Louisiana Healthcare Opportunities for International Graduates
The Louisiana Conrad 30/J-1 Visa Waiver Program provides international medical graduates the opportunity to work in health professional shortage areas (HPSAs) in Louisiana.
Well-Ahead can sponsor up to 30 eligible international medical graduates each year for waiver of the two-year home residency requirement of the J-1 Visa through its Louisiana Conrad 30/J-1 Visa Waiver Program. This sponsorship includes application support to eligible graduates who are requesting the J-1 Visa Waiver. On behalf of the eligible applicants, Well-Ahead submits the application, along with a letter of support, to the U.S. Department of State Waiver Review Division (DOS-WRD).
Applications for the Louisiana Conrad 30/J-1 Visa Waiver Program are accepted all year until all slots are filled.
What is a J-1 Visa Waiver?
The J-1 Visa requires foreign physicians to return to their home country for two years before returning to the United States to live or work. The J-1 Visa Waiver eliminates this two-year return home requirement and allows the physician to adjust their visa status to an H-1B visa, which is a temporary work permit, in order to provide services to underserved citizens for at least three years (up to five years for forensic pathologists).
Note: The waiver of the two-year return home requirement is not a visa and is only one step in a multi-step process.
The Louisiana Conrad 30/J-1 Visa Waiver Program accepts applicants who serve in health professional shortage areas and meet the facility and provider requirements. In exchange for serving in these underserved facilities, the program will provide a J-1 Visa Waiver that eliminates the two-year return home requirement and allows the physician to adjust their visa status to an H-1B visa.
All applicants of the Louisiana Conrad 30/J-1 Visa Waiver Program must be represented by a board-certified attorney. Well-Ahead will work closely with the attorney to ensure application packets are completed accurately and timely.
Eligible Health Professionals
Eligible healthcare professionals consist of foreign medical graduates and primary care physicians who practice one of the following:
- Internal Medicine
- Family Practice
- Forensic Pathology
- Psychiatry (will be accepted in a mental health shortage area)
Specialty physicians may participate in the waiver program following a letter of support from Well-Ahead and final approval from both the United States Department of State (US DOS) and the United States Citizenship and Immigration Services (USCIS). More details provided in the program terms section.
Note: This program will support up to three J-1 visa forensic pathologists who agree to provide services for up to five years.
Application Criteria for Eligibility
The healthcare professional must adhere to the following:
- Agree to be employed full-time in H-1B non-immigrant status at a healthcare facility located in an area designated by U.S. Department of Health and Human Services (HHS) as a Health Professional Shortage Area (HPSA). Verification by address can be found at http://hpsafind.hrsa.gov/.
- Obtain a contract from the healthcare facility located in an area designated by HHS as a HPSA.
- Obtain a “no objection” letter from his or her home country if the home government funded his or her exchange program.
- Agree to begin employment at the healthcare facility within 90 days of receipt of the waiver, not the date his or her J-1 visa expires.
- Represented by a board-certified attorney.
Employers may request support for three physicians and/or one forensic pathologist per J-1 year, per service location, until January 1. If there are remaining Louisiana Conrad 30/J-1 Visa Waiver Program slots at that time, additional requests may be submitted.
Applicants will be prioritized according to the following criteria upon submission:
- Priority will be given to physicians who agree to serve in HPSAs with the highest degree of shortage and whose service will have the greatest impact on underserved populations.
- Priority will be given to J-1 physicians who have completed their residency or fellowship in a Louisiana residency or fellowship program.
- Priority will be given to correctly completed packets over incomplete or incorrect ones.
Participants must complete the Louisiana Conrad 30/J-1 Visa Waiver Program application form giving all information requested in the application. The application should include all forms indicated in the application review checklist considered complete. Incomplete application packets submitted will not be considered.
All applicants must be represented by a board-certified attorney. Well-Ahead will work closely with the attorney to ensure application packets are completed in an accurate, timely manner.
Once a J-1 Physician has been hired by an employer or site and an employment contract has been signed, a completed Louisiana Conrad 30/J-1 Visa Waiver Program Application Packet can be submitted to Well-Ahead.
Obligations of the Health Professional
Well-Ahead will accept support applications from October 1 through March 31. Ten of the 30 available Louisiana Conrad 30/J-1 Visa Waiver Program slots will be open to sub-specialists and specialists and up to three slots will be open to forensic pathologists. If slots have not been filled as of January 1, the remaining slots for that J-1 year will be open to all positions (specialist or primary care) on a first-come, first-served basis.
Application Submission: By Mail
Applicants must mail one original hard copy to Well-Ahead and email a PDF version of the completed application to PCRH@la.gov. Application submission date will be based on the express mail delivery date to the Well-Ahead address listed below.
Note: Be sure to include on the envelope the address exactly as it appears below.
ATTN: Well-Ahead Louisiana Primary Care Office
Louisiana Department of Health
P.O. Box 3118
Baton Rouge, LA 70821-3118
- The physician’s US DOS Case Number must be placed in the bottom right-hand corner of each page of the application packet.
- All sections must be separated by colored divider pages, with each divider pare having the name of the section or appendix printed on the page.
- Do not use staples, binders, two-sided copies, and/or pages smaller than 8.5 x 11 inches. Use a large rubber band to hold your packet together if needed.
- Each listed form must be completed.
- The packet Application Packet Checklist must be signed and placed in the appropriate section of the packet. A document included in this packet list that does not apply to the applying physician or site must be denoted on the Application Packet Checklist by marking that section with an “N/A” to the left side of the number/letter on the checklist.
Incomplete or Incorrect Application Submissions
Submission of a complete Application Packet will hold a slot for this physician while the packet is under review. If the packet is considered to be incomplete or if there are edits needed following the review by the Louisiana Conrad 30/J-1 Visa Waiver Program Review Committee members, the point of contact for the packet (the physician, the attorney, the employer) will be notified of its incomplete and/or incorrect status in order for the packet to be completed or corrected as necessary.
In the event that the errors or incomplete sections are found to be too numerous or excessive, the packet will be returned to the point of contact as appropriate for correction and resubmission. In the event that the packet is considered to be incorrect and/or incomplete per this policy, the packet will be placed “on hold,” until it is corrected and/or completed.
The initial check of the application packet for completed documentation will be completed in a timely manner following receipt. If the packet is not complete, or does not meet program criteria at the time of this review, the point of contact will be notified in writing regarding the deficiencies and/or issues which need to be corrected/addressed.
Subsequent review of the packet will be completed by the remaining members of the Louisiana Conrad 30/J-1 Visa Waiver Program Review Committee. The Application Packet will be evaluated for support by Well-Ahead only when they are fully completed. Well-Ahead will make the determination about whether or not to support the physician’s waiver request application within 45 days after the packet is considered to be complete with all issues resolved.
Practice Site Approval
All employers and practice site locations must complete the Site Information Form (see below for additional information on practice sites for forensic pathologists). If the site is different from the employer, they must also submit a Site Information Form. The site must have the following in place at the time of submission of the Site Information Form:
- A written policy that states the site accepts all patients regardless of their ability to pay, as well as a sign posted in the waiting room informing all patients of this policy
- A sliding fee schedule, charity care or indigent-care policy for uninsured/underinsured patients who are at or below 200% of the most current federal poverty level
- Proof of provision of services to Medicare and Medicaid patients (e.g. A written policy)
The Site Information Form should document that a minimum of 30% of the following patient types were treated by the site in the previous year:
- Medicaid patients
- Medicare patients
- Uninsured/underinsured patients who were eligible for reduced fees under application of the sliding fee scale/indigent-care policy
- Total patients treated and number of visits to the site during the year
Note: All physicians and practice groups and/or services at the practice site must accept all of these patient types.
All new sites will receive an unannounced site visit prior to practice site approval. Any issues arising from any site visit must be addressed by the point of contact as necessary to resolve these issues. Approved sites will remain in and “approved” status for a three-year period from the date of approval (five-year period for forensic pathology sites).
As of the date of the submission of an application requesting participation in the Conrad 30/J-1 Visa Waiver Program, the practice site must be located in an area designated by the HRSA Shortage Designation Branch as a primary care HPSA, or mental health HPSA in the case of psychiatrists seeking program participation, or the applicant must provide documentation that the site serves residents of a nearby HPSA.
Documentation is considered proof that their patient base for the last year has been comprised of at least 30% of residents from a designated HPSA, of the appropriate type. The appropriate type means that primary care HPSAs are reviewed for primary care sites and mental health HPSAs are reviewed for mental health sites.
In order to document that the site meets the criteria, the site must include information regarding their patient base numbers, by patients’ zip codes, payer type (Medicare, Medicaid, uninsured) and the HPSAs served. This will be done by completing the FLEX (Non-HPSA) Request Form.
Note: Employers may request support for three physicians per J-1 year, per service location, until January 1. If there are remaining Louisiana Conrad 30/J-1 Visa Waiver Program slots at that time, additional requests may be submitted.
Practice Sites for Forensic Pathologists
- Acceptance of Medicare/Medicaid and uninsured/underinsured sliding fee scale patients is not required by the practice site for forensic pathologists only.
- Employers may request support for one forensic pathologist per program year, per service location, until January 1. If there are remaining forensic pathologist slots at that time, additional requests may be submitted.
- Forensic pathology applicants should use the forensic pathology version of the Site Information Form.
Application Packet Documents
Applicants must submit all the following documentation with their application. If there is a document included in this packet list that does not apply to the applying physician or site, it must be denoted on the Application Packet Checklist by marking that section with an “N/A” to the left side of the number/letter on the checklist.
Site Information Form
The Louisiana Conrad 30/J-1 Visa Waiver Program Site Information form must be filled out completely and placed on top of the application packet when submitted to Well-Ahead. Do not label or mark this form as a separate section of this application. For forensic pathology applicants, use the Site Information Form—Forensic Pathology.
- Application Packet Checklist
- Section 1: Form DS-3035 and/or the Third-Party Barcode Page
Section 2: Cover Letter (letter of support)
This letter will be inserted by Well-Ahead indicating the site’s support of this Louisiana Conrad 30/J-1 Visa Waiver Program request application.
Section 3: Employment Contract
It is suggested that the employer state the following Louisiana Conrad 30/J-1 Visa Waiver Program and Immigration Services requirements into an amendment to contain the following:
- The facility name, address, telephone number of all locations where the physician will be working or might work occasionally. These possible work locations can be listed separately as an addendum if they are numerous.
- Both the physician and head of the employing facility must sign and date the contract.
- The contract must state that the physician is a full-time employee working a minimum of 40 hours per week or 160 hours per month. The hours may include 8 hours of administrative time per week. This will not include hours in teaching settings, supervising residents, fellows, or students, supervising a clinic, or other administrative work.
- The term of the contract must be for a minimum of three years (five years for forensic pathologists) with a salary at least Level 2 of the United States Department of Labor’s prevailing wage guidelines for physicians of the same type in the same area. See Prevailing Wage Information under the appendices section for further details.
- A non-compete clause must not be included in the contract with no restrictions to practicing in the area once the service term requirements are met.
- The contract must include a clause stating that Well-Ahead will be notified at least 60 days prior to the termination of the contract by either party or immediately upon termination if an immediate termination occurs.
- The contract cannot be terminated without cause by either party and must include a statement to that effect.
- Well-Ahead will be notified of all post-approval contract amendments and assignments after the date of the original contract signing.
Note: Failure of the physician or the practice site to fulfill the employment contract which was submitted to Well-Ahead for review as a part of the of the Louisiana Conrad 30/J-1 Visa Waiver Program Application Packet will affect the visa status of the J-1 Physician and any decisions regarding future J-1 Physician placements for this employer at any of their locations throughout the state. Failure to comply with Louisiana Conrad 30/J-1 Visa Waiver Program criteria by the physician or the employer as indicated by signing the Criteria for Support by the State of Louisiana may affect the employer’s participation in other Well-Ahead recruitment and retention incentive programs at any of its service locations and may affect the visa status of the J-1 Physician.
Section 4: Documentation of HPSA Address Designation
The site will include documentation that they are located in a designated primary care HPSA and/or a mental health HPSA as appropriate for each application. Verification by address can be found on the Health Resources & Services Administration (HRSA) website. If the site is not located in a HPSA, the applicant must complete the FLEX (Non-HPSA) Support Request Form and include it in this section.
Section 5: Practice Site Letter of Need
A letter of explanation from the facility, detailing the need to hire a physician. Included in the letter should be a description of the population served, why it is necessary to hire a physician, and what will be accomplished with the hiring of this physician. The letter must be signed by the practice site administrator and be written on the practice site’s letterhead.
- Section 6: Physician Statement
Section 7: Curriculum Vitae
Physician’s current CV must be included.
Documents must be placed in the following order and labeled accordingly:
Copies of the following will be included:
- Copies of United States Medical Licensing Examination (USMLE) passing results for Step 1, Step 2 Clinical Skills, Step 2 Clinical Knowledge, and Step 3
- Any other relevant certifications/diplomas
- Applicant’s current Louisiana State Board of Medical Examiner’s license or a copy of the application for this license
The Physician Attestation must be signed, dated and notarized.
Legible copies of the physician’s IAP-66/DS-2019 forms covering every period the physician was in J-1 visa status will be included. These forms must be submitted in chronological order with “Begin a new program” first.
Form G-28 or Letterhead from Law Firm (if applicable)
Include this form if the J-1 physician wishes for their attorney to receive notice of actions taken regarding their waiver request application. The instructions and an electronic version of Form G-28 are available on the U.S. Citizenship and Immigration Services website.
I-94 Entry and Departure Cards and/or Passport Documentation
Photocopies of these cards, front and back, must be included and/or copies of the passport used when entering the United States.
Three Letters of Professional Recommendation
At least three letters from the physician’s peers, professors or those who know the physician’s qualifications, in which these people recommend the physician for placement at a site to practice the type of medicine for which the physician was hired must be included. NOTE: No form letters will be accepted.
Original Signed Copy of the Criteria for Support by the State of Louisiana
Provide a written description of the recruitment campaign and outcomes with documentation of the practice site’s position-specific advertisements.
- Must include proof of good-faith effort conducted at least three months prior to the application such as copies of ads, placement agreements, etc., and other evidence documenting unsuccessful attempts to recruit qualified US physicians. Acceptable documentation shall include copies of advertisements for the position published in newspapers, journals, copies of letters to state medical schools, targeted mailings, copies of on-line advertisements that specifically target the practice opportunity, and other supporting documentation which demonstrates a good faith effort to recruit American physicians. Additional documentation may also be included regarding written statements of other recruitment activity including phone conversations, personal visits and such.
- Must provide documentation of United State citizens who inquired or applied and were not hired: A list of all US citizens or permanent residents who applied for, or inquired about, this position who were not hired will be included along with the reason they were not offered the job or if they turned down this position. If none applied, please note this in this section.
Three Letters of Support from the Community
Letters of support from the medical community where the physician will be practicing including at least one from a primary care physician or a local hospital administrator. Letters from the applying facility/facilities will not be accepted.
Specialty Dire Need Criteria Form
The information requested in the Dire Need Criteria Form needs to be submitted if a specialist (non-primary care) physician is being hired. (For forensic pathology applicants, please use the Special Dire Need Criteria Form—Forensic Pathology.)
Copy of Verification of Employer’s Valid Medicaid ID Number
Prevailing Wage Information
Documentation of the salary range for the position, which must be 100% of the United States Department of Labor’s (US DOL) prevailing wage rate (at least Level 2 or higher) for physicians of the same-type in that area and/or the salaries of currently employed US citizens at the practice site if lower than US DOL’s noted wages. A copy of the most current prevailing wage for the type of physician applied for from US DOL should be included or verification that the salary offered is the same as US citizens with similar work experience who are working in the same position at this facility. Information on prevailing wage can be found on the Foreign Labor Certification Data Center Online Wage Library. If Level 1 wages are being used, an explanation of why this level is appropriate must be included. If information on prevailing wage being used is less than the wages listed on the U.S. DOL website, the applicant will need to have this wage level certified by U.S. DOL and provide documentation that the statistical information used as a basis for this other wage analysis is mathematically sound. A complete step-by-step guideline for selecting an appropriate prevailing wage can be found on the Foreign Labor Certification Data Center Online Wage Library.
Documentation of Sliding Fee Scale or Indigent Care Policy
The site must provide a copy of their sliding fee scale or indigent care policy for their uninsured or underinsured patients who are at or below 200 percent of federal poverty level including the actual scale used. The sign or notice that states that the site sees all patients regardless of ability to pay must be included. A picture of this sign posted in a conspicuous place in the waiting room of this site must be included.
Explanation for Out of Status (if applicable)
This information is required if the physician spent any time in some other visa status, out of status, or outside the United States.
A “No Objection” Statement (if applicable)
A statement from the physician’s government is required if the physician received government funding for their educational or living expenses while in school.
Following approval for the Louisiana Conrad 30/J-1 Visa Waiver Program, the physician, employer and Well-Ahead are accountable for specific obligations.
Responsibilities of the Physician/Employer
The physician/employer must provide Well-Ahead with a Quarterly Service Report after the physician has obtained their H1-B Visa and begins working. Reports are based on the federal fiscal year and are to be submitted by email. (For forensic pathology applicants, use the Quarterly Service Report —Forensic Pathology.)
Reporting Submission Schedule:
- Quarter 1 (October 1-December 21), due January 31
- Quarter 2 (January 1-March 31), due April 31
- Quarter 3 (April 1-June 30), due July 31
- Quarter 4 (July 1-September 30), due October 31
Note: Failure to provide these reports in a timely manner will jeopardize future Louisiana Conrad 30/J-1 Visa Waiver Program support for this practice site and may result in an out of compliance report for the J-1 Visa Waiver physician to the federal government.
Support Provided by Well-Ahead
- Verify that the practice site is located in a designed HPSA as determined by the US Secretary of Health and Human Services (per federal regulations) or that the practice is serving residents of a HPSA.
- Verify that the employer has an active practice site, such as one which is open at least 40 hours a week. For newly opened practices, Well-Ahead will verify that the site has been opened at least one year, has implemented a sliding fee scale/indigent care policy, and has complied all other criteria as required by and reported to Well-Ahead. The sliding fee scale/indigent care policy, including posted signage announcing it, must be implemented and in effect at least 90 days prior to the submission of the Louisiana Conrad 30/J-1 Visa Waiver support request application packet to Well-Ahead.
- Assist the applicant and their attorney with other forms that may be required for the physician or the physician’s family members as needed.
- Submit the completed application packet requesting that a Louisiana Conrad 30/J-1 Visa Waiver be approved to the appropriate federal government agency on behalf of the physician including a letter of support from Well-Ahead acting as an Interested Government Agency (IGA) supporting this Louisiana Conrad 30/J-1 Visa Waiver Program support request application packet.
- Complete all site visits as required prior to issuing a letter of support and as the physician completes their Louisiana Conrad 30/J-1 Visa Waiver obligation to ensure program compliance by all parties.