J-1 (ARC) Appalachian Regional Commission Waiver

Appalachian Regional Commission (ARC) J1 Visa Waiver for Doctors

The Appalachian Regional Commission (ARC) will recommend to the U.S. Department of State (DOS) that the two year home residency requirement be waived for foreign doctors in J1 status if certain criteria are met. The program is designed to serve 400 counties and 13 states that have a demonstrated need for physicians. The J1 visa waiver request must be sponsored by one of these states.

States that are included in the J1 Waiver ARC program

The following states are included in the 400 county program. However, not every county in these states participate in ARC.

Alabama
Georgia
Kentucky
Maryland
Mississippi
New York
North Carolina
Ohio
Pennsylvania
South Carolina
Tennessee
Virginia
West Virginia

Counties of Appalachia

Map of Appalachian Counties

Requirements for obtaining a J1 waiver recommendation from ARC

Physician’s Requirements

1. The J1 doctor must work three years in a rural Appalachian area with a minimum of 40 hours per week. You should note that travel time or on call time is not included in the 40 hour work week.
2. The area must be identified by the U.S. Public Health Service as a Health Professional Shortage Area (HPSA) and within the legislatively defined ARC service area. HPSA areas change and it is imperative that you confirm that you will be working in a HPSA area prior to filing your ARC application.
3. The J1 doctor must be licensed in the state where he or she will be practicing medicine. He or she must be licensed before starting employment with the ARC sponsor.
4. The physician must not have been out of status for more than 180 days since being granted J1 status.
5. The J1 physician must sign and notarize an affidavit of agreement (J1 Visa Waiver Affidavit and Agreement).
6. The J1 physician must have completed residency in one of the following areas:
   1. Family Practice
   2. Obstetrics
   3. General Internal Medicine
   4. Psychiatry
   5. General Pediatrics

Sponsor Requirements

1. The J1 waiver ARC sponsor must conduct reasonable, good faith recruitment for the job opportunity with the same salary during the six (6) months prior to the request for a waiver. As part of the good faith recruitment, the ARC sponsor must demonstrate that it attempted to recruit U.S. citizen physicians or lawful permanent physicians with comparable salaries through appropriate sources. Such recruitment sources may include, newspaper and medical journal advertisements, and notices at appropriate medical schools, including all medical schools in the state in which the hospital or clinic is located.
2. The ARC sponsor cannot use a restrictive covenant or non-compete clause which would discourage the doctor from working in the HPSA area subsequent to the doctors employment with the ARC sponsor.
3. The ARC sponsoring facility must provide health services to patients without discriminating based on their ability to pay for services or whether they are Medicare/Medicaid patients. The ARC facility may charge no more than the usual and customary rate prevailing in the HPSA in which services are provided, and must provide a sliding case of those who are 200% or below the poverty guideline.
4. The ARC sponsor must post a notice in a conspicuous location in the patient waiting area of the charges for service. This notice must also meet certain ARC specifications.
5. The sponsor must also demonstrate their recent record of serving and continuing intent to serve Medicare, Medicaid, and medically indigent patients.