What recruiters should remember about the HHS program for J-1 visa waivers

There are a host of ways you may recruit physicians for your openings. One of these is to help you fill your open position with a physician or surgeon who needs a waiver of their J-1 visa.

The U.S. issues J-1 visas to nonimmigrant research scholars, professors and exchange visitors in programs that promote cultural exchange. This includes medical training. According to the U.S. Department of State website, over 2,900 physicians obtained visas through the J-1 Exchange Visitor Program in 2019.

A J-1 visa normally includes a two-year home residency requirement; however, several waiver opportunities exist. One of those is through the U.S. Department of Health and Human Services Exchange Visitor Program.

The J-1 visa waiver program is available only for hard-to-fill positions and in locations where extensive recruiting has been done, and where no U.S. citizen or permanent resident has been willing to accept or is not qualified for the position. The benefit to a health care organization is that they will receive a well-trained physician who is also happy to obtain a position in the United States, allowing them to extend their stay.

You can recruit a physician through the HHS program if the physician is interested in research, or if they will deliver clinical care for three years in a mental health or primary care Health Professional Shortage Area (HPSA). In most situations, you will be seeking a clinical physician. In June 2020, HHS expanded its waiver program to include any facility, hospital or private practice.

When this is the case, there are certain rules involved, including:

1. All applications must be through a private facility (no government agencies or facilities).
2. Your physician’s specialty must be family medicine, general internal medicine, general pediatrics, OBGYN or general psychiatry. They also must have completed their training programs no more than 12 months before they start their employment under contract.

This means if you’re seeking a pediatric subspecialist or an internal medicine subspecialist, you cannot hire a physician through this program in most situations. However, you will need to check with your immigration attorney to verify this.

3. Your facility must have an HPSA score of 7 or higher. If you are unsure or have not heard of an HPSA, don’t be concerned. You can check by plugging your facility’s address into this tool.

If your location does not come up as an HPSA primary care, then you would not qualify unless your immigration attorney tells you differently. Here’s an example of what will pull up when you enter your address:

• ABC Dental HPSA: Yes
• HPSA Name: LI-Smith County
• ID: 0123456789
• Designation Type: HPSA Population
• Status: Designated
• Score: 15
• Designation Date: 04/10/2006
• Last Update Date: 03/30/2020
• Mental Health Inc. HPSA: Yes
• HPSA Name: Mental Health Area 3
• ID: 0123456789
• Designation Type: Geographic HPSA
• Status: Designated
• Score: 15
• Designation Date: 09/29/1997
• Last Update Date: 11/30/2016

• In a Primary Care HPSA: Yes
• HPSA Name: Brown County
• ID: 0123456789
• Designation Type: HPSA Population
• Status: Designated
• Score: 9
• Designation Date: 12/26/2018
• Last Update Date: 12/26/2018

This means if all of the other rules are followed, your facility could qualify because it states that it is a primary care HPSA with a score of 9 and a Mental Health HPSA of 15.

4. If you have an opportunity posted with the National Health Service Corps (NHSC) opportunities list, you may only offer employment to a physician on a J-1 visa waiver after the NHSC placement cycle has ended. Many hospitals and groups utilize this program for loan repayment.

Although J-1 visas and waivers aren’t related to loan repayments, the NHSC does use the HPSA guide to determine things like loans and locations. You can check out the NHSC site.

A huge bonus to going through the HHS program is that there’s no cap on the number of waivers available, unlike in the Conrad 30 program. Additionally, there are many other requirements you must go through as an employer. You can access more on the HHS program here.

Like Conrad 30, a physician can only have one pending petition or application at a time with the U.S. Department of State. For any potential applicant you’re thinking about interviewing, you must find out if they have a pending application in any program.

After your applicant successfully receives a recommendation under the HHS program:

1. The coordinator or director of the HHS program will send your petition to the U.S. Department of State’s J-1 Visa Waiver Division located in Washington, D.C.
2. If the requirements are met, your candidate’s application is forwarded to the U.S. Department of State. The Waiver is approved, and the U.S. Citizenship and Immigration Services will issue a notice of action approving the waiver.
3. When your immigration attorney receives the waiver approval notice, they will file an H1B petition.

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