DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
Applications Available to Request Waiver of the Two-Year
Foreign
Residence Requirement for Physicians with J-1 Visa Who Will Deliver
Health Care
Service
ACTION: Notice of Availability of Applications.
SUMMARY: The HHS Exchange Visitor Program announces the availability
of
applications to request waiver of the two-year foreign residency requirement
for
physicians with J-1 visas who agree to deliver health care services for
three years in
primary care or mental health Professional Shortage Areas (HPSAs)
or medically
underserved areas or populations (MUA/Ps).
FOR ADDITIONAL INFORMATION CONTACT: Michael Berry, Bureau
of
Health Professions, 5600 Fishers Lane, Rm. 8-67, Rockville, MD 20857.
Telephone:
301-443-4154;
Fax: 301-443-7904; MBerry@HRSA.gov.
ADDRESSES: Applications to request waivers to deliver health
care services are
available at http://www.globalhealth.gov
and the Office of Global Health Affairs,
200 Independence Ave., SW., Room 639-H,
Washington, DC 20201.
Telephone: 202-690-6174; Fax: 202-690-7127.
SUPPLEMENTARY INFORMATION: On December 19, 2002, the Department
of
Health and Human Services (HHS) published in the Federal Register (67 FR
77692) an
interim-final rule amending the regulations at 45 CFR Part 50 governing
the HHS Exchange
Visitor Program. Under this program, HHS acts as an Interested
Government Agency (IGA)
to request waivers, on the Exchange Visitors’
behalf, of the two-year foreign residency
requirement. The amendments expanded
the programto permit institutions and health care
facilities to submit to HHS
requests for waiver of the two-year home-country physical
presence requirement
for physician Exchange Visitors to deliver primary health care services
in underserved
areas, in addition to waivers to perform research.
In determining whether to request a waiver for an Exchange Visitor to deliver
primary health
care services, HHS will consider information from and coordinate
with State Departments of
Public Health (or the equivalent), other IGAs, HHS
programs such as the National Health
Service Corps, and other relevant government
agencies.
HHS will process applications in the order received. Please note
that HHS will not
accept applications submitted by Exchange Visitors. Applications for waiver
requests
must be
submitted by private or non-federal institutions, organizations, or agencies
or
by a component agency of HHS.
In brief, the criteria for a waiver recommendation by HHS acting as an IGA
are as
follows:
1. Eligibility to apply for HHS waiver requests is limited to primary care physicians,
and
general psychiatrists who have completed their primary care or psychiatric
residency
training programs. Primary care physicians are defined as: physicians
practicing general
internal medicine, pediatrics, family practice or obstetrics/gynecology
and who are willing
to work in a primary care HPSA or MUA/P; and general psychiatrists
willing to work in a
Mental Health HPSA.
NOTE: The regulations restrict eligibility to primary care
physicians, and general
psychiatrists who have completed their primary care
or psychiatric residency training
programs no more than 12 months before the
date of commencement of employment
under the contract described below. 45 CFR
50.5(b). For applications submitted prior to
October 1, 2003, HHS will ease
this12-month eligibility condition to enable physicians
who completed their
training programs in June 2002 to be eligible to apply for a waiver.
Without
this modification, physicians who completed their training programs in June
2002
would be unable to begin employment by the required date, July 2003, and
thus would be
ineligible to seek waivers. Accordingly, for applications received
prior to October 1, 2003,
the physician seeking a waiver must have completed
a primary care or general
psychiatric residency no earlier than June 1, 2002.
2. The petitioning health care facility must establish that it has recruited
actively and in
good faith for U.S. physicians in the recent past, but has been
unable to recruit a
qualified U.S. physician.
3. The head of a petitioning health care facility must execute a statement
to confirm that
the facility is located in a specific, designated HPSA or MUA/P,
and that it provides
medical care to Medicaid and Medicare eligible patients
and the uninsured indigent.
4. The Exchange Visitor must execute a statement that he or she does not have
pending,
and will not submit, other IGA waiver requests while HHS processes
the waiver request.
5. The employment contract must require the Exchange Visitor to practice a
specific
primary care discipline or general psychiatry for a minimum of three
years, 40 hours
per week in a specified HPSA or MUA/P. It may not include a
non-compete clause
that limits the Exchange Visitor's ability to continue to
practice in any HHS-designated
primary care or mental health HPSA or MUA/P after
the period of obligation. The
contract must be terminable only for cause and
not terminable by mutual agreement until
completion of the three-year commitment,
except that the contract may
be assigned to another eligible employer, subject
to approval by HHS and consistent with
all applicable INS and Department of
Labor requirements.
Dated: June 5, 2003
William R. Steiger
Director, Office of Global Health Affairs
![[picture of globe - click to skip nav]](/peth04/20041016111242im_/http://www.globalhealth.gov/images/homeglobe.gif)
