State Loan Repayment Program

The following are eligible to receive a SLRP award:

• Physicians (allopathic or osteopathic) including
  • General practice (with completed residency training program)
  • Family practice
  • Obstetrics/gynecology
  • Internal medicine
  • Pediatrics
  • General psychiatry
• Dentists (DDS or DMD general or pediatric)
• Primary care physician assistants
• Primary care certified nurse practitioners
• Certified nurse midwives
• Registered clinical dental hygienists
• Licensed clinical or counseling psychologists (Ph.D. or equivalent required)
• Health service psychologists (Ph.D. or equivalent required)
• Psychiatric nurse specialists
• Licensed professional counselors (Masters or Ph.D. required)
• Marriage and family therapists (Masters or Ph.D. required)
• Licensed clinical social workers (Masters or Ph.D. required)
• Alcohol and substance abuse counselors (Masters of Ph.D. required)

Professional Requirements

• Professionals who are United States citizens/nationals must have a current license by the appropriate licensing agency to practice in Louisiana.
• Professionals must agree to serve a minimum of three years in a federally designated HPSA appropriate for their discipline.
• Professionals must work full-time (40 hours/week), with a minimum of 32 hours per week providing clinical services in an outpatient/ambulatory care setting located in a federally designated HPSA.
  • There is an exception for obstetrics/gynecologists or nurse midwives who work at least 21 of those hours (per week) providing clinical services in an outpatient/ambulatory care setting.
  • The professional must not have a work week that is compressed into less than 4 days per week.
  • The professional shall not work more than 12 hours in any 24-hour period during their “regular” work week.
  • Time spent on call and travel time to a practice site will not count toward the 40 hours of work per week.
  • Hours worked over the required 40 hours per week will not be applied toward any other work week.
• Professionals who have not breached a health professional service contract with the federal, state, or local government, or other entities.
• Professionals who have completely satisfied any other obligation for health professional service that is owed under an agreement with the federal government, state government, the local governing body, or other entities prior to the beginning of service under this program.
• Professionals under contract to work for a public or nonprofit facility must agree to accept Medicare, all applicable Medicaid managed health plans, and to treat patients regardless of their ability to pay.
• Individuals in the Reserve Component of the U.S. Armed Forces or National Guard.
• Professionals who are willing to spend no more than seven weeks a year away from the practice site for vacations, holidays, continuing professional education, illness or any other reason; professionals with absences greater than seven weeks in a service year must extend their service commitment date.

Financial Requirements

• Professionals whose educational loans are from certified educational lenders, whether governmental or commercial, must have been incurred during completion of their education. Also, the loan funds must have been applied toward tuition, education, and reasonable living expenses for their own graduate/medical/undergraduate degrees.
• Professionals who have not had a lien levied against their property for a debt to the United States government.
• Professionals who have not defaulted on their educational loans at any time, unless corrective actions have been made and loans are now in good standing. Professionals must agree to share confidential information (name and social security number) with Louisiana Office of Student Financial Assistance (LOFSA) for the sole purpose of verifying loans are in good standing.
• Professionals who have not had a debt “written off” as uncollectible [pursuant to 31 U.S.C. 3711(a)(3)], or had any federal service or payment obligation waived.
• Professionals must offer a sliding fee scale (i.e., a discount fee schedule) to low-income, un-insured and under-insured people; must provide care at no cost for those unable to pay and must not discriminate against individuals based on their ability to pay or the type of payment offered. The sliding fee scale used must be based on the federal poverty guidelines and apply to at least those who are at or below the most recent 200% federal poverty level. Professionals must charge the usual and customary prevailing rates for the area in which their professional services are provided. The facility must have a posted sliding fee scale sign easily visible in the check-out or lobby area. One year of data for the site must be provided in order for the site to be eligible. This must be provided on the Louisiana SLRP Site Information Form by the facility at application and then updated at the end of the 1st and 3rd quarters throughout the duration of the contract. The site is not eligible if this cannot be provided.
• Professionals who agree to use these funds to repay qualifying educational loans. Public Law 111-148, the Patient Protection and Affordable Health Care Act, makes payments under the National Health Service Corps Loan Repayment Program and certain State Loan Repayment Programs tax exempt from federal tax. Up to six percent of these funds can be set aside to pay for the professionals’ Louisiana state income tax, however, any funds not needed for taxes must be paid towards educational loans.
• Professionals who are current on child support applications and those who are no longer in arrears with past child support payments.

Administrative Requirements

• Professionals will be required to register as a vendor through Louisiana’s LAGov system. This will require logging into the system and supplying your information to receive a vendor number and vendor profile that will be used to track your contract. Additional instruction will be given to the applicants accepted into the program.
• If accepted into this program, the applicant must receive clearance from the Louisiana Department of Revenue (LDR) prior to being approved. It is the applicant’s responsibility to ensure there are no issues with taxes or penalties from previous filing years. Given that these issues can take a long time to clear up, the applicant should contact LDR to ensure there are no issues at application. A delay in LDR issues may result in the contract offer being rescinded. To check clearance, e-mail LDROSPClearances@la.gov.

The following are ineligible to receive a SLRP award:

• Non-citizens or non-nationals of the United States, including permanent resident aliens and other aliens.
• Professionals who have an outstanding contractual obligation to provide a health professional service to the Federal Government (e.g., an active military obligation, National Health Service Corps (NHSC) Loan Repayment Program, NHSC Scholarship Program, Nursing Educational Loan Repayment Program or Nursing Scholarship Program obligation), or a state or other entity, unless that service obligation will be completely satisfied before the SLRP contract has been signed.
  • Be aware that certain bonus clauses in some employment contracts may impose a service obligation. If the SLRP participant’s military training or service, in combination with the participant’s other absences from the service site, exceed 35 workdays per service year, the SLRP service obligation should be extended to compensate for the break in “full-time” service.
• Professionals who have breached an obligation for health professional service to the federal government, state government, or local government or another entity.
• Professionals who owe an obligation for health professional service to the federal government or a state government, or another entity under an agreement with such federal, state, or other entity is ineligible for the loan repayment program, unless the obligation will be completely satisfied prior to the beginning of this program.
• Professionals who are obligated under another loan or scholarship payback program, regardless of source. Once a person has fulfilled other obligations, that person may apply for a SLRP. Professionals applying must meet all other eligibility requirements for a period that begins after the other obligation(s) end.
• Professionals who are delinquent on their child support payment obligation.
• Professionals who have a judgment lien against their property for a debt to the United States.
• Professionals who have a loan(s) in default status at time of application.
• Physicians who have not completed residency training programs.
• Students or residents who are not licensed and able to work full-time at an approved HPSA site at the time they apply.
• Professionals who are not working full-time (40 hours per week) at a public or nonprofit facility that treats everyone regardless of ability to pay.

Health professionals participating in SLRP must fulfill their service obligation at an eligible practice site. The following site types are eligible to be approved as practice sites for participants:

1. Federally Qualified Health Centers (FQHCs):
   1. Community Health Centers
   2. Migrant Health Centers
   3. Homeless Programs
   4. Public Housing Programs
2. FQHC Look-A-Likes
3. Centers for Medicare & Medicaid Services Certified Rural Health Clinics
4. Other Health Facilities:
   1. Community Outpatient Facilities
   2. Community Mental Health Facilities
   3. State and County Health Department Clinics
   4. Immigration and Customs Enforcement Health Service Corps
   5. Free Clinics
   6. Mobile Units
   7. School-based Programs
   8. Critical Access Hospitals affiliated with a qualified outpatient clinic
   9. Long-term Care Facilities
   10. State Mental Health Facilities
5. Indian Health Service Facilities, Tribally-Operated 638 Health Programs, and Urban Indian Health Programs:
   1. Federal Indian Health Service (IHS) Clinical Practice Sites
   2. Tribal/638 Health Clinics
   3. Urban Indian Health Program
6. Correctional or Detention Facilities:
   1. Federal Prisons
   2. State Prisons
7. Private Practices (Solo or Group)

1. Public and nonprofit private entities located in and providing health care services in HPSAs. Nonprofit private entity means an entity which may not lawfully hold or use any part of its net earnings to the benefit of any private shareholder or individual and which does not hold or use its net earnings for that purpose. A 501(c)(3) form from the IRS including the facility’s physical address is required.
2. For-profit health facilities operated by nonprofit organizations must accept reimbursement from Medicare, Medicaid, and the Children’s Health Insurance Program, utilize a sliding fee scale, and see all patients regardless of their ability to pay.
3. All practice sites must be located in federally designated HPSAs. Medically Underserved Areas or Populations and shortage areas designated by the state do not qualify.
4. Eligible practice sites must charge for professional services at the usual and customary prevailing rates except free clinics.
5. Eligible practice sites must provide discounts for individuals with limited incomes (i.e., use a sliding fee scale). For information about current HHS Poverty Guidelines, please visit the Federal Register website.
   1. For those with annual incomes at or below 100 percent of the HHS Poverty Guidelines, states must ensure that practice sites provide services at no charge or at a nominal charge
   2. For individuals between 100 and 200 percent of the HHS Poverty Guidelines, states must ensure that practice sites provide a schedule of discounts, which must reflect a nominal charge covered by a third party (either public or private)
   3. A state may allow practice sites to charge for services to the extent that payment will be made by a third party which is authorized or under legal obligation to pay the charges.

Applicants will be prioritized according to the following criteria requested when reviewing SLRP applications:

1. Priority is given to applicants who work in facilities with the highest percentage of underserved patients, including those who use Medicaid managed health plans and Medicare, those who are uninsured and indigent or underinsured and unable to find treatment. Some of these types of priority facilities would include public health units, FQHCs and their satellite sites, School-Based Health Centers, state operated facilities or other eligible facilities that are subsidized by the state/federal government. A Louisiana SLRP Site Application Form must be completed at application and after the 1st quarter of every year of contract eligibility. At application this must include one year of data for the site. The site is not eligible if this cannot be provided.
2. Priority is given to individuals who agree to serve in HPSAs with the highest degree of shortage, rural and whose service will have the greatest impact on underserved populations in these high-needs parishes (see maps of Louisiana HPSAs).
3. Priority is given to individuals who agree to accept referrals and provide healthcare services to a significant portion (at least 25%) of the HIV/AIDS patient-base.
4. Priority is given to applicants who agree to treat targeted populations who are designated as underserved in their service area (e.g. migrant farm workers, homeless, etc.).
5. Priority is given to providers working in an eligible facility that has an opioid treatment program with 25% of their caseload consists of these patients.
6. Applicants who submit incomplete application packets will not be considered.

Submission of online application:

You can upload all required documents using the online application. Note: You are unable to save your application and return back to it later.  Please make sure you have all required documents needed prior to beginning the application. You can find a list of all required documents under “Application Review Checklist.” 

Submission by mail:

If you prefer to submit your application via mail, you can download the application. You can mail it and associated documents to the following address: 

Louisiana Department of Health
ATTN: Well-Ahead Louisiana Primary Care Office
P.O. Box 3118
Baton Rouge, LA 70821-3118

The fully completed, signed application must be submitted along with the following forms and information:

• Online application or downloadable application. Please print the downloadable application if you prefer to submit via mail.
• Signed Site Information Form for all sites in which the applicant provides services
• Copy of executed employment contract OR a letter verifying employment, if an employment contract is not available
  • For public employees, a letter of agreement with the governmental agency and verification of employment will be accepted in lieu of an employment contract
• Resume
• Copy of current professional license
• Documentation of the current principle balance of the applicant’s certified educational debt. This should include name and account number for each loan
• Signed Site Agreement for All Participating SLRP Sites Form completed by employer
• Signed and notarized Attestation of No Other Obligation Form
• Signed Certification Regarding Environmental and Tobacco Smoke Form
• Signed Release from Liability Form
• Signed Consent for Release of Information Waiver of Confidentiality Form
• Documentation of employer’s sliding fee scale/discount fee policy (Example of Discounted/Sliding Fee Schedule)
• Documentation of employer’s sliding fee scale/discount fee schedule – actual scale
• Photo of employer’s sliding fee scale/discount fee policy posted in the checkout/lobby
• Photo of employer’s sign posted in the checkout/lobby that states “(Facility Name) accepts all patients regardless of ability to pay.”
• Copy of current Louisiana Medicaid Provider ID Number or a copy or application for this number (if provider does not have individual number, the facility number is acceptable)
• Completed IRS Form W-9-Request for Taxpayer ID Number that matches applicant address (this should include YOUR information, not your employer)
  • W-9 Directions
  • W-9 Form
• Completed Electronic Funds Transfer Form with voided blank check or direct deposit form from financial institution (the bottom of this form should be completed by your financial institution; please make sure the box on the middle left of the page is checked)
  • EFT Directions
  • EFT Form
• Proof of site’s nonprofit or public status (IRS Form 501c3 or Board Resolution)

Following notification of funding and receipt of the SLRP contract in the mail, the applicant should return the signed SLRP contract with the understanding that once the contract is signed by the Secretary of LDH, or their designee, and approved through the LDH contract approval process, the applicant is agreeing to accept repayment of their educational loans in exchange for providing outpatient primary care healthcare services for an agreed upon period of obligation in a federally designated HPSA.

Note: Neither the applicant nor the State is bound by the contract until:

• The Secretary of LDH, or their designee, has signed the SLRP contract;
• The contract has been approved by the Louisiana Division of Administration, Office of State Procurement.

Participating in Louisiana SLRP requires the provision of full-time clinical services at an eligible SLRP service site for the period agreed upon in the program contract. These sites are specific health care practice opportunities identified by the SLRP in certain federally designated health professional shortage areas (HPSAs) that have experienced special difficulty recruiting or retaining health professionals because of the site’s geographic isolation, severe economic need, or the chronically poor health status of the population to be served.

Approval of SLRP contracts is contingent upon verification that the service site accepts all applicable Medicaid managed health plans, Medicare, and sliding fee scale/discount fee patients. The site must also provide proof of nonprofit/public status to the applicant for inclusion in the SLRP application. This can be done using the IRS form 501(c)(3) form or Board Resolution Statement.