than 12 hours of work to be performed in any 24-hour period. Participants do not receive service credit for hours worked over the required 20 hours per week, and excess hours cannot be applied to any other work week. Full-time work done by a half-time participant will not change the participant’s half-time status (and will not entitle the clinician to full-time service credit). Also, time spent “on call” will not count towards the service requirement.