[Federal Register Volume 60, Number 181 (Tuesday, September 19, 1995)]
[Notices]
[Pages 48515-48516]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-23199]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary


Designation of Geographic Shortage Areas for Waiver of Two-Year 
Home-Country Physical Presence Requirement, International Medical 
Graduates, Exchange Visitor Program

AGENCY: Office of the Secretary, DHHS.

ACTION: Notice of availability of information about areas with 
shortages of health care professionals.

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FOR FURTHER INFORMATION CONTACT:
Dr. Evan R. Arrindell, Acting Director, Division of Shortage 
Designation, Bureau of Primary Health Care, 4350 East-West Highway, 
Room 9-1D-1, Bethesda, Maryland 20814, (301) 594-0816.

SUPPLEMENTARY INFORMATION: Section 220 of the Immigration and 
Nationality Technical Corrections Act of 1994 (Pub. L. 103-416) amended 
the Immigration and Nationality Act (``the Act'') (8 U.S.C. 1182(e)) to 
add a new subsection (k) to Section 214 of that Act (8 U.S.C. 1184) 
concerning waiver of the 2-year foreign residence requirement for 
international medical graduates (``IMGs''). IMGs who were admitted to 
the United States on a J-1 visa in the exchange visitor program, or who 
acquired this status after admission to the United States, are subject 
to a 2-year home country residence and physical presence requirement. 
This means that they must reside and be physically present in their 
country of nationality or last residence abroad for an aggregate of at 
least 2 years following departure from the United States prior to 
acquiring lawful permanent resident status, unless they have been 
granted a waiver of this requirement.
    Under section 212(e) of the Act, a waiver of the 2-year requirement 
may be granted by the Immigration and Naturalization Service (``INS'') 
upon favorable recommendation of the Director of the United States 
Information Agency (USIA) on the basis of: (a) Exceptional hardship to 
the applicant's U.S. citizen or permanent resident spouse or children; 
(b) persecution on account of race, religion, or political opinion; (c) 
a ``no objection'' statement issued by the applicant's 

[[Page 48516]]
``home'' country; or (d) a request made to USIA by an interested U.S. 
Government agency to recommend a waiver to USIA because the applicant's 
work is important to the public interest.
    The Immigration and Nationality Technical Corrections Act provided 
an additional basis for waiver of the 2-year requirement. A State 
Department of Public Health or its equivalent can request the Director 
of USIA to recommend that INS grant up to 20 waivers a year. Conditions 
for these requests are that: (a) in the case of an alien who is 
otherwise contractually obligated to return to a foreign country, the 
government of that country provides USIA with a written statement that 
it has no objection to the waiver; (b) the IMG demonstrates that he or 
she has a bona fide offer of full-time employment and will begin this 
employment within 90 days of receipt of a waiver, for a period totaling 
not less than 3 years; (c) the employment is in an area designated by 
the Secretary of Health and Human Services as having a shortage of 
health care professionals. Both INS and USIA have published in the 
Federal Register interim-final regulations, with requests for comments, 
setting forth procedures and requirements for obtaining State-requested 
waiver requests. 60 F.R. 26676 (May 18, 1995) and 60 F.R. 16785 (April 
3, 1995).
    Section 214(k)(1) of the Act (8 U.S.C. 1184) authorizes the 
Secretary of HHS to designate ``geographic area or areas * * * as 
having a shortage of health care professionals'' for purposes of the 
State-requested waiver. Notice is hereby given that both Health 
Professional Shortage Areas (``HPSAS'') and Medically Underserved 
Areas/Medically Underserved Populations (``MUAs/MUPs''), determined 
under Sections 332 and 330 of the Public Health Service Act, 
respectively, (42 U.S.C. 254e and 254c) are designated by the Secretary 
of HHS for purposes of 2-year home residency waiver requests by States 
under Section 214(k)(1) of the Act. HPSAs can be geographic areas, 
population groups, and health care facilities meeting regulatory 
criteria set forth at 42 CFR Part 5. Only physicians specialized in 
primary care (family practice, general internal medicine, pediatrics, 
and obstetrics and gynecology) are considered for physician shortage 
areas.
    MUAs/MUPs are shortage areas and population groups designated 
pursuant to criteria set forth at 42 CFR Sec. 51c.102(e) based on 
weighted values related to primary care physician ratios, infant 
mortality rates, the percentage of the population age 65 and over, and 
the percentage of the population below the poverty level. Whole 
counties and groups of contiguous counties can be designated.
    The Bureau of Primary Health Care, Health Resources Services 
Administration publishes periodically a list of HPSAs in the Federal 
Register. The latest list was published on January 21, 1994 (59 F.R. 
3412). This office also issues a list of MUAs/MUPs. Persons interested 
in obtaining this list or other information concerning HPSAs and MUAs/
MUPs should contact: Dr. Evan R. Arrindell, Acting Director, Division 
of Shortage Designation, Bureau of Primary Health Care, 4350 East-West 
Highway, Room 9-1D-1 Bethesda, Maryland 20814 (phone: (301) 594-0816).

    Dated: September 1, 1995.
Donna E. Shalala,
Secretary.
[FR Doc. 95-23199 Filed 9-18-95; 8:45 am]
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