2. Application Periods, Forms and Process

The Michigan Department of Health and Human Services invites all eligible primary care medical, dental, and mental healthcare providers working at HPSA-eligible practice sites to apply for the Michigan State Loan Repayment Program.  Providers' practice sites must be located in a Health Professional Shortage Areas or have HPSA facility designations and meet all requirements described under Program Requirements. This section includes information about MSLRP application periods, forms, and the application process up to the submission of the application package.  To successfully compete in the application process, providers and employers should carefully read the MSLRP Opportunity Update at the beginning of this website, all website sections, and the instructions on each application form.

Application Periods:

Annual application periods will February 5, 2018 and continue through February 9, 2018.  Application packages must be postmarked no earlier than February 5 and no later than Feb 9.  Applications will only be reviewed until a sufficient number of complete applications have been reviewed to obligate program funds.  This means applicants should mail their complete application packages as early as possible within the application period.

Program information, including MSLRP policy, requirements and procedures, will be updated each November for the following January through April application period. During each November, the updated information will be included in the MSLRP Opportunity Update and posted on the website. The MSLRP Update will also be emailed to employers on the MSLRP Marketing List to make them aware of the new application period and to facilitate their dissemination of program information to providers who may be interested.  Employers who wish to be included on the MSLRP Marketing List may email Brittany Brookshire, MSLRP Coordinator, at BrookshireB1@michigan.gov.  Providers can access the MSLRP Update on this website and through their employers.

 Application Forms:

New application forms will be available each November proceeding an application period.  The new forms must be used to apply.  Briefly, providers must complete the Provider Application Part A and Part B forms, and employers must complete the Practice Site Application and Declaration of Intent form and include all required attachments.  Loan repayment agreements for successful applicants will begin October 1, following each application period. 

Documents 1 through 3 must be included as part of the complete, single-submission MSLRP application package. Providers and employers should carefully read and follow the directions on each form.

 1.  Provider Application, Part A Form

      Provider Application, Part A Instructions

 2.  Provider Application, Part B Form  

      Provider Application, Part B Instructions

 

PLEASE NOTE: Current participants reapplying to the program, as well as those who have participated in the past, are required to submit Loan Repayment Documentation (LRD) to show they have paid down the loans included on their previous Part B forms by an amount at least equal to the amount received from the program. The amount of LRD must add up to the required amount, or the application will screen out of the review process.  When information provided on Part B forms by loan servicer agencies does not meet their LRD requirements, applicants must provide LRD as outlined under the Reapplying to MSLRP in the Participant Information and Requirements section of the MSLRP website.

 

 3.  Practice Site Application & Declaration of Intent Form (coming soon for 2018)

      Practice Site Application & Declaration of Intent Instructions (coming soon for 2018)

 

Application Process:

The MSLRP application process becomes more competitive each year. Those serious about submitting a successful application package should take the time to learn about the application process.

Early Preparation of Application Forms:

Providers and employers are urged to begin preparing their application forms well before the start of the application period.  This applies especially to Provider Application Part B forms, which take the longest to complete. 

Single Submission Application Packages Must be Mailed With a Postmark on Envelope:

All documents must arrive together at the MSLRP Office by mail in a single envelope, with a clearly-visible postmark and each document must be 100 percent complete and legible.  Only one provider application package may be mailed in a single envelop.

MSLRP cannot accept application forms submitted separately, or submitted by email, phone, or fax.  Application packages must include clear postmarks to determine their place among all documents pending review.

All application packages must be mailed together in a single envelope to:

Brittany Brookshire, MSLRP Coordinator,

Office of Planning

Michigan Department of Health and Human Services

South Grand Building

P.O. Box 30195

Lansing, MI 48909

 

Application Forms must be 100 Percent Complete and Legible:  Because application forms must meet all requirements described in the current MSLRP Opportunity Update, the website and on individual application forms, providers and employers should read all of this information.  They should start by reading the following key points for completing each form, along with the most common mistakes.   

The program will not preview applications for completeness before they are submitted.   

Key Points for Provider Application, Part A:

  • Providers must make sure they include all practice sites at which they may complete their MSLRP service obligation and should make sure that their employer lists all sites in the Practice Site Application. 

  • The number of practice sites, site names, addresses and hours worked at each site must be the same on the Provider Application, Part A and the Practice Site Application.

  • Loan repayment agreements can only be awarded for practice sites included in the original application.

  • Provider or employer requests to include additional practices sites during the contracting process will void the application, requiring the provider to reapply during the following application period.

  • Providers may enter zero (0) for Hours Worked Per Week for practice sites at which they are not currently working, but may be asked to work during their service obligations.

  • Hours of employment at sites where providers are currently working must total at least 40 hours of employment per week.

  • Due to new federal reporting requirements, providers must use nine-digit zip codes in their practice site addresses.

  • Eligible debt is not limited to government loans.  Private loans from commercial lending institutions, such as banks or credit unions, are eligible.  However, private loans form parents, relatives or other individuals are not. 

Common Misktakes on Provider Application, Part A form:

  • Not included in application package

  • An older version of the form was submitted (Check the website for current application forms

  • Missing one or more sections

  • Incomplete or illegible Social Security Number

  • One or more sections incomplete

  • Not a U.S. citizen, or citizenship not indicated

  • The number of hours of employment at practice sites is not indicated, or the total number of hours of employment at all practice sites is less than 40 hours per week

  • The number of practice sites, site names, addresses and/or hours worked at each site on the Provider Application, Part A are not the same as on the Practice Site Application

  • Ineligible provider type

  • Insufficient eligible debt for minimum loan agreement amount: $20,000 for two-year initial agreements, or $10,000 for final one-year agreement

  • Nine-digit zip codes were not used in the address for one or more practice sites

 

Key Points for Provider Application, Part B:

  • Eligible debt is not limited to government loans.  Private loans from commercial lending institutions, such as banks or credit unions, are eligible.  However, private loans form parents, relatives or other individuals are not. 
  • This form takes the longest to complete, so providers should get an early start by completing the top section and sending a form to each of their loan servicers as early as possible.
  • Starting early increases the likelihood providers will receive their Parts B forms back in time to complete their application packages and mail them as early as they intended.

  • Providers can save considerable time by emailing the forms to their loan servicers and asking their loan servicers to fax or email them back to them. 

  • Providers should not instruct the loan servicers to send completed Part B forms to the MSLRP Office.

Common Mistakes on Provider Application Part B form(s):

  • An older version of the form was submitted

  • Not included in the application package

  • The bottom of one or more Provider Application, Part B forms is not checked "Yes" or "No" to indicate whether or not the loans listed above entail a service obligation other than MSLRP.  In order to be eligible for state loan repayment programs, federal guidelines require that providers have no service obligations on their loans.

  • Insufficient eligible debt for minimum loan agreement amount: $20,000 for two-year initial agreements, or $10,000 for final one-year agreement

  • The form was not signed and/or dated by the loan servicer.
  • The loan servicer attached an internal document or report to the Part B form, but did not complete the form itself.

Key Points for Practice Site Application:

  • Employers must make sure they include all practice sites at which the applicant may complete their MSLRP service obligation.

  • The number of practice sites, site names, addresses and hours worked at each site must be the same on the Provider Application, Part A and the Practice Site Application. 

  • Loan repayment agreements can only be awarded for practice sites included on the original Practice Site Application.

  • Provider or employer requests to include additional practice sites during the contracting process will void the application, requiring the provider to reapply during the following application period.

  • Employers may enter zero (0) for Hours Worked Per Week for practice sites at which the applicant is not currently working, but may be asked to work during their service obligation. Hours of employment at sites where applicants are currently working must total at least 40 hours of employment per week.

  • Due to new federal reporting requirements, employers must use nine-digit zip codes in their practice site addresses.  

Common Mistakes on Practice Site Application Form:

  • Not included in application package

  • An older version of the form was submitted

  • Missing one or more sections

  • One or more sections incomplete

  • The number of hours of employment at practice sites is not indicated, or the total number of hours of employment at all practice sites is less than 40 hours per week

  • The number of practice sites, site names, addresses and/or hours worked on the Practice Site Application is not the same as on the Provider Application, Part A.

  • Ineligible practice site type

  • Discounted/Sliding Fee Schedule and Discount Fee Policy is not attached

  • Proof of Tax Exempt Status is not attached

  • Not all practice sites at which the provider may complete their MSLRP service obligation have been included

  • Nine-digit zip codes were not used in the address for one or more practice sites.

Loan Repayment Documentation (LRD):

  • Loan Repayment Documentation is only required for providers reapplying to MSLRP.Those reapplying should see the Participant Information and Requirements section of the website for details.

  • Incomplete LRD is a common reason the applications of those reapplying to the program are incomplete.

 

 
 

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