Office of Health Professionals Regulation

Rhode Island J-1 Visa Waiver Program

J-1 Visa Waiver Review and Recommendation Process for the State of Rhode Island

The State of Rhode Island is committed to assisting all residents in accessing quality, affordable health care. Therefore, the Rhode Island Department of Health, through its office of Primary Care, is prepared to consider recommending a waiver of the foreign residence requirement on behalf of physicians holding J-1 visas, under certain conditions.

The Rhode Island Department of Health's participation is completely discretionary and voluntary and may be modified or discontinued at any time. The submission of a complete waiver package to the Rhode Island Department of Health (the Department) does not ensure that the Rhode Island Department of Health will recommend a waiver. In all instances the Department reserves the right to recommend or decline any request for a waiver.

In order to facilitate review of waiver requests by the Rhode Island Department of Health, the request for waiver should come from a United States health care facility on behalf of a J-1 physician, and not directly from a J-1 physician or physician's representative.

All of the required information and documentation must be submitted in a single package with documents presented in the order set forth. All documents must contain the case number assigned by the U.S. Department of State. Waiver requests that do not comply with these requirements will be returned to the submitting health care facility for revision.

Procedure for Receiving a J-1 Visa Waiver Application Case Number

Section 1: Description of Waiver Process

Requests for a waiver of the foreign residence requirement should be made by applicants or their attorneys directly to the Department of Health, Board of Medical Licensure and Discipline. The Department will not accept incomplete files. It will consider applications only when they are submitted in accordance with this state's requirements.

Only thirty (30) waivers can be granted per state per federal fiscal year (October 1 through September 30). Each case file will be assigned a priority number at the end of a review process that begins on June 15 th of each cycle.

The Director of Health will make the decision whether to recommend a request for a waiver of the home residence requirement. If the decision is in the affirmative, the case file, along with necessary cover letters, will be sent to the United States Department of State. The complete state process may take up to 30 days.

Section 2: Waiver Request Guidelines and Documentation

PROGRAM GUIDELINES

1. The physician must demonstrate a bona fide offer of full-time employment at a health facility,  bona fide clinic (a copy of the complete contract) or private practice and must agree to begin employment at such facility or clinic within 90 days of receiving a waiver.

2. The offer must contain a provision, and the physician must agree, to work at the health care facility in which he/she is employed for a total of not less than 3 years.

3. The physician must practice medicine full-time in a geographic area or areas , or at a facility or facilities , which are designated by the Secretary of Health and Human Services as a Health Professional Shortage Areas (HPSAs), Mental Health Professional Shortage Areas (MHPSAs, applies to psychiatrists only) , or Medically Under-served Areas (MUAs).

4. The physician must be employed by a health care facility that accepts Medicaid/Medicare eligible patients, as well as medically indigent patients.

5. Recruitment/retention efforts must be described. Applications for community-based placements must also include a five year site review of prior J-1 placements (i.e. five year review of prior J-1 placement(s) at the site and current employment of the physician(s). If a physician is no longer at the site, a brief explanation must be included.)

6. The physician, prior to employment, must meet all medical licensure requirements for the state of Rhode Island.

7. The application must include copies of all DS-2019 “Exchange Visitor Program Certificate of Eligibility For Exchange Visitor (J-1) Status” (formerly IAP-66) forms for the physician and any family members. If the physician is contractually obligated to return to her/his home country, a copy of a letter is required from the home country stating that the home country has no objection to the physician remaining in the United States.

8. The request must contain a complete curriculum vitae of the physician.

9. The RI Department of Health will not approve waiver applications that include employment contracts with "non-compete" clauses.

10. Waiver physicians may be required to submit copies of their W-2 forms to the department yearly for the first three years of employment. Waiver physicians must also notify the RI Department of Health of any intention to pursue alternate employment or reassignment to another state during the three year waiver period.

Section 3: J-1 Visa Waiver Information Sheet For Foreign Physicians

Federal laws require foreign physicians seeking to pursue graduate medical education or training in the U.S. to obtain a J-1 exchange visitor visa. The J-1 visa allows physicians to remain in the U.S. until their studies are completed. However, upon completion of their studies, the physicians must return to their home country for at least two years before they will be able to return to the U.S.

Physicians who are subject to, but do not wish to comply with, the two-year home country residence requirement may apply for a waiver of that requirement under any one of the four grounds provided by the U.S. Immigration law:

• Exceptional hardship to his/her U.S. citizen or permanent resident spouse or child.
• Persecution if forced to return to home country.
• A statement supporting a waiver from an interested U.S. government agency.
• A statement supporting a waiver from a state department of public health or its equivalent.

The RI Department of Health will consider recommending a waiver of the foreign residence requirement on behalf of physicians holding J-1 visas under the following conditions:

• A waiver request to the Department of Health may come from a J-1 physician or physician's representative.
• The physician must be applying for a waiver to work in a Primary Care Health Professional Shortage Area (HPSA), Mental Health Professional Shortage Area (MHPSA, applies to psychiatrists only) , or a Medically Under-served Area (MUA) designated by the Secretary of Health and Human Services, in the state of Rhode Island.
• The physician must demonstrate a bona fide offer of employment at a health facility in Rhode Island and must agree to work 40 hours per week for at least three years for a Medicare and Medicaid certified medical facility that also accepts medically indigent patients.
• If the physician fails to fulfill the terms of the contract with the health care facility, they would not be eligible to apply for an immigrant visa or permanent residence unless they returned to their home country for two years.
• There will be a limit of 30 waiver requests per state per fiscal year.

Section 4: Waiver Package Checklist

Robert Crausman, MD, MMS
RI Department of Health
Board of Medical Licensure and Discipline
3 Capitol Hill Room 205
Providence, RI 02908

All documents must include the case number assigned by the U.S. Department of State.

1. Summary of Situation: A letter from the head of the facility at which the physician will be employed that:

•  Requests that the Rhode Island Department of Health act as an interested government agency and recommend a waiver for the J-1 physician;

•  Summarizes how the health care facility has attempted to locate qualified U.S. physicians;

•  Describes the physician's qualifications, proposed responsibilities and how their employment will satisfy important unmet health care needs of a medically under-served community; and

•  State unequivocally that the facility is offering the physician at least three years of employment in a job consistent with the Department's mission, a description of the critical need of the facility's service area and how the facility will assure that the physician will serve that need.

2. Description of the medical facility: Provide a detailed description of the health care facility, including the nature and extent of its medical services. This statement can be included in the facility letter describing the physician's duties.

3. Valid contract of employment with health care facility of not less than three (3) years.

4. List of Health Care Professional Shortage Areas (HPSAs), Medically Under-served Areas/Populations (MUA/MUPs) and documentation from state/local health care officials stating need for the services of the physician.

5. Recruitment and retention efforts: A statement describing recruitment efforts will suffice. Applications for community-based placements must also include a five year site review of prior J-1 placements. Also submit a statement detailing the plans for the physician during the 3-year obligation.

6. Qualifications: proof of Rhode Island medical licensure eligibility.

7. Physician curriculum vitae.

8. Copies of all copies of all DS-2019 “Exchange Visitor Program Certificate of Eligibility For Exchange Visitor (J-1) Status” (formerly IAP-66) forms for the physician and any family members as required by Immigration and Naturalization Services (INS).

9. Completed Waiver Review Application Data Sheet. You will need the free Adobe Acrobat Reader® to view or download the above document.

10. Physician statement of whether contractually obligated to return to home country, and if so obligated, statement of non-objection from home government. (sample available)

11. Original package and one unbound copy of entire package