The Delta Regional Authority Physician J-1 Waiver Program
Birth of the Delta Regional Authority
This week the Delta Regional Authority (DRA), a new federal agency charged with promoting the development of the impoverished eight-state Mississippi Delta region, announced plans to launch a new waiver program for physicians on J-1 visas, subject to a requirement to return to their home countries for two years.
The DRA program, created at the tail end of the Clinton Administration, is the product of the efforts of many. As a native of Memphis, Tennessee, which is smack in the middle of the Delta region, I was acutely aware of the need for physicans and was also closely involved in the program's creation. I learned that one of the missions of the agency would be to promote health care in the region. I knew that lack of access to doctors was a problem for people throughout this region of the country since I have worked with many of these communities in hiring foreign-born doctors. So why not have a J-1 physician waiver program to encourage international medical graduates to move to the region?
In early 2001, after President Bush was sworn in, Pete Johnson was appointed to be the first Federal Co-Chair of the DRA. The other co-chairs are the Governors of the eight states in the DRA region. I contacted Mr. Johnson, then a lawyer in Clarksdale, Mississippi, to see if he had an interest in the idea of a J-1 waiver program. Chairman Johnson reacted favorably to the idea and promised that after the DRA had its infrastructure in place and he was sworn in, he would begin looking at the idea.
Last spring the US Department of Agriculture announced the end of its J-1 waiver program and suddenly the physician shortage problem in the region took on a greater urgency. In the late spring, the DRA held a meeting to initially discuss the idea of its stepping in and creating its own J-1 program. I participated in that initial meeting along with Barry Walker, a well-respected immigration lawyer in Mississippi, Connie Burk, the immigration specialist for the University of Tennessee Health Science Center, Ed Tucker, a health care consultant charged with helping the DRA formulate its health care mission, and Pete Johnson.
The meeting was a breath of fresh air. The DRA made it clear that its goal is to help the people in the region and improving access to health care was a chief goal. Rather than being reluctant to take on the difficult task of establishing a J-1 program, it was eager to take on the project and get going as quickly as possible. Ed Tucker, Barry Walker and I were charged with examining the law and working to develop a draft program.
After several meetings with the Immigration and Nationality Act, the Code of Federal Regulations, numerous State 30 and Federal waiver programs, we crafted a program that was designed to comply with the law and meet the specific needs of the Delta region. Ed then left his consulting position with the DRA and passed the program on to Bill Triplett, Director of Policy at the DRA.
The DRA was then ready to test the program with two initial applications. One was a client of mine, a physician seeking to work in rural West Tennessee. The other was a physician seeking a position in Clarksdale. The DRA worked through the initial applications and sent them on to the State Department for review. DRA officials also flew to DC and met with the State Department to introduce the program to the State Department and make sure that it satisfied the State Department's Waiver Review Division. It did and the first cases were approved just recently by the State Department.
With some assurance that the program would meet all of the legal requirements, this week the DRA unveiled the waiver program in a meeting with officials from the various DRA states. The program was also attended by Mike Berry, the official at the Department of Health and Human Services who will be administering that agency's new J-1 program. Now the program will undergo its final review based on comments from the State officials. We can then look forward to many communities benefiting from having the doctors that they need so badly.
Delta Regional Authority Program
The DRA is headquartered in Clarksdale, Mississippi. It is a federal-state partnership serving a 240-country/parish area in an eight state region comprising parts of Mississippi, Louisiana, Alabama, Arkansas, Tennessee, Kentucky, Missouri and Illinois. A coverage map can be found at http://www.dra.gov/dra_coverage_map.html.
The agency's mission is to "remedy severe and economic distress by stimulating economic development and fostering partnerships that will have a positive impact on the region's economy."
The DRA also states that it is committed to helping all residents of the Delta region to have access to quality, affordable healthcare as a core part of the region's economic development. It is with this in mind that the DRA will sponsor J-1 physicians.
The DRA program, like other federal programs, is available to primary care physicians. Primary medical care includes general or family practice, general internal medicine, pediatrics, obstetrics and gynecology and psychiatry.
Physicians seeking a waiver must commit to providing primary care for not less than forty hours per week in a Health Professional Shortage Area (HPSA), Mental Health Professional Shortage Area (MHPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP) in a DRA county. The physician must also sign a contract committing him or her to providing three years or more of service. The contract must also not contain a non-compete clause.
Employers seeking to hire physicians under the program must show that they have been making a good faith attempt to recruit an American doctor in the same salary range without success.
[Note: The DRA's waiver program is undergoing final review at the current time and applications are not yet being accepted. When the program official debuts you will find application materials on the DRA web site at www.dra.gov.]
Gregory Siskind is a partner in Siskind, Susser, Haas & Devine's Memphis, Tennessee, office. After graduating magna cum laude from Vanderbilt University, he received his Juris Doctorate from the University of Chicago. Mr. Siskind is a member of AILA, a board member of the Hebrew Immigrant Aid Society, and a member of the ABA, where he serves on the LPM Publishing Board as Marketing Vice Chairman. He is the author of several books, including the J Visa Guidebook and The Lawyer's Guide to Marketing on the Internet. Mr. Siskind practices all areas of immigration law, specializing in immigration matters of the health care and technology industries. He can be reached by email at firstname.lastname@example.org.
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