Chapter 3701-56 Dentist Loan Repayment Program

As used in this chapter:

(A) “Dental health care provider sites” means nonprofit dental clinics or privately owned dental practices that provide services for medicaid recipients and offer sliding fee schedules based on the patient’s family income, significantly reduced fees or free care to clients who otherwise cannot afford private dental care.

(B) “Dental health resource shortage area” means an area in Ohio that experiences special dental health problems and dentist practice patterns that limit access to dental care as set forth by the director in accordance with rule 3701-56-04 of the Administrative Code.

(C) “Dental services” means the provision of diagnostic, preventive, restorative, emergency and palliative services provided by licensed general or pediatric dentists. The provision of dental services includes a reasonable amount of time for performing tasks related to the service, such as record-keeping.

(D) “Dentist” means a person who is licensed under Chapter 4715. of the Revised Code to practice dentistry.

(E) “Dentistry” means the practice of general or pediatric dentistry by a dentist as defined in paragraph (D) of this rule.

(F) “Department” means the department of health.

(G) “Director” means the director of the Ohio department of health or the director’s designee.

(H) “Educational expenses” means all or part of the principal and interest of a government or educational loan which has been taken by an individual and which meets the following criteria:

(1) The expenses were incurred while the individual was enrolled in, for up to a maximum of four years, a college of dentistry in the United States accredited by the commission on dental accreditation, recognized by the United States department of education to accredit dental education programs or a dental college located outside of the United States that meets the standards of section 4715.11 of the Revised Code; and

(2) The expenses were incurred for:

(a) Tuition;

(b) Other educational expenses, such as fees, books, and laboratory expenses, for specific purposes and in amounts determined to be reasonable by the director; and

(c) Room and board, in an amount determined to be reasonable by the director.

(I) “Individual” means:

(1) A dental student enrolled in the final year of dental college;

(2) A dental resident in the final year of residency training in general or pediatric dentistry; or

(3) A dentist who has been engaged in the practice of dentistry in this state, under Chapter 4715. of the Revised Code, for not more than three years prior to submitting an application.

HISTORY: Eff. 7-8-04

Rule promulgated under: RC 119.03

Rule authorized by: RC 3702.86

Rule amplifies: RC 3702.85 through 3702.93

R.C. 119.032 review dates: 07/01/2009

(A) An individual who is not receiving national health services corps tuition or student loan repayment assistance may apply to the director, on a form prescribed by the director, for placement in a dental health resource shortage area and participation in the dentist loan repayment program.

(B) The application shall be submitted by a date and on a form prescribed by the department. The form shall require an applicant to set forth the following information:

(1) The applicant’s name, permanent address or address at which the applicant is currently residing if different from the permanent address, and telephone number;

(2) The dental college the applicant is attending or attended, dates of attendance, and verification of attendance;

(3) If the applicant is a dental resident, the facility or institution at which the residency is being performed;

(4) A summary and verification of the educational expenses for which the applicant seeks reimbursement under the program;

(5) If the applicant is a dentist, verification of the applicant’s license issued under Chapter 4715. of the Revised Code to practice dentistry and proof of good standing; and

(6) Verification of the applicant’s United States citizenship or status as a legal alien.

(C) The director of health shall grant an application for placement in a dental health resource shortage area and participation in the dentist loan repayment program if both of the following apply

(1) Funds are available in the dentist loan repayment fund and the general assembly has appropriated funds for the program; and

(2) The director finds that the applicant is eligible for placement and participation in accordance with the priorities established under rule 3701-56-04 of the Administrative Code.

(D) Upon granting an application, the director shall notify and enter into discussions with the applicant. The object of the discussions is to facilitate recruitment of the applicant to a site within a dental health resource shortage area at which, according to the priorities established under rule 3701-56-04 of the Administrative Code, the applicant is needed. The department may pay the costs incurred by the applicant and the applicant’s spouse for travel, meals, and lodging in making one visit to one dental health resource shortage area. The department may also refer an applicant to the Ohio dental association for assistance in being recruited to a site within a dental health resource shortage area at which the applicant will agree to be placed.

(E) If the director and applicant agree on the applicant’s placement at a particular site within a dental health resource shortage area and the amount of the applicant’s educational expenses to be repaid, the applicant shall prepare, sign, and deliver to the director a letter of intent agreeing to that placement. The dentist loan repayment advisory board shall determine the amounts that will be paid as loan repayments on behalf of participants in the dentist loan repayment program.

(F) In the event that it is necessary to establish priorities among applicants, the director shall consider the following factors:

(1) The applicant’s background and career goals;

(2) The length of time the applicant is willing to provide dental services in a dental health resource shortage area;

(3) The amount of the educational expenses for which reimbursement is being sought;

(4) Other financial assistance the applicant has received such as national health services corps tuition or student loan repayment.

(5) The applicant’s expressed interest in working and staying in an underserved area including family members’ interest in the lifestyle associated with areas of underservice; and

(6) The extent to which the applicant has sought or undertaken culturally or economically diverse experiences.

(G) Each applicant will be evaluated against the factors listed in paragraph (F) of this rule. A score will be given to an applicant’s response to each factor and each factor will be weighted using the criteria scoring sheet attached to this rule as an appendix. Additional weight will be given to dentists desiring to practice in an area which has not had a dentist placed in the preceding four years, either through the Ohio dentist loan repayment program or through the federal national health service corps scholarship and loan repayment programs.

Each applicant will be given a total score. In addition, the director may instruct staff to interview applicants to gather responses not easily evaluated from the applicant’s written application. The applicants with the highest scores will be recommended for funding provided that funds are authorized and available. When necessary due to limited funds from the general assembly, payments of less than twenty thousand dollars per year may be made in order to maximize the number of dentists granted loan repayment in dental health resource shortage areas.

Appendix Prioritization of Loan Repayment Candidates Scoring Sheets

See Appendix at http://www.registerofohio.state.oh.us/pdfs/3701/0/56/3701-56-02_PH_FF_N_APP1_20040628_0909.pdf

HISTORY: Eff. 7-8-04

Rule promulgated under: RC 119.03

Rule authorized by: RC 3702.86

Rule amplifies: RC 3702.88 through 3702.90

R.C. 119.032 review dates: 07/01/2009

(A) An individual who has signed a letter of intent under section 3702.90 of the Revised Code may enter into a contract with the director and the Ohio board of regents for participation in the dentist loan repayment program. A lending institution may also be a party to the contract.

(B) The contract shall include all of the following obligations:

(1) Agreement by the individual to:

(a) Provide dental care services in the dental health resource shortage area identified in his or her letter of intent for at least one year;

(b) Provide dental services for a minimum of forty hours per week;

(c) Provide dental services without regard to a patient’s ability to pay;

(d) Meet the conditions prescribed by the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C.A. 301 as amended, and the Ohio department of job and family services for participation in the medicaid program established under Chapter 5111.of the Revised Code and enter into a contract with the Ohio department of job and family services and its contracting managed care plans to provide dental services to medicaid recipients; and

(e) Pay the Ohio board of regents the following as damages if the individual fails to complete the service obligation agreed to under this paragraph:

(i) If the failure occurs during the first two years of the service obligation, three times the total amount the Ohio board of regents has agreed to repay under paragraph (B)(3) of this rule;

(ii) If the failure occurs after the first two years of the service obligation, three times the amount the Ohio board of regents is still obligated to repay under paragraph (B)(3) of this rule;

(2) Agreement by the Ohio board of regents, as provided in section 3702.85 of the Revised Code, to pay, so long as the individual performs the service obligation to which he or she has agreed under paragraph (B)(1) of this rule, all or part of the individual’s educational expenses, but not exceeding twenty thousand dollars per year of service;

(3) If the Ohio board of regents assumes the individual’s duty to pay a loan, the contract shall set forth the total amount of principal and interest to be paid, an amortization schedule, and the amount of each payment to be made under the schedule;

(4) Other terms including but not limited to the following:

(a) An assignment to the Ohio board of regents of the individual’s duty to pay the principal and interest of a government or other educational loan taken by the individual for educational expenses; and

(b) Reimbursement for increased tax liability if repayment results in an increase in the individual’s federal, state, or local income tax liability.

HISTORY: Eff. 7-8-04

Rule promulgated under: RC 119.03

Rule authorized by: RC 3702.86

Rule amplifies: RC 3702.91

R.C. 119.032 review dates: 07/01/2009

(A) Dental health resource shortage areas shall include the following:

(1) A geographic area, facility (including federally qualified health centers), or population group in this state that has been designated by the United States secretary of health and human services as a dental health manpower shortage area under Title III of the “Public Health Services Act,’” 58 Stat. 682 (1944), 42 U.S.C.A. 201, as amended.

(2) A geographic area, one or more facilities within a particular area or a population group within a particular area which:

(a) Has a population to dentist ratio exceeding four thousand to one and is in an appalachian county; or

(b) Has a population to dentist ratio exceeding four thousand to one and a minority population which exceeds seventy percent; or

(c) Has a low-income population (less than or equal to two hundred percent of poverty level) to medicaid provider (adjusted to full time equivalent) ratio exceeding four thousand to one; or

(d) Has insufficient capacity, such as unusually long wait time for new patient appointments (more than six weeks for routine dental services) or two-thirds of dentists do not accept new patients; or

(e) Demonstrates the population in the area experiences significant barriers to obtaining dental care; or

(f) Has previously been designated to be a dental health manpower shortage area as described in paragraph (A)(1) of this rule but upon regular re-determination by the director, no longer meets the criteria of paragraph (A)(1) of this rule.

(B) In determining whether to approve an area, facility or population as a health resource shortage area, the director shall consider:

(1) Population groups that experience special oral health problems such as low-income, medicaid, minority, migrant, homeless, nursing home residents and other population groups determined by the director to have special oral health problems;

(2) Dentist practice patterns that limit access to dental care.

(C) The director shall give priority to the dental health resource shortage areas based on the following factors, with the population to dentist ratio receiving the highest priority:

(1) Population to dentist ratio in the shortage area;

(2) Oral health status indicators of the target population in the area such as community water fluoridation and the per cent of population with incomes below the poverty level;

(3) Travel time or distance to nearest source of care outside the health resource shortage area;

(4) Presence of dental health care provider sites in the area with vacancies for dentists,

(5) Availability of an eligible candidate interested in being recruited to a particular site within an area; and

(6) The distribution of dental health care provider sites in urban and rural regions.

HISTORY: Eff. 7-8-04

Rule promulgated under: RC 119.03

Rule authorized by: RC 3702.86

Rule amplifies: RC 3702.87 and 3702.88

R.C. 119.032 review dates: 07/01/2009