Massachusetts Loan Repayment Program for Health Professionals

Massachusetts Loan Repayment

Program for Health Professionals

PROGRAM GUIDE

Updated December 2023

40 Court Street, 10

Floor Boston, MA 02108

TABLE OF CONTENTS

Program Overview ............................................................................................................. 3

Eligibility for MLRP ............................................................................................................ 5

HEALTH PROFESSIONAL ELIGIBILITY................................................................................... 5

A. Eligible Professions .................................................................................................................................. 5

B. Other Health Professional Eligibility Requirements ............................................................................. 7

EMPLOYER ELIGIBILITY ........................................................................................................... 9

QUALIFYING EDUCATIONAL LOANS ................................................................................... 11

Service Obligation and Other Program Requirements ............................................... 12

HEALTH PROFESSIONAL SERVICE OBLIGATION AND OTHER PROGRAM

REQUIREMENTS ...................................................................................................................... 12

A. Service Obligation: MLRP’s Clinical Practice Requirements ........................................................... 12

B. Other MLRP Requirements ................................................................................................................... 13

EMPLOYER REQUIREMENTS ................................................................................................ 15

DPH COMMITMENT: MLRP OBLIGATIONS .......................................................................... 17

PARTICIPANT AND EMPLOYER CHANGES ......................................................................... 18

A. Temporary Suspension and Waiver .................................................................................................... 18

B. Transfer Requests .................................................................................................................................. 18

DEFAULT AND BREACH OF CONTRACT ............................................................................. 18

A. Default ...................................................................................................................................................... 18

B. Damages for Breach of Contract .......................................................................................................... 19

Application Process and Instructions .......................................................................... 21

PROGRAM TIMELINE .............................................................................................................. 21

APPLICATION REVIEW ........................................................................................................... 23

AWARDS AMOUNT AND PAYMENT PROCESS ................................................................... 24

A. Award Amount ......................................................................................................................................... 24

APPLICATION PROCESS ........................................................................................................ 25

Program Overview

Purpose of the Massachusetts Loan Repayment Program (MLRP)

The purpose of the Massachusetts Loan Repayment Program for Health Professionals

(MLRP) is to increase Massachusetts residents’ access to primary care in communities that

have significant shortages of health care providers and other identified barriers to care. The

MLRP repays the educational loans of health professionals who are working in eligible

healthcare organizations. Initiated in 1990 with funding provided by the U.S. Department of

Health and Human Services, this program is supported by a combination of federal and

state funds. It is a program of the Massachusetts Department of Public Health’s (DPH’s)

Health Care Workforce Center and is managed by the Massachusetts League of Community

Health Centers.

The MLRP is committed to achieving health equity by promoting racial justice, addressing

institutional and structural racism, and increasing access to health care through supporting

health professionals working in underserved communities

Who Is Eligible for MLRP?

MLRP provides educational loan repayment up to

$50,000 for a range of health professionals who

provide outpatient primary health care services,

outpatient behavioral health services and substance

use treatment and recovery services. Eligible

employers must be public or nonprofit healthcare

organizations with practice sites that are located in a

federally designated Health Professional Shortage

Area (HPSA) or for substance use disorder services

(SUD), that provide SUD outpatient or residential

treatment and recovery services.

How Does the Program Work?

Eligible health professionals apply directly to the program inclusive of an employer

application. Health professionals must commit to two years of full-time work, or the

equivalent extended commitment of part-time work (e.g., a 20-hour work week will mean a

four-year contract), providing health services in an eligible health care organization.

What is a HPSA?

A Health Professional Shortage

Area (HPSA) is a geographic

area, population group, or

health care facility that has

been designated by the Health

Resources and Services

Administration (HRSA) as

having a shortage of health

professionals. Go to HPSA Find

(https://data.hrsa.gov/tools/shor

tage-area) to see if your

employer qualifies.

How to Use This Guide

This guide provides information about the program and helps health professionals, and their

employers decide if they are eligible for the program. The guide is updated annually to

reflect the current program requirements based on available funding.

For a short summary of changes made annually, see the FAQ for the current year. This

guide also provides applicants and their employers with information about their obligations if

accepted to the program and the consequences of not meeting those obligations. A short

description of how to apply is located at the end of this document.

If you still have questions after reviewing this guide, please submit them via email to:

MLRP@massleague.org

Acknowledgments

This program is supported in part by the Health Resources and Services Administration

(HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number

H56HP00093 Bureau of Clinician Recruitment and Service, Grants to States for Loan

Repayment. The information or content and conclusions in this document are those of the

author and should not be construed as the official position or policy of, nor should any

endorsements be inferred by HRSA, HHS or the U.S. Government.

The MLRP reserves the right to amend or change this program guide, including criteria for

eligible health care organizations and sites, depending on assessment of workforce needs

and amendments to federal and/or state law.

Eligibility for MLRP

Both the health professional applicant and their employer must meet eligibility requirements

for the health professional to qualify for MLRP. In addition, the loan must be a qualifying

education loan. This section provides information on the eligibility requirements.

HEALTH PROFESSIONAL ELIGIBILITY

A. Eligible Professions

MLRP is available for a variety of health professionals who provide services in outpatient

primary care settings, outpatient behavioral health settings, and outpatient or residential

substance use disorder (SUD) treatment settings. Eligibility is dependent on federal and

state resources and changes annually due to state needs and funding availability. This guide

is updated annually to incorporate any eligibility changes. The chart below lists all the types

of providers eligible for MLRP.

Table 1: Eligible Health Professions for MLRP

Eligible Health Professions for Massachusetts Loan Repayment Program

Advanced Practice Registered Nurses, APRN

Eligible professions under this category include Certified Nurse Practitioners (with certifications in

adult, family, geriatrics, pediatrics, psychiatric and women’s health), Certified Nurse Midwives,

Psychiatric Clinical Nurse Specialists, and Clinical Nurse Specialist who are providing primary care.

All APRNs must have a Massachusetts registered nurse license, APRN authorization, and maintain

current certification.

Dentists, DDS & DMD

General Practice Dentists, including pediatrics, are eligible for MLRP. Individuals must be fully

licensed to apply.

Doctor of Osteopathic and Allopathic Medicine, DO & MD

Physicians who practice family medicine and osteopathic general practice, geriatrics, internal

medicine, pediatrics, psychiatry, obstetrics, and gynecology are eligible. Applicants must have

completed a residency training program.

Health Service Psychologists, HSP

Clinical or Counseling Psychologists with a Ph.D. or equivalent are eligible.

Licensed Independent Clinical Social Workers, LICSW

Licensed Independent Clinical Social Workers with a master’s or doctoral degree in social work are

eligible.

Licensed Professional Counselors, LPC

Licensed Professional Counselors with a

master’s or doctoral degree with a major study in counseling

are eligible.

Marriage and Family Therapists, MFT

Marriage and Family Therapists with a master’s or doctoral degree with a major study in marriage

and family therapy are eligible.

Mental Health Counselors, MHC

Mental Health Counselors with a master’s or doctoral degree with a major study in counseling are

eligible.

Pharmacist, PharmD

Eligible Clinical Registered Pharmacists must practice in one of the following locations (that also

meets the HPSA requirement for employers):

• Critical Access Hospital (CAH) affiliated with a qualified outpatient service,

• Small Rural Hospital affiliated with an outpatient service, as defined in Massachusetts hospital

regulations https://www.mass.gov/doc/105-cmr-130-hospital-licensure/download or

• Community Health Center located in rural or urban areas.

Physician Assistant, PA

PAs who practice adult, family, pediatrics, women’s health, psychiatry/mental health, and geriatric

medicine are eligible.

Registered Dental Hygienists, RDH

Registered Dental Hygienists, including pediatrics, are eligible for MLRP.

Substance Use Disorder (SUD) Clinicians, LADC-I; LADC-II or CADC-I; CADC-II, and Bachelor

Level SUD Services Professionals interested in becoming Licensed

Eligible Categories of SUD Clinicians inc

lude those practicing in outpatient and residential settings:

1) LADC-Is and CADC-IIs Practicing in a Health Professional Shortage Area

Eligible clinicians are m

aster’s level trained SUD clinicians who are practicing in a designated Primary

Care or Mental Health HPSA.

2) LADC-Is and CADC-IIs Not Practicing in a Health Professional Shortage Area

Eligible clinicians are LADC-Is and CADC-IIs who are not working in a HPSA practice site. This

category is dependent on available state resources and may have limited funding, as federal

resources cannot be used for providers not in a HPSA.

3) LADC-IIs and CADC-Is Practicing in or outside a Health Professional Shortage Area

Eligible clinicians are LADC-IIs and CADC-Is (non-master’s level licensed professionals) practicing in

or outside a HPSA. This category is dependent on available state resources and may have limited

funding, as federal resources cannot be used for awards to LADC-IIs or CADC-Is.

4) Non-licensed, Bachelors-Level SUD Services Professionals

Eligible clinicians are SUD clinicians who are not yet licensed or certified but are working in an SUD

treatment or recovery services setting. These practitioners must have already earned a bachelor’s

degree and be interested in, or working towards, becoming a LADC or CADC. The intent is to relieve

some of the financial burden of the SUD practitioner’s existing educational loan debt to allow them to

pursue the additional educational requirements needed to become licensed or certified.

This category

is dependent on available state resources and may have limited funding, as federal resources cannot

be used for providers not in a HPSA.

B. Other Health Professional Eligibility Requirements

In addition to working in an eligible profession (listed above), health professionals must meet

the following eligibility requirements:

1. Be a United States citizen or naturalized citizen.

2. Have completed a course of study required to practice independently without

supervision, with the exception of SUD counselors.

3. Have a current and non-restricted license to practice in the Commonwealth of

Massachusetts, with the exception of SUD counselors, and affirm that to the best of their

knowledge, there is no pending investigation or disciplinary proceeding related to this

license. Any licensed health professional with knowledge of a current investigation into

their professional conduct must wait until the investigation is completed before applying.

4. Provide lender information to the MLRP for the purpose of verifying outstanding loan

amounts and confirming the use of the award toward the health professional’s

outstanding loan balance including providing up-to-date information on loans prior to loan

repayment program processing of actual payment to confirm current debt, loan payment

priorities, address, and account number accuracy.

5. Have completed any other service commitments and/or not owe a service or

contractual obligation to any other federal/state/local government or other entity

for health professional service. Having another (simultaneous) service obligation

is disallowed at any time during the MLRP contract service-period, whether the

non-MLRP obligation was incurred before or after initiation of the MLRP contract,

with the exception of the Public Service Loan Forgiveness Program.

a. Conflicting health professional service may include incentive programs that benefit

the employer and the health professional.

b. Certain bonus clauses in employment contracts may impose a service obligation.

c. Armed Forces Exception: Individuals in a reserve component of the

Armed Forces are eligible to participate in the MLRP. Placement

opportunities may be limited by the MLRP in order to minimize the impact

that a deployment would have on the vulnerable populations served by the

reservist.

i. Military training or service performed by reservists will not satisfy the

MLRP service commitment. If a participant’s military training and/or

service, in combination with the participant’s other absences from the

service site, will exceed approximately 7 weeks per service year, the

participant should request a suspension of their service obligation. The

MLRP service obligation end date will be extended to compensate for

the break in MLRP service.

ii. If the approved MLRP site where the reservist is serving at the time of

their deployment is unable to reemploy that reservist, the MLRP will

reassign the participant to another MLRP approved service site to

complete his or her remaining MLRP service commitment. Because it

is sometimes difficult to identify short-term assignments, a participant

may be asked by the service site to sign an employment contract

which extends beyond the completion date of his or her MLRP service

commitment.

6. Have no judgement lien against your property for a debt owed to the United

States.

7. Have not defaulted on any federal or state payment obligations. This includes obligations

where the creditor now considers them to be in good standing.

8. Have not breached a prior service obligation to the military, federal/state/local

government, or other entity. This includes any obligation that has been satisfied

subsequently.

9. Have no federal debt written off as uncollectible (pursuant to 31 U.S.C. 3711(a)(3)) or

have no federal service or payment obligation waived.

10. Agree to the following conditions:

a. To building a long-term practice in an underserved community and remain with your

employer for the contracted commitment and meet the hourly requirement for direct

clinical contact during the entire service obligation.

b. To provide primary care, behavioral health, or SUD treatment/ recovery services as

defined in this program guide and agree not to discriminate on the basis of the

patient’s ability to pay for such care.

c. To provide a minimum of two years (24 months) of full-time employment or part-

time equivalent from the time of MLRP-contract initiation as part of this program.

d. To maintain current contact information on file with the MLRP including bank

information, email, telephone, and USPS mailing address. Notify the MLRP within

ten days of a change of any of this information or other relevant contractual

information.

e. To notify the MLRP at least two weeks prior to the start of a scheduled leave of 30

days or more (e.g., family, medical, personal, military leave, or state or national

emergency). The following information should be included in the notice: type of

leave, start date, end date or estimated end date, and whether the leave is paid or

unpaid. The time spent on extended leave from clinical practice will not count

toward the health professional's MLRP obligation. In this event, the MLRP will

extend the end date of this contract to ensure that the health professional delivers

24 months of clinical primary health care services.

f. After the contract term has ended, to respond to reasonable requests for

information from the MLRP regarding practice type, site, and professional

experiences to facilitate periodic evaluation of the MLRP; and

g. To acknowledge that the amount awarded varies per applicant depending upon

discipline and the availability of state and federal funds and that payments will be

made directly to a qualified lender.

EMPLOYER ELIGIBILITY

Practice sites (and their sponsoring healthcare organizations, if different) must be meet all

the following requirements to be an eligible employer for the health professional applicant:

1. Be public or nonprofit facility that delivers one of the following services:

a. outpatient primary health care services,

b. outpatient behavioral health services, or

c. outpatient and/or residential SUD treatment and/or recovery services.

2. Meet HSPA requirements or meet state SUD services requirements.

a. HPSA. The facilities must be located in a federally designated Health

Professional Shortage Area (HPSA) or a Mental Health Professional

Shortage Area or be a federally identified Auto-HPSA in order to be

eligible. The health professional applicant’s discipline and the HPSA

designation must match (e.g., dental, primary care, or mental health).

Pharmacists and substance use disorder (SUD) clinicians can work at a

site located in either a Primary Care Health Professional Area (HPSA)

OR a Mental Health Professional Shortage Area in order to be eligible.

Go to HPSA Find (https://data.hrsa.gov/tools/shortage-area) to see if your

employer qualifies.

i. School-Based Health Centers located in a HPSA and recognized

by the Massachusetts Department of Public Health or a satellite of

a Federally Qualified Health Center (FQHC) are eligible

employers. Applicants must provide direct patient care services at

the school-based health center to be eligible for MLRP. For a list of

school based health centers recognized by the Department of

Public Health go to https://www.mass.gov/service-

details/directory-of-school-based-health-centers. If the school-

based health center is not open year-round, with sufficient patient

visits to meet the clinical service requirements described in

Service Obligation Section, the applicant is required to work at

another eligible site either connected to the sponsoring FQHC or to

another eligible health care facility during the period the school-

based health center is closed. MLRP participants at school-based

health centers who either fail to provide required documentation

that they are meeting MLRP practice requirements at the school-

based health center year-round or who fail to obtain additional

employment necessary to maintain compliance with MLRP clinical

practice requirements may be placed in default of their contract’s

MLRP service obligation.

b. SUD Provider Service Requirements. Employers who offer SUD

services, both residential and outpatient, are eligible. Funding for loan

repayment comes from federal and state sources. Regardless of whether

state or federal funds are used to repay the applicant’s educational loans,

all requirements of the MLRP program must be met by the applicant.

3. Organizations must complete the “Section II. Employer Information” for each

application and submit with the health professional’s entire application.

Organizations may support a maximum of three health professional applicants

per program year. The submission of an application, or of multiple applications

per employer, does not guarantee an award.

a. Agencies or facilities submitting more than one application must

coordinate all applications through one identified employer contact that is

known to the Massachusetts League of Community Health Centers or

DPH.

b. Agencies or facilities submitting more than one application must clearly

prioritize (rank order) all applications submitted under the employer

section of the application.

c. Among applicants from the same agency, the program will prioritize

applicants that have practice sites in different counties or geographic

regions to serve as many areas of the state as possible.

4. Accept public insurance and offer discounted services to low-income, uninsured patients

on a sliding fee scale (http://aspe.hhs.gov/poverty/) with discounts based on income

levels.

QUALIFYING EDUCATIONAL LOANS

Qualifying educational loans are government and commercial loans for actual costs paid for

tuition and reasonable educational and living expenses related to the undergraduate or

graduate level education of the applicant that resulted in a degree for a MLRP-qualifying

profession (see Table 1). Applicants must provide to MLRP a copy of all qualifying loan

documentation (e.g., promissory notes). Government loans are loans that are made by

federal, state, county or city agencies that are authorized by law to make such loans.

Commercial loans are defined as loans made by banks, credit unions, savings and loan

associations, insurance companies, schools, and other financial or credit institutions which

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 lender has its place of business.

The following educational loans are NOT eligible for repayment:

1. Loans that were consolidated with any other type of debt (non-educational) or another

person’s debt;

2. HRSA Primary Care Loans;

3. Parent Plus loans;

4. Loans from a family member or friend;

5. Personal lines of credit;

6. Loans not obtained from a government entity or commercial lending institution;

7. Loans that have been repaid in full; and

8. Loans for which the associated documentation does not identify the loan as applicable to

undergraduate or graduate education.

Service Obligation and Other Program

Requirements

This section outlines the MLRP service obligations and other program requirements for

program participants and their employers. Failure to meet the service obligation and

program requirements can result in loss of support from the MLRP program. Read this

section carefully to ensure you understand the commitments you and your employer are

making to the program prior to accepting MLRP repayments. In addition, this section

outlines MLRP obligations to program participants, the process to follow for participant

status changes, and the process for default and/or breach of contract by the participant.

HEALTH PROFESSIONAL SERVICE OBLIGATION AND OTHER PROGRAM

REQUIREMENTS

MLRP health professionals have to meet certain clinical practice requirements (service

obligation) and other program requirements to maintain their status with MLRP.

A. Service Obligation: MLRP’s Clinical Practice Requirements

1. Program participants must provide a minimum of two years (24 months) of full-time

employment or part-time equivalent from the time of MLRP-contract initiation to maintain

status in the program.

a. “Full-time clinical practice” is defined as a minimum of 40 hours per week in a

clinical practice, for a minimum of 45 weeks per service year.

b. Part-time practice must be at least 20 hours per week (but not more than 39

hours per week) in exchange for an increase in the period of the service

commitment contract (e.g., a 20-hour work week will mean a 4-year contract), for

a minimum of 45 weeks per service year.

c. Time spent in an “on call” status does not count toward the 40-hour requirement.

Participants do not get service credit for hours worked over the required 40

hours/week.

2. Administrative or other non-clinical activities (e.g., teaching, research, attending staff

meetings) must not exceed 8 hours per week. Time spent in a management or

supervisory role, rather than direct patient care, is considered to be an administrative

activity.

a. For all health professionals except noted in (b) below: At least 32 of the

minimum 40 hours per week must be spent providing direct patient care in the

outpatient ambulatory care setting(s) or residential SUD setting, at the

approved service site(s), during normally scheduled office hours. The remaining

8 hours per week may be spent providing clinical services in alternative settings

not approved for MLRP (e.g., hospitals, nursing homes, shelters) as directed by

the employer or performing practice-related administrative activities. Any time

spent in a management or supervisory role, rather than direct patient care, is

considered to be an administrative activity.

b. For OB/GYN physicians and Certified Nurse Mid-Wives: At least 21 of the

minimum 40 hours per week must be spent providing direct patient care in the

outpatient ambulatory care setting(s) at the approved practice site(s), during

normally scheduled office hours. The remaining 19 hours of the minimum 40

hours per week may be spent providing clinical services in alternative settings

(e.g., hospitals, nursing homes, shelters) as directed by the approved practice

site(s) or performing practice-related administrative activities (limited to 8

hours/week).

3. No more than 7 weeks (35 workdays) per service year can be spent away from the

approved service site for vacation, holidays, continuing professional education, illness,

or any other reason. If the participant submits documentation supporting the need for

absence of longer than 7 weeks, he/she may qualify for a suspension of the service

obligation.

B. Other MLRP Requirements

Additional requirements for the MLRP program participant are listed below.

1. Program participant will respond timely and accurately to MLRP requests for information

such as loan payment verification and employment/service verification at the approved

site.

2. Program participant will complete MLRP surveys, including periodic surveys post the

commitment period.

3. Program participant will be responsiveness to other relevant MLRP inquiries.

4. Program participant will provide primary care, behavioral health, or SUD treatment/

recovery services as defined in this program guide and agree not to discriminate on the

basis of the patient’s ability to pay for such care.

5. Program participant will maintain current contact information on file with the MLRP

including bank information, email, telephone, and USPS mailing address. Participant will

notify the MLRP within ten days of a change of any of this information or other relevant

contractual information.

6. Program participant will notify the MLRP at least two weeks prior to the start of a

scheduled leave of 30 days or more (e.g., family, medical, personal, military leave, or

state or national emergency). Participant will provide the following information in the

notice: type of leave, start date, end date or estimated end date, and whether the leave

is paid or unpaid. The time spent on extended leave from clinical practice will not count

toward the health professional’s MLRP obligation. In this event, the MLRP will extend

the end date of this contract to ensure that the health professional delivers 24 months of

clinical primary health care services.

EMPLOYER REQUIREMENTS

All 2024 MLRP employers must agree to adhere to the MLRP guidelines, provide care

without discrimination as described above, maintain all necessary licenses, and must be in

good standing with MassHealth (Medicaid). MLRP employers (and sites, if different) must

continue to be located in a federally designated Health Professional Shortage Area (HPSA)

or be a federally identified Auto-HPSA, with the exception of addiction services clinicians.

The health professional’s discipline and the HPSA designation must continue to match (e.g.,

dental, primary care, or mental health). However, as mentioned earlier in the Eligibility

Section, pharmacists, and substance use disorder (SUD) clinicians can work at a site

located in either a Primary Care Health Professional Area (HPSA) OR a Mental Health

Professional Shortage Area. For all other disciplines, the HPSA must continue to match the

applicant’s discipline.

The Employer (and site, if different) agrees to:

1. Notify the MLRP in writing at least two weeks prior to the start of the health professional’s

scheduled leave of 30 days or more (e.g., family, medical, personal, military). The

following information should be included in the notice: type of leave, start date, end date

or estimated end date, and whether the leave is paid or unpaid. The MLRP will extend

the end date of this contract to ensure that the health professional delivers the equivalent

of two years of full-time clinical primary health care services.

2. Maintain the practice schedule of the MLRP participant at the practice site for the number

of hours per week and length of service specified in this agreement. Any change in

practice circumstances is subject to the approval of the MLRP based upon MLRP

policy. The employer must notify the MLRP and receive approval for any changes, at

least two weeks in advance of any consideration of permanent changes in the sites or

circumstances of the MLRP participant’s practice under this agreement.

3. Notify the MLRP in writing immediately of the date and circumstances of any early

termination of employment or any other substantial change in conditions of employment.

4. Provide or ensure that the health professional is provided with space and equipment

suitable for the adequate provision of services.

5. Continue to employ the health professional throughout their loan repayment contract

period.

6. Review and abide by the material in this program guide.

7. Not use the MLRP award to offset participants’ salaries or any of their compensation

package. The MLRP award is in addition to participants’ salaries which must be based

on prevailing rates.

8. Provide the organization’s Medicaid billing number.

9. Agree not to discriminate in the provision of services to individuals based on their ability

to pay, race, color, gender, national origin, disability, religion, sexual orientation, or

gender identification.

10. Provide a supportive environment for clinicians, facilitating mentorship, professional

development, and training.

11. Use a clinician credentialing process including reference review, licensure verification if

applicable, and a query of the National Practitioner Data Bank.

DPH COMMITMENT: MLRP OBLIGATIONS

Subject to the availability of funds and the health professional’s compliance with this

program guide, DPH agrees to:

1. Compensate the health professional in accordance with the terms of the Massachusetts

Loan Repayment Program for Health Professionals with direct payment to qualified

education loan institutions.

2. In the event funds to finance this agreement become unavailable, the MLRP may

terminate the agreement upon at least 14-days written notice to the employer and the

health professional. Notice shall be delivered by certified mail, return receipt requested,

or in person with delivery confirmation. MLRP shall be the final authority as to availability

of funds.

PARTICIPANT AND EMPLOYER CHANGES

The program participant may have changes in their personal or employment circumstances

that necessitate changes to their agreement with MLRP. This section details the various

options for responding to changes that are not a breach of contract.

A. Temporary Suspension and Waiver

The health professional participant may be granted a temporary suspension of the MLRP

obligation, consistent with the policies of the employing healthcare organization, if he/she

must interrupt their service commitment because of a personal or immediate family illness or

another emergency situation. Contract suspension will cover only the period of the medical

or other emergency. MLRP must be notified of this interruption in writing within 14 days. In

rare instances, MLRP may agree to suspend your service commitment if completing it

becomes impossible or would involve an extreme hardship and the health professional

becomes permanently unable to meet the service commitment.

B. Transfer Requests

Transfer requests are considered in extreme situations on a case-by-case basis. An

example of when a transfer request might be considered is the closure of the healthcare

organization. The health professional must contact the MLRP in writing regarding a

request to transfer and include the specifics for this request. Approval for a transfer

request should not be assumed. Should a transfer request be approved, the health

professional will be expected to continue the service at another qualified site that is both

eligible and able to employ the health professional.

DEFAULT AND BREACH OF CONTRACT

In some cases, the program participant may default on their MLRP obligations and

requirements resulting in a breach of contract with the program. If this default does not

meet the exceptions above listed under the “Participant and Employer Changes” section,

the participant may lose their support from the program and, in some circumstance, may

have to repay the program. This section discusses what happens when a participant is in

default.

A. Default

MLRP participants are considered to be in a default status if they do not begin and/or

complete the period of obligated service at the employer site in accordance with their

MLRP contract, or otherwise fail to comply with the terms of the MLRP guide and contract,

even if no monies have yet been disbursed to the participant. When a participant defaults

the MLRP service obligation, the MLRP must report the default to federal and state funders

of the program. If the health professional leaves the employing healthcare organization/site

without prior approval from the MLRP, he/she will be placed in default. Any change in

employment other than a temporary suspension or a transfer request as described above,

is considered a default of contract.

Further, failure to comply with the terms and conditions of the MLRP and contract shall be

regarded by the MLRP as a significant factor in determining the suitability of the health

professional, or the employer (and site, if different) for future MLRP applications, as

applicants are eligible to reapply for MLRP support once their contract ends (see Award

Amounts Section below).

B. Damages for Breach of Contract

The MLRP health professional is required by federal law to pay monetary damages to the

MLRP, within one year from the time of the default, as noted below, if he/she fails to fulfill

the service obligation or breaches the MLRP agreement. These penalties are severe. The

penalty dollar amounts are severe. The health professional will be liable to MLRP for an

amount equal to the total amount paid by MLRP to the health professional for loan

repayment for any period of obligated service not served, and an amount equal to the

number of months of obligated service not completed multiplied by $7,500, and interest on

the amount at the maximum legal prevailing rate, as determined by the Treasurer of the

United States from the date of breach. The amount that MLRP is entitled to recover will not

be less than $31,000.

All service obligations and penalties shall terminate upon the death of the health

professional.

Examples of debt calculation using default formula:

Example 1 – Participant defaults after receiving MLRP funds:

Dr. Jones had a 2-year (24-month) service obligation. His MLRP

award of $40,000 was disbursed to him on January 15, 2013. He

defaulted on May 1, 2013, after serving 6 months.

(A) Months not served = 18

(B) Amounts paid for months not served = $40,000 × 0.75 (18 months out of

24) = $30,000

(A) + (B) = $165,000

(D) Interest would accrue on $165,000 [(A) + (B)] at the rate of 10.125% per

year, based on the default date of May 1, 2013.

Example 2 – Participant defaults before receiving any funds:

Dr. Smith had a 2-year (24-month) obligation and defaulted on

February 1, 2013, after serving 3 months and before receiving any

funds.

(A) Months not served = 21

(B) Amounts paid for months not served = 0

(A) + (B) = $157,500

(D) Interest would accrue on $157,500 [(A) + (B)] at the rate of 10.625% per

year, based on the default date of February 1, 2013.

Interest rates and effective dates:

https://www.hhs.gov/about/agencies/asfr/finance/financial-policy-library/interest-

rates/index.html

Application Process and Instructions

This section describes the application process and provides instructions for health

professionals and employers who are completing applications.

It is important to note, only complete MLRP applications will be reviewed. All

applications will be evaluated and scored by our review teams based on the MLRP

priority criteria described below in the Application Review Section.

PROGRAM TIMELINE

The program timelines for the loan repayment program cycle are expedited to meet

deadlines to secure funding. It is important for applicants to commit to meet all

deadlines for submissions and to submit all information required. Applications for the

MLRP 2024 program cycle must be postmarked by 5:00 PM on Friday, January 19,

2024 to be accepted for review.

Mail to:

The Massachusetts League of Community Health Centers

Attention: MLRP Workforce Program

40 Court Street,10th Floor, Boston, MA 02108

Award notifications are made by email notification. Awardees must return signed

contracts within two weeks of award notification. All fully executed contracts will be

effective with a starting service date of June 30, 2024. Two-year full-time contracts will

have an effective ending service date of June 30, 2026. Part-time clinicians may extend

their service date to ensure completion of an equivalent of two years of full-time clinical

service.

MLRP 2024: Overview of Timeline

Activity

Deadline/Expected Date*

Application Launch

Wednesday, December 6

MLRP Webinars Hosted by the Mass

League and MDPH Health Care

Workforce Center

Join Zoom Meeting

https://massleague.zoom.us/j/5336813

904?omn=86226242567

Meeting ID: 533 681 3904

Wednesday, December 13

12:00

– 1:00 pm

MLRP Program Office Hours Hosted by

the Mass League

Updated: December 7, 2023

December 20

Join Zoom Meeting

https://massleague.zoom.us/j/5336813

904?omn=81661983708

Meeting ID: 533 681 3904

January 10

Join Zoom Meeting

https://massleague.zoom.us/j/5336813

904?omn=81711757116

Meeting ID: 533 681 3904

Wednesday, December 20

12:00 – 1:00 pm

Wednesday, January 10

12:00 – 1:00 pm

Application Deadline

Postmarked Friday, January 19

Decision Notifications*

Monday, April 15

Deadline to Return Signed Contracts

Monday, April 22

Deadline to Submit Loan Confirmation

Form

Friday, May 3

Award Disbursement Notifications*

Tuesday, June 11

Updated: December 7, 2023

APPLICATION REVIEW

Applications must be complete in order to be reviewed. Any history of non-compliance

by the applicant or employer (and site, if different) with respect to this program or any

comparable program operated or funded by the DPH will be considered as part of the

evaluation criteria.

Applications will be reviewed and awards will be prioritized based upon a set of criteria,

which include but are not limited to:

1. Qualifications and previous professional experience of the health professional,

including experience with rural and/or underserved communities.

2. Characteristics of the practice site, including payer mix, geographic location, and

unmet service needs.

3. Characteristics of the patient population served by the health professional, including

demographics, cultural/linguistic needs, health disparities, and barriers to care.

Updated: December 7, 2023

AWARDS

Applicants will be notified by e-mail regarding approval for an award and the award

amount. Awards will be paid directly to the awardee’s eligible education loan institution.

Awards made through the MLRP are exempt from federal and state taxation. Please

consult your tax information resources as needed.

A. Award Amount

Health professionals may be awarded between $30,000 to $50,000 per contract

depending on the health profession. Award amounts depend upon available program

funding (partial funding may be awarded), number of eligible applications, and the

discipline mix of the applicants. Applicants will not be awarded more than their

outstanding loan amount.

1. Dentists, nurse practitioners, physicians, physician assistants, and psychologists are

eligible for up to $25,000 per year ($50,000 total award for a two-year full-time

practice contract).

2. All other qualified health professionals are eligible between $15,000 to $20,000 per

year ($30,000 to $40,000 total award for a two-year full-time practice contract).

Applicants may re-apply to the MLRP when their contract obligation is complete. Repeat

applicants may not receive more than $100,000 in total MLRP funding over time. The

award is contingent upon contract compliance, completing essential paperwork

throughout the contract period, providing service verification, and participating in MLRP

participant surveys.

Updated: December 7, 2023

APPLICATION PROCESS

Applications must be submitted through the United State Postal Services ONLY. No

other form of delivery will be accepted, such as emailed or faxed applications. The

mailed application must contain one (1) completed original application with all of the

requested information, required attachments, and required signatures. Application

must be mailed and postmarked no later than Friday, January 19, 2024, to:

Massachusetts League of Community Health Centers, Inc.

Attention: Massachusetts Loan Repayment Program

40 Court Street, 10

Floor

Boston, MA 02108

Be sure to keep a copy of the application for your records. Applicants will be notified

that their application has been received within 10 business days of the application

deadline.

All questions should be submitted via email to: MLRP@massleague.org