Agencies | Governor
Virginia Regulatory Town Hall

Proposed Text

Action:
Amend Regulations Following Periodic Review
Stage: Proposed

Part I
Definitions

12VAC5-520-10. Definitions.

The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Accredited dental school" means any dental school in the United States receiving accreditation from the Commission on Dental Accreditation.

"Accredited residency" means an advanced dental education program in general or specialty dentistry accredited by the Commission on Dental Accreditation and approved by the American Dental Association.

"Board" or "Board of Health" means the State Board of Health.

"Commissioner" means the State Health Commissioner.

"Dental practice" means the practice of dentistry by a recipient in general or specialty dentistry in a geographic area determined location within Virginia that is designated as a dental underserved area to be fulfillment of the recipient's scholarship or loan repayment obligation or practice as a dentist within a designated state facility.

"Dental student" means an individual who is studying the practice of general or specialty dentistry.

"Dental underserved area" means 1) a geographic area in Virginia designated by the State Board of Health as a county or city in which the ratio of practitioners of dentistry to population is less than that for the Commonwealth as a whole as determined by the commissioner or; 2) a dental health professionsprofessional shortage area using criteria described in Part II (12VAC5-520-80 et seq.) of this chapter. ; or 3) a designated state facility.

"Dentist loan repayment program" means the program established by § 32.1-122.9:1 of the Code of Virginia that allocates funds appropriated in conjunction with the dental scholarship program to increase the number of dentists in underserved areas of Virginia.

"Department" means Virginia Department of Health.

"Designated state facility" means practice as a dentist in a facility operated by the Virginia Department of Health, Virginia Department of Behavioral Health and Developmental Services, Virginia Department of Juvenile Justice, or the Virginia Department of Corrections.

"Full-time dental practice" means the practice of dentistry for an average of a minimum of 32 hours per week for 48 weeks per year excluding those exceptions enumerated in Part III (12VAC5-520-160 et seq.) of this chapter.

"Interest at the prevailing bank rate for similar amounts of unsecured debt" means the prime lending rate plus 2.0% as published in the Wall Street Journal on the first day of the month in which the decision to repay is communicated to the commissioner by the recipient or on the first day of the month that the commissioner determines the recipient to be in default the legal rate of interest pursuant to § 6.2-302 of the Code of Virginia.

"Loan repayment award" means an award paid to a dentist for dental school loans in an amount equivalent to the current in-state tuition and mandatory fees at Virginia Commonwealth University School of Dentistry, and for which the dentist is under a contractual obligation to repay through practice in an a dental underserved area or designated state facility. This amount may be capped at the discretion of the commissioner.

"Participant" or "Recipient" means an eligible applicant who enters into a contract with the commissioner and participates in the scholarship or loan repayment program.

"Practice of general or specialty dentistry" means the evaluation, diagnosis, prevention and treatment (nonsurgical, surgical or related procedures) of diseases, disorders and conditions of the oral cavity, maxillofacial and adjacent and associated structures and their impact on the human body.

"Restitution" means three times the award amount received plus interest at the prevailing bank rate for similar amounts of unsecured debt as set forth in this regulation, owed to the Commonwealth of Virginia by a scholarship or loan repayment recipient who is in default of his contractual obligation as provided for in this chapter.

"Scholarship award" means an amount equivalent to one year of in-state tuition and mandatory fees at Virginia Commonwealth University School of Dentistry for the academic year a student is enrolled and for which the dental student entered a contractual obligation to repay through practice in an a dental underserved area or designated state facility. This amount may be capped at the discretion of the commissioner.

"Scholarship recipient" means an eligible dental student who enters into a contract with the commissioner and receives one or more scholarship awards from the Virginia Dental Scholarship Program.

"Specialty dentistry" means the advanced practice of dentistry in any specialty approved by the American Dental Association and accredited by the Commission on Dental Accreditation.

12VAC5-520-20. Administration of program. (Repealed.)

The State Health Commissioner, as executive officer of the Board of Health, shall administer this program. Any requests for deviation from the prescribed definitions shall be considered on an individual basis by the board in regular session.

Part II
Dental Underserved Area

12VAC5-520-80. Population and dentist data.

In order to determine the population-to-dentist ratio, the commissioner shall:

1. Use the population data or projections from the United States Census for independent cities, counties and counties with independent cities within their boundaries;

2. Determine the number of practitioners of dentistry from data secured from the Virginia State Board of Dentistry and the American Dental Association, adjusting for those dentists licensed in Virginia but practicing in other states, the military and retired dentists with active licenses;

3. Calculate this ratio every five years; and

4. Include as dental underserved areas those cities and counties determined to be dental health professions shortage areas as defined by the Department of Health and Human Services or designated a federal shortage area for the practice of dentistry as outlined in 42 CFR 5.142 CFR 5.2.

Part III
Scholarship and Loan Repayment Awards

12VAC5-520-130. Eligible applicants.Eligibility for scholarships and loan repayment awards.

A. Any currently enrolled dental student in good standing and full-time attendance at Virginia Commonwealth University School of Dentistry who has not entered the first year of an accredited residency shall be eligible for the Virginia Dental Scholarship Program. Preference for the scholarship award shall be given to residents of the Commonwealth, students who are residents of a dental underserved area, and students from economically disadvantaged backgrounds.

B. Any graduate of an accredited dental school in the United States who is establishing a practice in general or specialty dentistry in an underserved area or practicing dentistry in a designated state facility shall be eligible to apply for the Virginia Dentist Loan Repayment Program. General practice dentists will be within five years of graduation from an accredited undergraduate dental program and have existing loans accumulated as a result of their undergraduate dental program. Specialty practice dentists will be within five years of completion of their specialty training and have existing loans accumulated as a result of their undergraduate dental program. Dentists who received Virginia scholarship awards or other scholarships that paid their full tuition and fees are not eligible for the Dentist Loan Repayment Program for the years they received those awards.

A. In order to be considered for the Virginia Dental Scholarship Program, an applicant shall:

1. Be a United States citizen, a United States national, or a qualified alien pursuant to 8 USC § 1621;

2. Be currently enrolled, in good standing with a cumulative GPA of at least 3.0 and attend the Virginia Commonwealth University School of Dentistry;

3. Not have entered the first year of an accredited residency;

4. Demonstrate financial need, which is verified by the school’s financial aid officer or authorized person as part of the application process;

5. Submit a completed application form and appropriate grade transcript prior to the established deadline dates; and

6. Preference for scholarships shall be given to:

a. Bona fide residents of Virginia as evidenced by being domiciled in the Commonwealth for at least one year as defined by § 23.1-502 of the Code of Virginia; and

b. Students who are residents of a dental underserved area, and students from economically disadvantaged backgrounds.

B. In order to be considered for the Virginia Dentist Loan Repayment Program, an applicant shall:

1. Be a United States citizen, a United States national, or a qualified alien pursuant to 8 USC §1621;

2. Be a graduate of an accredited dental school in the United States;

3. Be establishing a practice in general or specialty dentistry in a dental underserved area;

4. Be a general practice dentist within five years of graduation from an accredited dental program or a specialty practice dentist within five years of completion of specialty training;

5. Have existing loans accumulated as a result of the applicant’s dental program;

6. Not have received Virginia scholarship awards or other scholarships that paid the applicant’s full tuition and fees; and  

7. Submit a completed application form prior to the established deadline dates.

8. Preference shall be given to Virginia Commonwealth University School of Dentistry graduates.

12VAC5-520-140. Scholarship and loan repayment award. (Repealed.)

A Virginia dental scholarship or loan repayment shall be awarded to the recipient upon or following the recipient's execution of a contract with the commissioner for scholarship or loan repayment by practicing dentistry in an underserved area or designated state facility as defined in this chapter.

12VAC5-520-150. Distribution of scholarships and loan repayment awards.Number of applications per student, amount of scholarships, and selection criteria.

The Virginia General Assembly establishes the total combined appropriation for the dental scholarship and dentist loan repayment programs. Funds shall be awarded for these programs based on the following criteria:

1. The governing board of Virginia Commonwealth University School of Dentistry shall use the application procedure established by the commissioner and annually submit the names of qualified students to receive scholarships in accordance with the criteria for preference enumerated in 12VAC5-520-130. The total number of scholarship awards willshall be based on availability of funds. Scholarship awards willshall be made annually by October 30 to third-year and fourth-year dental students. First-year and second-year students willshall be considered for an award only in the event of extreme financial need. Individual scholarship recipients may receive a maximum of five scholarship awards.

2. The application period for the Dentist Loan Repayment Program willshall begin in October with awards made by the end of each fiscal year. Preference for loan repayment awards willshall be given to graduates of Virginia Commonwealth University School of Dentistry. Individual loan repayment recipients may receive a maximum of four awards upon graduation from dental school. All awards willshall be competitive and will be based on availability of funds.

12VAC5-520-155. How to apply.

Eligible applicants shall submit a complete application made available by the department on the department’s website. A complete application shall include documentation of all eligibility requirements. The deadline for submission of the application shall be announced by the department on the department’s website.

12VAC5-520-160. Contractual practice obligation.Conditions of scholarships and contractual practice obligation.

A. Prior to the payment of money to becoming a scholarship or loan repayment recipient, the applicant shall enter into a contract with the commissioner shall prepare and enter into a contract with the recipient. The contract shall: agreeing to terms and conditions upon which the scholarship or loan repayment is granted.

1.Provide B. The contract shall provide that the recipient of the scholarship award shall pursue the dental course of Virginia Commonwealth University until graduation and upon graduation or upon graduation from an accredited residency program that does not exceed four years,. For each scholarship received, the participant agrees to engage in the equivalent of one year full-time dental practice in a dental underserved area of Virginia. The recipient shall notify the commissionerdepartment, in writing of his proposed practice location or intent to enter a residency not more than 30 days after graduation and begin his approved practice within 90 days after completing dental school or residency, and thereafter, within 180 days of graduation from the dental course of Virginia Commonwealth University or upon graduation from an accredited residency program that does not exceed four years, of the type of dental practice to be performed or intent to enter a residency. The notice shall include the name and address of the employer for approval. Thereafter the recipient shall continuously engage in full-time dental practice in a dental underserved area of Virginia or in a designated state facility for a period of years equal to the number of annual scholarships received. Dental practice in federal agencies, military service or the U.S. Public Health Service may not be substituted for scholarship obligation.

2. ProvideC. The contract shall provide that upon graduation from an accredited dental school and receiving notification of the dentist loan repayment award, the dentist shall begin his approved practice within 90180 days and thereafter continuously engage in. For each loan repayment received, the participant agrees to engage in the equivalent of one year full-time dental practice in an a dental underserved area of Virginia or in a designated state facility for a period of years equal to the number of loan repayment awards receiveddesignated by the Board of Health.

3.ProvideD. The contract shall provide that at any time prior to entering practice, the scholarship or loan repayment recipient shall be allowed to select a future practice location from the listing of dental underserved areas maintained by the board.

4.ProvideE. The contract shall provide that the recipient may request approval of a change of practice location. The commissioner in his discretion may approve such a request, but only if the change is to a practice location in a dental underserved area or a state facility designated by the Board of Health.

5. ProvideF. The contract shall provide that the recipient shall repay the scholarship or loan repayment obligation by practicing dentistry on a full-time basis in a dental underserved area, shall maintain office hours convenient for the population of the area to have access to the recipient's services and shall participate in all government-sponsored insurance programs designed to ensure access to dental services of recipients of public assistance, including but not limited to programs established pursuant to §§ 32.1-325 and 32.1-351 of the Code of Virginia. The recipient shall not selectively place limits on the numbers of such patients admitted to the practice.

6. ProvideG. The contract shall provide that the scholarship recipient shall not voluntarily obligate himself for more than the minimum period of military service required of dentists by the laws of the United States and that upon completion of the minimum period of military service, the recipient shall promptly begin and thereafter continuously engage in full-time dental practice in a dental underserved area of Virginia or in a designated state facility for the period of years equal to the number of scholarships received. Dental practice in federal agencies, military service or the U.S. Public Health Service may not be substituted for scholarship obligation.

7. Provide that the recipient shall receive credit toward fulfillment of his contractual obligation at the rate of 12 months of dental practice for each scholarship or loan repayment award paid to the recipient. The recipient may be absent from the place of approved practice for a total of four weeks in each 12-month period for personal reasons. Absence for a period in excess of four weeks without the written permission of the commissioner shall result in proportional reduction of the period of credit toward fulfillment of the contractual obligation.

8. Provide that should the scholarship recipient pay restitution by not serving his scholarship obligation in an underserved area, and within five years of paying restitution fulfills the terms of his contract through dental practice as outlined in this section, that the recipient will be reimbursed for all or part of any scholarship award paid based on the fulfillment of the scholarship and availability of funds.

H. Absence for a period in excess of four weeks without the written permission of the commissioner shall result in proportional reduction of the period of credit toward fulfillment of the contractual obligation.

Part IV
Special Requests

12VAC5-520-170. Special requests for approval.

Special requests for approval of the practice of dentistry in an area in which the ratio does not meet the definition of an area of needa dental underserved area shall be considered by the Board of Health on an individual basis. To obtain the board's approval, the scholarship or loan repayment recipient shall substantiate to the board's satisfaction that the ratio does not correctly depict the provision of dental services in the city or county and that additional practitioners are necessary. Examples of situations deserving special consideration may include topography, age or physical health of dental practitioners in the area, and sub-areas of high density population that can be geographically identified and shown to have a ratio less than the state ratio.

Part VI
Default Breach of Contract

12VAC5-520-190. Default.Breach of contract.

A. With respect to default, the contract shall provide that a scholarship or loan repayment recipient who fails to fulfill his obligation to practice dentistry as described in 12VAC5-520-160 shall be deemed in default under the following circumstances and shall forfeit all monetary scholarship or loan repayment awards made to him and shall repay the Commonwealth of Virginia as provided for in this chapter. The contract shall:

1. Provide that if the scholarship recipient defaults while still in dental school, by voluntarily notifying the commissioner in writing that he will not practice dentistry in a Virginia dental underserved area as required by his contract, by voluntarily not proceeding to the next year of dental education, or by withdrawing from dental school, the student shall pay the Commonwealth of Virginia all monetary scholarship awards plus interest at the prevailing bank rate for similar amounts of unsecured debt.

2. Provide that the scholarship recipient who defaults by failing to maintain grade levels that will allow the dental student to graduate, or by reason of his dismissal from dental school for any reason, shall repay the Commonwealth of Virginia all monetary scholarship awards plus interest at the prevailing bank rate for similar amounts of unsecured debt.

3. Provide that if the scholarship or loan repayment recipient is in default due to death or permanent disability so as not to be able to engage in dental practice, the recipient or his personal representative shall repay the Commonwealth all monetary awards plus 8.0% interest on the amount of the award. Partial fulfillment of the recipient's contractual obligation by the practice of dentistry as provided for in this contract prior to death or permanent disability shall reduce the amount of repayment plus interest due by a proportionate amount of money, such proportion being determined as the ratio of the number of whole months that a recipient has practiced dentistry in an approved location to the total number of months of the contractual obligation the recipient has incurred. The commissioner may waive all or part of the scholarship or loan repayment obligation under application by the recipient or his estate under these conditions and consider whole or partial forgiveness of payment or service in consideration of individual cases of hardship or inability to pay.

4. Provide that any recipient of a scholarship or loan repayment who defaults by evasion or refusal to fulfill the obligation to practice dentistry in an underserved area or designated state facility for a period of years equal to the number of annual scholarships or loan repayment awards received shall make restitution to the Commonwealth of Virginia.

B. A scholarship or loan repayment recipient will be considered to be in such default on the date:

1. The commissioner is notified in writing by the recipient that he does not intend to fulfill his contractual obligation;

2. The recipient has not accepted a placement and commenced his period of obligated practice as provided for in subdivisions 1 and 2 of 12VAC5-520-160; or

3. The recipient absents himself without the consent of the commissioner from the place of dental practice that the commissioner has approved for fulfillment of his contractual obligation.

A. A scholarship recipient shall be in breach of contract if:

1. The recipient fails to complete his dental studies;

2. The recipient fails to begin or complete the terms of obligated service under the terms and conditions of the scholarship contract;

3. The recipient falsifies or misrepresents information on the program application, the verification of employment forms, or other required documents; or

4. The recipient’s employment is terminated for good cause as determined by the employer and confirmed by the department. If employment is terminated for reasons beyond the participant’s control (e.g. closure of site), the participant shall transfer to another site approved by the board in the Commonwealth within six months of termination. Failure of participant to transfer to another site shall be deemed to be a breach of the contract.

B. A loan repayment recipient shall be in breach of contract if:

1. The recipient fails to begin or complete the term of obligated service under the terms and conditions of the loan repayment contract;

2. The recipient falsifies or misrepresents information on the program application, the verification of employment forms, or other required documents; or

3. The recipient’s employment is terminated for good cause as determined by the employer and confirmed by the department. If employment is terminated for reasons beyond the participant’s control (e.g. closure of site), the participant shall transfer to another site approved by the board in the Commonwealth within six months of termination. Failure of the participant to transfer to another site shall be deemed to be a breach of the contract.

12VAC5-520-195. Deferment and waivers.

A. For recipients completing part of the scholarship or loan obligation prior to becoming permanently disabled or in the event of death, the total amount of the funds owed plus applicable interest shall be reduced by the proportion of obligated years served. The obligation to make repayment and restitution may be waived by the board upon application of the participant or the participant’s personal representative to the board.

B. Individual cases of undue hardship may be considered for a variance by the board of payment or service pursuant to § 32.1-12 of the Code of Virginia.

C. All requests for deferments, waivers or variances must be submitted in writing to the department for consideration and final disposition by the board.

Part VII
Repayment

12VAC5-520-200. Repayment.

A. Repayment requirements for scholarship and loan repayment recipients are as follows:

1. Payment of restitution or repayment of award plus interest shall be due on the date that the recipient is deemed by the commissioner to be in defaultbreach of contract.

2. The commissioner in his discretion shall permit extension of the period of repayment for up to 24 months2 years from the date that the recipient is deemed to be in defaultcompletes postgraduate training or the recipient enters into the full-time practice of dentistry, whichever is later.

3. Partial fulfillment of the recipient's contractual obligation by the practice of dentistry as provided for in this the recipient’s contract shall reduce the amount of restitutionrepayment by a percentage based on the number of whole months that the recipient has practiced dentistry in an approved location and the total number of months of the contractual obligation the recipient has incurred.

4. Failure of a recipient to make any payment on his debt when it is due shall be cause for the commissioner to refer the debt to the Attorney General of the Commonwealth of Virginia for collection. The recipient shall be responsible for any costs of collection as may be provided in Virginia law.

B. A scholarship recipient who defaults while still in dental school by voluntarily notifying the commissioner in writing that he will not practice dentistry in Virginia as required by his contract shall repay the total amount of scholarship funds received plus interest to the Commonwealth of Virginia. A scholarship recipient who commits a breach of contract after graduation shall pay a penalty of three times the amount of all monetary scholarship awards paid to the scholarship recipient plus interest to the Commonwealth of Virginia.

12VAC5-520-205. Fulfillment after default payments.

In the event that a recipient, in accordance with the terms of the contract, fully repays the Commonwealth for part or all of any scholarship or loan repayment because of breach of contract and later fulfills the terms of the contract after repayment, the Commonwealth shall reimburse the award amount repaid by the recipient minus applicable interest and fees.

Part VIII
Records and Reporting

12VAC5-520-210. Reporting requirements.

A. Reporting requirements of Virginia Commonwealth University School of Dentistry scholarship and loan repayment recipients are as follows:

1. Virginia Commonwealth University School of Dentistry shall maintain accurate records of the enrollment and academic status of scholarship recipients until the recipient's graduation from dental school. The dental school shall provide a report listing the status of each recipient annually to the commissioner.

2. Each scholarship and loan repayment recipient shall at any time provide information as requested by the commissioner to verify compliance with the contractual practice requirements obligation of the scholarship or loan repayment contract.

B. The recipient shall report any changes of mailing address, change of academic standing, change of intent to fulfill his contractual obligation and any other information that may be relevant to the contract at such time as changes or information may occur. The recipient shall respond within 30 days with such information as may be requested by the commissioner. notify the department in writing within 30 days if any of the following events occur:

1. Recipient changes name;

2. Recipient changes address;

3. Scholarship recipient changes dental program;

4. Recipient changes practice site (a recipient is required to request in writing and obtain prior approval of changes in practice site);

5. Recipient no longer intends or is unable to fulfill service obligation as a dentist in the Commonwealth;

6. Recipient ceases to practice as a dentist; or

7. Scholarship recipient ceases or no longer intends to complete his dental program.