Posts Tagged ‘MAVNI’

Conrad 30 Physician J-Waiver Update for Washington State, Oregon, Idaho, Montana, and Alaska

Thursday, October 17th, 2019 by W. Scott Railton

The demand for Conrad 30 J-1 Physician waivers has risen substantially in the past few years for Washington State and Oregon. Both states received more applications than they used to when this fiscal year began on October 1st. This is probably attributable to a number of factors, including desirability of the living in these beautiful states (including in some amazing semi-rural locations), increasing employer familiarity with the J-1 program, and growing demand for qualified physicians. In particular, demand for certain specialists has grown dramatically, to some extent reflecting both growth and aging populations.

As of October 15th, Washington State reports that it has received 15 specialists applications and two primary care applications. State regulations only permit the approval of 10 specialist applications, prior to April 1st in the fiscal year. Seven specialist applications are pending approval, as in one primary care application. In all likelihood, the remaining applications may have issues which require further attention, though probably some of these concerns are quickly addressed. FLEX spots, which are for non-health professional shortage areas, become available on January 15th, provided slots remain.

As of this writing, 22 of 30 spots are reported reserved for 2020 for Oregon. The past few years, Oregon has filled up with increasing speed.
Alaska, Idaho, and Montana usually do not fill up their 30 spots.

In my experience, applications do not come together over night, as there are several components that require consideration and preparation. The starting point is coming to agreement on a contract which satisfies physician and employer, while meeting all state requirements for the waiver. Beyond that, there is much paperwork, which several discrete requirements that require differing amounts of attention. All this is to say, time is of the essence for anyone seeking spots for this fiscal year in Oregon or Washington. For 2021, it will be best to plan far ahead of the October 1st open window date, as there are some time sensitive requirements that must be met in advance of filing.

All is not lost, necessarily, if all the spots fill up. Sometimes other temporary and permanent solutions exist. Some physicians can successfully obtain O-1 Alien of Extraordinary Ability work authorizations, based on their accomplishments. Canadians physicians can sometimes obtain H-1B status, due to the fact that Canadians are “visa exempt”. It is also sometimes possible to commute from Canada to work in the U.S., and thus fulfill the two year residency requirement while working in the U.S. The U.S. Department of Health & Human Services also operates a J waiver program that can work for primary care and mental health practitioners sometimes. Other federal agencies can also act as sponsors, such as the Department of Defense has previously done via its Military Accessions Vital to the National Interest program (MAVNI). That program however is not currently operating, though DOD has authority to sponsor.

Several bills have been introduced over the years to improve the Conrad 30 program. The Conrad State 30 and Physician Access Reauthorization Act (H.R. 2895) would expand the program, and help address physician shortage needs. As a member of the International Medical Graduate Task Force, I try to stay up on the latest legislative efforts, and always willing to help connect physicians with legislators in an effort to improve access to care and physician opportunity.

I am happy to schedule consultations with physicians and/or potential employers to further discuss these and other immigration-related matters.

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Posted in General, Scott Railton |

Immigration In A Time of Restrictions

Saturday, July 15th, 2017 by W. Scott Railton

Immigration restrictions are one of the defining characteristics of the Trump Administration, which is now about 6 months in. Each week it’s something new, but the overall picture is the Administration intends to restrict all immigration, however it can.

I know from talking with clients that there is a great deal of fear and concern. Know that despite all the restrictive activity, the agencies are still granting petitions and visas, at least outside of those directly subject to travel bans. There may be longer delays, and the likelihood of increased red tape has to be anticipated. Sometimes, caution is needed, and frankly, competent legal advice is sometimes very valuable. Understanding things ahead of time is more likely to lead to predictable outcomes. This is how we try to help.

Here are some of the latest developments:

  • The Supreme Court will take up the travel ban case this fall.  In the meantime, the Court permitted a revised, limited ban to go forward. Lawsuits immediately commenced, on just how to deal with the Court’s limitations, including whether grandparents could be exempt. As this drags on in Court, I can’t help but wonder if the emergency aspect of these orders is moot. So did SCOTUS, by the way, when they granted certorari. Meanwhile, consulates in certain countries aren’t issuing visas like they ordinarily have in the past. Consular officers have many ways to deny and/or delay visa applications, with or without an official travel ban. There is no judicial review of visa denials. Some consulates have always been tougher than others, but this is different. Recently, I’ve heard of some 35 Pakistani doctors who were unable to get visas for unexplained reasons. Long-time practitioners say they’ve never seen anything like it.
  • The U.S. Trade Representative notified Canada and Mexico that it wishes to renegotiate the terms of North American Free Trade Agreement (NAFTA). Public comments were accepted, and three days of hearings were held in Washington D.C. to gauge priorities. The focus of the discussion seems to be on trade (think Detroit/Toronto auto industry; softwood lumber), but trade in service and immigration was discussed. Some calls were made to update the list of NAFTA TN professions to include Software Designers, Financial Analysts, IT Consultants, Physician Assistants, and Nurse Practitioners. There is a need for an update, as the list is nearly 25 years old, but there is great fear that the list will be excessively limited. We will be monitoring NAFTA TN developments closely.
  • The Deferred Action for Childhood Arrivals (DACA) program continues for now. This program allows certain undocumented “Dreamers” to get temporary work authorization and avoid deportation. President Trump seems in favor of the program. However, several states have joined to challenge the program, and DHS Secretary Kelly says the program may need to end. Attorney General Sessions, historically an opponent when he was in the Senate, is equivocal on whether he will defend the program. Other Obama measures, such as relief for parents of U.S. citizens, have already been officially rescinded.
  • Temporary Protected Status (TPS) is a form of humanitarian relief provided to persons from certain designated countries, where great harms have occurred, or continuing dangers exist. For example, in recent years, citizens of Haiti and Nepal have been able to obtain TPS, due to earthquake and rebuilding. The Administration indicates it may soon cancel TPS statuses in a number of cases.
  • Sanctuary cities is another well-reported flashpoint. President Trump has issued an order to review defund designated as sanctuary cities, and AG Sessions has actively been speaking out on the subject.
  • The Pentagon is looking at canceling its Military Accessions Vital to the National Interest program, which provided a path to naturalization for persons who enlist and who are vital to the national interest. Examples include Iraqi interpreters and specialized medical workers for the military. Our colleague Margaret Stock has been a driving force in the success of this wonderful program. It would be a shame for the program to be pulled, since the troops get much needed support from certain persons with vital skill sets. It’s not hard to fathom that we should take care of interpreters who are helping us fight terrorism.
  • The President’s budget includes substantial funding for planning the wall, and for more boots on the ground for immigration enforcement. It includes $1.5 billion for added interior enforcement and $2.6 billion for Customs and Border Protection.  Expect a full-on debate on these figures soon in Congress.
  • Access to legal counsel is under attack, as the Department of Justice sent a cease and desist letter to NW Immigrant Rights Project, requiring that they file a Notice of Appearance if they are going provide counsel to persons in removal proceedings. NWIRP historically provides limited representation at the Detention Center. For example, they provide education sessions and initial case assessments. DOJ is trying to halt all that. NWIRP has filed suit in federal court.
  • The USCIS Field Offices and CBP Ports of Entry are asking many more questions about use and possession of legalized marijuana. Officers from each agency now have scripts, prepared by counsel, designed to extract disqualifying admissions (e.g. “Yes, I smoked pot, in Washington, where it’s legal.”). These admissions become the basis for denying admission, based on a violation of federal law. Persons with no criminal record denied visas, entry, green cards or naturalization–based only their admission to having used legalized pot at some point. Recently, a group of Congress representatives wrote the agencies for more information on these practices.
  • The Administration also recently suspended implementation of the International Entrepreneur Rule, which was designed to provide noncitizen entrepreneurs of Silicon Valley and elsewhere a pathway to stay in the U.S. and continue to develop their ideas and businesses. Basically, this was another bridge-gap administrative rule by the Obama Administration, to temporarily address a need, since Congress can’t get the job done. While I found the rule awkward, it’s not a bad idea, and would guarantee more American jobs. Its no secret that many, many of the tech companies in the United States have noncitizen founders. The American dream often starts in a garage somewhere. I fear that garage may end up in another country.
  • There has been a spike in persons entering Canada illegally, to claim asylum. This is well-reported, and happening right here in Whatcom County with some frequency. The Third Safe Country Agreement between the US and Canada prevents persons from claiming asylum at the ports of entry in most circumstances, as this would be deemed as forum shopping. However, if persons enter illegally, and arrive on Canadian soil via the U.S., they may claim asylum. There is a growing perception that Canada is more welcoming to refugees.


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Posted in General, Scott Railton |