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Visa Process 101 – FQHC Basic Questions and Answers

Many FQHC leaders tend to shy away from candidates that need visa sponsorship.  Their thinking is that it is a complex process and expensive.  UHC Solutions dba thefqhcrecruiters.com has had success with many of these candidates over its 21 year history.  As the provider shortage continues unabated, FQHCs are realizing the advantages of recruiting great providers, reducing flight risks and in many cases meeting the language and culture needs of its patient population.  Recently, Tim Mulvaney-UHC Solutions CEO sat down with immigration attorney Sid Chary in New York and asked him, “Sid, can you demystify the different types of Visas, costs, time-line, etc. for our FQHC clients and candidates that may not know a lot about the visa process?”  See below on his responses.

UHC: What is the process for hiring a candidate in need of a J-1 waiver?

Sid: First step is to find out if the FQHC is in a Health Professional Shortage Area or HPSA (most FQHCs are). Next is to find out the graduation date of the candidate, the J-1 waiver and subsequent H-1B process takes 6-12 months to complete, applications for J-1 waivers are for residents graduating one year out or have already graduated and it has been less than one year since their graduation date. Once you’ve completed those steps, you will need to find a candidate you like and work with an immigration attorney to have the employment agreement tailored to the J-1 waiver requirements. Additionally, you will have had to been searching to fill the open position for at least 3-6 months ahead of time – UHC can help with the documentation and so can an immigration attorney.

UHC: How time consuming is the process and what if we have never done this before?

Sid: It is not a problem if the FQHC has never filed a J-1 waiver or H-1B, an experienced immigration attorney will be able to handle the majority of the work for your practice and will take the stress out of the process. You will need to supply basic information about the FQHC and will need signatures for documents, recruitment efforts (this can be handled by UHC) and some letters of recommendation. Other than that, the attorney will coordinate and mail everything out. Additionally, an attorney will be able to help advise throughout the entirety of the process.

UHC: Does the candidate need an H-1B visa and what about the lottery or H-1B cap?

Sid: Yes, after the J-1 waiver is obtained the provider needs work authorization via an H-1B visa. A J-1 waiver recipient is not subject to the H-1B cap. Once you’ve received the J-1 waiver, the facility must apply for the H-1B visa so the physician has proper work authorization.

UHC: What are the basic terms of employment?

Sid: 3 Years, Full-Time (40 hours/week), Pay the Prevailing Wage, Accept All Patients Regardless of Ability to Pay, and No Restrictive Covenants. Prior to hiring a J-1 physician, you will need an immigration lawyer to edit the contract. Please note that the J-1 waiver requirements are non-negotiable. There may be other requirements, contact us for a further explanation.

UHC: What is likelihood of obtaining a J-1 waiver?

Sid: While no legal case has a guaranteed outcome, an experienced immigration attorney who understands the nuances of this process will be able to put forth a strong application that meets all of the requirements. I find that more often than not, the various government entities will request further information rather than just deny an application on its face. Again, an experienced attorney will be able to handle all of the correspondence and inquiries – should that situation ever arise.

UHC: What are costs associated with the entire process?

Sid: Attorney’s charge different prices for the entire process, however most of the time it is billed as a flat fee in two to three stages. First stage is the J-1 wavier. The second stage and third stage are the H-1B attorney and government filing fees. H-1B fees (attorney and government) must be paid for by the employer and cannot be recouped in any manner.

This is not intended to be used as legal advice, please contact an attorney for specific requirements.


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