J-1 Visa Waiver Program (Conrad 30) July 26, 2018 45 th Annual Arizona Rural Health Conference Ashley Neves Workforce Health Planning Consultant
Arizona Department of Health Services Arizona State Hospital Division of Public Health Services Division of Policy and Operations Public Health Prevention Public Health Preparedness Licensing Services Women's & Children's Health Nutrition and Physical Activity Tobacco and Chronic Disease Epidemiology & Disease Control Public Health Emergency Preparedness Emergency Medical Services & Trauma System State Laboratory Services Medical Marijuana Program Smoke-Free Arizona AZ Care Check Online Complaint Forms Residential Facilities Childcare Providers Long Term Care Providers Medical Facilities Special Licensing
Core Function: Primary Care Office Serves as the Primary Care Office for Arizona Develops and implements strategies for strengthening primary care and health care delivery system Administers programs to increase the number of providers and improve services in underserved areas Identifies areas that need improved health services and assist with federal/state shortage designations Provides technical assistance to statewide partners
J-1 Visa Wavier Program Workforce Programs National Interest Waiver Program Arizona State Loan Repayment Program (SLRP) National Health Service Corps Provide technical assistance for the Scholarship Programs and Loan Repayment Program Nurse Corps Provide technical assistance for the Scholarship Programs and Loan Repayment Programs
Agenda Understanding the benefits of the J1 Visa Waiver Program Learning the basic program requirements and expectations Understand program application time frames for better recruitment planning and coordination Identifying tools to help recruit J1 physicians
Goal of the J-1 Program Improving the accessibility of health care services in rural underserved areas in Arizona.
Problem People who are uninsured, low-income, members of racial and ethnic minority groups, or living in rural or inner-city areas are likely to lack a usual source of care. Arizona is facing a statewide provider shortage especially in rural areas.
Problem 605 Physicians to eliminate 187 primary care HPSAs 456 Dentists to eliminate 183 dental HPSAs 233 Psychiatrists to eliminate 176 mental HPSAs
What is a J1 Visa? AZ J1 Visa Waiver Program (Conrad 30 Program) Temporary, Nonimmigrant Status Clinical Resident or Fellow Duration limited to seven years Limited exclusively to Graduate Medical Education (i.e., no moonlighting) Spouse is able to work Mandatory, across-the-board, two-year home residence obligation
AZ J1 Visa Waiver Program (Conrad 30 Program) RELEVANCE OF TWO-YEAR HOME RESIDENCE OBLIGATION: Disqualifies J-1 from H-1B visa and/or permanent residence status unless: Obtains Waiver of obligation; or Returns to home country for two years J-1 WAIVER OPTIONS: Interested Governmental Agency (IGA) State Department of Health Exceptional Hardship Persecution
Roles of those Involved Know the players: States Federal Government Employers Physicians ROLE OF STATES: J-1 Waiver Recommendations Physician Need Statement for NIW Monitoring ROLE OF FEDERAL GOVERNMENT: Final J-1 Waiver Approval Adjudicating H-1B Petition Adjudicating Permanent Residence (Green Card) ROLE OF EMPLOYER: J-1 Waiver Application Filing H-1B Petition Sponsoring Permanent Residence ROLE OF PHYSICIAN: Assure site is in designated MUA/HPSA Knowledge of program expectations including reporting requirements Adhere to state and federal policy
Advantages Community Improve access to care Physician Pathway to citizenship (Green Card) Don t have to return to their home country Employer Three year commitment is required with a possible two year extension if pursuing National Interest Waiver Provider cannot move unless there are extenuating circumstances Cost savings Two J1 physicians are allowed per site per year Recruitment and Retention tool
Physician Eligibility Be licensed or eligible for an AZ medical License Primary Care Providers Family Medicine General Internal Medicine Obstetrics/Gynecology Pediatrics Hospitalists Psychiatrists Specialists (when an exceptional need for the specialty is substantiated) Providing services in a federally designated primary and mental HPSA, MUA, or MUP Have a valid offer of full-time employment and contract to work at an eligible service site for at least 3 years. (40 hours per week or 160 hours per month)
Service Site Eligibility Health Professional Shortage Area (HPSA) or federally designated Medically Underserved Area or Population (MUA/P) Accept all patients regardless of their ability to pay Accept State Medicaid (AHCCCS) and Medicare Charge patients at the usual and prevailing rates in the area Provide services to those who have no health insurance coverage Use a sliding fee schedule for all patients who are uninsured and at or below 200% of Federal Poverty Guidelines. Post a notice of discount Have proof of unsuccessful recruitment efforts of a US citizen physician for at least 6 months prior to the J-1 application submission. Have been operational and providing care for at least 6 months as of the date of the request Have the financial means to support the J-1 physician for at least 3 years (salary, benefits and malpractice insurance expenses)
Timeframes AZ Department of Health Services (ADHS) Processing Time Application period opens October 1 st of each year Application period closes November 30 th of each year 8-12 weeks to review Department of State (DOS) Processing Time 4-6 weeks U.S. Citizenship & Immigration Services (USCIS) Processing Time 2-6 weeks Total processing time: 3.5-6 months
Waiver Slots 30 available slots each federal fiscal year October 1 through November 30 22 slots Primary Care Physicians or Psychiatrists 7 slots for specialists 1 discretionary slot If slots remain available at the end for the first application period, the program will begin accepting applications for its second cycle and again for a third cycle.
Application Process A J-1 applicant must submit: 1. Application (notarized) 2. Service Site Application (notarized) 3. Supporting Documentation All forms can be found on our website at: https://www.azdhs.gov/prevention/health-systemsdevelopment/workforce-programs/j-1-visawaiver/index.php#applications-process
Supporting Documents DS-3035 Review Application Form, Data Sheet A letter from the head of the organization that wishes to hire the J-1 physicians Signed valid contract of full time employment Evidence the facility is in a HPSA, MUA, or MUP Physicians IAP-66/DS-2019 forms Resume / CV G-28 Form Description of the J-1 Physician s proposed responsibilities and schedule Documentation demonstrating unsuccessful recruitment efforts for at least 6 months or longer prior to submitting the application. Physician Application Service Site Application (one for each site) Sliding Discount- to Fee Schedule (SFS), policy/procedure, and SFS notice 3 letter of community support on letterhead Copy of Physician s license or license application *** all documents must have the case number on it.
Where to Submit J-1 Visa Waiver Program Manager Bureau of Women s and Children s Health Arizona Department of Health Services 150 N. 18th Avenue, Suite 320 Phoenix, AZ 85007 **We will not accept any documents via email.
Tracking the Service Signatures must be notarized. Submitted to ADHS quarterly Reporting Period January March April June July September October - December To be submitted by the 10 th business day: April July October January
https://www.3rnet.org/ Is a national, non-profit organization that works to improve rural and underserved communities access to qualify healthcare through: Recruitment of physicians and other healthcare professionals, Development of community-based recruitment and retention activities, and National advocacy relative to rural and underserved healthcare workforce issues.
ARIZONA PRIMARY OFFICE CONTACT INFORMATION Patricia Tarango, Bureau Chief, Bureau of Women s and Children s Health, ADHS Email: Patricia.Tarango@azdhs.gov Phone: (602) 542-1436 Ana Lyn Roscetti, Workforce Section Manager, Bureau of Women s and Children s Health, ADHS Email: ana.lyn.roscetti@azdhs.gov Phone: (602) 542-1066 Ashley Neves, Workforce Health Planning Consultant, Bureau of Women s and Children s Health, ADHS Email: ashley.neves@azdhs.gov Phone: (602) 542-1211 Tracy Lenartz, Designations Specialist/Health Planning Consultant Email: Tracy.Lenartz@azdhs.gov Phone: (602) 542-1772
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