USDA J-1 Visa Residency Waiver Program

SUBJECT: USDA J-1 Visa Residency Waiver Program

TO: Interested Parties

FROM: Richard S. Soper
Assistant Administrator

Enclosed are the U.S. Department of Agriculture's J-1 visa waiver request guidelines and policy statement. These revised guidelines will become effective May 1, 1995. Requests containing all the required documentation received before that date will be processed under the current program guidelines.

Further information and guidance can be obtained by providing your questions in writing by mail or FAX (301) 504-5298. Please address your inquiries to:

Linda Seckel
Program Manager
J-1 Visa Residency Waiver Program
Building 005, BARC West
10300 Baltimore Boulevard
Beltsville, MD 20705-2350

Enclosure

USDA Program Policy Waiver of J-1 Visa Residency Requirements for International Medical Graduates

Background

J-1 (educational visitor) visas are authorized by 8 U.S.C.A. 15(J)(1) to permit certain foreign nationals -- i.e., "aliens" -- e.g. a student, scholar, trainee, teacher, professor, research assistant, specialist, or leader in a field of specialized knowledge or skill, to enter the U.S. temporarily to participate in a program approved by the United States Information Agency (USIA), for the purpose of teaching, instructing, lecturing, studying, observing, conducting research, consulting, demonstrating special skills, or receiving training. During the 94th Congress (1975-76), the code was amended (P.L. 94-484, sec 601(b)(4) to include an alien coming to the U.S. to participate in a program under which the alien receives graduate medical education or training, if certain other statutory requirements are met, including the commitment to return to the country of nationality or last residence upon completion of the education or training, for a period of not less than two years, before re-entering the U.S. This program addresses the circumstances under which this requirement may be waived to permit, in coordination with appropriate state authorities, foreign national physicians who complete their training in the United States to practice primary care medicine in medically underserved, rural areas of the United States immediately following their course of training.

By law, if the director (of USIA), upon request of an interested U.S. government agency, favorably recommends the waiver, the two-year foreign residency requirement may be waived by the Immigration and Nationality Service (INS). (Note that any federal agency may act as an "interested government party".) The Secretary of Agriculture has determined that, in appropriate cases, USDA may act as the "interested government party" requesting USIA to approve waivers for sponsored foreign nationals, who are physicians, and who sign employment contracts to serve in "medically-underserved" rural areas of the U.S., provided they fulfill certain other basic criteria. Because of its experience administering J-1 visa requests for agricultural research scientists, the authority to process J-1 visa waiver requests for physicians serving rural, medically-underserved areas has been delegated to the office of the Under Secretary for Research, Education and Economics.

1994 changes in federal immigration law permit a State Department of Public Health to request up to 20 visa waiver requests per state per year, in lieu of an interested federal & government party. This authorization supplements the federal program, and may alleviate the shortage of physicians in a given area, but it does not displace the federal program. The State Department of Health (or equivalent agency) must keep track of all J-1 medical visa waivers, to determine the extent to which the shortage of physicians within a given rural region has been alleviated.

Since August 1994, applications originating from facilities within the territorial jurisdiction of the Appalachian Regional Commission (ARC) will be considered and processed by the ARC. USDA will not consider these applications. The counties within the thirteen states under the jurisdiction of the ARC are attached.

Definitions

For the purposes of this program, words shall have the following meanings:

"Rural": All counties described in the publication Butler, M.A. and C.L. Beale. 1994. "Rural-Urban Continuum Codes for Metro and Nonmetro Counties 1993." Agriculture and Rural Economy Division, Economic Research under 20,000 not adjacent to a metro area. These are listed as codes 7 and 9 (op. cit. p.1).

"Health Care Facility": A not-for-profit hospital or clinic. Requests from private practitioners and organizations which hire physicians to be contracted out to medical facilities will not be considered.

"Medically-underserved Area": USDA will accept requests for waivers that pertain to Health Professional Shortage Areas (HPSA) as determined and defined by HHS in the 1994 Federal Register 59 (14) 3412-3507, as superseded, if superseded. The HHS published data may be updated by information received for a State Department of Public Health reflecting prior approval of a J-1 visa waiver to serve in the area under consideration.

"Primary care physician": Includes qualified health care practitioners in the field of pediatrics, ob/gyn, internal medicine, family practice, general surgery, emergency medicine and general psychiatry.

Basic Qualifications

Waiver Request Initiation: Waiver requests to USDA must be initiated by either a U.S. health care facility intending to hire the physician, or a State Department of Public Health (or equivalent agency). Requests initiated directly by an applicant will be returned to the originating source.

Relationship to State Programs: The USDA program relies on State concurrence of physician placement within their jurisdiction. The State Department of Public Health, not the Federal Government, is in the best position to adjudge the need and advisability of the placement of a particular foreign doctor within a rural area of their state. An application which does not contain the concurrence of a State Department of Public Health (or equivalent agency) will be rejected.

Conditions of Employment: To qualify for a J-1 visa waiver request from USDA, the applicant must have a written employment contract for a period of not less than three years with a hospital, clinic, in which he/she agrees to work not less than 40 hours per week as a primary care physician in a medically-underserved rural area of the United States.

Waiver Package Contents

The package should be assembled in the order listed. Submit original and 1 unbound copy of entire package.

1. Letter from state health department stating they have reviewed the request and concur.

2. Letter from the medical care facility describing its program and the geographical area in which it is located, the critical need for the physician, and the effect of waiver denial.

3. Completed USIA data sheet.

4. Curriculum vitae and bibliography. Please do not include copies of publications.

5. An IAP-66 for each year physician has been in the U.S. Physicians must not be out of status more than 6 months at the time the request is submitted.

6. Proof that the area is a health professional shortage or medically-underserved area, and that it is a rural area as defined by this program.

7. Contract of employment with a health care organization which states that the physician agrees to work not less than 40 hours per week as a primary care physician for at least 3 years.

8. Letters from interested parties and letters of support, e.g. elected officials, businesses, citizens.

9. Letters or recommendation from those who know the physician and his/her work personally.

10. Proof of recruitment efforts, e.g. copies of advertisements, agreements with placement services, etc. Please do not include copies of articles outlining the shortage of health care professionals in the U.S.

11. Qualifications (copies of licenses, etc.) Physician should be qualified to obtain license in the state where he/she will practice.

Process

The Secretary of Agriculture has designated the Under Secretary for Research, Education and Economics as the agency responsible for processing applications. Further details for preparing an application will be provided by J-1 Visa Residency Waiver Program, USDA, ARS, 10300 Baltimore Blvd., BARC West, Building 005, Room 320, Beltsville, Maryland 20705 (FAX 301-504-5298; Voice 301-504-6543).

Responsibility of Applicant

1. You are responsible for locating and negotiating a contract for a minimum of 3 years to serve as a primary care physician in an underserved rural area. The listings of Health Professional Shortage Areas (HPSA) can be found at the public library in the Federal Register (January 21, 1994) 59(14):3412-33507 or any superseding determination). Those counties that are considered rural, i.e. population less than 20,000, listed in the "Continuum Codes for Metro and Nonmetro Counties, 1993" as category 7 or 9 qualify for the USDA program (see definitions above).

2. You must obtain the concurrence of the State Department of Public Health, or its equivalent in the State where you have secured a job.

3. Prepare the waiver package as outlined above.

4. Submit the package to the State agency for initial processing, if required. Currently Georgia, Ohio, Mississippi and New York require that requests be submitted to the State Health Department for review.

5. Confirm the State Department of Public Health, or its equivalent, is supportive of your application, and include this in your packet (item #1 on Waiver Package Contents).

6. Give Waiver Package to your proposed employer for submission to USDA.

Responsibility of USDA

1. USDA does not accept applications directly from the applicant. These must come through either a U.S. health care facility or a State Department of Public Health, or equivalent, as discussed above.

2. Review the package to insure all documents are in order.

3. Recommend action to the Under Secretary who has the authority to act on behalf of USDA as the interested party. From receipt of the completed package to decision by the Under Secretary takes at least 30-45 days.

4. If the request is supported, the case file, along with necessary support letter from USDA, are sent to the U.S. Information Agency (USIA). USIA checks with the organization that signed the IAP-66 (Certificate of Eligibility for Exchange Visitor J-1 Status) bringing the alien into the United States and with the country of residence. If these organizations have no objections to granting a waiver, and the case has all necessary documents, USIA will forward the package to Immigration and Naturalization Service (INS) with a favorable recommendation. This process can take up to 90 days. INS processing can take a considerable time. The total elapsed time from submission to the State to final action by INS may be 3 to 6 months.

5. The USDA does not approve the waiver, it only assures the documents are in order and the waiver request fits USDA policy. The request if then forwarded to USIA with a recommendation that they consider action on the case.

6. USDA does not process any applications that fall within the Appalachian Regional Commission's jurisdiction.

7. USDA does not have information on medical facilities seeking physicians.

USIA Data Sheet

1. Full name:

2. Date of birth:

3. Country of nationality of last legal permanent residence.

4. Date and place of issuance of original exchange visitor (J-1) visa.

5. Present address:

Immigrant District:

6. Home phone:
Business phone:

7. List of exchange visitor programs in which you have participated. If known, give the program number. Also include field of specialization.

8. Alien Registration Number, if known:

9. If your exchange visitor program includes funding from the U.S. government, your owngovernment or an international organization, please give full particulars concerning thefunding:

10. Is your spouse in J-1 status? _____ If so, is he/she also applying for a waiver? (Please give full explanation.)

11. Give the reasons for not wishing to fulfill the 2-year home-country residence requirement to which you agreed at the time you accepted exchange visitor status. (Use additional sheet if needed.)

12. Please include copies of all IAP-66's issued you during your stay in this country.

Signature
Date

ARC STATES & COUNTIES

ALABAMA

Bibb
Blount
Calhoun
Chambers
Cherokee
Chilton
Clay
Cleburne
Colbert
Coosa
Cullman
DeKalb
Elmore
Etowah
Fayette
Franklin
Jackson
Jefferson
Lamar
Lauderdale
Lawrence
Limestone
Madison
Marion
Marshall
Morgan
Pickens
Randolph
St. Clair
Shelby
Talladega
Tallapoosa
Tuscaloosa
Walker
Winston

GEORGIA

Banks
Barrow
Bartow
Carroll
Chatoosa
Cattooga
Dade
Dawson
Douglas
Fannin
Floyd
Forsyth
Franklin
Gilmer
Gordan
Gwinnett
Habersham
Hall
Haralson
Heard
Jackson
Lumpkin
Madison
Murray
Paulding
Pickens
Polk
Rabum
Stephens
Towns
Union
Walker
White
Whitfield

KENTUCKY

Adair
Bath
Bell
Boyd
Breathitt
Carter
Casey
Clark
clay
Clinton
Cumberland
Elliott
Estill
Fleming
Floyd
Garrard
Green
Greenup
Harlan
Jackson
Johnson
Knott
Knox
Laurel
Lawrence
Lee
Leslie
Letcher
Lewis
Lincoln
McCreary
Madison
Magoffin
Martin
Menifee
Monroe
Montgomery
Morgan
Owsley
Perry
Pike
Powell
Pulaski
Rockcastle
Rowan
Russell
Wayne
Whitley
Wolfe

MARYLAND

Allegany
Garrett
Washington

MISSISSIPPI

Alcorn
Benton
Calhoun
Chickasaw
Choctaw
Clay
Itawamba
Kemper
Lee
Lowndes
Marshall
Monroe
Noxubee
Oktibbeha
Pontotoc
Prentiss
Tippah
Tishomingo
Union
Webster
Winston

NEW YORK

Allegany
Broome
Cattaraugus
Chautaugua
Chemung
Chenango
Cortland
Delaware
Otsego
Schoarie
Schuyler
Steuben
Tioga
Tompkins

NORTH CAROLINA

Alexander
Alleghany
Ashe
Avery
Buncombe
Burke
Caldwell
Cherokee
Clay
Davie
Forsyth
Graham
Haywood
Henderson
Jackson
McDowell
Macon
Madison
Mitchell
Polk
Rutherfold
Stokes
Surry
Swain
Transylvania
Watauga
Wilkes
Yadkin
Yancey

OHIO

Adams
Athens
Belmont
Brown
Carroll
Columbiana
Clemont
Coshocton
Gallia
Guernsey
Harrison
Highland
Hocking
Holmes
Jackson
Jefferson
Lawrence
Meigs
Monroe
Morgan
Muskingum
Noble
Perry
Pike
Ross
Scioto
Tuscarawas
Vinton
Washington

PENNSYLVANIA

Allegheny
Armstrong
Beaver
Blair
Bedford
Bradford
Butler
Cambria
Cameron
Carbon
Centre
Clarion
Clearfield
Clinton
Columbia
Crawford
Elk
Erie
Fayette
Forest
Fulton
Green
Huntingdon
Indiana
Jefferson
Juiata
Lackawanna
Lawrence
Luzerne
Lycoming
McKean
Mercer
Mifflin
Monroe
Montour
Northumberland
Perry
Pike
Potter
Schuylkill
Snyder
Somerset
Sullivan
Susquehanna
Tioga
Union
Venengo
Warren
Washington
Wayne
Westmoreland
Wyoming

SOUTH CAROLINA

Anderson
Cherokee
Greenville
Oconee
Pickens
Spartanburg

TENNESSEE

Anderson
Bledsoe
Blount
Bradley
Campbell
Cannon
Carger
Claiborne
Clay
Cocke
Coffee
Cumberland
DeKalb
Fentress
Franklin
Grainger
Greene
Grundy
Hamblen
Hamilton
Hancock
Hawkins
Jackson
Jefferson
Johnson
Knox
Loudon
McMinn
Macon
Marion
Meigs
Monroe
Morgan
Overton
Pickett
Polk
Putnam
Rhea
Roane
Scott
Sequatchie
Sevier
Smith
Sullivan
Unicoi
Union
VanBuren
Warren
Washington
White

VIRGINIA

Allegheny
Bath
Bland
Botetourt
Buchanan
Carroll
Craig
Dickerson
Floyd
Giles
Grayson
Highland
Lee
Pulaski
Russell
Scott
Smyth
Tazewell
Washington
Wise
Wythe

WEST VIRGINIA

Barbour
Berkeley
Boone
Braxton
Brooke
Cabell
Calhoun
Clay
Doddridge
Fayette
Gilmer
Grant
Greenbrier
Hamsphire
Hancock
Hardy
Harrison
Jackson
Jefferson
Kanawha
Lewis
Lincoln
Logan
McDowell
Marion
Marshall
Mason
Mercer
Mineral
Mingo
Monongalia
Monroe
Morgan
Nicholas
Ohio
Pendleton
Pleasants
Pocahontas
Preston
Putnam
Raleigh
Randolph
Ritchie
Roane
Summers
Taylor
Tucker
Tyler
Upshur
Wayne
Webster
Wetzel
Wirt
Wood
Wyoming

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