On October 1st, Health Departments around the country will begin accepting J-1 waiver applications under the Conrad program. Each state is allotted 30 spots, with the majority going to primary care physicians, who agree to work for three years in a health professional shortage area. In turn, their two year foreign residency requirement is waived. We routinely prepare these applications.
Rules vary state to state, although the federal government has minimum requirements. Washington State, where we are located, historically takes between six and twelve months to fill all of its spots. However, last year Oregon, which also used to be slow to fill, filled their spots in record time. Some states receive more than 30 applications on the first day the window opens.
Here are a few of the key rules for Washington State:
- Up to ten sponsorships are available for Specialists between October 1st to March 31st. Last year, more than 10 applications were submitted during this period, but spots were still left available after March 31st. This has historically been true too.
- Washington State also allows 10 non-designated FLEX waivers per year, with these slots opening on January 15th.
- Washington State limits employers to only three waivers, prior to June 1st of the fiscal year.
- Applicants, including integrated health care systems in a single HPSA, are limited to a.) two sponsorships per practice location; b.) one hospitalist sponsorship per hospital; c.) no more than three sponsorships total across all practice locations in the HPSA between October 1st and May 31st; d.) and no more than three FLEX spots by a an applicant for a single county.
- Sponsors must show at least 15% of total patient visits are for Medicaid or other low income patients. This is up from the former 10% figure.
- The process also requires that sponsors show at least six months of qualifying recruitment in the past 12 months in Washington State.