Is There a Doctor In The House…or Senate?

 

A long-term patient known as ‘Conrad’ is about to expire on September 30, 2015 unless Congress can resuscitate it and provide a permanent cure.

The ‘Conrad 30’ Program, named after former North Dakota Senator Kent Conrad - the law’s original sponsor, is a program for foreign physicians who come to the U.S. with a J-1 visa to complete their medical residency.  The J-1 visa permits foreign medical graduates to receive education and training in a Residency program in the U.S.  However, one of the terms of the J-1 visa – also known as an ‘exchange-visitor’ visa – is that it requires the visa holder to return to his or her home residence for 2 years before being eligible to adjust status or change to another type of visa that permits her to practice medicine in the U.S.  In other words, the newly-trained physician must return home for 2 years before being able to practice medicine in the U.S… unless….

…the physician is able to get a ‘waiver’ of the 2-year home residency requirement found in §212(e) of the Immigration & Nationality Act.

There are several ways in which any J-1 visa holder may request a ‘waiver’ of the 2-year home residency requirement; among these are ‘subject to persecution’ if she were to return to her home residence, exceptional hardship, and other scenarios with very high standards that not everyone can meet.  But physicians have a friend in ‘Conrad’.

The ‘Conrad 30’ program is designed specifically for physicians who desire a waiver of the 2-year home residency requirement.  Each state runs its own ‘Conrad 30’ program with its own set of guidelines, but there are a few fundamental terms that all ‘Conrad 30’ programs share; among those are that a physician must be willing to serve at least 3 years in H-1B visa status working at least 40 hours/week in a federally-designated medically underserved area providing primary care – and sometimes specialty care – to the underserved population.   You already know why it’s named ‘Conrad’; the ‘30’ stands for the number of slots available in each state for physicians willing to serve in these medically underserved areas.

Although there are some other programs that provide ‘waivers’ for physicians in J-1 visa status, (for example, Appalachian Regional Commission, the U.S. Department of Health & Human Services, U.S. Dept. of Veterans Affairs, etc.), these other programs have narrow restrictions that limit their availability.  It is recognized that the Conrad 30 program is likely the most useful waiver program for physicians in J-1 status.

However, the original Conrad 30 program had a ‘sunset’ date that has been extended by Congress to keep the program alive for years.

Unless you’ve been in a coma for the past several years, you must recognize that the volatility and rancor of our elected leaders in Congress make the prognosis of their cooperation on an immigration bill anything but certain.

 This year presents a risk that the program will die due to the negligence – and perhaps the intentional refusal of care - of our politicians.

The good news is that Senators Klobuchar of Minnesota and Heitkamp of North Dakota have introduced a Bill in the Senate, (S. 1189) that not only extends the life of the Conrad 30 program, but makes it a permanent federal law by removing the ‘sunset’ provisions.

Known as the ‘Conrad State 30 and Physician Access Act’, this bill would also clarify certain elements of the National Interest Waiver for physicians and permitting the spouses of H-1B visa-holding physicians to change status to other types of visas besides the ‘H-4’ derivative visa, among other things.

The ‘Conrad State 30’ Program is a powerful incentive for healthcare systems in rural, urban and other medically underserved areas to attract and keep physicians to care for communities in need of primary care medical services.  Many healthcare systems rely heavily upon the benefits of the Conrad 30 program to staff their hospitals and facilities - and foreign medical graduates recognize the valuable benefit it provides for them; its demise would impact these communities disproportionately.

So if you were waiting for the right opportunity to contact your U.S. Senator or Representative on an issue that overwhelmingly affects the health of small, rural communities, this would be a good time to ask for their support of Senate Bill 1189 – before it’s too late.