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Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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LRP IHS Loan Repayment Program Resource Advantage
IHS Loan Repayment Program News & Information Volume 1 Issue 3
Loan Repayment Program Male Health Professional
In This Issue:
IHS Supplemental Loan Repayment – Recruitment Incentive and Good Investment
Loan Repayment Program Overview
Open Communication With the Loan Repayment Program
IHS Loan Repayment Program Online
Contact Us

LRP Resource


Supplemental Loan Repayment Program

2000–the first year Indian Health Service sites were authorized to offer SLRP

IHS Supplemental Loan Repayment – Recruitment Incentive and Good Investment

CAPT Timothy Lozon, DDS Deputy Director, IHS Division of Oral Health
CAPT Timothy Lozon, DDS Deputy Director,
IHS Division of Oral Health

It’s no secret that health professions students want guaranteed loan repayment. That’s why the Indian Health Service (IHS) Supplemental Loan Repayment Program (SLRP) is a great incentive that can give a hiring edge to facilities with hard-to-fill health professional vacancies, especially when the national Loan Repayment Program (LRP) has run out of funds for the year.

6 sites offering SLRP
in 2008

5 IHS Areas offering SLRP including Aberdeen, Billings, Navajo, Phoenix and Portland
2-year service obligation
for SLRP recipients


If you have vacancies for physicians, nurses, pharmacists or other health or allied health professionals and want to participate, notify the LRP that you’re interested. Identify the discipline or disciplines and the number of positions you would like to fund. Your cost for the initial two-year contract is approximately $52,000 (for a contract of $20,000 plus applicable taxes per year). One-year contract extensions can be funded for $26,000 ($20,000 plus applicable taxes per year). Money can be sent to LRP when you find an applicant for your vacancy who is eligible for loan repayment, or you can send it before you find a candidate. If you send money in advance but an applicant isn’t found, the money will be returned to you in early September.

The IHS Department of Oral Health (DOH), for example, has successfully utilized SLRP to fill vacant dental positions in high-priority sites. Currently, there are facilities in several Areas that are using the program to attract dentists, said CAPT Timothy Lozon, DDS, Deputy Director of the IHS Division of Oral Health.

“Navajo Area has been particularly successful in filling positions and, in fact, was one of the pioneers of the program,” he said. “In our vacancy listings, we put a green dollar sign next to listings offering SLRP. We make it stand out, and it’s a good marketing strategy if candidates are searching for dollars. Even though they might be altruistic and want to come to IHS, they want to meet their financial obligations, too, and LRP is one way to do that. With the kind of debt they’re looking at, they want help. If a facility looking for dentists tells me they want to put this incentive on their vacancy, I’ll market it strongly. It’s what the candidates are looking for, and it’s money in the bank for the facility.”

CAPT Lozon believes that SLRP is more than just an incentive to health professions job candidates – it’s a good investment for facilities with hard-to-fill vacancies, especially if those vacancies would normally generate third-party revenue. DOH ran the numbers in a cost-benefit analysis: besides the human pain and suffering that results from care not being provided, dollars are spent on contract care and lost third-party collections. SLRP can recover those dollars, and possibly pay for itself in the process.

“Consider how much money you can collect from Medicaid or insurance and ask: Can that money offset the money that would be paid in guaranteed loan repayment? Our assertion is yes, it can. Say a facility goes six months without filling a dental position. They should have six months of lapsed salary money. If that money is put toward guaranteed loan repayment, the facility gets a dentist guaranteed for two years who, in that time, should bill more than that amount to Medicaid or insurance. That covers the guaranteed loan repayment and can, in fact, be a nice interest payment on the investment.” Read More

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Loan Repayment Program Overview

Supplemental Loan Repayment Helps With Retention

LRP recipient practicing optometryFinancial considerations are one of the primary reasons that employees leave IHS. The Loan Repayment Program is a great incentive for individuals to work with IHS, but the reality is that the demand for LRP contracts consistently exceeds the capacity to award all program applicants. The Supplemental Loan Repayment Program has assisted several facilities with the recruitment and retention of their much-needed health care professionals, and it has helped close the gap between the amount of funding authorized by Congress and the actual money needed for employees’ contracts.

Additionally, employees often would remain employed with IHS if they could extend their original LRP contracts. Extensions from the original two-year service obligation can be made on an annual basis. The additional funding provided by SLRP has helped retain professionals beyond their initial SLRP contract.

How Payments Are Made to Recipients

The LRP and SLRP will repay qualifying health professions education loans. To give you a better understanding of how the payments are made, the following charts outline two different payment scenarios for one year.

Scenario I – Recipient with a two-year service contract and $90,000 in qualified educational loans.

Details for an annual LRP award of $20,000.

LRP Award

Amount Recipient Receives

Amount Withheld by IHS for Recipient’s Portion of FICA

Additional Payments
Made by IHS

Total Payments Made by IHS

(For each




Income tax liability on the
part of the recipient

Employer’s portion of FICA


Scenario II – Recipient has obtained professional degrees in nursing and nutrition and comes to work at IHS as a registered nurse. Only the loans obtained in pursuit of the nursing education ($36,000) are eligible for repayment; the nutrition training is not eligible for repayment.

Details for an annual LRP nursing award of $18,000 for educational portion.

LRP Award

Amount Recipient Receives

Amount Withheld by IHS for Recipient’s Portion of FICA

Additional Payments
Made by IHS

Total Payments
Made by IHS

For educational portion for nursing (for each year)




Income tax liability on the part of the recipient

Employer’s portion of FICA


Change in Work Status With LRP and SLRP

Recipients have contracts with the Loan Repayment Program and must provide the clinical services for their two-year service obligation at the site where their award was initiated. There are times when recipients may request a change in their work status due to unforeseen circumstances. Examples of a change in work status may include:

  • Transfer to another facility. All transfers require prior approval from the Loan Repayment Program. A letter from the facility the individual is leaving is also required, stating the impact on the facility’s day-to-day operations, as well as approval from the facility that is accepting the transfer.
  • Time spent by recipients in further training in their clinical profession, such as internships, residencies or other advanced clinical training, is considered a change in work status. The time spent in training is not counted toward fulfillment of the two-year period of obligated service. Before starting further training, individuals must get approval from the Loan Repayment Program to defer their service obligation until their training is completed.

Occasionally, recipients decide to terminate their employment and not complete their service obligations. A formula is used to determine the amount of damages the US government is entitled to recover from the recipient in such cases. For a detailed explanation of the formula and for more specifics about contract defaults, please visit www.loanrepayment.ihs.gov and download the LRP Application Handbook.

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Open Communication With the Loan Repayment Program

LRP staff membersJackie Santiago, chief of the Loan Repayment Program, and her experienced staff encourage you to contact them with any questions you may have regarding the LRP and SLRP programs. If you are interested in knowing whether there are any LRP recipients at your site, you may contact Jackie directly at Jackie.Santiago@ihs.gov or 301-443-3396.

LRP staff contacts and telephone numbers.
Branch Chief (301) 443-2486
Dentists, Podiatrists (301) 443-2514
Optometry, Mid-Level Practitioners (301) 443-1795
Nurses (301) 443-2553
Pharmacy (301) 443-2544
Behavioral Health, Rehabilitative Services (301) 443-2465
Physicians, other health profession
includes medical technologists,
X-ray technicians, respiratory therapists, dieticians, medical records specialists, engineers,
and sanitarians)
(301) 443-2556

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IHS Loan Repayment Program Online

LRP Home
About LRP
Recipient Responsibilities
Frequently Asked Questions

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Contact Us

IHS Loan Repayment Program
(301) 443-3396
Contact Loan Repayment Program

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IHS Supplemental Loan Repayment, continued

SLRP is a particularly good investment if you get into the program early in the year and have multiple vacancies. By getting in early, your candidates have a better chance of getting national LRP, thus leaving your SLRP incentive funds to be used for the other positions.

Says CAPT Lozon: “Since SLRP is guaranteed loan repayment, advertising it early in the fiscal year means you’ll get more people looking at your sites early in the year and thus more chances of filling the jobs. Round one of national LRP is in January – if your site is high enough on the priority list, your candidate could be successful in the early rounds. You then have the flexibility to shift the SLRP funds to another position or take them back.”

Vacancies cost a lot in terms of dollars and services not provided to the population. SLRP is a way to recover those costs; but more importantly, it’s a means to becoming fully staffed in order to fulfill the IHS mission. Says CAPT Lozon: “We need to do whatever we can to get health care providers where we need them the most. We owe that to the patients. SLRP can really help and is something everyone who has hard-to-fill vacancies should strongly consider.”


For more information on this program, please contact Jackie Santiago at the IHS Loan Repayment Program.

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