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S1291.................................................by HEALTH AND WELFARE IDAHO CONRAD J-1 VISA WAIVER - Adds to existing law to adopt the Idaho Conrad J-1 Visa Waiver Program to authorize the Department of Health and Welfare to recommend foreign trained physicians to locate in underserved areas of Idaho for a limited time; to define the application and approval procedures; to provide criteria for community participation; and to provide limits which apply to the program. 02/09 Senate intro - 1st rdg - to printing 02/10 Rpt prt - to Health/Wel 02/11 Rpt out - rec d/p - to 2nd rdg 02/12 2nd rdg - to 3rd rdg 02/17 3rd rdg - PASSED - 32-0-3 AYES -- Bailey, Bunderson, Burkett, Calabretta, Cameron, Compton, Darrington, Davis, Gannon, Geddes, Goedde, Hill, Ingram, Kennedy, Keough, Little, Lodge, Malepeai, Marley, McKenzie, McWilliams, Noble, Noh, Pearce, Richardson, Schroeder, Sorensen, Stegner, Stennett, Sweet, Werk, Williams NAYS -- None Absent and excused -- Andreason, Brandt, Burtenshaw Floor Sponsor - Bailey Title apvd - to House 02/18 House intro - 1st rdg - to Health/Wel 03/05 Rpt out - rec d/p - to 2nd rdg 03/08 2nd rdg - to 3rd rdg 03/09 3rd rdg - PASSED - 69-1-0 AYES -- Andersen, Barraclough, Barrett, Bauer, Bayer, Bedke, Bell, Black, Block, Boe, Bolz, Bradford, Campbell, Cannon, Clark, Collins, Crow, Cuddy, Deal, Denney, Douglas, Eberle, Edmunson, Ellsworth, Eskridge, Field(18), Field(23), Gagner, Garrett, Harwood, Henbest, Jaquet, Jones, Kellogg, Kulczyk, Lake, Langford, Langhorst, Martinez, McGeachin, Meyer, Miller, Mitchell, Moyle, Naccarato, Nielsen, Pasley-Stuart, Raybould, Ridinger, Ring, Ringo, Roberts, Robison, Rydalch, Sali, Sayler, Schaefer, Shepherd, Shirley, Skippen, Smith(30), Smith(24), Smylie, Snodgrass, Stevenson, Trail, Wills, Wood, Mr. Speaker NAYS -- McKague Absent and excused -- None Floor Sponsors - McGeachin & Ring Title apvd - to Senate 03/10 To enrol 03/11 Rpt enrol - Pres signed 03/12 Sp signed 03/15 To Governor 03/19 Governor signed Session Law Chapter 128 Effective: 07/01/04
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]] Fifty-seventh Legislature Second Regular Session - 2004 IN THE SENATE SENATE BILL NO. 1291 BY HEALTH AND WELFARE COMMITTEE 1 AN ACT 2 RELATING TO THE CREATION OF THE IDAHO CONRAD J-1 VISA WAIVER PROGRAM; AMENDING 3 TITLE 39, IDAHO CODE, BY THE ADDITION OF A NEW CHAPTER 61, TITLE 39, IDAHO 4 CODE, TO ADOPT THE IDAHO CONRAD J-1 VISA WAIVER PROGRAM, TO PROVIDE A 5 SHORT TITLE, TO PROVIDE THE PURPOSE OF THE CHAPTER, TO PROVIDE SEVERABIL- 6 ITY, TO PROVIDE FOR INCORPORATION OF FEDERAL LAW, RULES AND REGULATIONS BY 7 REFERENCE, TO DEFINE TERMS, TO DESCRIBE GENERAL REQUIREMENTS AND LIMITA- 8 TIONS, TO PROVIDE GUIDING PRINCIPLES, TO DEFINE CRITERIA FOR APPLICANTS, 9 TO DEFINE CONTRACT REQUIREMENTS, TO DEFINE CRITERIA FOR THE PRACTICE LOCA- 10 TION, TO DEFINE CRITERIA FOR PHYSICIANS, TO DESCRIBE REPORTING REQUIRE- 11 MENTS, TO REQUIRE AN APPLICATION FEE, TO DESCRIBE APPLICATION CRITERIA AND 12 ACCOMPANYING DOCUMENTS, TO DEFINE CRITERIA FOR FEDERALLY DESIGNATED FACIL- 13 ITIES, TO PROVIDE FOR DEPARTMENT REVIEW AND TO DESCRIBE DEPARTMENT 14 ACTIONS, TO DESCRIBE LIMITATIONS TO PROGRAM PARTICIPATION AND TO DEFINE 15 DEPARTMENT REPORTING REQUIREMENTS. 16 Be It Enacted by the Legislature of the State of Idaho: 17 SECTION 1. That Title 39, Idaho Code, be, and the same is hereby amended 18 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap- 19 ter 61, Title 39, Idaho Code, and to read as follows: 20 CHAPTER 61 21 IDAHO CONRAD J-1 VISA WAIVER PROGRAM 22 39-6101. SHORT TITLE. This chapter shall be known and may be cited as the 23 "Idaho Conrad J-1 Visa Waiver Program." 24 39-6102. PURPOSE. The "Idaho Conrad J-1 Visa Waiver Program" would autho- 25 rize the state of Idaho department of health and welfare to recommend up to 26 thirty (30) foreign trained physicians per federal fiscal year to locate in 27 communities that are federally designated as having a health workforce short- 28 age. Final approval of J-1 visa waiver requests are made by the U.S. depart- 29 ment of state and the bureau of citizenship and immigration services. Under 30 this chapter, rural and underserved communities in Idaho would be able to 31 apply for the placement of a foreign trained physician after demonstrating 32 that they are unable to recruit an American physician, and all other 33 recruitment/placement possibilities have proven to be inaccessible. 34 39-6103. SEVERABILITY. The provisions of this chapter are hereby declared 35 to be severable and if any provision of this chapter or the application of 36 such provision to any person or circumstance is declared invalid for any rea- 37 son, such declaration shall not affect the validity of the remaining portions 38 of this chapter. 39 39-6104. INCORPORATION BY REFERENCE. P.L. 103-416, amended by P.L. 2 1 107-273, November 2, 2002, 8 U.S.C. 1184(l) and 22 CFR sec. 514.44(e), F.R. 2 volume 60, No. 197, and 18 U.S.C. 1001 are incorporated by reference. 3 39-6105. DEFINITIONS. As used in this chapter: 4 (1) "Applicant" means a health care facility that seeks to employ a phy- 5 sician and is requesting state support of a visa waiver. 6 (2) "Area of underservice" means a health professional shortage area in 7 primary care or mental health, a medically underserved area, or a medically 8 underserved population, federally designated by the secretary of health and 9 human services. 10 (3) "Department" means the Idaho department of health and welfare. 11 (4) "De-designation threshold" means the number of full-time equivalent 12 primary care physicians necessary to remove the federal designation as an area 13 of underservice. 14 (5) "Employment contract" means a legally binding agreement between the 15 applicant and the physician named in the visa waiver application which con- 16 tains all terms and conditions of employment, including, but not limited to, 17 the salary, benefits, length of employment and any other consideration owing 18 under the agreement. The employment contract must meet all state and federal 19 criteria, including labor and immigration rules. 20 (6) "Federal fiscal year" means the twelve (12) months which commence the 21 first day of October in each year and close on the thirtieth day of September 22 of the following year. 23 (7) "Full time" means a working week of a minimum of forty (40) hours at 24 a health care facility. 25 (8) "Health care facility" means an entity with an active Idaho taxpayer 26 identification number doing business or proposing to do business in the prac- 27 tice location where the physician would be employed, whose stated purposes 28 include the delivery of primary medical or mental health care. 29 (9) "Interested government agency" means an agency that has the authority 30 from the United States department of state to submit requests for J-1 visa 31 waivers of foreign physician petitioners on behalf of public interest. 32 (10) "J-1 visa" means an entrance permit into the United States for a for- 33 eign trained physician who is a nonimmigrant admitted under section 34 101(a)(15)(J) of the United States information and education exchange act or 35 who acquired such status or who acquired exchange visitor status under the 36 act. 37 (11) "New start" means a health care facility as defined in subsection (8) 38 of this section, that has been in existence for twelve (12) months or less. 39 (12) "Physician" means the foreign physician, named in the visa waiver 40 application, who requires a waiver to remain in the United States to practice 41 medicine. 42 (13) "Primary care" means a medical doctor or doctor of osteopathy 43 licensed in pediatrics, family medicine, internal medicine, obstetrics, gyne- 44 cology, or psychiatry. 45 (14) "Sliding fee discount schedule" means a written delineation 46 documenting the value of charge discounts granted to patients based upon 47 financial hardship and federal poverty guidelines. 48 (15) "Unmet need" means a vacancy or shortage of primary care health phy- 49 sicians experienced by a community or population, as defined by federally des- 50 ignated health professional shortage areas or medically underserved 51 areas/populations. 52 (16) "Vacancy" means a full-time physician practice opportunity in the 53 delivery of primary care services. 54 (17) "Visa waiver" means a federal action that waives the requirement for 3 1 a foreign physician, in the United States on a J-1 visa, to return to his home 2 country for a two (2) year period following medical residency training. 3 39-6106. GENERAL REQUIREMENTS AND LIMITATIONS. (1) Visa waiver request. 4 The department may only submit a visa waiver request when: 5 (a) The application contains all of the required information and documen- 6 tation; and 7 (b) The application meets all state and federal criteria; and 8 (c) Foreign exchange physicians having a J-1 case number assigned by the 9 United States department of state have paid all federal processing fees; 10 and 11 (d) The applicant has paid the state of Idaho application processing fee. 12 (2) Limitations of department actions. 13 (a) Prior to submission of an application, the department may provide 14 information to the applicant on preparing a complete application. 15 (b) The department will not be responsible for adding any information to 16 incomplete application packets. 17 (c) For applicants who have benefitted from department waiver requests 18 previously, the applicant's history of compliance will be a consideration 19 in future decisions for waiver requests. 20 (d) In any single program year, a health care facility in any one (1) 21 area of underservice: 22 (i) Will not be allotted more than two (2) waiver request applica- 23 tions; and 24 (ii) Will not exceed by more than one and nine-tenths (1.9) full- 25 time equivalents, the number of physicians needed to eliminate the 26 physician shortage as defined by the current de-designation threshold 27 in any single program year. 28 (e) The shortage area designation must be current on the date the United 29 States department of state reviews and recommends the application and on 30 the date the immigration agency approves the J-1 visa waiver. Any applica- 31 tion that is being submitted to the department at the end of the three (3) 32 year health professional shortage area designation cycle may be summarily 33 denied if the renewal is not obtained. 34 (i) Participation by the department in the Idaho conrad J-1 visa 35 waiver program is completely discretionary and voluntary. The depart- 36 ment may elect not to participate in the program at any time. The 37 submission of a complete waiver package does not ensure the depart- 38 ment will recommend a waiver. The department reserves the right to 39 recommend or decline any request for a waiver. 40 (ii) The department, its employees or agents are held harmless of 41 any perceived consequence for the denial of a waiver petitioner, or 42 the approved placement of one that is not favorable. 43 (iii) Application procedures for Idaho conrad J-1 visa waiver physi- 44 cian placements were developed by the department in compliance with 45 P.L. 103-416 and subsequent revisions. They are subject to updates 46 and changes at any time. Interpretation of these procedures rests 47 solely with the department in consultation with the appropriate fed- 48 eral agencies. 49 39-6107. APPLIED PRINCIPLES. (1) Option of last resort. The visa waiver 50 program is considered a final source for recruiting qualified physicians. It 51 is not a substitute for broad recruiting efforts for graduates from United 52 States medical schools, but an option of last resort. Any application that 53 qualifies for consideration under any other interested government agency or 4 1 federal program, such as the one administered by the department of health and 2 human services, must be submitted under that program in lieu of the Idaho 3 conrad J-1 visa waiver program. 4 (2) Waiver request applications will only be considered for health care 5 facilities that can provide evidence of sustained active recruitment over a 6 period of at least six (6) months for the primary care vacancy in the practice 7 location. 8 (3) The visa waiver program will be used to assist health care facilities 9 that can document the provision of primary health care services to all resi- 10 dents of the federally designated underserved area. When a federal designation 11 is for an underserved population, the health care facility must document the 12 provision of care to, and assure access by, the underserved population. 13 39-6108. CRITERIA FOR APPLICANTS. (1) Applicants must be existing health 14 care facilities that: 15 (a) Have an active taxpayer identification number in Idaho; and 16 (b) Have provided medical or mental health care in Idaho for a minimum of 17 twelve (12) months prior to submitting the application, or meet the 18 requirements for a new start as defined in this chapter. 19 (2) The waiver request to the department must come from a U.S. health 20 care facility on behalf of the physician and not directly from the physician 21 or his representative. 22 (3) J-1 visa waiver petitioners with fellowship training must contract 23 with employers to provide primary care services full time. 24 (4) Applicants must not be former J-1 visa waiver physicians who are cur- 25 rently fulfilling their required three (3) year obligation. 26 (5) Applicants may not submit waiver requests for a relative. 27 (6) Applicants must accept all patients regardless of their ability to 28 pay. 29 (7) Except for state institutional and correctional facilities designated 30 as federal shortage areas, the applicant must: 31 (a) Serve medicare clients, medicaid clients, low-income clients, unin- 32 sured clients, and the population of the federal designation. 33 (b) Agree to implement a sliding fee discount schedule. The schedule must 34 be: 35 (i) Available in Spanish (where applicable) and English; and 36 (ii) Posted conspicuously; and 37 (iii) Distributed in hard copy on request to individuals making or 38 keeping appointments with that physician. 39 (8) Applicants must have a signed employment contract with the physician, 40 and guarantee wages for the three (3) years of the contract. 41 (9) Applicants must cooperate in providing the department with clarifying 42 information, verifying information already provided, or in any investigation 43 of the applicant's financial status and payer mix. 44 (10) Applicants must first apply through any organization with federal or 45 interested governmental agency authority which submits waiver requests for 46 Idaho's underserved rural areas. Documentation which fully explains why this 47 route was not taken for placement is required as part of the application. 48 (11) The physician's name and practice location will be made available to 49 the public as a provider of primary health who accepts medicare, medicaid and 50 utilizes a sliding fee schedule for the low-income population. 51 (12) An assurance letter that the health care facility, its principals, 52 and the J-1 petitioning physician are not under investigation for, under pro- 53 bation for, or under restriction for medicare or medicaid fraud, or other 54 violations of law or licensure restrictions that may indicate that it may not 5 1 be in the public interest that a waiver of the two (2) year home residency 2 requirement be granted, must be provided. 3 (13) The applicant and its principals must be free of default on any fed- 4 eral or state scholarship or loan repayment program such as the national 5 health service corps or by the state. 6 39-6109. CONTRACT REQUIREMENTS. Throughout the period of obligation, 7 regardless of physician's visa status, the employment contract must: 8 (1) Meet state and federal requirements; 9 (2) Not prevent the physician from providing medical services in the des- 10 ignated shortage area after the term of employment. A noncompetition clause or 11 any provision that purports to limit the J-1 visa waiver physician's ability 12 to remain in the area upon completion of the contract term is prohibited by 13 regulation; 14 (3) State that the physician must serve medicare clients, medicaid cli- 15 ents, low-income clients, uninsured clients, and the population of the federal 16 designation for the area of underservice full time; 17 (4) Include a notarized statement by the physician that he agrees to meet 18 the requirements set forth in section 214(l) of the immigration and national- 19 ity act; 20 (5) Guarantee the physician a base salary of at least ninety-five percent 21 (95%) of step II of the local prevailing wage for the field of practice in the 22 area to be served; 23 (6) Specify that benefits offered are not included as part of base sal- 24 ary; 25 (7) Include leave (annual, sick, continuing medical education and holi- 26 day); 27 (8) State that amendments shall adhere to state and federal J-1 visa 28 waiver requirements; 29 (9) Acknowledge that the contract may be terminated only with cause and 30 cannot be terminated by mutual agreement until the statutorily required three 31 (3) years have expired; 32 (10) Be assignable only by the employer to a successor with concurrence of 33 the department; 34 (11) Include the practice site address, the days and hours of practice, 35 field of medicine, and a statement that on-call and travel times are not 36 included in the minimum hours; 37 (12) Not commence until after the physician's J-1 waiver and appropriate 38 work authorization are approved and his residency program has been success- 39 fully completed. The contract shall affirm that no transfer or other modifica- 40 tion regarding the duration of contract dates will be approved unless extenu- 41 ating circumstances are shown to exist, as determined by the department and 42 approved by the United States attorney general in accordance with applicable 43 federal rules and regulations; 44 (13) Not be subject to changes which result in termination of contract, 45 change in practice scope, or relocation from a site approved in the applica- 46 tion. Any proposed changes must be presented in writing to the department for 47 consideration and approval at least thirty (30) days prior to the proposed 48 change. Moving or placement of a physician to a location that was not approved 49 by the department will result in the physician and applicant being in noncom- 50 pliance with the program and will be reported as such to the immigration 51 agency. It will also limit the applicant's future participation in the pro- 52 gram; 53 (14) Be signed by both the J-1 visa waiver petitioning physician and the 54 applicant employer, and the date it is signed must be clear. 6 1 39-6110. CRITERIA FOR PROPOSED PRACTICE LOCATION. (1) The proposed prac- 2 tice location must be located in: 3 (a) A federally designated primary care health professional shortage 4 area; or 5 (b) A federally designated mental health professional shortage area for 6 psychiatrists; or 7 (c) An area having a federal designation as a medically underserved area 8 or a medically underserved population; or 9 (d) A combination of federally designated areas. 10 (2) If a new practice location is planned, additional criteria apply. New 11 practice locations must: 12 (a) Have the legal, financial, and organizational structure necessary to 13 provide a stable practice environment, and must provide a business plan 14 that supports this information; 15 (b) Support a full-time physician practice; 16 (c) Have written referral plans that describe how patients using the new 17 primary care location will be connected to existing secondary and tertiary 18 care if needed. 19 39-6111. CRITERIA FOR THE PHYSICIAN. (1) The physician must not have a 20 J-1 visa waiver pending for any other employment offer, and must provide a 21 notarized statement testifying to this fact. 22 (2) The physician must have the qualifications described in recruitment 23 efforts for a specific vacancy. 24 (3) Physicians must: 25 (a) Provide direct patient care full time; and 26 (b) Be trained in: 27 (i) Family medicine; or 28 (ii) Internal medicine; or 29 (iii) Pediatrics; or 30 (iv) Obstetrics and gynecology; or 31 (v) Psychiatry and its subspecialties. 32 (4) Physicians must have an active Idaho medical license. The physician 33 may be participating in an accredited residency program for this application, 34 but must have successfully completed the third year of their residency train- 35 ing program for their employment contract to be activated. The physician must 36 have an unrestricted license to practice in the state of Idaho and be board 37 certified or eligible in his respective medical specialty. A copy of the 38 license must be included in the waiver request. 39 (5) Physicians must have at least one (1) recommendation from their resi- 40 dency program that: 41 (a) Addresses the physician's interpersonal and professional ability to 42 effectively care for diverse and low-income persons in the United States; 43 and 44 (b) Describes an ability to work well with supervisory and subordinate 45 medical staff, and adapt to the culture of United States health care 46 facilities; and 47 (c) Documents the level of specialty training, if any; and 48 (d) Is prepared on residency program letterhead and is signed by resi- 49 dency program staff or faculty; and 50 (e) Includes name, title, relationship to physician, address, and tele- 51 phone number of signatory. 52 (6) The physician must agree with all provisions of the employment con- 53 tract as described herein. Other negotiable terms of the contract are between 54 the physician and the hiring agency. 7 1 (7) The physician must: 2 (a) Agree to work full time for no less than three (3) years in an area 3 of underservice in the state of Idaho; and 4 (b) Provide health care to medicare and medicaid beneficiaries; and 5 (c) Post and implement a sliding fee discount schedule; and 6 (d) Serve the low-income population; and 7 (e) Serve the uninsured population; and 8 (f) Serve the shortage designation population; or 9 (g) Serve the population of a local, state, or federal governmental 10 institution or corrections facility as an employee of the institution. 11 39-6112. JOINT REPORTING REQUIREMENT UPON COMMENCEMENT OF PRACTICE. (1) 12 Notification of waiver status and commencement of employment must be submitted 13 to the department upon receipt of written notification of approval from the 14 immigration agency. This notification must include the date the three (3) year 15 obligation commences, and a copy of the notification of approval from the 16 immigration agency. 17 (2) The physician and the applicant must, on commencement of practice and 18 annually thereafter or more frequently as determined by the department, and 19 upon expiration of the first three (3) years of the contract, verify the 20 physician's practice site address and field of practice. Further, for 21 population-designated health professional shortage areas, documentation that 22 the population the physician was to serve was indeed served must be submitted. 23 This will include the facility's payer mix, the number of patients seen by the 24 physician, and the payer mix of those patients. When submitting the final 25 report, the physician must indicate whether he intends to remain in the short- 26 age area to practice. 27 (3) Sites receiving waiver approval must agree to report to the depart- 28 ment on the status of the physician's activities at the beginning of the 29 physician's employment and every year thereafter during the three (3) year 30 waiver service period. Failure to provide these reports within thirty (30) 31 days of the annual anniversary date of approval of the J-1 visa in an accurate 32 manner or failure to demonstrate good faith in utilizing a physician's ser- 33 vices in accordance with these policies will jeopardize future eligibility for 34 placements and will be cause for reporting and referral to the United States 35 department of state and immigration agency. This referral could ultimately 36 lead to deportation proceedings against the J-1 physician. 37 (4) Any amendments made to the required elements of the employment con- 38 tract during the first three (3) years for primary care physicians of con- 39 tracted employment must be reported to the department for review. The depart- 40 ment will complete review and provide notice of approval or declination of 41 such amendments within thirty (30) calendar days of receipt. 42 39-6113. APPLICATION FEE. At the time the application is submitted to the 43 department, an administrative fee must be paid to the department by the appli- 44 cant. The fee amount will be determined by the director of the department, 45 will not be less than one thousand dollars ($1,000), and may be revised at the 46 beginning of the state fiscal year by the director based on costs to adminis- 47 ter the program. The fee is nonrefundable. 48 39-6114. REQUIRED APPLICATION FORMS AND ACCOMPANYING DOCUMENTS. (1) 49 Applications for the Idaho conrad J-1 visa waiver program must include, but 50 not be limited to, the following: 51 (a) Evidence the applicant has no other mechanism through another process 52 or interested government agency to apply for a J-1 visa waiver for the 8 1 physician; 2 (b) Evidence of recruiting efforts over a minimum of six (6) months prior 3 to when the physician applied for the vacancy; this must include regional 4 and national print advertising stating the position available and the 5 practice site location and at least six (6) certified letters to medical 6 schools to advertise the vacancy. Copies of advertisements submitted must 7 show the publication date. Advertisements run at the time of or after 8 preparation of the employment contract are unusable. Online advertisements 9 must show dates the advertisements were online. Contracts with recruitment 10 firms are allowable as evidence in lieu of print advertisements or letters 11 if the activities described in this section are provided under contract. 12 Recruitment firm contracts must be included if applicable; 13 (c) Evidence the physician selected for the position visited the practice 14 site; 15 (d) A mailing list of physicians who applied for the position and the 16 reason they were not selected; 17 (e) Evidence the applicant has been providing medical or mental health 18 care in Idaho for at least twelve (12) months or meets the requirements 19 for a new start as defined in this chapter. This includes, but may not be 20 limited to, the Idaho taxpayer identification number, facility address, 21 fax and telephone numbers, and staffing list; 22 (f) A copy of an employment contract between the physician and the appli- 23 cant for no less than three (3) years; 24 (g) Evidence the employment site is in a designated area of underservice; 25 (h) The request must be submitted by the applicant or applicant's repre- 26 sentative. The letter must be written on the applicant's letterhead sta- 27 tionery, which includes address, telephone and fax numbers, if any. Let- 28 ters, contracts and forms must contain original signatures; 29 (i) A copy of the sliding fee scale which the health care facility must 30 agree to implement and post; 31 (j) A copy of the physician's license to practice medicine; 32 (k) Legible copies of all IAP-66/DS 2019 forms (certificate of eligibil- 33 ity for exchange visitor status), covering every period the physician was 34 in J-1 status, submitted in chronological order; 35 (l) Legible copies (front and back) of all I-94 entry and departure cards 36 for the physician and family members; 37 (m) The physician's curriculum vitae; 38 (n) A statement of "no objection from the government" of the physician's 39 country of nationality, if applicable. The government of the country to 40 which the physician is otherwise contractually obliged to return must fur- 41 nish a letter to the director of the United States department of state 42 with a statement in writing that there is no objection to such waiver in 43 cases where the physician's medical education or training is funded by the 44 government of the physician's home country. Whether or not there is for- 45 eign government funding can be determined from examining the physician's 46 IAP-66 form. This letter must be in English and follow the procedures and 47 format outlined in federal register volume 60, number 197, published Octo- 48 ber 12, 1995 (or subsequent revisions); 49 (o) Payment of the department's administrative application processing 50 fee; 51 (p) Federal form G-28 or letterhead from the law office, if the physician 52 is being represented by an attorney, with telephone and fax numbers, and a 53 contact name and address; 54 (q) A copy of the United States department of state issued instruction 55 sheet with case number. 9 1 (2) The state may require any other documentation or information for the 2 support and approval process in the waiver application on the part of the phy- 3 sician or the applicant. 4 (3) These requirements are subject to change without notice. 5 (4) Idaho conrad J-1 visa waiver program application forms and instruc- 6 tions are available and may be requested from the department. 7 (5) The physician's case number must appear on each page. The case number 8 is assigned by the United States department of state. 9 (6) All required information and documentation must be submitted in a 10 single package with all documents presented per instructions that will be pro- 11 vided by the department upon request. One (1) single-sided, unbound original 12 and one (1) single-sided, unbound copy must be included. Waiver requests that 13 do not comply with these requirements and the instructions provided by the 14 department will not be considered. 15 39-6115. CRITERIA APPLIED TO FEDERALLY DESIGNATED FACILITIES. Local, 16 state, or federal institutions which offer primary care services and are fed- 17 erally designated as a shortage facility accompanied by a health professional 18 shortage area score may submit an application. Physician services may be lim- 19 ited to the population of the institution. All other state and federal 20 requirements must be met. 21 39-6116. DEPARTMENT REVIEW AND ACTION. (1) The department will review 22 applications for completeness in date order received. 23 (2) Applications submitted for physicians with language skills appropri- 24 ate to the community they wish to serve will be given priority. 25 (3) Selection preference will be given to applications received from 26 HPSAs having the greatest unmet need for primary care physicians. 27 (4) Applications must be mailed, sent by commercial carrier, or delivered 28 in person. Applications may not be sent electronically. The department is not 29 responsible for applications or related materials lost in the mail. 30 (5) The department may limit the time period during which applications 31 may be submitted including refusing to process applications after the depart- 32 ment has submitted requests for all applications allowed in a given federal 33 fiscal year. 34 (6) In the event an applicant for a J-1 visa waiver submits an applica- 35 tion to the department, the department will acknowledge receipt of the copy of 36 the application within five (5) business days of receipt. 37 (7) The department will review applications within fifteen (15) working 38 days of receipt of the application to determine if the application is com- 39 plete, and provide a written explanation of missing items. 40 (8) An additional fee will not be charged for incomplete applications if 41 the missing items are provided within thirty (30) calendar days of the date on 42 the letter of explanation from the department. If new information is not 43 received within this time frame, the application will be returned to the 44 applicant. The application fee will not be returned. 45 (9) The department will return applications and application fees to 46 applicants having had two (2) approved J-1 visa waiver requests in the current 47 federal fiscal year for the shortage area, applications received that exceed 48 the de-designation threshold limit, and applications received after thirty 49 (30) placements have been recommended. 50 (10) The department will review complete applications against the criteria 51 specified in this chapter. 52 (11) The department may: 53 (a) Request additional clarifying information; 10 1 (b) Verify information presented; 2 (c) Investigate the financial status of the applicant; 3 (d) Request verification of the health care facility's payer mix for the 4 previous twelve (12) to eighteen (18) months. 5 (e) Return the application as incomplete if the applicant does not supply 6 the requested clarifying information in its entirety within thirty (30) 7 days of request. The application fee is nonrefundable. Incomplete applica- 8 tions must be resubmitted with the application fee. Resubmitted applica- 9 tions will be considered new applications and will be reviewed in date 10 order received. 11 (12) The department may request the director of the United States depart- 12 ment of state to recommend that the immigration agency grant the waiver. 13 (13) The department will notify the applicant in writing of action taken 14 by the department. If the decision is to decline the J-1 visa waiver request, 15 the department will provide an explanation of how the application failed to 16 meet the stated criterion or criteria. The application fee is nonrefundable. 17 (14) The department may deny a visa waiver request or, prior to United 18 States department of state approval, may withdraw a visa waiver recommendation 19 for cause, which shall include the following: 20 (a) The application is not consistent with state or federal criteria; 21 (b) Fraud; 22 (c) Misrepresentation; 23 (d) False statements; 24 (e) Misleading statements; 25 (f) Evasion or suppression of material facts in the visa waiver applica- 26 tion or in any of its required documentation and supporting materials; 27 (g) Incomplete or insufficient information; 28 (h) Allowable number of recommendations for the area or year has been 29 met. 30 (15) Applications denied may be resubmitted with concerns addressed, with 31 the application fee. Resubmitted applications will be considered new applica- 32 tions and will be reviewed in date order received. 33 (16) The department retains the authority to audit, monitor and conduct 34 unannounced site visits. 35 39-6117. ELIGIBILITY FOR FUTURE PARTICIPATION. Health care facilities may 36 be denied future participation in the Idaho conrad J-1 visa waiver program if: 37 (1) The required annual reports are not submitted in a complete and 38 timely manner; 39 (2) A physician does not serve the designated shortage area or shortage 40 population approved at the time of placement for the full three (3) years of 41 employment. This does not apply only if the approved site is in a designated 42 health professional shortage area that loses its designation after the physi- 43 cian begins employment; 44 (3) A physician does not remain employed by the applicant for the full 45 three (3) years of employment; 46 (4) The applicant or physician is not in compliance with the terms 47 defined in this chapter or any federal requirements. 48 39-6118. DEPARTMENT RESPONSIBILITY TO REPORT. The department shall report 49 to the United States department of state and the immigration agency if the 50 applicant or physician is determined to be out of compliance with any of the 51 provisions of this chapter or if the physician is determined to have left 52 employment in the federally designated area.
STATEMENT OF PURPOSE RS 13528C2 The Conrad or State J-1 Visa Waiver Program would authorize the State of Idaho Department of Health and Welfare to recommend up to 30 (thirty) foreign trained physicians per federal fiscal year to locate in communities that are federally designated as having a health workforce shortage. Final approval of J-1 Visa Waiver requests are made by the U.S. Department of State and the Bureau of Citizenship and Immigration Services. Under this proposed program, rural and underserved communities in Idaho would be able to apply for the placement of a foreign trained physician after demonstrating that they are unable to recruit an American physician, and all other recruitment/placement possibilities have proven to be inaccessible. FISCAL IMPACT The administration of a Conrad/J-1 Visa Waiver Program in Idaho will be funded by receipts generated from levying a processing fee for each application received. The fee amount will be $1,000.00 per application, and may be revised at the beginning of each state fiscal year by the Director of the Department based on costs to administer the program. The number of applications processed cannot exceed 30. Fiscal Impact to communities seeking this resource is estimated at $2,000 for FY 2005. The processing fee will support the time of a Program Specialist, clerical support, and travel expenses associated with processing the application, providing technical assistance, monitoring and program evaluation. Other than the obligatory fee, there are no federal or state funds to support this program. There is no impact to the General Fund. CONTACT Name: Richard Schultz Agency: Department of Health and Welfare Phone: 334-6996 Statement of Purpose/Fiscal Impact S 1291