Haley Clements, a nurse practitioner working at a rural clinic in Eufaula, Alabama, received a $25,000 loan repayment grant from the Department of Health and Human Services. After one of her supervisors died and the other retired, Clements was unable to find other qualifying work near Eufaula. She tried to return the full $25,000 award, but HHS refused to take the money, instead asking her to choose between moving out of state for a qualifying job or paying $217,500 in fines. Clements has three young children and supports her parents and in-laws in Eufaula, making a move impossible.

Clements argues the fine violates the U.S. Constitution's Excessive Fines Clause.

On September 26, 2024, HHS notified Ms. Clements that it had determined it would be against equity and good conscience to require her to pay her debt. For that reason, the agency waived in full her service obligation and the total amount of her debt, $237,535.20.