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Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsJune 2013

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Statutory Authority: 16 Delaware Code, Section 122(3)a and 11(8) (16 Del.C. §122(3)a & 11(8))
16 DE Admin. Code 4104
3.2 Under this program, DHSS has established state-specific procedures that require sponsoring sites to submit a Site Application. This application consists of 1) a needs assessment, 2) proof that the sponsoring site has unsuccessfully attempted over a six month period to hire a physician with United States citizenship, 3) three letters of support from community leaders and/or leaders without financial interest in the practice site who reside in the practice site’s service area, 4) strategy for long-term and short-term retention, 5) sponsoring site waiver agreement, 6) non-refundable processing fee of $200, and 7) a site application form.
3.4 The Site Application will be reviewed and approved or disapproved by a Board. DHSS will provide written notice to the site of the application’s approval/disapproval. A J-1 visa waiver application on behalf of for a particular J-1 physician may not be submitted until the sponsoring site has been approved. J-1 visa waiver applications will only be accepted from J-1 physicians who have signed a contract with a pre-approved site.
3.7 The Bureau of Health Planning and Resources Management within the Delaware Division of Public Health shall charge a non-refundable processing fee of $200 to each sponsoring site submitting a Site Application at the time the application is submitted. A non-refundable processing fee of $250 shall be charged to each pre-approved site to process the waiver request application for each J-1 physician that the site plans to employ. The check is to be made payable to the State of Delaware, and mailed to the attention of the Bureau at the following address:
3.8 DHSS reserves the right to bar sites and/or physicians found to be non-compliant with program policies and/or to have a high turnover rate of J-1 physicians from future program participation.
The Health Systems Management Section of the Delaware Division of Public Health (DPH) has primary responsibility within DHSS for processing J-1 visa waivers. DHSS serves as the “interested state agency” with the Director of Public Health having the authority to sign the recommendations. Applications must be processed in the best interest of the health care needs of Delawareans.
6.1 Sponsoring Site Pre-Approval Application Requirements. The Site Application (see Appendix A for Application forms) must, at a minimum, include the following:
6.1.1.1 Sponsoring Site: Provide the name, address, county, telephone number, fax number and the e-mail address of site requesting approval to hire a J-1 physician. Also, the site must specify whether it is a for-profit or not-for-profit business.
6.1.1.2 Practice Site: Provide the name, address and county of actual practice site(s) where the requested J-1 physician would practice, if different from the primary location of the sponsoring site.
6.1.1.3 Recruitment Contact: Provide the name, address, county, telephone number, fax number and e-mail address of the individual responsible for physician recruitment.
6.1.1.4 Site Data Regarding Active Clients: Provide the total number of active patients at the practice site in the previous calendar year. Indicate total patients, as applicable, for primary care, specialty care and mental health services. Provide pro-rated or estimated annual totals if the site was not operational for the entire previous calendar year. For new sites, estimate the number of patients anticipated for the next year. Of the total number of patients, provide the percentage of all current patients, broken out by given age groups, making payment by conventional insurance plans, Medicare, Medicaid or on a sliding fee scale. A copy of the sliding fee scale must be submitted.
6.1.1.5 Sites approved to participate in the Conrad State 30/J-1 Visa Waiver Program must also participate in state programs designed to increased access to care for the uninsured/under insured such as the Community Healthcare Access Program (CHAP), the VIPII provider network, and, if appropriate other charitable programs. Sponsoring sites must verify that they will enroll in the VIPII Program within 30 days of site approval (if they are not already network members). To enroll in the VIP program, call Wheeler and Associates the Medical Society of Delaware at 302-335-1560 302-224-5190 (select option 1). To enroll in CHAP, please call 2-1-2 or 302-744-1040.
6.1.1.6 Staffing Levels: Provide the total number of budgeted full-time equivalent providers currently on staff. Also include the number of J-1 physicians requested, by specialty, and the projected hire date of each.
6.1.1.7 Practice Site Hours of Operation: Indicate the normal operating hours of the practice site(s) by the days of the week. If hours of operation vary by practitioner, please specify.
6.1.1.8 Proposed J-1 Physician Weekly Work Schedule: Indicate the proposed weekly work schedule of the proposed J-1 physician(s). Include the number of hours (with start and end times) and the location (hospital/practice site(s)). The schedule must indicate the amount of time the J-1 physician is actually providing services; do not include travel or on-call time.
6.1.2 Needs Assessment. Sponsoring sites are encouraged to work with their local hospital and their community to complete the needs assessment. A comprehensive, data driven needs assessment must be completed, which, at a minimum, includes the following:
6.1.2.3 Documentation that of whether the sponsoring site’s service area is located within a Health Professional Shortage Area (HPSA) or a Medically Underserved Area (MUA). If in a HPSA or MUA, Pplease indicate the following: HPSA Type(s), HPSA Service Area Number, HPSA FIPS State/County Code and the sponsoring site’s primary service area (by City/County).
6.1.3 Retention. The sponsoring site must provide thorough, written documentation of plans to retain the J-1 physician in the service area upon completion of the three-year practice obligation. Specifically, this plan must include short and long-term strategies that will not only keep the physician in the service area, but also will encourage the physician to continue to practice the specialty for which he/she was hired including but not limited to malpractice insurance, partnership opportunities, if applicable, annual and sick leave, a competitive salary and salary increases and a health and/or benefits package.
6.1.3.3 The employment contract may not contain any Restrictive Covenants or Non-Compete Clauses or similar language, regardless of how they may be labeled.
6.1.4.2 Non-compete language and/or clauses are strictly prohibited. The employment contract may not include a restrictive covenant or non-compete clause. Please see 6.1.3 above.
6.1.5 Proof of Failed Recruitment Attempts. The sponsoring site must provide proof that attempts have been made to hire a physician with United States citizenship throughout the past six months to no avail. This section must include a written description of the failed attempts to recruit as well as back up documentation including, but not limited to, medical journal and newspaper advertisements, letters to medical residency programs and/or medical schools, etc. Please state any attempts to gain recruitment support from the hospital within the practice site’s geographic service area, and if applicable, indicate efforts to use the Delaware State Loan Repayment Program, the National Rural Recruitment and Retention Network (3R Net at www.3RNet.org), and the National Health Service Corp. to recruit a US citizen.
6.1.6 Letters of Support. The sponsoring site must submit at least three letters of support from community members without financial interest in the practice site who reside in the site(s) service area. Each letter must indicate the benefits of, or need for, the placement of a J-1 physician with the sponsoring site. At least one letter must be from an elected public official. At least one letter must be from a medical professional. At least one letter must be from an individual representing the patient population.
6.1.8 Signature. The director or applicant applying official of the sponsoring site must provide an original, dated application with a live signature (using blue ink). This signature binds the site to the information provided and verifies that the form has been completed with accurate and current information.
6.2.1 Applications will only be accepted from J-1 physician applicants who already have an employment contract with a pre-approved sponsoring site (see section IV above). The completed application must include the original application package and two complete copies. Applicants are also encouraged to submit a complete application in electronic format (CD or e-mail). No more than 30 physician applications will be approved each federal fiscal year (October 1-September 30). DHSS reserves the right to recommend or decline any request for a waiver.
6.2.2.1.3 Confirmation that the sponsoring site and the J-1 physician participate in or has have applied to participate in the CHAP or VIPII Program. J-1 physicians must apply to participate in the program within 30 days of executing an employment contract with a sponsoring site. To enroll in the VIP program, call Wheeler and Associates at 302-335-1560 the Medical Society of Delaware at 302-224-5190 (select option 1). To enroll in CHAP, please call 2-1-1 or 302-744-1040. Once enrolled, the VIPII program manager will physician must notify the J-1 Program manager.
6.2.3 Employment Contract
A statement that the J-1 physician will work not less than four days per week or more than 12 hours in a 24 hour period. The hours must be performed during normal office hours or non-traditional hours which that best meet the needs of the community (e.g. evenings and/or weekends). Travel and on-call time can not be included.
Personal time such as including vacation and sick leave must be specified.
6.2.5 Submission of Payment of the Department of State ‘User Fee Required for Waiver Processing’
6.2.6 J-1 Visa Waiver Statements. The J-1 physician applicant must sign and include the enclosed ’J-1 Physician Waiver Statements.’
7.4 Timelines. Pre-approved sponsoring sites (whose applications were received by June 30) will be eligible to make a contractual offer to a J-1 physician for the following federal fiscal year (beginning October 1st of each year). However, if not all thirty Conrad State 30/J-1 Visa Waiver slots have been used for the current federal fiscal year, pre-approved sponsoring sites may make a contractual offer to a J-1 physician for the current fiscal year and the physician may submit a J-1 visa waiver application packet (see Appendix C for forms) immediately.
7.5 Guidelines for Review of Applications Submitted After June 30
7.6 Notice of Approval/Disapproval
8.1 Site Application Submission DHSS will accept Site Applications Forms each year through the end of the business day on June 30 Site Applications submitted after June 30 will be eligible to receive approval only if 1) DHSS has not used the allotted thirty recommendations for the year and 2) an emergent need for the placement of a J-1 physician is clearly demonstrated. (Please see definitions section of the regulations for definition of emergent need.)
8.2 Site Notification DHSS will notify sponsoring sites in writing of the decision to approve or disapprove their site by September 15th of each year. Inquiries regarding the status of pending applications will not be accepted at any time prior to September 15th.
8.3 J-1 Visa Waiver Request Submission J-1 Visa Waiver Requests may be submitted with the start of each Federal fiscal year, October 1st.
12.1 An annual reporting process is utilized for each J-1 physician practicing under a waiver to ensure the J-1 physician continues to practice in an underserved area of Delaware for the required three years. Included in this application is a copy of the Annual Practice Forms. The sponsoring site must deliver to DHSS a completed, signed form within thirty (30) days of the anniversary of the J-1 physician’s start date. Additional forms may be requested by contacting the J-1 program manager at (302) 741-2960 744-4555. The annual reporting forms must be submitted for each year of practice obligation. Failure to submit the forms render the sponsoring site non-compliant.
12.2 Notification of waiver status and commencement of employment contract must be submitted to DHSS upon receipt of written notification of approval from INS USCIS. This notification must include the date the three-year obligation commences.
The Bureau of Health Planning and Resources Management within the Delaware Division of Public Health shall charge a non-refundable processing fee of $200 to each sponsoring site submitting a Site Application at the time the application is submitted. A non-refundable processing fee of $250 shall be charged to each pre-approved site to process the waiver request application for each J-1 physician that the site plans to employ. The check will be made payable to the State of Delaware.
Last Updated: December 31 1969 19:00:00.
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