The Underserved Physician Workforce (UPW) Loan Repayment Program assists communities in recruiting physicians to their non-profit healthcare facilities. Requirements include U.S. citizenship and willingness to practice primary care, emergency room medicine or general surgery either full-time or half-time, in a Federal Health Professional Shortage Area (HPSA) in Illinois without regard for the patient's ability to pay. For more program requirements and information, please visit the IDPH website at: http://www.dph.illinois.gov/topics-services/life-stages-populations/rural-underserved-populations/slrp.
UPW Table of Contents
- Program Background
- Site Registration
- Practice Location Registration
- Site and Provider Applications
- UPW Reporting
- UPW File Submission
1. Program Background
The application process for UPW begins July 1st each year. Although there is no deadline to apply, the program has limited funding available each year. The Center for Rural Health recommends applying early while funds are more readily available. Once funds are exhausted, the application will close.
2. Site Registration
Sites must agree to sponsor any provider who wishes to be considered for the UWP Program. Prior to applying, sites must register and be approved by the Illinois Department of Public Health, Center for Rural Health. Click Site Registration to register a site.
3. Practice Location Registration
Additionally, sites must register each practice location in which a potential UPW physician will perform services. This may be completed during the initial site registration process. For previously registered sites, additional practice locations may be registered at Site Practice Locations.
4. Site and Physician Applications
Overview
- For applicants to be considered, the Center for Rural Health must receive an application from both the physician and the registered site. For physicians who are interested in the program, please first reach out to the appropriate site personnel to see if the UPW Program is offered and if the site is eligible (unregistered sites will not be available within the application). Sites must be non-profit, providing primary care services in an outpatient setting for primary care applicants, or be a facility where the emergency room physician or general surgeon practice in a non-profit facility located in a Health Professional Shortage Area (HPSA).
- After physicians have consulted with their respective site, both parties must read the directions below prior to clicking on the appropriate "Proceed to Application" link.
- Complete the application form and click the "Submit" button.
- Upon submission, the applicant will receive a confirmation e-mail (contact the Center for Rural Health if you do not receive this e-mail within 48 hours of submitting the application). Program staff at the Center for Rural Health will begin the review process once the site and provider applications are received. If additional information is needed, applicants will be notified via e-mail.
*Ensure the e-mail address you provide in the application is correct. Communication between the Department and the applicant will be through e-mail. The Department is not responsible if an applicant provides an inaccurate e-mail address.*
- By clicking on the “Proceed to Site” or “Physician Application” link below, sites and physicians confirm that they have read the above guidelines and UPW Program rules (http://www.ilga.gov/commission/jcar/admincode/077/07700582sections.html). Physicians also agree that the application is not complete until the Department receives and approves the following:
- A) A copy of physicians current professional license.
B) An updated personal W-9 form (please ensure the required information is typed).
C) Proof of current qualified educational loan balance (screenshots of online account with qualifying lender).
- Before submitting the application, review all of the information for accuracy.
- Contact program staff if you have submitted an application and need to make changes. Do not submit another application. Duplicate applications will not be processed.
Proceed to Site Application
Proceed to Provider Application
5. UPW Reporting
For Physicians:
Physician Quarterly Reports
- Quarterly Work Reports are required per the grant agreement.Quarterly Work Report
Quarterly Report Part 1: Please indicate your name, e-mail address, specialty, site name, report year, report quarter (select the three month period this report covers) and any hours off you have taken during the quarter (including vacation, holidays, sick days, extended leave or any other time not spent providing services).
Quarterly Work Report Part 2: Please select the practice location(s) where you provide primary care services as well as the total number of hours worked and the number of direct patient care hours worked each week at the approved location.
Reminder: Full-time primary care physicians are required to work at least 40 hours a week, with 32 of those being direct patient care. Half-time providers are required to work at least 20 hours a week with at least 16 of those being direct patient care. Emergency room phycians and general surgeons must work a minimum of 32 hours a week providing direct patient care. When submitting your report, please include all of your hours and specify which hours are spent performing direct patient care.
Quarterly Work Report Part 3: Upload a file (screenshot from account with qualified lender) documenting the proof of quarterly educational loan payment(s). This may also be completed separately under “Physician Files.”
- Proceed to your Quarterly Work Report. Click on “Physician Quarterly Report.”
- Complete the quarterly report form and click the "Submit" button.
- Program staff at the Center for Rural Health will review each report. Upon review, the applicant will receive a confirmation e-mail. If additional information is needed, the grantee will be notified via e-mail.
For Sites:
Site Quarterly Reports
- Site Quarterly Reports are required per the grant agreement.
Site Quarterly Report Part 1: Please select the site name for the approved SLRP grant. Next, indicate the site contact name, site contact e-mail, physician name, report year, and report quarter.
Site Quarterly Report Part 2: Upload a file (photocopy of the cancelled check) documenting the proof of UPW payment to the physician for services provided during the selected quarter. This may also be completed separately under “Site Files.
- ”Proceed to Site Quarterly Report. Click on “Site Quarterly Report.”
- Complete the quarterly report form and click the "Submit" button.
- Program staff at the Center for Rural Health will review each report. Upon review, the site contact will receive a confirmation e-mail. If additional information is needed, the grantee will be notified via e-mail.
6. UPW File Submission
Applicants and UPW Participants (Sites and Physicians) may submit single file uploads through the File Submission interface. The file types are listed below.
For Physicians:
Required File Types for Physicians Include a typed and signed form W-9, copy of Professional License, proof of Current Loan Balance, signed Grant Agreement, provider’s Lump Sum Loan Payment, provider’s Quarterly Loan Payment, and Amendments (if applicable).
- When submitting a file, please include your name, contact information, site name, report year, and report quarter (if payment is a quarterly payment). Additionally, please indicate the file type and file name that you will be uploading.
- Locate the file document you wish to submit.
- Select the file and click “Physician Files.”
- Upload the file form and click the "Submit" button.
- Program staff at the Center for Rural Health will review each file. Upon submission, the applicant/grantee will receive a confirmation e-mail. If additional information is needed, the applicant/grantee will be notified via e-mail.
For Sites:
Required File Types for Sites may include a W-9, Signed Grant Agreement, Site's Cancelled Checks, or an Amendment.
- When submitting a file, please include the site contact name, site contact information, and site name. Additionally, please indicate the file type and file name that you will be uploading.
- Locate the filed document you wish to submit.
- Select the file and click “Site Files.”
- Upload the file form and click the "Submit" button.
- Program staff at the Center for Rural Health will review each file. Upon submission, the applicant/grantee will receive a confirmation e-mail. If additional information is needed, the applicant/grantee will be notified via e-mail.
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