I would like to wish all of you a Happy Diwali (festival of lights) for all of you who celebrate this holiday.

President Obama has a Diwali message for all of us.

Recently we obtained a no objection waiver for our Tanzanian client.

First we contacted the Tanzanian government via phone since there was no information on the website regarding the no objection statement. After a short while and a few explanations of the situation, we were routed through the offices and was connected with a Tanzanian Embassy representative who knew exactly what we were after.

 The most important thing on his list was who we wanted this information for!  We let the applicant remain anonymous and after being told that the applicant would have to call and get the procedure themselves, the representative rattled off a list of hurdles to cross and documents to send.

 The best part of the story is this: we prepared the J-1 waiver application, sent the documents to the US State Department and sent the package of documents required by Tanzania to the Embassy. We got a positive answer within two months!  It was amazing since processing times may be lengthy.  Neither the applicant nor our offices were contacted and asked for any additional documents so maybe getting it right the first time helped. But with nothing in writing from the Tanzanian government regarding their requirements (it evidently is not the Tanzanian way) it was dicey.  We’re glad it worked out and want you all to know that no matter how impossible it can seem to work with your government’s bureaucracy and our government’s bureaucracy the job can get done! 

-Kaushik Ranchod
Attorney at Law
Ranchod Law Group

President Obama recognizes the importance of the Conrad 30 program by signing Public Law 111-9, on March 20, 2009.

This extends the date until Sept. 30, 2009 by which international medical graduates have to have been granted J-1 nonimmigrant status in order to later qualify for the “Conrad 30” program. Before this latest extension was granted, the most recent sunset date for qualifying J-1 admission was March 6, 2009.

Under the “Conrad 30” program, each state health department may submit a request directly to the Department of State (DOS) to initiate the waiver process for a J-1 medical doctor. This request enables J-1 doctors to obtain a waiver of the two-year foreign residence requirement, if DOS submits a favorable recommendation to USCIS and will generally be granted as long as there are no underlying concerns.

Once the waiver is granted, J-1 doctors must practice medicine for at least three years in a medically underserved shortage area or areas. The Department of Health and Human Services designates the medical shortage areas.

The Conrad 30 (originally Conrad 20) program was originally established in 1994 to address the shortage of qualified doctors in medically underserved areas, and has been extended several times since then. In 2004, Congress amended the program to exempt J-1 doctors who received a Conrad 30 waiver from the annual H-1B numerical limitation (otherwise known as the “H-1B cap”), as these doctors must complete their required three-year period of service as H-1B nonimmigrants.

This current sunset date of Sept. 30, 2009, applies to the date the medical doctor originally entered theUnited States in J-1 status or received a change of status to J-1, to complete a residency program in the United States. Doctors who acquired J-1 status before Sept. 30, 2009, may pursue a waiver of the two year foreign residence requirement under the Conrad State 30 program, if they meet all the eligibility requirements.

Legislation, S.628, was proposed on March 18, 2009 to provide incentives to physicians to practice in rural and medically underserved communities.

This bill will make the J-1 visa waiver program permanent, and in doing so, amend the provisions that were previously imposed on H-1B practitioners, ultimately providing an expansion in the number of foreign physicians accepted each year to a specific state (i.e. make it more than 30).  Many states such as California and Texas use their 30 slots, demonstrating the need for physicians in underserved areas.

It has as four main sections. The first simply acknowledges that this initiative may also be referred to as “Conrad State 30 Improvement Act”. Section two eliminates the Sunset provision of the Conrad state 30 program by removing the section that reads “and before September 30, 2009” in the 1994 Immigration and Nationality Technical Corrections Act.

Section three proposes incentives for physicians to practice in medically underserved communities, by amending specific subsections of the original act, and Section four of the bill attempts to retain physicians in medically underserved communities.

Many physicians are contacting us to ascertain whether states have availability for their Conrad 30 programs.  Although some popular J1 Waiver Conrad 30 programs are no longer accepting applications including Texas and New York, many states are accepting applications for their J1 waiver programs.  Pennsylvania is currently accepting Conrad 30 J1 Waiver applications;  however, Pennsylvania may no longer have availability for their Conrad 30 program within the next two months.  On December 14, 2008 California had availability for 10 more Conrad 30 slots.  California has revised its Specialist policy and may accept applications on March 1, 2009 if the aforementioned primary care slots are not utilized.  Many states throughout the Midwest, Northeast and Northwest have availability for their J1 Waiver Conrad 30 Programs.  For instance, Maine has received one application and Washington has received 20 applications.  If you have questions about a particular state’s Conrad 30 J1 Waiver Program call our office at 415-986-6186.

There is still time to obtain a J-1 waiver.   Many states such as California that normally receive a large number of J-1 waiver applications are far from reaching their quota:  California has only received eight applications, Washington has received 4 applications, but Texas does not have any availability for their Conrad 30 Program.  (It is interesting to note that this year, Texas, one of the most popular Conrad 30 programs, did not fill all of their Conrad 30 slots on the first day, as they normally do).

There has been a significant decline in J-1 Waiver Conrad 30 applications this year due to the overall decline in the J-1 visa program.  In 2007 approximately 850 J-1 waiver applications were granted.  In contrast, in 2006 approximately 1000 J-1 waiver applications were granted.  The Wall Street Journal reports that “the number of foreign physicians with J-1 visas has decreased from 11,000 in 1995-1996 to 6,000 in 2005-2006″  (Jordan, Wall Street Journal, 2/16).  The popularity of the H-1B visa as an alterniative to the J-1 visa, and without the two year home residency requirement, is one of primary reasons that the popularity of the J-1 visa is in its decline.

However, the decline in J-1 waiver applications is a boon to physicians who have not applied for their J-1 waiver this year.

More information on the Conrad 30 Waiver page.

The President has approved new legislation that extends the Conrad 30 program.  This extension was critical to the survival of the Conrad 30 program.

This legislation has three subsections. Section one simply highlights the dates that are to be amended.

Section two targets to expand the flexibility of the Conrad state 30 program and implements this by changing the figure “5″ to “10″ in Section 214(1)(1)(D)(ii) of the aforementioned Act.  This section is advantageous since the new legislation expands the number of flex spots from 5 to 10.  Thus, a health care facility does not need to be in a Health Professional Shortage Area (HPSA) if a considerable number of patients from the HPSA are served at the health care facility.

Lastly, Section three accents the terms of the new waiver into two parts, the first of which states that federal programs granting the two year waivers for medical doctors are typically geared towards making sure these doctors practice in underserved areas, and the second of which emphasizes that the Secretary of Health and Human Services should consider the needs of vulnerable populations in low-income and impoverished communities, and communities with high infant mortality rates when determining whether or not a location qualifies as a HPSA.

This is the new bill that the President signed:

One Hundred Tenth Congress

of the

United States of America

AT THE SECOND SESSION

Begun and held at the City of Washington on Thursday,

the third day of January, two thousand and eight

An Act

To extend for 5 years the program relating to waiver of the foreign country residence

requirement with respect to international medical graduates, and for other purposes.

Be it enacted by the Senate and House of Representatives of

the United States of America in Congress assembled,

SECTION 1. EXTENSION OF WAIVER PROGRAM.

Section 220(c) of the Immigration and Nationality Technical

Corrections Act of 1994 (8 U.S.C. 1182 note) is amended by striking

‘‘June 1, 2008” and inserting ‘‘March 6, 2009”.

SEC. 2. EXPANDING THE FLEXIBILITY OF THE CONRAD STATE 30 PROGRAM.

Section 214(l)(1)(D)(ii) of the Immigration and Nationality Act

(8 U.S.C. 1184(l)(1)(D)(ii)) is amended by striking ‘‘5” and inserting

‘‘10”.

SEC. 3. SENSE OF CONGRESS.

It is the sense of the Congress that-

(1) Federal programs waiving the 2-year foreign residence

requirement under section 212(e) of the Immigration and

Nationality Act (8 U.S.C. 1182(e)) for physicians are generally

designed to promote the delivery of critically needed medical

services to people in the United States lacking adequate access

to physician care; and

(2) when determining the qualification of a location for

designation as a health professional shortage area, the Secretary

of Health and Human Services should consider the needs

of vulnerable populations in low-income and impoverished

communities, communities with high infant mortality rates,

and communities exhibiting other signs of a lack of necessary

physician services.

Speaker of the House of Representatives.

Vice President of the United States and

President of the Senate.

California has updated its policy regarding whether or not their program will consider applications from specialist physicians.  Specialist physcians may apply for a J-1 Conrad 30 waiver until September 30, 2008.

On September 3, 2008 Texas started to accept J-1 Waiver applications and as of September 4, 2008 Texas has 10 J-1 waiver slots available.

Primary care physicians, as defined by Federal Regulations, are physicians who practice internal medicine, pediatrics, OB/GYN, psychiatry, or family medicine.  Specialists may qualify for the Conrad 30 program depending upon the state’s policy.  Pursuant to Public Law 108-441 of the United States 108th Congress, December 3, 2004: states do have the option to consider if some of the 30 slots may be allocated to licensed and contracted specialist physicians.  Not all of the 50 states in the union exercise their option to allow specialists apply for the J-1 waiver.  For instance, California does not accept J-1 waiver applications for a doctor that practices specialty medicine.  However, in California, specialists may qualify for a J-1 waiver by working as a primary care physician.  In January 2009 California could change its policy regarding allowing specialists to apply for a J-1 waiver, if all of the J-1 waiver Conrad 30 slots are not utilized.

Based on the foregoing, it becomes apparent that if you are a specialist you should ensure that your potential employer is in a state that allows specialists to apply for the Conrad 30 waiver.