(A) An individual who will not have an outstanding obligation for dental hygiene services to the federal government, a state or other entity at the time of participation in the dental hygienist loan repayment program and meets one of the following requirements may apply for participation in the dental hygienist loan repayment program:
(1) A dental hygiene student enrolled in the final year of dental hygiene school; or
(2) A person who is licensed under Chapter 4715. of the Revised Code to practice dental hygiene in the state of Ohio.
(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:
(2) Current and permanent mailing address;
(3) Telephone number;
(4) The dental hygiene college the applicant attended, dates attended and verification of attendance;
(5) A summary and verification of the educational expenses for which reimbursement is sought under the dental hygienist loan repayment program;
(6) Verification of United States citizenship or legal alien status;
(7) Verification of license to practice dental hygiene under Chapter 4715. of the Revised Code and proof of good standing; and
(8) Any other information requested by the department.
(C) The director of health shall grant an application for placement in a dental health resource shortage area and participation in the dental hygienist loan repayment program if both of the following apply:
(1) The general assembly has appropriated adequate funds for the dental hygienist loan repayment program; and
(2) The director finds that the applicant is eligible for placement and participation, and that, in accordance with priorities established under rule 3701-58-04 of the Administrative Code, the applicant is needed in a dental health resource shortage area.
(D) Upon granting an application, the director shall notify and enter into discussions with the applicant. The object of the discussions is the placement of the applicant in the dental health resource shortage area which, according to the priorities established under rule 3701-58-04 of the Administrative Code, the applicant is most needed. The department may also refer the applicant to the Ohio dental hygienist's association for assistance in being recruited to a dental practice site within a dental health resource shortage area at which the applicant will agree to be placed.
(E) In the event 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 extent to which the applicant's background is similar to the population in the dental health resource shortage area;
(3) The length of time the applicant is willing to provide dental hygiene services in a dental health resource shortage area;
(4) The applicant's expressed interest in staying and working in an underserved area and whose family members are interested in the lifestyle associated with areas of underservice;
(5) The extent to which the applicant has sought or undertaken culturally or economically diverse experiences;
(6) The amount of the loan balance for which the applicant is requesting repayment assistance;
(7) The type of dental practice site as defined in paragraph (A) of rule 3701-58-01 of the Administrative Code;
(8) The location of the dental practice site as defined under paragraph (A) of rule 3701-58-04 of the Administrative Code:
(9) The percentage of individuals served by the dental practice site who participate in the medicaid program established under Chapter 5613. of the Revised Code, and the percentage of individuals who pay sliding fee payments or reduced fees based on the individual's family income;
(10) To ensure an equitable distribution of dental hygienists desiring to practice in a dental health resource shortage area, preference will be given to applicants desiring to practice in a dental health resource shortage area which does not have a dental hygienist placed in the area, either through the Ohio dental hygienist loan reapayment program or through the federal national health service corps scholarship and loan repayment programs.
(F) Each factor listed in paragraph (E) of this rule shall be used by the department to develop scoring criteria which shall be made available to loan repayment applicants as part of the dental hygienist loan repayment program application. Each applicant will be evaluated against the criteria and a score will be given for the applicant's responses to each criterion.
Each applicant will be given a total score. In addition, the department staff may 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. The Ohio dentist loan repayment program advisory board shall determine the amounts that will be paid as loan repayments on behalf of participants in the dental hygienist loan repayment program.
If the dental practice site, the director and the applicant agree on the applicant's placement in a particular 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.