*In the event of conflicting information between this guidance and a Request for Proposal (RFP), the conflict
shall be resolved according to the RFP.
Cristie Duric, MPH, RRT
Primary Care Programs Manager
Kevin Wooddell
Administrative Assistant
April 1, 2024
Primary Care Provider
Loan Repayment
Table of Contents
Summary _______________________________________________________________________ 1
Program Overview ________________________________________________________________ 1
Eligible Health Profession Disciplines and Specialties Awards ____________________________ 1
Service Obligation Requirements ___________________________________________________ 1
Full-time, 2-Year Service Obligation or Half-time, 2-Year Service Obligation Requirements ......... 1
Half-time, 4-Year Service Obligation Requirements ....................................................................... 2
Eligibility Conditions _____________________________________________________________ 2
Eligibility Requirements __________________________________________________________ 4
Description of Eligibility Requirements _______________________________________________ 4
Eligibility Verification _____________________________________________________________ 9
Award Recipient and Employer Responsibilities ______________________________________ 12
Award Recipient Responsibilities ................................................................................................. 12
Employer Responsibilities ............................................................................................................ 12
Funds Disbursement ____________________________________________________________ 13
Tax Liability ___________________________________________________________________ 13
*In the event of conflicting information between this guidance and a Request for Proposal (RFP), the conflict
shall be resolved according to the RFP.
Summary
The Iowa Department of Health and Human Services administers the Primary Care Provider Loan
Repayment Program (LRP). Licensed healthcare practitioners in eligible disciplines can receive loan
repayment assistance through the Primary Care Provider LRP in exchange for a service obligation at
an eligible practice site(s) that is located in a federally designated health professional shortage area
(HPSA) that corresponds to practitioners' discipline.
Award
Two-year, Half-time
Service Obligation
Two-year, Full-time
Service Obligation
Up to
$50,000
Up to
$25,000
Four-year, Half-time
Service Obligation
When to
Apply
Where to
Apply
Eligible
Applicants
Get Notified
Licensed Healthcare Practitioners who provide:
Primary Health Care
Dental/Oral Health Care
Behavioral and Mental Health Care
The annual application cycle is typically open late summer/early fall.
IowaGrants: https://www.iowagrants.gov/index.do
Subscribe here to receive notifications about this program and other
important information about rural healthcare workforce initiatives.
*In the event of conflicting information between this guidance and a Request for Proposal (RFP), the conflict
shall be resolved according to the RFP.
Program Overview
The Primary Care Provider LRP provides loan repayment assistance to eligible healthcare
practitioners through a competitive Request for Proposal (RFP)* process. The program has an
application cycle that opens annually, typically in August/Sept. timeframe. The funding opportunity is
posted on IowaGrants
, which is also where applications are submitted.
Awarded funds are applied to the principal, interest, and related expenses of outstanding government
(i.e., federal, state, or local) and commercial (i.e., private) student loans. Loan repayment assistance
is limited to the minimum undergraduate or graduate education required to obtain licensure in the
profession and specialty (if specialty is applicable) declared in the application.
The objectives of the Primary Care Provider LRP are to:
Objective 1: Improve access to primary health care among rural, underserved populations.
Objective 2: Expand the primary care provider workforce in rural, underserved areas of Iowa.
Objective 3: Distribute primary care providers where they are most needed.
This Primary Care Provider LRP is part of Iowa’s effort to assure access to healthcare across the
state. Student loan repayment is a recruitment and retention tool, assisting in access to care in areas
including, but not limited to, rural areas and urban underserved areas. On average, there are 10-20
recipients annually. The number of program awards is dependent on available funds and awardee
profile.
*In the event of conflicting information between this guidance and a Request for Proposal (RFP), the conflict shall be resolved according to the RFP.
Eligible Health Profession Disciplines and Specialties Awards
Family Medicine Physician (and
osteopathic general practice)
General Internal Medicine Physician
Pediatrics Physician
Obstetrics/Gynecology Physician
Geriatrics Physician
Psychiatry General Practitioner
General and Pediatric Dentistry
Nurse Practitioners and Physician
Assistants (Adult, Family, Pediatrics,
Psychiatry/mental health, Geriatrics, and
Women’s health)
Psychiatric Nurse Specialist
Certified Nurse Midwife
Health Service Psychologist (Clinical
and Counseling)
Pharmacist
Licensed Clinical Social Worker
Licensed Independent Social Worker
Licensed Master Social Worker
Licensed Professional Counselor
Marriage and Family Therapist
Registered Clinical Dental Hygienist
Registered Nurse
Alcohol and Substance Abuse
Counselor
Maximum Award
Two-year, Full-time
OR
Four-year, Half-time
Service Obligation
$50,000
Maximum Award
Two-year, Full-time
OR
Four-year, Half-time
Service Obligation
$40,000
Maximum Award
Two-year, Full-time
OR
Four-year, Half-time
Service Obligation
$30,000
Maximum Award
Two-year, Half-time
Service Obligation
$25,000
Maximum Award
Two-year, Half-time
Service Obligation
$20,000
Maximum Award
Two-year, Half-time
Service Obligation
$15,000
*In the event of conflicting information between this guidance and a Request for Proposal (RFP), the conflict
shall be resolved according to the RFP.
Service Obligation Requirements
FULL- TIME, 2- YEAR SERVICE OBLIGATION OR HALF- TIME, 2- YEAR SERVICE
OBLIGATION REQUIREMENTS
• If the service obligation includes more than one practice site, ALL sites must meet practice site
eligibility requirements.
• Service credit begins when the contract period
starts.
• Award recipients are required to provide services
for a minimum of 45 weeks per service year for the
duration of the service obligation.
• Recipients have the option to take a maximum of 7
weeks of time off (35 full-time workdays or 280 full-
time working hours) per service year for any reason
(e.g., vacation, holidays, sick leave, or continuing
education). However, time-off does NOT count
toward the 45 week service requirement (45 weeks
service + 7 weeks optional time off = 52 weeks per year). Requests for additional time off are
considered and if approved, require a contract amendment to extend the service obligation
(contract end date).
• Services are provided under full-time employment status. Full-time service is defined as 40
hours per week.
• The 40 hours per week may be compressed into no less than 4 days/week, with no more
than 12 hours of work to be performed in any 24-hour period.
• Hours in excess of 40 hours per week cannot be applied to any other work week.
• If an award recipient works more than the
minimum number of 40 hours per week, and it
is not considered overtime, the only allotted
time off that will need to be deducted are the
hours of absence that cause a participant’s
work hours to fall below the required 40 hours
per week.
• Overtime hours do not count toward service
obligation.
• “On call” hours do not count toward the
service obligation, except to the extent the provider is providing patient care during that
period.
• At least 32 hours per week full-time are spent providing patient care at practice sites.
• Telehealth delivered services, if applicable, cannot exceed more than 75 percent of the
minimum weekly hours required to provide direct patient care.
• No more than 8 hours per week full-time are spent in a teaching capacity or performing clinical-
related administrative activities.
• Award recipients are allowed to change full-time or half-time employment status once per
service obligation upon request to the Agency. If approved, the change will require a contract
amendment and may require a change to the service obligation period/contract term.
If eligible and awarded,
healthcare practitioners must
sign a contract and complete a
minimum service obligation at an
eligible practice site(s) that is
located in a federally designated
health professional shortage area
(HPSA).
Example: A practitioner is sick
for 24 hours one week. He works
a standard 60 hours that week
with no overtime so he will only
need to claim 4 hours of allotted
time-off for the week.
HALF- TIME, 4- YEAR SERVICE OBLIGATION REQUIREMENTS
• If service obligation includes more than one practice site, ALL sites must meet practice site
eligibility requirements.
• Service credit begins when the contract period starts.
• Award recipients are required to provide services for a minimum of 45 weeks per service year
for the duration of the service obligation.
• Recipients have the option to take a maximum of 7 weeks of time off (35 half-time workdays or
140 half-time working hours) per service year for any reason (e.g., vacation, holidays, sick
leave, continuing education). However, time-off does NOT count toward the 45 week service
requirement (45 weeks service + 7 weeks optional time off = 52 weeks per year). Requests for
additional time off are considered and if approved, require a contract amendment to extend the
service obligation (contract end date).
• Services are provided under half-time employment status. Half-time service is defined as a
minimum of 20 hours per week not to exceed 39 hours per week.
• The 20 hours per week may be compressed into no less than 2 days/week, with no more
than 12 hours of work to be performed in any 24-hour period.
• Hours in excess of 20 hours per week cannot be applied to any other work week.
• If an award recipient works more than the
minimum number of 20 hours per week, and
it is not considered overtime, the only allotted
time off that will need to be deducted are the
hours of absence that cause a participant’s
work hours to fall below the required 20
hours per week.
• Overtime hours do not count toward service
obligation.
• “On call hours do not count toward the service
obligation, except to the extent the provider is providing patient care during that period.
• At least 16 hours per week are spent providing patient care at practice sites.
• Telehealth delivered services, if applicable, cannot exceed more than 75 percent of the
minimum weekly hours required to provide direct patient care.
• No more than 4 hours per week are spent in a teaching capacity or performing clinical-related
administrative activities.
• Award recipients are allowed to change full-time or half-time employment status once per
service obligation upon request to the Agency. If approved, the change will require a contract
amendment and may require a change to the service obligation period/contract term.
Eligibility Conditions
The following conditions automatically disqualify an applicant from being considered for an award
under the Primary Care Provider LRP. Individuals who have experienced ANY of the following
conditions should not apply.
1. Eligible applicants must not have judgment liens arising from federal or state debt.
2. Eligible applicants must not have a current default on any federal payment obligations, [e.g.,
Department of Education student loans, Health Education Assistance Loans, Nursing Student
Loans, Federal Housing Administration Loans, federal income tax liabilities, federally
Example: A practitioner is sick
for 24 hours one week. He works
a standard 36 hours that week
with no overtime so he will only
need to claim 8 hours of allotted
time-off for the week.
guaranteed/insured loans (e.g., student or home mortgage loans) or any non- federal payment
obligations (e.g., court-ordered child support payments or state tax liabilities)] even if the
creditor now considers the default to be in good standing.
3. Eligible applicants must not have breached a prior service obligation to the federal/state/local
government or other entity, even if the service obligation was subsequently satisfied.
4. Eligible applicants must not have write-offs/charge-offs of any federal or non-federal debts as
uncollectible or waiver of any federal service or payment obligation.
5. Eligible applicants must not have an existing current service obligation (e.g., an NHSC
Scholarship, Loan Repayment Program obligation, NURSE Corps Loan Repayment Program
obligation), or other state loan repayment program, and agree not to incur any service
obligation that would be performed concurrently with, or overlap with, their Primary Care
Provider Loan Repayment Program service obligation.
a. Certain provisions in employment contracts can create a service obligation (e.g., an
employer offers a physician a recruitment bonus in return for the physician’s agreement
to work at that facility for a certain period of time or pay back the bonus).
b. EXCEPTION: Individuals in the Reserve Component of the U.S. Armed Forces or
National Guard are eligible to participate in Primary Care Provider LRP. In making
awards to reservists, the Agency must inform the potential Primary Care Provider LRP
participant that:
i. Placement opportunities may be limited by the Primary Care Provider LRP
program in order to minimize the impact that a deployment would have on the
vulnerable populations served by the reservist.
ii. Military training or service performed by reservists will not satisfy the Primary
Care Provider LRP service commitment.
iii. If participant’s military training and/or service, in combination with the
participant's other absences from the service site, exceed 35 workdays per
service year, the Primary Care Provider LRP service obligation must be
extended to compensate for the break in service.
iv. If the participant is a reservist and is called to active duty, the amount of time
he/she is on active duty (which does not count as Primary Care Provider LRP
service) must be added to the length of the original Primary Care Provider LRP
obligation.
Eligibility Requirements
To be considered for an award, applicants must meet ALL eligibility requirements. The documentation
required to be submitted with an application may take several days to weeks to obtain so plan
accordingly.
Description of Eligibility Requirements
Descriptions are provided as necessary. Some eligibility requirements do not have accompanying
descriptions.
• Applicants may apply with a provisional license or certificate but must have a current, full,
permanent, unencumbered, and unrestricted health professional license, certificate, or
registration, as applicable, prior to the posting of the Notice of Intent to Award.
• Applicant’s license or certificate MUST be consistent with the professional discipline
declared in the application.
Eligibility
Requirement
2
Eligibility
Requirement
3
Eligibility
Requirement
1
Eligibility
Requirement
4
Applicants must be a U.S. citizen or U.S. naturalized citizen.
Applicants must be licensed, board eligible, or board-certified to
practice in Iowa as a health care provider in an eligible discipline and
specialty (if specialty is applicable).
Click here for eligible health profession disciplines and specialties.
Applicants must have qualifying education that is related to the
applicant’s discipline.
Applicants must have qualifying educational loans.
Eligibility
Requirement
5
Applicants must work at an eligible practice site.
Click here for eligible practice site types.
Description of Eligibility Requirement 2: Health Profession Discipline & Specialty
• Applicants have the opportunity to submit individual, consolidated, or refinanced federal or
commercial student loans.
• Qualifying educational loans:
• Are limited to the minimum undergraduate or graduate education required to obtain
licensure in the profession declared in the application.
• Must have a related transcript or signed statement included in the application.
• Must correspond to the dates indicated on educational transcripts (or signed
statements from educational institutions) provided in the application.
• Are government and commercial loans for actual costs paid for tuition and reasonable
educational and living expenses related to the education of the applicant.
• Reasonable educational expenses are costs of education, exclusive of tuition, (e.g., fees,
books, supplies, clinical travel, educational equipment and materials, and board
certification/licensing exams), which do not exceed the school's estimated standard student
budget for educational expenses for the participant's degree program and for the year(s) of
that participant's enrollment. Debt associated with residency programs or relocation is not
considered a “reasonable educational expense”.
• Reasonable living expenses include the costs of room and board, transportation, and
commuting costs, which do not exceed the school’s estimated standard student budget for
living expenses at that school for the participant’s degree program and for the year(s) of
that participant’s enrollment. Debt associated with residency programs or relocation is not
considered a “reasonable living expense”.
Ineligible loans include:
• Credit Card debt
• Loans for which the applicant incurred a service obligation which will not be satisfied prior
to the start of this contract.
• Loans obtained after the applicant submits an application for loan repayment assistance.
• Loans not obtained from a government entity or commercial/commercial student loan
lending institution. (Most loans made by private foundations to individuals are not eligible
for repayment)
• Loans that have no current balance or have already been paid in full.
• Loans subject to cancellation (for example, Perkins Loans may require documentation to
confirm no cancellation through service).
• Loans that have been consolidated with another person’s loans (e.g., a spouse or child).
This makes the entire loan ineligible.
• Loans that have been consolidated with any personal debt.
• Parent Plus loans (reference https://studentaid.gov/understand-aid/types/loans/plus)
• Personal lines of credit/Personal loans
• Primary Care Loans, as they have an obligation for health professional service to the
federal government.
• Residency loans
• Relocation loans
Description of Eligibility Requirement 4: Qualifying Educational Loans
• Loans for other educational degrees that were not required to obtain licensure in the
professional discipline and specialty (if specialty is applicable) declared in the application.
• If an otherwise eligible educational loan is consolidated/refinanced with ineligible (non-
qualifying) debt of the applicant, no portion of the consolidated/refinanced loan will be
eligible for loan repayment.
Practice Site Business Structure
An eligible business structure can be one of the following (a resource to verify the business
structure is on the Secretary of State’s website at https://sos.iowa.gov. Search
Databases/Business Entities):
• Public entity (any state or local government)
• Non-profit private entity (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)
• For-profit health facility operated by a non-profit organization
NOTE: For-profit, private entities are NOT eligible.
Practice Site Patient Non-discrimination Policy (NDP)
The NDP must indicate that the site will not discriminate in the provision of services based on
an individual’s: Inability to pay; Medicare, Medicaid, or Children Health Insurance Program
coverage; or race, color, sex, national origin, disability, religion, age, sexual orientation, or
gender identity.
Practice Site Telemedicine Practices
• The originating site (location of the patient) and the distant site (location of the Primary
Care Provider LRP participant) must be located in a HPSA and be an eligible practice site.
• Applicants must comply with all applicable telemedicine policies of their site as well as all-
applicable federal and state rules and policies regarding telemedicine services.
• Applicants must be practicing in accordance with applicable licensure and professional
standards.
• Applicants must be available, at the discretion of the approved practice site(s), to provide
in-person care at the direction of each telehealth site on the application regardless of
whether such sites are distant or originating.
• Telehealth may be conducted to or from an approved alternative setting as directed by the
participant's practice site(s).
• All service completed in an approved alternative setting is restricted to the program
guidelines.
• If telehealth services are provided to patients in another state, the clinician must be
licensed to practice (including compacts) in both the state where the clinician is located
(i.e., the distant site) and the state where the patient is physically located (i.e., the
originating site).
Description of Eligibility Requirement 5: Qualifying Practice Sites
• Telehealth services must be furnished using an interactive telecommunications system,
defined as multimedia communications equipment that includes, at a minimum, audio and
video equipment permitting two-way, real time interactive communication between the
patient at the originating site and the applicant at the distant site.
• Telephones, facsimile machines, and electronic mail systems do not meet the definition of
an interactive telecommunications system.
Practice Site Sliding Fee Scale Policy
• Sliding fee scale must be the most updated version in accordance with U.S. Department of
Health and Human Services (HHS) Poverty Guidelines.
• For information about the U.S. Department of Health and Human Services (HHS) Poverty
Guidelines, please visit https://www.federalregister.gov/documents/2023/01/19/2023-
00885/annual-update-of-the-hhs-poverty-guidelines.
• Sliding Fee Policy must indicate that:
• For individuals with annual incomes at or below 100 percent of the HHS Poverty
Guidelines, practice sites provide services at no charge or at a nominal charge.
• For individuals between 100 and 200 percent of the HHS Poverty Guidelines, practice
sites must provide a schedule of discounts, which must reflect a nominal charge
covered by a third party (either public or private).
• Practice sites may 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.
• Critical Access Hospitals must utilize a Sliding Fee Discount Program, at a minimum,
for low-income patients in both the emergency room and the affiliated outpatient
clinic. The Sliding Fee Discount Program requirements do not extend to the Critical
Access Hospital inpatient fee structure (i.e., the Critical Access Hospital in-house
discounted fee schedule or charity care program for other settings) or for
requirements necessary to meet Medicare certification requirements.
• Practice sites cannot require Medicare, Medicaid, or Children’s Health Insurance
Program application or proof of denial before allowing a patient to apply and be
eligible for the Sliding Fee Discount Program
Here is a sample of a sliding fee scale policy and schedule.
Practice Site Health Insurance Acceptance
Each eligible practice site must accept insurance, including Medicare, Medicaid, and the
Children’s Health Insurance Program.
Practice Site Professional Services Rates
Each eligible practice site must charge for professional services at the usual and customary
prevailing rates (free clinics are exempt from this requirement).
Practice Site Patient Acceptance
Each eligible practice site must accept all individuals regardless of their ability to pay.
Practice Site Type
• Centers for Medicare & Medicaid Services Certified Rural Health Clinics
• Community Outpatient Facilities
• Community Mental Health Facilities
• Correctional or Detention Facilities
• Federal Prisons
• State Prisons
• Critical Access Hospital affiliated with a qualified outpatient clinic
• Federally Qualified Health Centers (FQHCs), may include:
• Community Health Centers
• Migrant Health Centers
• Homeless Programs
• Public Housing Programs
• FQHC Look-Alikes (community-based health care providers that meet all HRSA Health
Center Program requirements and are part of the Health Center Program but do not receive
federal award funding)
• Free Clinics
• Immigration and Customs Enforcement Health Service Corps
• Indian Health Service Facilities, Tribally-Operated 638 Health Programs, and Urban Indian
Health Programs to include:
• Federal Indian Health Service (IHS) Clinical Practice Sites
• Tribal/638 Health Clinics
• Urban Indian Health Program
• IHS and tribal hospitals
• Mobile Units
• Private Practices (Solo or Group), must be operated by a non-profit organization
• School-based Programs
• State and County Health Department Clinics
• State Mental Health Facilities
Ineligible Practice Site Types
• Homes of Patients or Providers
• Retail Pharmacies
• Private, For-profit Entities
• County/local prisons
• Inpatient hospitals, unless specified
• VA Medical Centers and Clinics, Military Bases, and Civilian Health Care Providers in the
Tricare Network
• Long-term care facilities
Eligibility Verification
Verification Item What is Needed
Verification of
Citizenship
One of the following:
• Certified copy of the applicant’s birth certificate issued by a state or
territory of the U.S.
• Valid, unexpired U.S. passport or U.S. passport card
• Certificate of Naturalization
• Certificate of Citizenship
Verification of Legal
Name(s) Change, if
Applicable
One of the following:
• Marriage Certificate
• Divorce Decree
• Court Order
Verification of Eligible
Discipline
Professional license or professional certificate to practice in Iowa
Verification of Eligible
Specialty
Specialty board certificate (e.g. ANCC or AANP for Nursing; or ABFM,
ABP, or BCGM for Physicians).
Verification of
Qualifying Education
Official educational transcript or signed statement from educational
institution on official letterhead for EACH educational institution
attended to obtain the minimum degree required for licensure under the
applicant’s discipline. (Certificates or diplomas are not acceptable
documentation.)
Documentation must include institution name, student name, dates of
attendance, and degree obtained.
Authorization to
Access Student Loan
Data
In the application, consent is provided by the applicant for the Agency
and the Iowa College Student Aid Commission (ICSAC) to access the
National Student Loan Data System (NSLDS) in order to verify student
loan information.
Verification of Student
Loans
All of the following:
• Debtor Name/Borrower Name (i.e., the PCPLRP applicant)
• Lender/Holder Name
• Loan Account Number
• Original Loan Date
• Original Amount Disbursed
• Last Date of Disbursement
• Principal Balance
• Current Outstanding Balance/Total Balance (must be no more than
30 days from the date of the PCPLRP application submission).
• Current Interest Rate
• Outstanding Interest Balance
• Loan Type (e.g. Direct Subsidized Loan, Direct Unsubsidized Loan,
Direct Grad PLUS Loan, Direct Consolidation Loan)
• Loan Identifier (e.g. token, group, or number for each loan)
• Servicer Name
•
School Name
For a consolidated loan, additional information and documents will be
required:
• Original date of consolidation.
• Original balance of consolidation.
• Account number.
• What loans were included in the consolidation
•
Supporting documentation (see below) for each loan included
NOTE: If a loan was consolidated twice, each consolidation must be
listed separately in the application. Information must be provided about
all of the loans included in the first consolidation and all of the loans that
were included in the second consolidation.
Required Supporting Documentation. Applicants will be required to
provide an account statement and a disbursement report for each
commercial loan, each consolidated loan, and for each loan included in
the consolidation. Supporting documentation for an individual federal
loan is not required (unless the loan is part of a consolidation).
Account Statement. This document is used to provide current
information on qualifying educational loans and should:
• Be on official letterhead or other clear verification that it comes
from the lender/holder;
• Include the name of the debtor/borrower (i.e., the PCPLRP
applicant);
• Contain the account number;
• Include the date of the statement (cannot be more than 30 days
from the date of PCPLRP application submission);
• Include the principal balance and outstanding/accrued interest
• Include the current outstanding balance/total balance (principal and
interest); and
• Include the current interest rate.
Disbursement Report. This report is used to verify the originating loan
information and should:
• Be on official letterhead or other clear verification that it comes
from the lender/holder;
• Include the name of the debtor/borrower;
• Contain the account number;
• Include the type of loan;
• Include the original loan date (must be prior to the date of the
PCPLRP application submission);
• Include the original loan amount; and
• Include the school name.
NOTE: For non-federal loans, the disbursement report requirement may
be satisfied through various types of documents including a promissory
note, a disclosure statement, and letters directly from the lender
containing the required information (as indicated above). The applicant
may be able to obtain this disbursement information on their lender’s
website or from other documentation; however, all documentation must
be on official letterhead and clearly demonstrate that the loan originated
from the servicer/lender.
Verification of
Employment
All of the following:
• Employer Legal Name
• Employer Address, City, State, Zip
• Business Structure
• Business Type
• Authorized Representative Name, Email, Phone
Verification of
Employer/Practice Site
PATIENT Non-
discrimination
Practices
Non-discrimination policy on official letterhead.
• Documentation MUST be a copy of an official document of the
employer/practice site and must be identified as such.
• Employee non-discrimination policies are NOT acceptable
documentation.
Verification of
Employer/Practice Site
Telemedicine Practices
In the application, applicants will indicate adherence to telemedicine
policies for employer/practice site(s).
Verification of
Employer/Practice Site
Sliding Fee Scale
Practices
Sliding Fee Scale and Policy on official letterhead.
• Documentation MUST be a copy of an official document of the
employer/practice site and must be identified as such.
Verification of
Employer/Practice Site
Health Insurance
Acceptance
Requirement
In the application, applicants will indicate adherence to acceptance of
health insurance requirements.
Verification of
Employer/Practice Site
Professional Services
Rates Requirement
In the application, applicants indicate adherence to rate requirements.
Verification of
Employer/Practice Site
In the application, applicants will indicate adherence to patient
acceptance requirements.
Patient Acceptance
Requirement
Verification of Practice
Site(s)
All of the following:
• Practice Site Name
• Doing Business As (DBA)
• Practice Site Address
• Practice Site City, State, Zip
• Practice Site County
• Practice Site Type
• FTE (what portion of time will be spent at each practice site (e.g.
0.2 FTE, 0.7 FTE)
• Rural-Urban Status
• County-level Poverty
• Health Professional Shortage Area (HPSA) Discipline
• HPSA ID
• HPSA Name
• HPSA Score
Award Recipient and Employer Responsibilities
AWARD RECIPIENT RESPONSIBILITIES
1. Refrain from consolidating or refinancing approved educational loans with any other debt.
2. After receiving an award disbursement, render payment of approved educational loans directly
to the lender(s). Disbursement payments must be made in lump sum, and are not a substitute
for regular monthly payments of educational loans, regardless of “Pay Ahead Status” of
loan(s).
3. Continue to make regularly scheduled loan payments toward the outstanding balance(s),
regardless of “Pay Ahead Status” of loan(s), and remain in good standing with lenders
throughout the entire service obligation (i.e. your monthly payments are $50. In August, you
paid $100 instead. You still need to pay $50 in September and each month after).
4. Provide proof of regularly scheduled payments of approved educational loans.
5. Maintain credentials for your professional discipline.
6. Maintain appropriate malpractice insurance for the duration of the service obligation.
7. Provide clinical services for the duration of the service obligation.
8. Accept reimbursement under Medicare, Medicaid and the Children’s Health Insurance
Program, as appropriate for your professional discipline.
9. Utilize a sliding fee scale.
10. See all patients regardless of their ability to pay.
11. Complete and submit required reports.
12. Participate in a site visit with the Employer and the Agency, as needed.
EMPLOYER RESPONSIBILITIES
1. Verify that the Practitioner has no other service obligation for the duration of the contract
period indicated on the contract face sheet.
2. Verify that the practitioner is appropriately credentialed in the healthcare discipline indicated
on the contract face sheet.
3. Verify that the Practitioner does not have a restricted professional license/certificate.
4. Verify that the Practitioner is rendering services at the approved practice site(s).
5. Make all attempts to employ the practitioner for the duration of the contract period indicated on
the contract face sheet.
6. Provide a salary for the practitioner that is based on the prevailing rate in the area and is not
supplanted by the contract award.
Funds Disbursement
Primary Care Provider LRP award disbursements are contingent on contract compliance and will
be dispersed in year one of the service obligation.
Award disbursement payments are not a substitute for regular monthly payments of educational
loans.
If at any time during the service obligation, the outstanding balance of approved educational
loans is less than the maximum disbursement amount, any unused funds must be returned to the
Agency and the contractor will remain obligated to complete the service obligation.
If an approved educational loan is forgiven and a credit is due to the debtor/borrower that
includes all or part of the Primary Care Provider LRP disbursement, then that portion of the credit
must be returned to the Agency.
Within 60 days of receiving an award disbursement, the Practitioner must render payment of
approved educational loans directly to the lender(s).
Payment must be made in lump sum, and is not a substitute for regular monthly payments of
educational loans, regardless of “Pay Ahead Status” of loan(s).
Within 90 days of receiving an award disbursement, the Practitioner must submit documentation
of payment to the lender(s).
Tax Liability
Loan repayment program awards are not subject to federal or state income taxes. Public Law
111-148, the Patient Protection and Affordable Care Act, makes payments under the National
Health Service Corps Loan Repayment Program and certain state loan repayment programs tax
exempt. The Primary Care Provider LRP is Iowa’s State Loan Repayment Program. The
provision is effective for loan repayment grants received by an individual in taxable years
beginning after December 31, 2008.
Iowa income taxes were coupled with the Internal Revenue Code as of January 31, 2005,
thereby exempting Primary Care Provider LRP funds from state income taxes under the same
effective dates reflected in federal legislation.