J-1 Delta Regional Commission Waiver - J1 Visa Waivers

J-1 Delta Regional Commission Waiver

Delta Regional Authority (DRA) J1 Visa Waiver for Doctors

woman-doc-three-asian.jpgDelta Regional Authority (DRA) may recommend to the U.S. Department of State (DOS) that the two year J1 visa home residency requirements be waived for foreign doctors in J1 status if they meet the Delta Doctors program’s requirements. This program is designed to serve 240 counties and 8 states in the Mississippi Delta Region that have a demonstrated need for physicians.

The following states are included in the 240 county program but not every county in these states are included in the DRA’s jurisdiction.


Physician Specialists are eligible for a DRA J1 visa waiver recommendation

The DRA waiver program is one of the few waiver programs that will recommend a waiver for specialists. Generally, the various waiver programs are only available for J1 doctors who will engage in: 1) general or family practice; 2) general internal medicine; 3) pediatrics; 4) obstetrics/ gynecology; or 5) psychiatry. The DRA waiver program, however, includes specialists if the J1 doctors meet additional requirements, as outlined below.

Requirements for obtaining a J1 waiver recommendation from DRA include

    1. The J1 doctor must work three years in a rural DRA area with a minimum of 40 hours per week in primary medical care or a specialty (per the specification below).
    1. The area must be identified by the U.S. Public Health Service as a Health Professional Shortage Area (HPSA); Mental Health Professional Shortage Area (MHPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP), and be within the congressionally defined DRA 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 DRA application.
    1. The J1 doctor must be licensed in the DRA state where he or she will be practicing medicine. He or she must be licensed before starting employment with the DRA sponsor.
    1. The J1 physician must not have been out of status for more than 180 days.
    1. The J1 physician must sign and notarize an affidavit of agreement (J1 Visa Waiver Program Affidavit and Agreement).
    1. A personal statement must be submitted by the J1 physician explaining why he or she does not wish to fulfill the two year home country residence requirement per Section 212(e) of the Immigration and Nationality Act.

J-1 Waiver Specialist Requirements:

The DRA will submit a waiver recommendation for specialty physicians if the DRA agency can demonstrate the exceptional need for the specialty. This standard may be met by meeting the following application requirements for doctors who would like to practice medicine in a specialty area.

    1. DRA sponsor letter – The DRA sponsor must provide a letter outlining the reasons that a doctor with particular specialized training is needed in the area. The letter must also provide the following information:
      (a) The impact on the community because of the inadequate accessibility of the specialized services
      (b) The closest location where this specialty is available and whether public transportation is available
      (c) How the physician in this specialty would be viable in the service area (with supporting documentation)
    1. Demographic Information – A description must be provided, explaining the service area demographics and any other information that may be used to determine exceptional need for the specialty.
    1. Letter from the Chief Medical Officer – The DRA facility’s Chief Medical Officer must provide a letter which should explain the need for the specialty doctor and his support your waiver.
    1. Supporting Letters – Two or more letters of support from primary care centers and primary care physician practices in the area and that are not affiliated with the sponsor, explaining the need for this specialty in the area.
    1. Additional Information – Any additional evidence can be provided to support the contention that specialty services are needed in this area. For example, letters from local health officers in the area may also be submitted.

Sponsor Requirements

    • The DRA sponsor must engage in good faith recruitment for 60 days prior to submitting the waiver request. This recruitment must include advertisements done on the national and in-state levels, as well as recruitment at state medical schools. The DRA sponsor must demonstrate that it was unable to recruit U.S. citizen physicians or lawful permanent resident physicians with comparable salaries.
    • The DRA sponsor cannot use a restrictive covenant or non-compete clause that would discourage the doctor from working in the HPSA area subsequent to the doctors employment with the DRA sponsor.
    • The DRA 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 DRA 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.
    • The DRA sponsor must also demonstrate their recent record of serving and continuing intent to serve Medicare, Medicaid, and medically indigent patients.

The DRA’s application guidelines for its Delta Doctors program are very detailed. To ensure that all documentary and eligibility requirements are met, it may be advisable to seek the assistance of counsel. To learn more about how a J1 waiver immigration attorney can help you prepare the appropriate documentation to meet the sponsor and physician requirements, please contact our office at 415-986-6186.