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Siskind Susser, PC
Conrad State 30 Program Chart
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Alabama 30 HPSA or MUA Family Practice, Up to fifteen Must include a Advertising No policy has Apps for PC &
Kristi Mitchell Internal (15) max specified required at 3 been developed mental health & SS
334-206-5229 (updated Medicine, with limit of liquidated levels: national, yet. apps for rural
Kristi.Mitchell@adph. 10/01/09) Pediatrics, no more damages in-state, & AL facilities accepted
state.al.us OB/GYN & than two (2) clause; med schools, all beginning Oct 1;
Psychiatry per employer Incorporation in the 6 months SS apps for non-
of all the before applying. rural accepted
terms and Web ads not beginning Jan 1.
conditions of accepted as
the AL Waiver proof. Must Physician must be
Program; submit tear ineligible for ARC
cannot include sheets & proof of waiver
non-compete coordination with
restrictions AL med schools http://www.adph.o
rg/ruralhealth/inde
x.asp?id=882
Alaska 30 HPSA or MUA N/A Yes 40 hours a None All applications Ongoing process.
Triptaa Surve week for 3 are reviewed on
907-334-2640 (updated years a case-by-case http://www.hss.sta
Triptaa.Surve@alaska 10/01/09) basis. te.ak.us/commissio
.gov ner/Healthplanning
/workforce/assets/
akPandP.pdf
Arizona 30 Primary Care Family Practice, Up to 7 slots 40 hours a Include a Site must be Apps accepted Oct
Fabian Valle HPSA, General reserved for week; must description of located in HPSA, 1, 2009 – Nov 30,
602-542-1066 (updated MHPSA, Practice, full-time start work efforts & copies MUA or MUP. 2009.
vallef@azdhs.gov 10/01/09) Federal MUA Pediatrics, specialists within 90 of ads or
or MUP OB/GYN, days; may not announcements. Review is 10-12
General For more have a non- Must include the weeks.
Internal info: compete number of U.S.
Medicine and www.hs.stat clause; must physicians who Facility must
Psychiatry e.az.us/hsd/ specify work applied & complete service
visa_waiver. site outcome of any site application.
htm interviews. Must
show that a good Physician should
faith effort was contact Dept to
made to recruit ensure eligibility
U.S. physician in before applying.
the same salary
http://www.azdhs.
range.
gov/hsd/visa_waiv
er.htm
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Arkansas 30 HPSA, Family Practice, Yes 40 hours a Any/all methods Slots will only be 20 apps from Aug
Mary Fuller MHPSA, Internal week for 3 over any period available if any 1 to Oct 31; 10
501-661-2771 (updated MUA, MUP or Medicine, years; salary of time or a slots remain apps from Jan 1 to
mary.fuller@arkansas 10/01/09) Facility Pediatrics, stated; strongly worded open after March Mar 31
.gov Designation Gerontology, physician & letter 31. They will be
OB/GYN & employer filled on a first Facility must be in
Psychiatry must agree to come, first serve operation 6
comply with basis. Applicants months prior to
No distinction INA 214; must submit application.
between physician & evidence that a
primary care employer min of 30% of
and specialties. must sign & their current
date contract; patient base
no non- resides in a
compete/non- neighboring
solicitation HPSA or MUA.
clauses.
California 30 HPSA, MUA Family Accepts sub- 40 hours a Efforts to recruit 5 slots may be Apps accepted Oct
Tine Nagy or MUP Medicine, specialists week for 3 a US physician used for 1 – Sep 30 on
916-449-5753 (updated General only if slots years; must and provide specialists if slots first-come, first-
Tina.Nagy@dhcs.ca.g 10/28/09) Pediatrics, remain. start work long-range plans remain. Must served basis.
ov General within 90 days for retention of demonstrate that
Obstetrics, foreign physician a significant http://www.dhcs.c
Internal percentage of a.gov/services/rur
Medicine, the physician’s al/Pages/J-
Psychiatry patients reside in 1VisaWaiver.aspx
one or more
designated
underserved
areas.
Colorado 30 HPSA, Family Practice, Yes, but 3 year Must show Need evaluated Rolling application
Steve Holloway MHPSA, MUA General preference contract efforts for 6 on a case-by- process.
303-692-2582 (updated or MUP Practice, for primary months prior to case basis.
stephen.holloway@st 10/01/09) Internal care application with http://www.cdphe.
ate.co.us Medicine, proof of state.co.us/pp/pri
OB/GYN, recruitment on a marycare/j1/index.
Pediatrics, national level html
Psychiatry
Connecticut 30 HPSA, MUA N/A Yes 40 hours a Evidence that Does not Apps accepted
Steve Carragher or MUP week for 3 efforts have participate. from Oct 1 to Sep
860-509-7590 (updated years; failed 30.
stephen.carragher@p 10/01/09) physician
o.state.ct.us must agree to http://www.ct.gov/
abide by INA dph/lib/dph/practiti
oner_licensing_and_
investigations/applic
ations/pdf/j1app.pdf
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Delaware 30 HPSA or MUA Family Practice, Yes, if need 40 hours a Proof of failed 5 FLEX waivers Site applications
Joan Barnwell General is shown week for 3 attempts to are used in areas must be submitted
302-744-4555 (updated Internal years; not less recruit a US that are not by June 30.
joan.barnwell@state. 10/21/09) Medicine, than 4 days a physician designated as a
de.us Pediatrics or week; cannot HPSA, but $200 site
OB/GYN include a nevertheless application fee;
restrictive have been $250 waiver
covenant or identified by the processing fee.
non-compete state as being
clause underserved. http://dhss.delawa
re.gov/dhss/dph/h
sm/j1visahome.ht
ml
District of Columbia 30 HPSA, General Yes 3 years; no Must show 5 slots for those Accepts apps on a
Lauren Ratner MHPSA or Internal restrictive efforts for six in either cancer, rolling basis.
202-442-9168 (updated MUA Medicine, covenants; months prior to heart disease,
lauren.ratner@dc.gov 10/01/09) OB/GYN, Family must provide application cerebrovascular Must affiliate with
Medicine, contract – no disease, DC Health Care
Pediatrics & offer letters HIV/AIDS, or Alliance
Psychiatry anesthesiology
Must show ability
to serve racial &
ethnic populations.
http://doh.dc.gov/
doh/cwp/view,a,13
74,q,601506.asp
Florida 30 HPSA, MUA General Up to 5 slots 40 hours a No minimum Up to 5 slots Deadline for 09/10
Karen Lundberg or MUP Pediatrics, are available week for 3 requirements may be available cycle is Nov 2,
850-245-4444 (updated General for full-time years for non-HPSA/ 2009
ext. 2704 10/22/09) Internal specialists. Facility must MUA/P locations.
Karen_Lundberg@do Medicine, post notice of Physician must Priority for safety-
h.state.fl.us Family Practice, Additional availability provide clinical net providers.
OB/GYN and slots can be services.
Psychiatry used for These apps will http://www.doh.st
specialists if be considered ate.fl.us/workforce
there are ONLY if there are /recruit1/Waivers.
unused unused waivers html
waivers at after the initial
the end of review & scoring
the period. Only
application those apps
period. received by the
established
deadline will be
considered.
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Georgia 30 HPSA, MUA Internal 10 slots for 40 hours a Must show Consideration Apps accepted
Tina Orrick or FQHC Medicine, specialists week for 3 recruitment will be given to from Oct 1.
229-401-3094 (updated (Federally Family Practice, until April 1. years; no non- efforts for 6 applications on a
torrick@dch.ga.gov 10/22/09) Qualified Pediatrics, After this compete months prior to case by case http://dch.georgia.
Health OB/GYN or time, slots clause; SORH application basis. Priority gov/00/channel_tit
Center) Psychiatry available to must be will be extended le/0,2094,3144671
both PC and notified of any to underserved 1_40949889,00.ht
SS on first- changes to and shortage ml
come, first- contract; must designated
served basis. have damage areas.
clause of
$250,000
Hawaii 30 HPSA, MUA General Up to 7 slots 40 hours per Show six months Must include Contact Rural
R. Scott Daniels or MUP Internal may be used week for 3 of efforts. information Health Office.
808-775-8883 (updated Medicine, for full-time years. about necessity
scott.daniels@doh.ha 10/01/09) Family Practice, sub-specialty for FLEX Slots or http://www.hawaii.
waii.gov Pediatrics, physicians. specialist slots. gov/health/family-
OB/GYN & child-health/rural-
Psychiatry health/j1visa.html
Idaho 30 HPSA, Family Practice, No 3 years; must Regional and State Code $1000 non-
Laura Rowen MHPSA, MUA Internal start work national print requires Idaho to refundable fee
208-334-5993 (updated or MUP Medicine, within 90 days ads and 6 letters recommend only
rowenl@dhw.idaho.g 10/01/09) Pediatrics, of waiver to area medical those physicians http://healthandw
ov OB/GYN and schools willing to elfare.idaho.gov/H
Psychiatry practice in a ealth/RuralHealtha
community with ndPrimaryCare/J1V
HPSA or MUA isaWaiverNationalI
designation. nterestWaiver/tabi
d/413/Default.aspx
Illinois 30 HPSA for PC, Family Practice, 12 slots per Minimum 3- Must explain May grant five 12 slots in the first
Bronwyn Jones-Leach HPSA or MUA General year year contract recruitment waivers to & second quarters
217-782-1624 (updated for SS Internal difficulties physicians in of the calendar
or 10/01/09) Medicine, other than year are reserved
800-821-3635 General primary care for PC & 6 slots for
bronwyn.jones@illinoi Pediatrics, specialties who rural psychiatrists.
s.gov OB/GYN, will practice at
Combined medical facilities Site approval.
Medicine/ that can show at
Pediatrics or least 51% of the Only 2 waivers per
Psychiatry participating facility
physicians’
patients come http://www.idph.st
from a HPSA or ate.il.us/about/rur
MUA/P. al_health/rural_ho
me.htm#j1
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Indiana 30 HPSA, Internal Med, Yes, but 40 hours a Show efforts for Up to 5 slots Apps accepted
Natalie Brown MHPSA, MUA Family Practice, priority for week for 3 6 months may be used for during Oct only. If
317-630-0845 (updated or MUP General primary care years applicants not in slots remain, can
NBrown@isdh.in.gov 10/01/09) Pediatrics, HPSA or MUA, apply after Dec 1.
OB/GYN & but who will see
Psych patients from Review is 8-12
those areas. weeks.
http://www.in.gov/
isdh/24409.htm
Iowa 30 HPSA, MUA Family Practice, Yes 40 hours a Documentation Will use 10 slots. Applications
Bobbi Buckner Bentz or MUP General week for 3 of at least 6 accepted from
515-281-7223 (updated Surgery, years; must months of Must show need. October 1
bbuckner@idhp.state 10/22/09) Internal start work recruitment
.ia.us Medicine, within 90 Priority for primary
OB/GYN days; must care and rural
Pediatrics, include salary areas, hold slots
Psychiatry for FQHCs.
http://www.idph.st
ate.ia.us/hpcdp/pri
mary_care.asp
Kansas 30 PC HPSAs/ General If 15 slots 40 hours a Demonstrate Will use 5 slots Rolling process
Barbara Huske MHPSAs Internal are not week for efforts for 6 in areas of the beginning Oct 1
785-296-2742 (updated or MUAs Medicine, needed by minimum of 3 months state where need
bhuske@kdheks.gov 10/01/09) designated Family Practice, primary care, years; must for service is Priority for PC.
within the General they are start work demonstrated,
last 3 years. Pediatrics, released at within 90 days with or without http://www.kdhe.s
Emergency intervals for of waiver; no qualifying for a tate.ks.us/olrh/j-
Areas with Medicine, specialists. non-compete federal shortage 1visa_waiver.html
low income OB/GYN, clauses designation.
pop HPSA & Emergency SS are
RHC/CHC Medicine and reviewed on
entities with Psychiatry case-by-case
HPSA design- basis &
nations are facility must
also eligible show need
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Kentucky 30 HPSA or MUA Family Practice, 6-8 slots for 40 hours a Summary of Will use the 5 Accept apps in Oct
Gary Williams General specialists. week for 3 efforts waiver slots for only.
502-564-8966 (updated Practice, If too few PC years placements in
ext. 3773 10/01/09) Pediatrics, physicians non-designated Priority for critical
GaryL.Williams@ky.g OB/GYN and apply, will areas if program access hospitals &
ov Internal accept more feels the need. safety net
Medicine specialists. providers
Psychiatrists in http://chfs.ky.gov/
MHPSAs dph/info/dpqi/KY+
J1+Visa+Waiver+P
rogram.htm
Louisiana Call for HPSA or Internal 6 slots 40 hour a Efforts for 6 Will use 5 FLEX Priority for those
Jeanne R. Haupt slot MHPSA Medicine, reserved for week for 3 months prior to slots per year. who do residency
225-342-3506 availability Pediatrics, specialists years - 32 of contract; proof in Louisiana.
Jeanne.Haupt@LA.GO Family Practice from Oct 1 to which must be of contact with Must show 30%
V General Mar 30. On clinical care; residency of patients are http://www.dhh.lo
Medicine, Apr 1, slots must start directors either residents uisiana.gov/offices
OB/GYN and available on work within 90 especially all of a designated /page.asp?id=88&
Psychiatry first-come, days of those in state, HPSA, and/or detail=4985
first-served approval; no requesting that within a 30
basis. non compete this opening be minute drive (25
clause; do not posted (not miles via
Must show allow required if there interstate roads
dire need for termination is no residency and/or 20 miles
sub-specialty without cause for the specialty along other
in contract. in the state); roadways) of a
must show designated HPSA
posting on Med
Job LA web site
as well for PC
positions
Maine 30 HPSA or MUA No distinction Yes 40 hours a Length of time Yes Applications
Charles Dwyer between week for 3 position was accepted Oct 1 to
207-287-5524 (updated If HPSA/MUA primary care & years; must vacant; Sept 15.
charles.dwyer@main 10/01/09) is based on a specialties start work placement
e.gov population within 90 days agreements, Review is within 30
group, the of issuance of attendance at days of receipt of
physician waiver recruitment fairs, application.
must ads, etc.; plans
increase for retaining http://www.maine.
health care physician; Needs gov/dhhs/boh/orhp
access for assessment for c/
that group increased access.
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Maryland 30 HPSA Family Practice, Consider 32 out of 40 Document efforts Preference is as Physician cannot
Elizabeth Vaidya Internal specialists in hours must be for 6 months follows: be absent from site
410-767-5695 (updated Medicine, June of each direct patient prior to 1) Counties more than 2
EVaidya@dhmh.state 10/27/09) General fiscal year care; 3 year application without FQHCs; consecutive
.md.us Pediatrics or contract; no 2) State- months or total 6
Psychiatry non-compete Must post designated HPSA; months.
clause vacancy in all in- 3) Hospitals that
are the only
Those with any state med Physician must
provider in their
other specialty schools verify that he/she
geographic area;
training are 4) Disproportion-
did not pay a fee
automatically ate Share to facility or
ineligible for Hospitals not recruiter.
the program located in HPSAs;
unless there 5) Areas that http://www.fha.sta
are still slots cannot ensure te.md.us/ohpp/pco
open in June or access to PC, _j1visa.cfm
FLEX slots are peds, OB, or
available. certain specialties
Massachusetts 30 HPSA, Internal Yes, but 40 hours a Efforts for 6 Will use up to 5 Apps accepted Oct
Nicole Watson MHPSA, MUA Medicine, preference week for 3 months and long waivers per year 1 to Jan 15.
617-624-6075 (updated or MUP Family Practice, for primary years; salary; range retention to place qualified
nicole.watson@state. 10/01/09) Pediatrics, care. duties of plans beyond the physicians in Prefer IMGs who
ma.us OB/GYN and physician 3-year eligible facilities speak a language
Psychiatry. obligation. not located in represented at the
designated site.
Must include shortage areas.
Facility must
description of These facilities
participate in
how long the must document
MassHealth.
position was that they are
vacant, how serving patients
Sponsor must
many inquiries from federally
comply with J-1
were submitted, designated high-
monitoring.
salary offered, & need areas.
if position was http://www.mass.gov
offered to any /?pageID=eohhs2sub
US citizens. topic&L=7&L0=Home
&L1=Provider&L2=G
uidelines+and+Resou
rces&L3=Guidelines+
for+Services+%26+P
lanning&L4=Health+
Systems+%26+Work
force+Development&
L5=Health+Care+Wo
rkforce+Assistance+P
rograms&L6=J-
1+Visa+Waiver+Prog
ram&sid=Eeohhs2
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Michigan 30 HPSA only Internal Yes, but 40 hours a None Michigan will $100 request fee;
Kim Burley Medicine, priority for week for 3 make up to 5 $200 application
517-347-8086 (updated Family Practice, primary care. years non-HPSA fee;
Kim.Burley@mimom. 10/01/09) OB/GYN, and placements if $1200 processing
org Pediatrics Specialists there are not 30 fee (refundable if
willing to applicants not processed)
Application Requests: work in rural received from
J-1 Visa Waiver Staff areas have HPSA locations Priority for those
2410 Woodlake Drive priority over within the willing to work at
Suite 440 those application Critical Access
Okemos, MI, 48864. working in window. Hospitals, FQHCs,
urban areas. prisons, State
Facility must psychiatric
document that a hospitals, State-
portion of its funded primary
annual patient care clinics, County
caseload resides or District Health
in a neighboring Depts, & Mental
HPSA and/or Health clinics
MUA/P.
http://www.mimo
m.org/hpsa.php?in
c=hpsa
Minnesota 30 HPSA, Family Practice, Yes 40 hours a Recruitment and 10 FLEX slots per Physician may not
Lawrence Colaizy MHPSA, MUA General week for 3 retention efforts year. apply for LPR until
651-201-3851 (updated or MUP Internal years must be has been at site for
lawrence.colaizy@sta 10/01/09) Medicine, described Must show need 2 years.
te.mn.us Pediatrics, for physician &
OB/GYN or that facility has http://www.health.
Psychiatry enough patients state.mn.us/divs/c
living in under- hs/j1/j1main.htm
served areas.
Mississippi 30 HPSA or Family Practice, Yes 40 hours a 6 months of Flex slots are Site approval.
Rozelia Harris MHPSA General week for min regional & given on a first
601-576-7216 (updated Internal Require- of 3 years (4 national efforts; come first serve Population-to-
rozelia.harris@msdh. 10/01/09) Medicine, ments for is preferred); 4 certified letters basis in non- physician ratio
state.ms.us General specialists on must start to med schools; HPSA areas to must exceed
Pediatrics, the website work within 90 must show that sub-specialist on 3000:1.
Psychiatry or days; no hiring J-1 is a a case by case
$1500 fee.
OB/GYN commence- last resort; review.
ment or copies of CVs Transfers must
expiration received; names commit 2 years in
dates; no of US candidates the new site.
restrictive & reasons for not
clauses hiring; must give http://www.msdh.
priority to H-1Bs state.ms.us/msdhs
ite/index.cfm/44,0,
112,html
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Recruitment Policy
Accepted Terms
Missouri 30 HPSA Family Practice, Yes, if slots 3-year Recruitment and Missouri does not Apps accepted
Barry P. Backer General are available contract retention efforts have a policy from Oct 1 until all
573-751-6219 (updated Practice, and facility – provide plan to regarding the slots have been
Barry.Backer@dhss. 10/27/09) General can show retain physician five flexibility filled.
mo.gov Pediatrics, need beyond 3 years slots as they
OB/GYN or have always had Site approval.
Psychiatry enough qualified
applicants. Priority for
physicians whose
spouses were
Missouri residents
or were previous J-
1 visa waiver
participants.
http://www.dhss.
mo.gov/j1visa/inde
x.html
Montana 30 HPSA, MUA, Family Practice, May be 40 hours a Proof of efforts N/A Must complete
John Schroeck MUP Internal considered if week for 3 for six months. application forms.
406-444-3934 (updated Medicine, fill a proven years; facility
jschroeck@mt.gov 10/01/09) (Prefer Pediatrics, community contact info; Review of
HPSA) OB/GYN or health care salary; applications is 15-
Psychiatry need. agreement to 20 working days.
FQHC’s also abide by INA;
accepted. liquidated Must submit
damages original and 3
clause; no copies of
non- compete application.
clauses.
http://www.dphhs.
mt.gov/PHSD/Prim
ary-Care/primary-
care-j-1info.shtml
Nebraska 30 HPSA or MUA N/A Will consider 40 hours a Description of Same criteria Reviewed on a
Tom Rauner any applicant week for 3 efforts applies. Sites case-by-case
402-471-0148 (updated if facility can years; must wishing to use basis.
thomas.rauner@dhhs 10/01/09) show it is in start within 90 (No minimum the flex slots
.ne.gov the state’s days of waiver requirement) need to give NE http://www.hhs.st
interest an indication of ate.ne.us/orh/j1.ht
their plans. m
Review is on a
case by case
basis.
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
Nevada 30 HPSA, Family Practice, On a case by 40 hours a Proof of Nevada will Apps accepted Nov
Doug Schrauth MHPSA, MUA General case basis week for 3 recruitment & consider these 1 - Dec 31
775-684-4047 (updated or MUP Practice, “at the years in PC (or retention on a case by
dschrauth@health.nv 10/01/09) Geriatrics, discretion of specialty care efforts, copies of case basis. The 5 slots are
.gov Pediatrics, the Health if an exception ads, placement practice site reserved for
General Division was granted); service must be located emergency staffing
Internal when the must agree to agreements, in a federally needs.
Medicine, Division accept etc. designated
OB/GYN and determines Medicare, Primary Care Site approval.
Psychiatry. there is a participate in Facility must HPSA or MUA/P
critical need the Medicaid/ provide outline or a site Max 3 waivers per
for a Nevada Check- describing the approved by the facility in a fiscal
specialty Up program, & site’s long range State as a year.
provider in a provide care plans for geographic
specific on a sliding fee retention of the exception. http://health.nv.go
area.” scale to low- physician v/index.php?option
income, beyond the =com_content&tas
uninsured three-year k=view&id=500&It
patients. obligation. emid=982
New Hampshire 30 HPSA, MUA Family Practice, Priority for Meet all Show prior Must provide Applications
David Roberts or MUP Internal primary care. Federal and recruitment/ information accepted Oct 1 -
603-271-4741 (updated Medicine, State policy retention efforts regarding the Aug 1
droberts@dhhs.state. 10/01/09) Pediatrics, Specialties guidelines; for US application prior
nh.us OB/GYN, must support Must work 40 physicians for a to applying. Physician or facility
Geriatrics, primary care. hours in a minimum of 6 should contact
Hospitalist, clinical months; Must One slot is held Dept. to ensure
Psychiatry & Criteria outpatient show good faith for the discretion eligibility before
Dentistry based on setting; Use a effort was made of DHHS applying.
needs of the sliding- to recruit a US Commissioner or
community, discount-to-fee physician in the DPHS Director. Health Care Facility
physician’s based on the same salary or its immigration
specialty, patient’s ability range. Three attorney must
percentage to pay; Must distribution submit requests
of population start work rounds are for NH J-1 Visa
being within 90 days reviewed for Waiver
served, use of issuance of application recommendations.
of sliding fee waiver; 3 year process.
scale, type of contract; no Applications
facility, non-compete Contact the approved by DOS
distance to clause; Provide Primary Care after Sept. 30 will
nearest CHC, service to Workforce be carried over to
language those who Coordinator at 1- next fiscal year.
other than have no health 800-852-3345
English that insurance ext 2276 for the http://www.dhhs.n
is significant coverage; Meet criteria h.gov/DHHS/RHPC
to that area. all NH medical information. /j1.htm
licensure
requirements.
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
New Jersey 30 HPSA and Family Practice, No 4 year Copies and NJ accepts Year-round
Linda Anderson FQHC OB/GYN, obligation, no summary of applicants who application process
609-292-1495 (updated General non-compete efforts over the will be working in
linda.anderson@doh. 10/01/09) Pediatrics, clause; must past year designated Priority for Family
state.nj.us Internal start within 90 HPSAs and Practice & OB/GYN.
Medicine or days FQHCs only.
Psychiatry http://www.state.n
j.us/health/j-1/
New Mexico 30 HPSAs for Family Practice, Yes 40 hours a Summary of Physicians must Apps accepted Sep
Gabriel Chavez primary care General week for 3 efforts have NM license. 17 until Nov 30
505-841-5866 (updated physicians, Internal years; proviso Facility must
gabrielc@DOH.STATE 10/01/09) MUAs or Medicine, that physician show it provides Sign & notarize
.NM.US MUPs for OB/GYN, will pay substantial affidavit,
(accepts specialists Pediatrics or penalty of amount of care Candidate Site
35 apps) Psychiatry $250,000 in to patients who Location & Report
case of default reside in HPSAs, Agreement &
MUAs or MUPs. Candidate Data
Facility must also Sheet
show there is a
significant
shortage of the
specialty & a
need for this
specialty among
its patients.
New York 30 HPSA, MUA Internal Must 40 hours a All efforts for 6 Up to 10 waivers Application
Steve Swanson or MUP Medicine, demonstrate week for 3 months prior to can be used for deadline is Dec 1.
518-473-7019 (updated Family Practice need. years; must application facilities not Decisions are
sas03@health.state.n 10/23/09) (prefer or Pediatrics start work located in HPSAs made by March.
y.us HPSAs) within 90 days or MUA/Ps but
of waiver; whose patients Physician must try
must state that reside in HPSAs to use other IGA
physician or MUA/Ps. Must programs first.
agrees to treat document that
all patients, the sponsoring Physician may not
regardless of employer &/or be out of status for
ability to pay. physician will more than 6
serve months.
populations
residing in Physician must
HPSAs or qualify for a limited
MUA/Ps. NY medical license
http://www.health.s
tate.ny.us/professio
nals/j-
1_visa_waivers/inde
x.htm
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
North Carolina 30 HPSA Family Practice, No 40 hours a N/A Highly selective Rolling process
Genesa Parker Internal week, for 48 process.
919-733-2040 (updated Must be Medicine, weeks, for 4 Physician must
ext. 203 10/01/09) community Pediatrics or years; must Contact score min 550 on
genesa.parker@ncma with a OB/GYN start work Department prior TOEFL or 213 on
il.net population within 90 days to submitting the CBT, 50 on TSE-P.
less than of waiver; no application. To
20,000. non-compete use a Flex slot, Physician must try
clause; facility must to obtain other IGA
statement that draw from a waivers first
physician will large HPSA
abide by INA patient pool. Facility must be
non-profit.
http://www.ncrural
health.org/j1.html
North Dakota 30 HPSA or MUA Family Practice, Only in State requires Must show First come, first Apps accepted Oct
Gary Garland Internal certain a 3-year evidence of served, based on 1 - Sept 30
701-777-4018 (updated Medicine, cases. contract; efforts and show need. If a site
ggarland@nd.gov 10/01/09) General facility may that no US receives 1 of http://www.ndheal
Surgery or request longer candidate was these waivers in th.gov/OCA/J-
Psychiatry periods available a year, they will 1%20Program.pdf
not have priority
No openings for the next year.
Obstetrics or
Pediatrics
Ohio 30 HPSA or Adolescent Yes, no limit 40 hours a Evidence of Applicants have Apps accepted
Krista Sapp MHPSA Medicine, on the week for 3 efforts for 6 to show how from Sep 1 & are
614- 466-1629 (updated OB/GYN, number years; no non- months prior; they serve a due 2 weeks
Krista.Sapp@odh.ohi 10/01/09) Geriatrics, accepted. compete list of physicians HPSA/MHPSA before a meeting
o.gov Family Practice, clause; J-1 who were population.
Pediatrics, Visa Liquidated interviewed; 10 physicians
Internal Damages copies of letters approved 3X per
Medicine and Clause only sent to year: Dec 1, Mar 1
Psychiatry required for residency & Apr 15 (may pre
ARC; language programs that approve 3 apps for
regarding use train the type of the next year)
of mediation physician being
services to recruited; copies Site approval.
settle any of letters sent to
disputes the 7 Ohio Non-refundable fee
medical schools; of $3571
copies of ads,
http://www.odh.oh
etc.
io.gov/odhProgram
s/chss/PCRH_Progr
ams/recruitment/j
visa.aspx
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
Oklahoma 30 HPSA, Internal On a case- 40 hours a N/A Uses FLEX slots. Rolling
Michael Brown MHPSA or Medicine, by-case basis week for 3 applications.
405-271-8428 (updated MUA Family Practice, only – must years; No non-
mikebr@health.ok.go 10/01/09) Pediatrics, show need compete Only 2 physicians
v OB/GYN or and submit clauses per county per FY
Psychiatry physician’s
CV prior to
submission
of waiver
application
Oregon 30 HPSA, MUA Family Practice, 6 slots per 40 hours a Provide efforts Will consider $2000 fee
Dia Shuhart or MUP General year; may week for 3 for 6 months placements in
503-373-0364 (updated Internal consider years; wages prior. non-designated Contact before
dia.shuhart@state.or. 10/01/09) HPSA is Medicine, more, if need and conditions areas (pilot applying.
us preferred OB/GYN, is shown equal to US program) with
Review is 15
Pediatrics or physicians; no prior approval
business days.
Psychiatry non-compete
clause MUA/Ps that are
Priority for not also HPSAs
Family Practice need to receive
and Psychiatry. approval prior to
applying.
http://oregon.gov/
DHS/ph/hsp/conra
d/index.shtml
Pennsylvania 30 HPSA, MUA, Family Practice, Yes, but 40 hours a Efforts for 6 Facility must Facility must
Connie Hanna MUP General primary care week for 3 months within state intent to contact office.
717-772-5298 (updated Pediatrics, applications years; no non- the last year apply for slot in
channa@state.pa.us 10/22/09) OB/GYN, are given compete letter of need & Must include
General priority clause justify need; sliding fee scale
Internal must document showing discounts
Medicine or that 20% of up to 200% of the
Psychiatry patients are from federal poverty
PC HPSA or level.
MUA/P or 30%
Must include
from low income
statement from the
HPSA; must
physician that
provide EIN; one
he/she does not
request per
have an approved
facility per FFY
waiver or one
pending (including
hardship waivers)
http://www.dsf.health.sta
te.pa.us/health/cwp/view
.asp?A=169&Q=204585
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
Rhode Island 30 HPSA, Family Practice, Yes 40 hours a Summary of Will evaluate use Apps accepted
Robert Crausman MHPSA, MUA Internal week for 3 efforts of flexibility slots from June 15.
401-222-3855 (updated or MUP Medicine, years; salary on a case-by-
RobertCrausman@he 10/01/09) Pediatrics/ should not be Must also case basis. Priority for:
alth.ri.gov Pediatric less than 90% provide Spanish speakers;
Neurology, of mean salary retention plan Community or
OB/GYN, for similarly mental health
Anesthesiology, employed centers & state
Child Psychiatry physicians; no agencies;
or General non-compete Anesthesiology esp
Psychiatry clauses. with exp serving
underserved
Breach of populations;
contract Physicians found
clauses may through Brown.
result in denial
of application http://www.health.
ri.gov/hsr/professi
ons/visa/j1visa.ph
p
South Carolina 30 N/A Family Practice, Must show 3-year contract Proof of Uses FLEX slots. Safety net sites
Mark Jordan Pediatrics, that the unsuccessful apply in Aug;
803-898-0766 (updated General specialty is efforts others apply in Oct
JORDANMA@dhec.sc. 10/01/09) Internal in the public
gov Medicine, interest Site approval.
OB/GYN or
Psychiatry http://www.scdhec
.gov/health/opc/j1.
htm
South Dakota 30 HPSA or MUA Family Practice, Yes 40 hours a Facility must 5 slots reserved Rolling applications
Josie Petersen General week (at least document for urban areas
605-773-3517 (updated Practice, 32 hours of efforts & 5 reserved for $200 fee.
josie.petersen@state. 10/23/09) OB/GYN, direct patient non-urban before
sd.us Internal care) for 3 April 1 of each http://doh.sd.gov/
Medicine, years; no non- year. On April 1, RuralHealth/J1.asp
Pediatrics compete the department x
clauses may approve any
application until
all 10 slots are
filled.
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
Tennessee 28 HPSA or Family Practice, 9 slots 3-year contract Efforts for the May be used in Apps accepted Oct
Ann Cranford MUA; HRSA General past 6 months affiliation with 1 - Sep 1
615-741-2101 (updated Pediatrics, must be hospitals not
ann.cranford@tn.gov 10/22/09) OB/GYN or provided located in a PC placed in rural
General HPSA or MUA areas; SS placed
Internal who can show with hospitals.
Medicine that fifty percent
or more of its http://health.state.
patients reside in tn.us/rural/j1visa0.
a HPSA or MUA. html
Texas 12 Geographic Internal Yes 40 hours a None Will consider Flex Apps for FY 2010
Clay Daniel HPSAs, Medicine, week for 3 5 apps on a first- accepted beginning
512-458-7518 (updated FQHCs and General years; list of come, first- September 1.
clay.daniel@dshs.stat 10/22/09) Rural Health Practice, Family benefits; served basis
e.tx.us Clinics with Practice, statement that starting March 2, $2500 fee
“automatic” Pediatrics, any 2010 if there are
facility HPSA OB/GYN and amendments slots available. 6 letters of
designation. Psychiatry will adhere to Apps must community
federal & state include proof support.
Geographic visa waiver that patients
MUAs also regulations served by the http://www.dshs.s
accepted for facility reside in tate.tx.us/chpr/j1i
specialties. shortage areas. nfo.shtm
Utah 30 HPSA with a Family Practice, Must show 40 hours a Must provide Will accept FLEX Apps accepted Oct
Erin Olsen current Internal that the sub- week for 3 evidence of applications on a 1 – Sep 30 on a
801-273-6618 (updated shortage of Medicine, specialty is years; must unsuccessful first-some, first- first-come, first-
elolsen@utah.gov 10/23/09) providers General in the public start within 90 efforts for at served basis. served basis
Pediatrics, interest days of waiver; least one year
OB/GYN and no non- prior to More info at http://health.utah.
Psychiatry compete application http://health.utah gov/primary_care/
clauses .gov/primarycare/ employment.html
pdfs11-
00/FlexSlots.pdf
Vermont 30 HPSA, Family Practice, Yes 40 hours a No minimum Must provide Rolling process
Dawn Miller MHPSA, MUA General week for 3 requirement sliding fee scale,
802-951-5179 (updated or MUP Internal years; must recruitment, Facility must
DMIller@vdh.state.vt. 10/01/09) Medicine, start within 90 demographics of contact Dept. for
us Pediatrics and days of waiver; patients served, checklist & notify
OB/GYN valid Vermont documented of intent to hire
medical license community need
for “specialty” http://healthvermo
healthcare nt.gov/local/rural/
services, nearest programs.aspx#j
source of care to
the facility.
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
Virginia 30 HPSA, Family Practice, Yes, if need 40 hours a Proof of 6 Must document Include copy of
Ellen McCutcheon MHPSA, MUA Internal is shown. week (at least months of that there is an Medicaid &
804-864-7435 (updated or MUP Medicine, 4 days) for 3 unsuccessful extreme need. Medicare Provider
Ellen.McCutcheon@v 10/01/09) Pediatrics, Priority for years; no non- recruitment Agreements.
dh.virginia.gov Priority for OB/GYN and primary care. compete More detailed
facilities in Psychiatry clauses; information is Preference for
HPSAs over physician available at: physicians trained
MUAs and Priority for agreement to http://www.vdh. in Virginia.
MUPs physicians with abide by INA; virginia.gov/prim
residency in PC fixed salary. care/center/pdfs/ Review is 30-90
or Psychiatry. J- days.
Include 1 1_Guideline_Revi
original and 1 sions.pdf http://www.vdh.vir
copy ginia.gov/ppova/j1
.htm
Washington 14 PC; HPSA or Internal 10 slots. 3-year contract Proof of 6 Accept apps Apps accepted Oct
Jennell Prentice 10 SS whole county Medicine, for primary months of active beginning April 1 1 - Sep 30.
360-236-2814 MUA Family Practice, If still has PC care; efforts in the 12 of each year;
jennell.prentice@doh. (updated Family Practice slots 5-year contract months prior to must serve Physician must be
wa.gov 10/26/09) with Obstetrics, available for specialty; the waiver patients from finished with
Geriatrics, after April 1, No non- application HPSAs (minimum training or in the
To check slot Pediatrics, will accept compete percentage), final year of a
availability, visit OB/GYN, and additional clauses describe who will training program.
website. Psychiatry sub-specialty benefit (address
applications. Submit 2 Medicaid/Medi- Review of apps is
Physicians with copies with care access), 10 working days.
other training original provide detailed
are ineligible signatures explanation of http://www.doh.w
for PC. recruitment. a.gov/hsqa/ocrh/R
&R/j1.htm
West Virginia 30 HPSA, Family Practice, Yes, on a 40 hours a Document Uses FLEX slots. Site approval.
Monique Mahone MHPSA, MUA Internal case-by-case week (at least efforts for 6
304-558-4382 or (updated or MUP Medicine, basis 4 days a months prior Failure to comply
888-442-3456 10/01/09) Pediatrics, week), 45 with the program
monique.w.mahone@ OB/GYN and weeks a year, will result in
wv.gov Psychiatry for 4 years; no default & penalties
non-compete
clause; http://www.wvoch
physician must s.org/dr/j-1.aspx
abide by INA
State & Contact Info Number of Designation Definition of Accept Sub- Required Required Flexibility Slot Other
Slots Areas Primary Care Specialties Contract Terms Recruitment Policy
Accepted
Wisconsin 30 HPSA or MUA Family Practice, Yes 40 hours a Evidence of Will use slots for Apps accepted
Anne Dopp General week, with at unsuccessful physicians who from Aug 15.
608-267-7121 (updated Pediatrics, least 24 hours efforts will serve
anne.dopp@wisconsi 10/01/09) General in an out- populations in Must have US
n.gov Internal patient setting, surrounding residency.
Medicine, for 3 years; shortage areas &
General benefits equal if exceptional http://dhs.wisconsi
OB/GYN and to similar need and public n.gov/localhealth/J
General physicians interest can be _1VISA/index.htm
Psychiatry demonstrated.
Wyoming 30 HPSA, General Yes, but on a 3 years Proof of efforts, Uses FLEX slots. Year round apps.
Jeff Hopkins MHPSA, MUA Internal limited basis including a
307-777-2930 (updated or a state Medicine, contract with a Site approval.
Jeff.Hopkins@health. 10/22/09) designated Family Practice, recruiting firm,
wyo.gov shortage Pediatrics, ads placed in a If establishing a
area OB/GYN and national clinical practice in
Psychiatry publication over WY, must be
a 3-year period licensed by WY
or longer. Board of Med.
http://wdh.state.w
y.us/rfhd/rural/Wo
rkforce_Developme
nt.html
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