FAQ: State Loan Repayment Program (SLRP)

Funding Opportunity Number: HRSA-22-048

Will SLRP carry over funds from previous years be exempt from the one-to-one match requirement?

These will be new awards and there is no competing continuation component because they are funded out of the American Rescue Plan (ARP) funds. Therefore, you will not be able to carry over funds from the current project period (FY 2018-2022). However, you can request a no-cost extension.

What HPSA type should be used for pharmacists and nurses?

Pharmacists and nurses must use a Primary Care Health Professional Shortage Area (HPSA).

Please NOTE: at the webinar, we responded that pharmacists and nurses could use either a Mental Health or Primary Care HPSA, but that was an error.

Can part of the 10% of funds for administrative costs be used for subcontracting with an external evaluator?

Yes, the 10% administrative and management costs could be used for a subcontracting with an external evaluator. Again, as with any costs, it has to be clearly identified in your budget and your budget justification, with a clear narrative description on how it supports the project.

What is the maximum amount that can be awarded to a full-time provider per year?

Programs are allowed to make an award of up to $25,000 a year in federal funds to a full-time provider (i.e., up to $50,000 for an initial two-year contract), serving at a SLRP-approved service site with a designated HPSA score.

Full-time clinical practice is defined as a minimum of 40 hours/week, for a minimum of 45 weeks each service year. The 40 hours per week may be compressed into no less than four days/week, with no more than 12 hours of work to be performed in any 24-hour period.

In addition, time spent “on call” will not be counted towards the service obligation, except to the extent the provider is providing patient care during that period.

What is the maximum amount that can be awarded to a half-time provider per year?

Programs are allowed to make an award of up to $12,500 a year in federal funds to a half-time provider (i.e., up to $25,000 for an initial two-year contract), serving at a SLRP-approved service site with a designated HPSA score.

Half-time clinical practice is defined, as 20-39 hours/per week for a minimum of 45 weeks each service year. The minimum 20 hours/week may be compressed into no less than two days/week, with no more than 12 hours of work to be performed in any 24-hour period.

Participants do not receive service credit for hours worked over the required 20 hours/week and excess hours cannot be applied to any other workweek.

In addition, time spent “on call” will not be counted towards the service obligation, except to the extent the provider is providing patient care during that period.

Can you explain the ceiling amount, the 10% administrative, and management costs?

This program has a ceiling amount up to $1,000,000 per year, which is inclusive of direct loan repayment, a maximum 10% administrative, and management costs. Please note, applicants may request any amount up to the ceiling amount, inclusive of the administrative and management costs up to 10%.

Administrative and Management Costs: A maximum of 10% of funding may be requested per year for administrative and management of the program; e.g. project staff time, indirect costs, etc.

Examples:

• An applicant requests the maximum ceiling of $1,000,000, of which $900,000 is dedicated for direct loan repayment and $100,000 for 10% in administrative and management costs.
• An applicant requests $500,000 direct loan repayment and includes 10% administrative and management costs of $50,000, for a total annual budget amount of $550,000.
• An applicant requests $500,000 per year for loan repayment funds and includes 0% administrative and management costs, for a total annual budget amount of $500,000.
• An applicant requests $500,000 per year for loan repayment and includes 5% in administrative and management costs of $25,000, for a total annual budget of $525,000.

Will we need a Memorandum of Agreement (MOA) with an outside community partner who would provide administrative support to the project?

Yes, an MOA will be necessary. As with any costs, it has to be clearly identified, in the budget and budget justification, with a clear narrative description of how it supports the project.

Are licensed nurses working at Federally Qualified Health Centers, who do not provide direct patient care (such as nurse managers, informatics nurses, pharmacy services, nurses, etc.) eligible to receive loan repayment?

No, these types of providers do not provide direct patient care and are therefore not eligible for SLRP. The Faculty Loan Repayment Program is an option for providers interested in teaching.

Are Registered Nurses eligible if they are in a teaching capacity? For example, nurse faculty at university. We have a severe shortage of nurses in our state, including nursing faculty.

No, these types of providers do not provide direct patient care and are therefore not eligible for SLRP.

However, providers who are offering direct patient care can use 8 hours of their 40-hour workweek toward administrative purposes, which include teaching. The BHW Faculty Loan Repayment Program is an option for healthcare providers who are in a teaching capacity.

Who is eligible to apply for the NOFO?

Entities eligible to apply for this grant include the 50 states, the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the U.S. Virgin Islands, American Samoa, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. Entities or agencies designated by the aforementioned are able to apply.

Are for-profit organizations allowed to access this funding?

No, to be eligible, practice sites must meet the following criteria, and there is one exception:

1. Public and non-profit private entities located in and providing health care services in HPSA. Non-profit 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.
2. Exception: For-profit health care facilities operated by non-profit 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.

Is there a clear definition of direct patient care that HRSA follows; we haven't been able to find one?

The National Health Service Corps (NHSC) defines direct patient care as the clinical services provided and activities in which a provider participates that have a direct influence on the care of a patient or client, such as examinations, treatments, counseling, patient education, self-care training, and the administration of medications.

For the sustainability component, if we use the 10% of the grant for administrative cost and no match, is it understood that we will have to reevaluate in 2026?

The availability of funding linked to these flexibilities may or may not be available in 2026. While there's no match at play during this funding cycle, you may want to sustain your existing relationships and methods for securing match. Therefore, if you wish to speak to sustainability as it relates to match, not just within the 4-year period but also after 2026, it can be part of your impact response.

Are we allowed to contract out the writing of the grant application?

No, that would not be an allowable using grant funds because, it occurs prior to the grant award. However, you can contract the writing of the grants using non-SLRP funds.

What are the expected benefits of partnerships and stakeholder involvement (e.g., academia, Primary Care Association's governor's office)?

These partnerships are important in operationalizing, administering and managing the SLRP program. For example, states have partnerships with the universities that support recruitment and retention through the university pipeline, etc.

Can we keep the match component as we currently have it even if it is not required by HRSA for the upcoming award cycle?

Yes, states can keep the match. States can use match funds to their advantage to offer awards that are more competitive and enhance recruitment efforts, etc.

What have other states done to sustain their program?

Various states administer their program in different ways to meet primary healthcare needs. It is recommended that states have one-on-one Technical Assistance with some of the seasoned states that have participated in the program for a while to get more insight on how to address sustainability.

Are there any COVID vaccine requirements for either the applicant organization or the SLRP recipients?

Executive Order. 14042 (September 9, 2021) Ensuring Adequate COVID Safety Protocols for Federal Contractors does not apply to grant recipients.

Executive Order. 14043 (September 9, 2021) Requiring Coronavirus Disease 2019 Vaccination for Federal Employees does not apply to grant recipients.