MISSISSIPPI STATE BOARD OF HEALTH ADOPTS IMPROVED CONRAD 30 AND NATIONAL INTEREST WAIVER PROVISIONS

On April 7, 2013, the Mississippi State Board of Health met and approved proposed revisions to the Mississippi Conrad 30 J-1 Waiver Program and Physician National Interest Waiver regulations.

These revisions were proposed after considerable lobbying efforts on the part of numerous Mississippi healthcare employers, that rely on the services of foreign medical graduates to provide medical services to shortage areas in Mississippi. The previous program requirements had proven to be very cumbersome, expensive and fraught with difficulty. The previous 6 month recruitment requirement often resulted in the loss of a prospective candidate. When employers did not have evidence of a national print media ad, appearing within the preceding 6 months, they would be required to place a national print ad, and then were required to wait 6 months to determine if any U.S. physicians responded to the ad, prior to filing the waiver application with MSDH. Foreign physicians seeking employment during the last year of their residency, could not be expected to wait 6 months while the prospective employer completed the recruitment requirements. Consequently, many promising J-1 waiver prospects were lost to Mississippi. A state that ranks 2d in the percentage of population living in a medical shortage area, cannot afford to lose good medical candidates.

For that reason, the recent improvements to the Conrad 30 program are to be welcomed. The new revisions are effective May 15, 2013, and the changes include:

• The recruitment period is reduced from 3 months to 6 months
• For FLEX candidates, the sponsoring facility must show that 30% of its patients come from a nearby HPSA shortage area. The state will require patient origin data
• Documentation of recruitment efforts are somewhat relaxed and evidence may now include:
• Regional and/or national print media ads
• Online ads
• Certified letters to medical schools
• The employer can provide any other evidence that shows recruitment
• There is no specific requirement for community support letters
• The regulations continue to require HIV and tuberculosis screening for the J-1 waiver applicant. Those physicians that test positive for TB must undergo a treatment program.

The Board of Health also approved a much needed change to the Physician National Interest Waiver regulations. Specifically, the regulations no longer contain a requirement that the foreign physician must have practiced in Mississippi for at least 2 years prior to applying for the statutorily required state support letter. The previous 2 year practice requirement essentially destroyed the usefulness of the NIW, because it prevented the NIW physician from applying for adjustment of status during the first 2 years of practice in Mississippi. This deprived physician spouses and family from receiving the work and travel authorization that Congress intended them to have when the NIW program was created in the Nursing Relief Act of 1999.

With the 2 year restriction no longer in place, NIW applicant physicians in Mississippi will be able to immediately obtain the benefits of the NIW, including work and travel benefits for their spouses and family members.

The NIW regulations include the same HIV and TB screening and treatment provisions as appear in the Conrad 30 program.

I applaud the staff of the Mississippi Department of Health, including Ms. Rozelia Harris, for drafting and presenting these revised regulations. These changes should aid the recruitment and retention of foreign medical graduates to medically underserved areas in Mississippi, and they clearly serve the public interest.