Mississippi State Loan Repayment Program (SLRP)- Healthcare Professional

The program recruits and retains healthcare professionals to serve at eligible practice sites located in health professional shortage areas (HPSAs).

HPSAs can be geographic areas, populations, or facilities. These areas have a shortage of primary, dental, or mental health care providers.

Program participants (MDs and DOs ONLY) must practice at least two years at an approved public or private healthcare organization and can receive up to $150,000.00 toward educational loan repayment.

Project Details

• Reference ID: 2026-RFA-172
• Department: Office of State Health Planning and Research
• Department Head: Jennifer Gholson (-)

Important Dates

• Questions Due: 2029-05-28T05:00:00.000Z

Evaluation Criteria

• Eligible SLRP Discipline (MD or DO) (10 pts) —

  Confirm that the applicant holds a qualifying medical degree as a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). The discipline must align with SLRP eligibility requirements and any program-specific priorities (e.g., primary care, psychiatry, or other high-need specialties). Documentation should clearly indicate the degree awarded and field of practice.

• Proof of U.S. Citizenship or U.S. National Status (10 pts) —

  Verify that the applicant is a U.S. citizen or U.S. national, as required by federal SLRP guidelines. Acceptable documentation may include a valid U.S. passport, birth certificate, certificate of naturalization, or other federally recognized proof. Documentation must be current and legible.

• Proof of Mississippi Healthcare Professional License (10 pts) —

  Ensure the applicant holds an active, unrestricted license to practice in the state of Mississippi. The license must be valid at the time of application review and remain in good standing. Verification may be conducted through the appropriate Mississippi licensing board.

• Healthcare Professional Personal Statement (10 pts) —

  Review the applicant’s personal statement for completeness and alignment with SLRP goals. The statement should describe the applicant’s commitment to serving in underserved or rural areas, career goals, and motivation for participating in the program. This document may also be used to assess program fit and prioritization. Extra points for applicants that specifically work with MS residency programs.

• Original Loan Application and/or Agreement (Applicable Loans) (10 pts) —

  Confirm submission of the original loan application or loan agreement for each qualifying educational loan. This documentation must demonstrate that the loan was used for eligible educational expenses (e.g., medical school tuition). Only loans that meet SLRP criteria should be considered.

• Promissory Note (10 pts) —

  Review the promissory note associated with each loan to verify loan terms, borrower responsibility, and original loan amount. The note must clearly identify the applicant as the borrower and provide sufficient detail to confirm loan eligibility under program guidelines.

• Disclosure Statement (10 pts) —

  Ensure that a disclosure statement is provided for each loan, outlining key financial details such as interest rates, repayment terms, and lender information. This document helps validate the structure and legitimacy of the loan.

• Current Account Statement (10 pts) —

  Obtain and review the most recent loan account statement to verify the current outstanding balance, payment status, and loan servicer details. The statement must be recent (typically within 30–90 days) and is used to confirm the amount eligible for repayment under the program.

• Has the applicant's personal or student loans ever been under federal court judgment? (1 pts) —
  • Pass: Applicant selects “No.”
  • Fail: Applicant selects “Yes,” indicating loans have been subject to federal court judgment.
    Reviewer Notes:
    A “Yes” response may indicate significant financial delinquency and requires further review for program eligibility.
• Has the applicant ever filed for bankruptcy? (1 pts) —
  • Pass: Applicant selects “No.”
  • Fail: Applicant selects “Yes.”
    Reviewer Notes:
    Bankruptcy history may impact financial responsibility assessment. Additional documentation or explanation may be required depending on program policy.
• Is the applicant in default for any federal payment obligation? (1 pts) —
  • Pass: Applicant selects “No.”
  • Fail: Applicant selects “Yes,” indicating default (e.g., student loans, federal taxes, or other obligations).
    Reviewer Notes:
    A default status is typically disqualifying and must be resolved prior to participation.
• Has the applicant breached a prior service obligation to the federal government? (1 pts) —
  • Pass: Applicant selects “No.”
  • Fail: Applicant selects “Yes,” indicating a breach of a previous service agreement (e.g., prior loan repayment or scholarship program).
    Reviewer Notes:
    This may result in automatic disqualification depending on federal and state program rules.
• Does the applicant have an existing service obligation? (1 pts) —
  • Pass: Applicant selects “No,” or “Yes” with documentation confirming the obligation will be completed prior to SLRP start date (if allowed by policy).
  • Fail: Applicant selects “Yes” without sufficient documentation or indicates a conflicting obligation period.
    Reviewer Notes:
    Applicants must not have overlapping service commitments unless explicitly permitted and documented.

Submission Requirements

• Healthcare Professionals' Personal Information
• Healthcare Professional Name (required)
• Insert Date of Birth (MM/DD/YYYY) (required)
• Insert Social Security Number (SSN) (required)
• Provide proof of US Citizenship or US National (required) —

  Please upload a clear, legible copy of an official document verifying your status as a U.S. citizen or U.S. national. Acceptable documents include a U.S. birth certificate, valid U.S. passport, Certificate of Naturalization, Certificate of Citizenship, or documentation confirming U.S. national status. Drivers license and Social Security cards are NOT acceptable proof of citizenship. 

• Insert Home Street Address, City, State, and Zip (required)
• Insert Phone Number (required)
• Insert Email (required)
• Gender (required) —

  Demographics are for federal reporting purposes only. 

• Race/Ethnicity (required) —

  Demographics are for federal reporting purposes only. 

• Check the appropriate discipline. (required)
• Check the appropriate specialty. (required)
• Insert Medical License Number (required)
• Provide copy of Mississippi Medical License (required) —

  Please upload a clear, legible copy of your current and active medical license issued by the appropriate state licensing board. The document must include your full name, license number, issue date, and expiration date. Ensure the license is valid and unexpired at the time of submission.

• Insert National Provider Identifier (NPI) (required)
• Are you under any service obligation with any entity that you agreed to serve for a specific period in a particular area or practice site (such as an employment sign-on bonus)? (required)
• If question 1.13 is yes, explain:
• Have you ever been a National Health Service Corps (NHSC) or another federal service program recipient? (required)
• If question 1.15 is yes, which program and provide obligation dates:
• Have you ever applied for and been a National Health Service Corps (NHSC) or other federal service programs? (required)
• If question 1.17 is yes, which program and provide obligation dates
• If question 1.17 is yes and you were denied. When did you apply and were denied?
• Are you currently in the Public Service Loan Forgiveness (PSLF) program? (required)
• Health Care Professional Education —

  Please provide details about your educational background related to your current healthcare profession. Include all relevant undergraduate, graduate, and professional training programs that led to your licensure or certification. Information should include the name of the institution(s), degree(s) earned, field(s) of study, and completion date(s).

  Only include education directly applicable to your current clinical role or professional credentials.

• Undergraduate School Name, City, State: (required)
• Undergraduate School Degree and Date Completed (required)
• Undergraduate School Name, City, State (2): —

  If applicable, please provide details for any additional undergraduate institution(s) you attended. Include the name of the school, degree(s) earned (if any), field(s) of study, and dates of attendance or completion.

• Graduate/Professional School Name, City, and State (required)
• Graduate/Professional School Degree and Date Completed (required)
• Graduate/Professional School Name, City, State (2): —

  If applicable, please provide details for any additional graduate/professional institution(s) you attended. Include the name of the school, degree(s) earned (if any), field(s) of study, and dates of attendance or completion.

• Residency Site, City, State, Date Attended (required)
• Additional Postgraduate Training, City, State, Date Attended
• Health Care Professional Loan Information —

  Complete the following information for each outstanding educational loan received to support undergraduate or graduate students that led to completing your current professional training and licensure. If any eligible loan is consolidated or refinanced with the non-educational loan, no portion of the consolidated/refinanced loan is eligible for loan repayment.

• Have you ever defaulted on a personal or student loan? (required)
• If question 3.1 is yes, provide the date of default
• Were any personal or student loans ever under a federal court judgment? (required)
• if question 3.3 is yes, provide date of judgment.
• Have you ever filed for bankruptcy? (required)
• If question 3.5 is yes, what is the date?
• Complete the following table for each outstanding educational loan received to support undergraduate or graduate students that led to completing your current professional training and licensure. (required) —

  Please download the below documents, complete, and upload.

• Upload copy of the original loan application, agreement, promissory note (if applicable), disclosure statement, and current account statement dated within 30 days of application (required) —

  Please upload complete and legible copies of all relevant loan documentation associated with your educational loans. This includes the original loan application, loan agreement, promissory note (if applicable), disclosure statement, and a current account statement dated within 30 days of your application submission.

  Documentation must clearly display your name, lender/servicer information, loan balance, and account status. Ensure all pages are included and readable. If multiple documents are required, please combine them into a single file before uploading. Acceptable file formats include PDF, JPEG, or PNG.

• Health Care Practice Site Information —

  Please complete the Health Care Practice Site Information section by providing accurate details for each location where you deliver direct patient care services. You are responsible for ensuring that all practice site locations are listed.

  Each practice site identified must also complete and submit a separate Health Care Practice Site Application. Incomplete or missing practice site information may delay the review and processing of your application.

• Practice Site Name (required)
• Practice Site Address, City, State, Zip (required)
• Primary Point of Contact Name (required) —

  Please designate a primary contact person for this practice site. This individual will be responsible for responding to quarterly verification requests from the State to confirm provider contract compliance.

  The contact person should be knowledgeable about provider schedules, employment status, and service obligations, and must be available to provide timely and accurate information when requested.

  The designated contact person may include, but is not limited to:

  • Practice Manager or Clinic Administrator
  • Medical Director or Clinical Supervisor
  • Office Manager or Front Office Supervisor
  • Human Resources Representative
  • Credentialing or Compliance Coordinator
• Primary Point of Contact Phone Number (required)
• Primary Point of Contact Email (required)
• Date of Employment at Practice Site (required) —

  Please provide the date you began employment at the listed practice site. This should reflect your official start date of providing services at this location. If you have had multiple periods of employment at this site, include the most recent start date. Ensure the date is accurate, as it will be used to verify eligibility and service commitment requirements.

• Hours worked per week at Practice Site (required) —

  Please indicate the average number of hours you work per week at this practice site. Include total hours spent providing direct patient care and any required clinical-related duties, administrative duties as defined by program guidelines. Do not include on-call time unless you are actively providing patient care. Ensure the hours reported accurately reflect your regular work schedule, as this information will be used to assess compliance with service requirements. 

• Hours worked providing direct patient care per week at Practice Site (required) —

  Please indicate the average number of hours per week you spend providing direct, in-person or telehealth patient care at this practice site. Include only time spent delivering clinical services to patients. Do not include administrative duties, training, travel, or on-call hours unless you are actively engaged in patient care. Ensure the hours reported accurately reflect your regular schedule, as this information will be used to determine compliance with program requirements.

• Practice Site Name (2) —

  If applicable, please provide information for all additional practice sites where you deliver direct patient care services. You must list each location separately and include complete and accurate details for each site.

• Practice Site Address, City, State, Zip (2)
• Primary Point of Contact Name (2)
• Primary Point of Contact Email (2)
• Date of Employment at Practice Site (2)
• Hours worked per week at Practice Site (2)
• Hours worked providing direct patient care per week at Practice Site (2)
• Health Care Professional Personal Statement
• Personal Statement (required) —

  Please upload a typed personal statement (no more than three (3) pages) describing your training and experience working with underserved populations in Mississippi. Your statement should include, at a minimum, the following components:

  • A summary of your clinical and/or professional experience serving underserved, rural, or vulnerable populations
  • Discussion of observed health disparities in the communities you serve (e.g., access to care, chronic disease burden, preventive care gaps, socioeconomic barriers)
  • Description of how you, your team, and your practice site are actively working to address these disparities and improve health outcomes
  • Explanation of your short-term and long-term professional goals related to service in underserved areas
  • Your commitment to your current practice site, including factors that influenced your decision to work in the community and at this location
  • If applicable, a description of your involvement with Mississippi residency programs, including the nature of your role and engagement

  Please ensure the statement is clear, well-organized, and reflects your commitment to serving underserved populations and improving community health outcomes.

• Health Care Professional Application Attestation (required) —

  I have read and understand the Overview & Guidelines Document, which describes the Mississippi State Loan Repayment Program (MSLRP) requirements and affirm that I meet the qualifications for participation in the program. I authorize the MS State Department of Health Center for Rural Health and Population Studies to contact the listed employing health care practice site(s) and relevant licensing authorities for the purpose of obtaining information about my professional qualifications and experience.

  I certify that the information given in this application and attachments is accurate and complete to the best of my knowledge. I understand that the information I have provided is subject to verification and that willfully providing false information may result in immediate disqualification from participation in this program. Any person who knowingly makes a false statement or misrepresentation in this loan application repayment transaction fraudulently obtains repayment for a loan or commits any other legal action in connection with this transaction is subject to repaying any amount received from this program, plus interest.

• Competition/Joint Efforts Verbiage (required) —

  Should the language for Competition/Joint Efforts be used in this RFA?

• Statement of Need (required) —

  Is there a Statement of Need required with submittals for this RFA?

• Estimated Dollar Amount (required) —

  What is the estimated dollar amount budgeted for this request?

• Funding Information —

  Be sure that the following three financial info pieces add up to 100% or this will not be approved.

• Internal Order (required) —

  Please specify the internal order information. Be sure to include the % of each internal order. If there are multiple internal orders, please separate each with a comma and be sure they add up to 100% or your posting will not be approved.

  EXAMPLE 1
  30000035771  100%

• Functional Area (required) —

  Please specify the functional area information. Be sure to include the % of each functional area. If there are multiple functional areas, please separate each with a comma and be sure they add up to 100% or your posting will not be approved.

  EXAMPLE 1
  13010101000000DV  100%

• Cost Center (required) —

  Please specify the cost center information. Be sure to include the % of each cost center. If there are multiple cost centers, please separate each with a comma and be sure they add up to 100% or your posting will not be approved.

  EXAMPLE 1
  1301010707  100%