Yes, if the sponsoring employer is in agreement and the moonlighting site is in a Health Professional Shortage Area (HPSA).  An employment agreement for the moonlighting site should be provided to DHH’s BPCRH.  For more information, see pages 9-12 of the Louisiana J-1 Visa Waiver Program Policy under Recruitment Services.  The physician should be sure that the BCIS has authorized the participation in moonlighting activities as the H-1B petition only authorizes a worker to work for a specific employer.  Please seek legal advice prior to engaging in moonlighting.

Yes, J-1 visa waiver physicians may work for private, for-profit entities, as well as public or nonprofit entities.

Yes.  However, it is imperative that the site can show evidence of the ability to pay the prevailing wage as defined in the H-1B petition (see question below).  Also, the site must be ready to open immediately upon the arrival of the J-1 visa waiver physician.

Yes, but only after the move has been approved by DHH’s BPCRH and BCIS.  To protect the physician’s waiver, the employer must provide a contract amendment or new contract.  DHH’s BPCRH will issue its decision to the employer and the physician.  BCIS approval has to be received before the physician may change work places. See pages 9-12 of the Louisiana J-1 Visa Waiver Program Policy.

If the entire facility has moved, documentation of the change of address, such as a lease or public announcement or documentation of purchase, should be submitted to DHH’s BPCRH.  The sponsoring employer must submit several documents and forms to BCIS.  If the change satisfies BCIS’s regulatory and policy requirements, it will approve the change.  Legal advice should be obtained prior to changing the physician’s work location.

With an approved site application, usually about 8 months from the time DHH receives the J-1 visa waiver request packet to the time the physician begins work.  However, delays related to recruitment efforts, contract negotiations, and J-1 visa waiver processing at BCIS, may prolong the process.   Therefore, DHH cannot guarantee when the J-1 visa waiver physician will actually be able to begin practicing.  If you are in immediate need of a physician, this program may not be the appropriate choice for your site.

No. You are not required to hire a J-1 visa waiver physician even though you applied and were approved for a slot.  NOTE: DHH requests that you notify the BPCRH when you decide not to use a J-1 visa waiver physician so that another site can utilize the available slot.

Yes. Replacing a J-1 visa waiver physician that is leaving your site with another J-1 visa waiver physician is not automatic. A new site application must be submitted and approved before an offer can be made to the new physician who needs a J-1 visa waiver. 

Yes.  An H-1B petition should be filed about six months prior to the time the H-1B worker will commence employment.  However, the application for change of status may not be filed until the Department of State (DOS) issues its waiver recommendation to Bureau of Citizenship and Immigration Services (BCIS).  For specific advice, seek legal counsel.

The most commonly reported problem from physicians is the lack of other physicians to share call in rural areas and isolation from others who share their culture and background.

The most commonly reported problem from employers is that physicians do not integrate into the community, do not market themselves in the community, and are not committed to working the long hours necessary to build a practice.

If the contract is not fulfilled, the physician may become subject to the two-year foreign residence requirement again.  Both the physician and the sponsoring employer should notify DHH as soon as any problem arises.  All parties should obtain the advice of legal counsel.

If the employing facility closes or extenuating circumstances beyond the control of the physician arise, the waiver will not be revoked, provided the three years of service in H-1B status can be completed at another eligible facility.  A subsequent H-1B petition must be filed with BCIS and DHH, accompanied by evidence of the closure of the facility or extenuating circumstances, an employment contract the balance of the three year period, evidence that the proposed new employment is in a HPSA in Louisiana, and the original signed copy of the Criteria for J-1 visa waiver Support by the State of Louisiana.

The physician will probably have to leave the United States to obtain a new H-1B visa if a new petition for new employment is not filed within ten days of the termination of the last employment.

The J-1 visa waiver, issued from the State Conrad Program or other federal programs, makes a foreign national exempt from the return home requirement.  J-1 visa waiver holders are allowed to stay in the United States.

A J-1 visa, also called an exchange visitor visa, is a visa used by foreign nationals who come to the U.S. for the purpose of teaching, training, studying, research, etc.  It is often referred to as a student visa.  Foreign nationals are required to physically return to their home country or the country of last residence for at least two years before they are eligible to apply for any other non-immigrant visa or Lawful Permanent Residence.

The executed contract should include at least a three-year commitment for outpatient preventative and primary care or an approved specialty.  The contract should also include:

• The address of each practice site;
• The normal office hours for outpatient care for each practice site. The physician’s 40 hours should not be performed in less than four days a week;
• No non-compete clause;
• A $250,000 damages clause.  This amount must be paid to the provider if the J-1 visa waiver physician does not satisfactorily complete service under the employment contract;
• Any other restrictions on the J-1 visa waiver applicant negotiated in the contract and agreed to by the employer and the J-1 visa waiver applicant.

Additional contract information can be found in the J-1 Visa Waiver Program Policy, which can be accessed under Recruitment Services.

The minimum requirements are:

• Submitter’s cover letter and G-28, if applicable
• Letter of need from medical facility
• Department of State Data Sheet (2 copies)
• Readable copies of J-1's IAP-66 forms for each year in J-1 status
• CV, including Social Security number
• Notarized Department of State attestation forms
• CRITERIA FOR J-1 VISA WAIVER SUPPORT BY THE STATE OF LOUISIANA
• Copy of notarized, dated, executed contract plus documentation of site visit
• Evidence of employer’s regional and national recruitment efforts
• Proof of health professional service area and documentation of site approval received from DHH
• Letters of support from within the community.  NO FORM LETTERS WILL BE ACCEPTED
• Letters of recommendation from those who know the J-1 physician's qualifications
• Qualifications (diplomas, licenses) and Medicaid Identification Number
• Proof of facility’s existence
• Names of all U.S. citizens or permanent resident physicians applying for and/or interviewed and reason not hired
• Proof of physician’s visit to site of employment

A site should advertise for all qualified physicians and not just J-1 visa waiver physicians. 

For the J-1 visa waiver application, either the employer or physician may pay the filing fees.  According to Department of Labor's regulations, the sponsoring employer is required to pay the filing fees for the H-1B portion of the case.