HHS Exchange Visitor Program

PCRH’s immigration programs exist to help recruit physicians to underserved areas. When physicians travel to the US to complete their graduate medical education, they come on a J-1 Visa. This visa allows them to complete their training, but then requires them to return to their home country for two years before applying for a work visa. Physicians can waive this requirement by obtaining a waiver through the Health and Human Services Exchange Waiver Program.

After international medical graduates with an exchange visitor (J) visa finish their residency or medical schooling, they are required to live in their country of origin for at least 2 years before returning to practice in the U.S.
The U.S. Exchange Visitor Program accepts physician applications to request a waiver of the 2-year foreign residency requirement. Then, the agency submits its recommendation to the Department of State for its approval and recommendation to the U.S. Citizens and Immigration Service (USCIS). USCIS is the agency with the authority to officially grant a waiver.
The Utah Department of Health and Human Services (DHHS) can provide a letter of support for qualifying physicians applying for a waiver through the HHS Exchange Visitor Program.
To be eligible for a DHHS letter of support, the physician must provide documentation that they will be employed in Utah in a position that serves the public interest.

To qualify for such a waiver, the physician must provide primary care services needed in a Health Professional Shortage Area (HPSA), Medically Underserved Area (MUA), or Medically Underserved Population (MUP) in Utah. Qualifying physicians must agree to deliver health care services for 3 years in a federally designated shortage area with a primary care HPSA score of at least 7. For psychiatrists, a mental health HPSA score of at least 7 is required. While no score is required for an MUA/MUP, it must be located within a federally-designated shortage area.

Click here to learn about HPSAs.

HHS Exchange Visitor Program

Refer to the following checklist when requesting a letter from the Utah Department of Health and Human Services supporting your application for a U.S. Health and Human Services Exchange Visitor visa waiver.

The Utah Office of Primary Care and Rural Health (PCRH) processes requests on a first-come, first-served basis and requires up to 30 days to screen and process waiver requests. Incomplete applications and those that do not serve the public interest may be denied. All required information must be submitted at the same time. This program is governed by Administrative Rule R434-100 , which takes precedence over all other documents.

Submit the following required information, in order, via email to:

Anna West, [email protected]
Amanda De Lucia, [email protected]

Download HHS Exchange visitor program checklist PDF version

Definitions

“PCRH” refers to the Office of Primary Care and Rural Health in the Utah Department of Health and Human Services.
"Department" refers to the Utah Department of Health and Human Services.
"Health care facility" includes a doctor's office, local health department, clinic, or licensed health care facility where an HHS J-1 visa waiver physician may work under the supervision of the sponsoring physician.
“HHS” refers to the United States Department of Health and Human Services
"Primary care physician" refers to a physician who specializes in general internal medicine, family medicine, general pediatrics, obstetrics and gynecology, or psychiatry.
“HPSA” denotes a federally-designated health professional shortage area.
“MUA/MUP” denotes a federally-designated medically underserved area or medically underserved population.
“J-1 waiver” refers to a Conrad 30 waiver allowing J-1 foreign medical graduates to apply for a waiver of the 2-year foreign residence requirement upon completion of the J-1 exchange visitor program. The program addresses the shortage of qualified doctors in medically underserved areas.

Request requirements

The physician must submit a written request to the Department for an HHS J-1 visa waiver letter of support. The request must include from the health care facility:

the address of the facility where the physician will practice medicine
a statement that the physician has agreed to work an annual full-time equivalency of 40 hours in patient care per week
an assurance letter that the health care facility and its principals are not under investigation for, under probation for, or under restriction for:
- Children's Health Insurance Program, Medicaid, or Medicare fraud;
- violations of Division of Occupational and Professional Licensing statute or rules;
- default on any federal or state scholarship or loan repayment program offered by the National Health Service Corps or by the state under Section 26B-4-703, Rural Physician Loan Repayment Program; or
- other violations of law that may indicate that it may not be in the public interest that a waiver of the two-year home residency requirement be granted.
assurance that the facility:
accepts Medicaid, Medicare, Children's Health Insurance Program, Primary Care Network and Utah Medical Assistance Program eligible patients; and
implements a sliding fee scale, payment schedule, or similar method that demonstrates that it provides discounts to medically indigent patients.

Public interest requirements

The Department may issue a state recommendation letter finding that its support of the applicant’s HHS J-1 visa waiver is in the public interest if the Department determines that the request satisfies the requirements and the applicant meets the following additional criteria:

If the applicant is a primary care provider other than a psychiatrist, they will work as a primary care physician located within a federally designated primary care HPSA with a score of 7 or higher; or
If the applicant is a psychiatrist, they will work in a mental health HPSA with a score of 7 or higher.
They may also be located within a federally designated MUA/MUP.