Conrad 30 and Physician Access Act of 2013 (S.616) Will Benefit Medically Underserved Communities in the United States

My practice is concentrated in the representation of foreign medical graduates (FMG’s), and the health care employers who rely on these physicians to help provide medical care to medically underserved communities throughout the United States. For the past several years, I have participated as a member of an advocacy team, promoting federal legislation which would remove some of the legal barriers and pitfalls which inhibit the recruitment, placement and retention of FMG’s to some of the neediest communities in our country.

 

On February 20 of this year I traveled to Washington and spoke with several Senate and House staff persons, for the purpose of promoting beneficial legislation. It is beginning to look like our efforts may be coming to fruition. On March 18, 2013, a bi-partisan group of Senators introduced S.616, the “Conrad 30 and Physician Access Act”. This proposed legislation contains several features which would improve the legal environment for FMG’s. The bill is budget neutral, i.e. it does not require any expenditure of money, and it enjoys bi-partisan support. The bills co-sponsors are, Sen. Amy Klobuchar (D. MN), Sen. Heidi Heidkamp (D. ND), Sen. Jerry Moran (R. KS), and Sen. Susan Collins (R. ME). The bills principal features are:

 

Removes sunset provision of Conrad 30 program, making it a permanent program. It is now scheduled to expire in 2015

 

Exempts National Interest Waiver physicians from the worldwide immigration quotas. This provision would encourage FMG’s to work for five years in an underserved area.

 

Employment Protection Provisions:

 

Would allow an FMG to leave an employer during the 3 year J-1 waiver obligation period, without demonstrating “extenuating circumstances”, merely by agreeing to serve an additional year of service.

 

Doctors whose employment is terminated would have 120 days to begin new employment in an underserved area before being considered out of status.

 

Increases Conrad 30 numbers: When at least 90% of states (not including states that approved less than 5 waivers) have exhausted the Conrad 30 slots in a given year, all states would be allotted 5 additional slots for the following year.

Academic Medical Centers will be granted 3 waivers per state. These are in addition to the Conrad 30 waivers.

 

J-1 Dual Intent: FMG’s who enter the US as J-1 exchange visitors, in order to undertake graduate medical training, would not be subject to Sec. 214(b), which requires nonimmigrants to prove that they are not intending immigrants.

 

Alternate Visa Status: During the Conrad 3 year service period, FMG’s would be permitted to hold statuses other than the H-1B.

 

National Interest Waiver provisions:

Clarifies that specialists are eligible for the physician national interest waiver.

Allows the NIW for “flex” locations, i.e. locations outside medical shortage areas, but in facilities that serve surrounding shortage areas.

 

I believe these provisions would help alleviate some of the legal impediments to the placement of foreign medical graduates in underserved areas.  We are urging all of our health care employer clients to contact their Senators and to urge support for Senate Bill 616, the “Conrad 30 and Physician Access Act”.

I-Squared Act is Bi-Partisan Effort to Improve Immigration of High-Technology Workers

In recent weeks, much has been reported in the media concerning comprehensive immigration reform. Many people tend to focus on the estimated 11 million undocumented persons in the United States.  But of equal importance to our economy and our international competitiveness is the need to improve and increase the immigration of highly skilled technology workers to the United States.

On January 29, 2013, a bi-partisan group of Senators introduced Senate Bill 169, the “Immigration Innovation Act of 2013 (I-Squared Act)” an important bill that would vastly reform and improve the immigration system for high-technology workers. For years, antiquated U.S. immigration law has impeded the natural migration of high-technology workers, many of whom have been educated in the United States. Many economists and some politicians, across the ideological spectrum, have advocated for increased and eased entry of foreign high-technology workers. Science, Technology, Engineering and Mathematics (STEM) workers help to propel and sustain technology innovation and development. Many foreign-born STEM workers are among the most successful U.S. entrepreneurs. In short, it is now widely recognized that foreign-born STEM workers do not displace U.S. workers, rather they help create and grow U.S. jobs.

The I-Squared Act would improve and increase numbers of both temporary (nonimmigrant) and permanent immigration to the United States.

 In the area of permanent (green card) immigration: I-Squared provides for the recapture and use of employment-based green cards that were not used in previous years; it would exempt dependents of employment-based green card recipients, U.S. STEM advance degree graduates,  persons of extraordinary ability, and outstanding professors and researchers from the 140,000 annual cap. The law would provide for the roll-over of unused employment-based green cards to the following fiscal year so as to avoid the need to recapture these in the future, and it would eliminate the annual per-country limits for employment-based green cards and raise per-country caps for family-based green cards.

In the area of H-1B (temporary high-skilled workers requiring at least a bachelor’s degree): The proposed I-Squared law would increase the H-1B annual numerical limitation from 65,000 to 115,000, and it would establish a market-based H-1B escalator, that would adjust up or down to the demands of the economy. The law would uncap the existing U.S. advanced degree cap exemption (there is currently a cap exemption for the first 20,000 U.S. advanced degree holders per year), and it would authorize employment for dependent spouses of H-1B visa holders.

I-Squared would also unburden F-1 foreign students by providing for “dual intent”, i.e. the intent to study temporarily in the U.S., while also pursuing lawful permanent immigration. The “un-abandoned residence” requirement has long hampered and discouraged foreign students who wish to enter the U.S. to study.

Based on our years of representation of high-tech workers and their employers, we instinctively know that there is an enormous amount of pent-up entrepreneurial and innovation energy that lies untapped within the high-skilled immigrant population in the U.S. If I-Squared is enacted, we believe this country will experience a palpable burst of economic and technological advancement. Let’s do more than keep our fingers crossed. We urge everyone to contact their congressmen and senators to urge passage of the bi-partisan “Immigration Innovation Act of 2013”.