Only the neediest regions will qualify under new HHS application requirements for a waiver allowing foreign medical graduates to practice in underserved areas.
On Dec. 10, HHS announced it is accepting applications for fiscal year 2004 for the J-1 visa waiver of the two-year foreign residence requirement for the Exchange Visitor Program that provides clinical care in federally designated shortage areas.
"To target communities and populations in the greatest need for primary care and mental health services," HHS says that, starting in 2004, it will process waiver applications only for facilities in a health professional shortage area (HPSA) with a minimum score of 14.
J-1 visas are issued to foreign students, including medical residents who are studying in the United States, who are required to return to their home country for at least two years after they complete their training. The J-1 waiver allows foreign doctors to practice for three to five years in areas with health professional shortages.
Under the new guidelines, qualifying facilities with a score of 14 or higher must be either a health center as defined under Section 330 of the Public Health Service Act, a rural health clinic as defined under Sections 1102 and 1871 of the Social Security Act, or a Native American/Alaskan Native tribal medical facility as defined by the Indian Self Determination and Education Assistance Act.
About 20% of the U.S. population resides in primary medical care health professional shortage areas. HHS says it is not known how many of the qualified centers are recruiting or are interested in recruiting a J-1 physician.
The criteria for waivers based on research remain unchanged.
Lawrence Colaizy, provider recruitment and retention coordinator for the Minnesota Department of Health, says the new score requirement is one reason the federal waiver program doesn't get a lot of use in his state, which is eligible for 30 J-1 waivers under a state program.
Minnesota does not require a qualifying facility to be in a HPSA with a certain score -- it is either designated or it is not, Colaizy says.
"One of the things that concerns us about that change is it fairly closely resembles the qualifications for the National Health Service Corps program," Colaizy says. "That puts the J-1 waiver directly in competition. Those who don't quality for NHSC tend to take a harder look at the J-1 program. If the qualifications are the same, they have nowhere else to go for help."