Workforce Recruitment and Retention

The Washington State Office of Community Health Systems, Rural Health section can assist clinicians and students in several ways. We provide direct recruitment services, assistance with loan repayment programs and coordinate the J-1 Visa Waiver Program.

J-1 Visa Waiver Program
The Washington State Department of Health administers the J-1 Physician Visa Waiver program. The goal of the program is to increase the number of physicians available to work in rural and underserved areas of the state. The program is considered a secondary tool in recruitment, used when efforts to recruit a U.S. trained physician have been unsuccessful for an extended period.

Washington State will sponsor up to 30 waivers per federal fiscal year (October 1 through September 30). Federally qualified health centers and rural health clinics hiring primary care J-1 physicians are encouraged to use the U.S. Department of Health and Human Services J-1 Visa Waiver Program for Clinical Care.

J-1 Physician Visa Waiver program background and overview information fact sheet

2024 J-1 Visa Program Application Cycle

Updates

The department filed the CR-103 Permanent Rule (PDF) on August 30, 2024, to amend the WAC 246-562 Physician Visa Waiver (PDF). The new rules will be effective October 1, 2024. Here’s a summary what to expect from the new rules:

Application Review Periods

The department will only be receiving applications during the following review periods effective October 1, 2024.

First Application Review Period (October 1st – October 15th)

  • Complete waiver applications will be received for review and scoring. Incomplete applications will be returned to the applicant and may not be considered for this application review period.
  • Applications will be scored according to the following scoring rubric: J-1 Waiver Scoring Criteria.
  • Sponsorships will be provided to applicants according to weighted score.
  • Applicants will not be allotted more than two sponsorships per practice location(s) and three sponsorships total.

Second Application Review Period (November 15th – September 1st)

  • This review period is only open if there are available waiver slots! The Application Cycle Dashboard will be updated accordingly to show the number of waiver slots available, and the number of applications received.
  • Applications will be reviewed on a first-come, first-serve basis and will not undergo scoring.
  • Flex (or non-HPSA) waiver applications will be accepted on January 1st if waiver slots are available.

Application Requirements

Please read the following application instructions carefully.

  • An electronic PDF version of the Washington State Waiver application package must be submitted  via email. This email submission will serve as your date stamp for application review purposes.
  • Only the secondary application being sent to the Department of State will be mailed in.
  • Provide a table of contents and labeled color pages to identify each document.
  • Application package contents must be on 8.5” x 11” paper.
  • Please use a single fastener to hold together the pages of the application. Do not use staples or paperclips to attach documents together.
  • Application package must be single-sided.
  • All documentation must have the U.S. Department of State Case Number on the bottom-right hand corner of each page.
  • Electronic signatures for DOH-specific documents are permissible at this time.
  • Review the Application Checklist for required documentation.

2024 Application Cycle Dashboard

Waiver Slots Available

Number of Applications Received

8 open for applications now

22
Last updated on August 20, 2024.


Health Professional Shortage Area Information

To see areas in Washington state that currently have Health Professional Shortage Area (HPSA) designations please consult the Health Resources and Services Administration Data Warehouse.


Applications and Forms

Please use the forms below for applications and reports.

Applications

Eligibility Requirements

Full requirements for the applicant employer and physician can be found in the Washington Administrative Code 246-562: Rules governing J-1 physician waiver process. A summary is below.

Employer eligibility requirements

Employers can be for-profit, non-profit or government organizations. The employer must:
  • Be licensed to do business in Washington State.
  • Be located in a federally designated Health Professional Shortage Area (HPSA). 
  • If located in a HPSA specific to a population, serve that population.
  • Meet the criteria in WAC 246-562-075 if the practice location is not located in a federally designated HPSA.
  • Be able to document at least six months of unsuccessful recruitment activity.
  • Serve Medicare and Medicaid patients, with at least 15 percent of the total patient visits in the 12 months prior to application coming from Medicaid and/or other low-income patients (such as sliding fee discount and no pay).
  • Have an updated sliding fee scale schedule available for patient use and signage letting patients know about the discounts posted in the waiting area.
  • Have a signed employment contract containing all the required components with the J-1 physician for a term of three years. The employment contract must not contain a non-compete clause.
  • Pay the physician the prevailing wage.
  • Submit all required documents in the J-1 Physician Visa Waiver Application (PDF).
Added eligibility requirements effective October 1, 2024
  • All practice location(s) must be an existing practice location in Washington state for at least 12 months prior to application submittal.

J-1 physician eligibility requirements

  • On October 1 of each year, the physician must have completed either their training or be in the final year of their training program.
  • If not complete with their training, physicians must provide a letter of good standing from the training program including expected completion date.
  • Physicians must be board-eligible or board certified.
  • Primary care waivers are not available to physicians who have any sub-specialty training, except for geriatric and obstetrical fellowships.
  • Physicians must have a signed contract with an eligible employer for three years of service.
  • Physicians must have an active Washington State medical license or provide documentation of a pending application for their Washington State medical license.
  • Submit required annual physician reports (PDF) to department after starting work.
  • Physician must provide the following documents to their employer for inclusion in the J-1 Physician Visa Waiver Program Application (PDF).
  • Copy of current Curriculum Vitae
  • Copies of all DS-2019 forms (formerly IAP-66)
  • Proof of passage of U.S. Medical Licensing Examinations (if not already licensed in Washington)
  • Medical degree or diploma, translated as necessary (if not already licensed in Washington)
  • U.S. Department of State data sheet
  • Physician attestation statement
  • Physician personal statement
  • No objection statement or statement that physician isn't contractually obligated to return to their home country depending on which is applicable.
Added eligibility requirements effective October 1, 2024
  • Physicians must have an active Washington State medical license without any pending enforcement action cases and without any restrictions due to disciplinary action or unprofessional conduct. Or the physician can provide documentation of a pending application for their Washington State medical license.

Requests for Letters of Attestation

Effective October 1, 2024. Please see WAC 246-562-135 of the adopted rules for full details. A summary is provided:
  • Send requests for letters of attestation to the J-1 Visa Waiver Program Manager via email.
  • The practice location(s) must be in a HPSA designation.
  • Requests must include a letter from the employer. The letter must:
    • Be on employer letterhead
    • Identify the waiver program
    • Describe how the physician’s practice is in the public interest
    • State that the employer treats all patients regardless of their ability to pay, accepts Medicare, Medicaid, and S-CHIP assignment, uses a sliding fee discount, and may charge no more than the customary rate prevailing in the geographic area in which the services are provided
    • Be signed and dated by the head of the organization
  • Requests must include the employment contract.

For additional information, please contact the J-1 Visa Waiver Program Manager by email.

Student Loan Resources

National Health Service Corps

Healthcare professionals interested in loan repayment opportunities with rural and urban underserved employers are encouraged to contact the Department's Direct Recruitment Program for more information.

  • NHSC Loan Repayment Program is open to licensed primary care medical, dental, and mental and behavioral health providers who are employed or seeking employment at approved sites.
  • Students to Service Loan Repayment Program is open to dental students and allopathic and osteopathic medical students in their fourth year at an accredited medical or dental school.
  • NHSC Scholarship Program is open to fulltime students pursuing a degree in Medicine (MD or DO), dentistry (DDS or DMD), advanced practice nursing, nurse midwifery or physician assistance.

A list of approved NHSC employers in Washington can be found on the NHSC Jobs Center site.

Washington State Health Professional Loan Repayment and Scholarship Program

Washington has two loan repayment programs administered by the Washington Student Achievement Council.

NURSE Corps

The federal NURSE Corps has two different programs that help nurses with education expenses:

The NURSE Corps Scholarship Program is open to students accepted or enrolled in a diploma, associate, baccalaureate or graduating nursing program.

The NURSE Corps Loan Repayment Program is open to licensed registered nurses (including advanced practice nurses) and nurse faculty working full time at an eligible critical shortage facility or school of nursing.

Public Service Loan Forgiveness Program

The Public Service Loan Forgiveness Program is managed by the U.S. Department of Education. Healthcare professionals and others employed by a government or nonprofit may be able to receive forgiveness of certain federal loans after working 10 years and making 120 qualifying monthly payments.

Student Loan Advocacy

Washington Student Achievement Council offers a Student Loan Advocacy Program that supports current and future student loan borrowers in Washington state. The Student Loan Advocates offer Public Service Loan Forgiveness information and work directly with loan borrowers to address complaints and help them navigate issues and identify resources.

National Interest Waiver Program

The federal National Interest Waiver Program allows foreign physicians to request a waiver of the U.S. Citizenship and Immigration Services labor certification requirements based on a letter of support from the Department of Health.

Foreign physicians working full time for five years in designated Health Professional Shortage Areas or whole-county medically underserved areas are eligible. Time spent in H1-B status to fulfill a J-1 Visa Waiver requirement may count towards the five-year requirement.

The Department of Health requires interested physicians to submit the following:

  • A letter from their employer describing how their work in the shortage area will improve access to care and is in the public's interest.
  • A copy of their contract showing they have completed or will complete five years of service.

Documents sent via UPS/FedEx:

Washington State Department of Health
Office of Community Health Systems, Rural Health Section
Attention: J-1 Visa Waiver program manager
111 Israel Rd. S.E. (MS: 7853)
Tumwater, WA 98504

Documents sent via U.S. Postal Service:

Washington State Department of Health
Office of Community Health Systems, Rural Health Section
Attention: J-1 Visa Waiver program manager
P.O. Box 47853
Olympia, WA 98504-7853

For additional information please contact:
J-1 Visa Waiver program manager
360-236-2862
J1VisaWaiver@doh.wa.gov

Direct Recruitment

The Rural Health Section provides recruitment services for healthcare facilities located in rural and underserved areas statewide. Our goal is to ensure that the rural healthcare system in Washington state has the professionals needed to help build healthy communities.

Direct recruitment efforts are provided for the following types of practice sites:

  • Rural areas, including Rural Health Clinics and Community Health Centers
  • Tribal settings (Indian Health Service or self-governed)
  • Urban sites providing care to medically underserved patients
  • State correctional and mental health facilities

Primary recruitment focus areas are:

  • Primary care physicians (family medicine, general internal medicine, general surgery, OB/GYN, pediatrics and psychiatry)
  • Dentists
  • Physician assistants (PA)-certified
  • Advanced registered nurse practitioners (NP)
  • Behavioral health providers
  • Registered nurses

If you're a provider looking for employment opportunities, register here. This link takes you to 3RNET.org, a third-party site the Rural Health Section uses to assist us in our recruitment work. Contact information and resumes are kept private and only shared with hiring organizations with your permission.

If you're an employer seeking help with provider recruitment, posting an open vacancy, or would like information on programs and resources important to the health care workforce in rural and under-served areas see the 3RNET recruitment webpage.

National Rural Recruitment and Retention Network (3RNET)

As a member of the non-profit National Rural Recruitment and Retention Network (3RNET) we help health professionals access job opportunities in rural and underserved communities throughout the country. The best and easiest way to receive direct recruitment assistance is to register online at the 3RNET website.

Health Student/Residency Presentations

The Rural Health Sections Workforce Team travels the state to present to primary care medical residents, medical students, dental students, and advanced registered nurse practitioners/physician assistant (ARNP/PA) students. The discussion includes working in rural/underserved Washington, loan repayment programs and finding the right opportunity after graduation. We're always happy to consider requests for presentations, if interested email us.

Loan Repayment Opportunities

More information about the National Health Service Corps and Washington State Health Professional Loan Repayment Program is on the loan repayment section of our site.

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