It also increases the number of FLEX 5 slots from five slots per year to ten slots per year per state. Each state department of health may award five of the annually allotted 30 J-1 physician waiver slots per year to physicians not physically located in medically underserved areas but who treat patients who reside in underserved areas. The increase will benefit states who do not currently use their thirty slots and teaching hospitals.

A similar bill has been introduced in the Senate (S. 2672) which has a number of more beneficial provisions and we would urge all our readers to contact their Senators and Congressperson and urge them to support the Senate Bill. We suggest you email, call and fax your Congressional representatives. You may locate your Congressperson by clicking on: www.congress.org.

The provisions include:

1)Permanent reauthorization of the Conrad State 30 program. We are all relieved to finally have this wonderful program up for permanent reauthorization.

2) Allowing physicians who completed residency and fellowships in H-1B status to use State 30 slots. In return for working in medically underserved areas, the H-1B physician can obtain the following benefits:

-Exemption from the H-1B Cap. This is particularly valuable when physicians will be employed by for-profit groups.

-Exemption from the six year limit of time permitted in H-1B status.

-Exemption from the employment-based green card quotas.

3) Increase in Flex 5 slots from 5 to 10. The total annual limit of Conrad State 30 physician Waiver would continue to be 30, but 10 of the 30 could be used for physicians employed at facilities not physically situated in underserved areas, as long as the physician serves patients who live in an underserved area.

4) Increase in per state allotment. If 90% of the national total of State 30 waivers are filled in a given year, the number of physician waivers allowed per state would increase to 35. Then if 90% of the adjusted total of nationwide waivers were filled, the per state allotment would increase to 40, with upward adjustments permitted under the formula. The per state cap would reset to 30 at the beginning of each year.

A full summary follows:

Conrad State 30 Improvement Act

The Conrad State 30 program allows foreign doctors on J-1 visas to obtain a waiver of the J-1 requirement to return to their home country for two years, if they agree to serve for 3 years in an underserved area in the U.S. Each state is allowed 30 such waivers. In recent years, almost 1000 additional doctors have annually begun practicing in underserved communities in all 50 states as a result of the Conrad 30 program. The Conrad State 30 Improvement Act would make this successful program permanent and implement various reforms intended to increase the number of the doctors in underserved areas. Below is a section-by-section summary of the bill.

Section 1. Title- Conrad State 30 Improvement Act

Section 2. Permanent Authorization- Make the Conrad 30 program permanent. Since its inception in 1994, the program has been repeatedly reauthorized on a temporary basis.

Section 3. H-1B Participation & Increase in Per State Allotment

H-1B Participation- Allow doctors who come to the U.S. on an H-1B visa to obtain a Conrad 20 waiver slot. Currently, only J-1 doctors are eligible for the program. There would be no new slots created initially; the H-1B doctors would simply be incorporated into the current 30 waiver per state system. H-1B doctors do not have a requirement to return home, so in return for their 3 years of service in the Conrad 30 program, these doctors would receive an exemption from:

a) H-1B caps (helpful for those doctors who originally obtained an H-1B visa through a cap-exempt employer, but wish to stay in the U.S. when their employment with such employer terminates, and would thus be subject to the H-1B caps if seeking employment with a nonexempt employer);

b) the 6-year limit on H-1B visas; and

c) green card caps (see section 4 below).

Increase in Per State Allotment- If 90% of the nationwide waivers are filled in a given year, the number of waivers allowed per state would increase to 35. then if 90% of the adjusted total of the nationwide waivers were filled, the per state allotment would increase to 40, and so on indefinitely. Only states that received at least 5 waivers in any of the three pervious years would be included when calculating the 90% threshold. The per state cap would reset to 30 at the beginning of each year.

Section 4. Green Card Cap Exemption- Green card cap exemptions for doctors who have completed the Conrad 30 Program. Due to current caps, many doctors face extremely long waits to obtain green cards, because a very high percentage of doctors come from heavily oversubscribed countries, such as India. A cap exemption would provide an important incentive for doctors to practice in underserved communities.

Section 5. Increased Flex Slots- Increase the number of "flex slots" from 5 to 10. Currently, states can use 5 of their 30 slots for doctors employed at facilities not actually located in an underserved area, as long as such facilities serve patients who live in an underserved area.