Temporary USDA Resumption of Visa Waiver Program Not a Solution to California’s Rural Physician Deficit
Although the Department of Agriculture last week temporarily reversed its decision to end participation in a federal program that allows foreign-born doctors to practice in underserved areas, some California advocates and lawmakers say the decision does not solve the problem of attracting providers to rural areas, the Fresno Bee reports (Doyle, Fresno Bee, 4/19). Under Immigration and Naturalization Service rules, immigrants admitted to the United States to participate in educational exchange programs receive a J-1 visa. They must return to their home nations for two years after participation in the program before applying for an immigrant visa, permanent residence in the United States or an additional nonimmigrant visa. However, certain government agencies can request a waiver of the two-year home residence requirement. Since 1994, the USDA has participated in the Waiver of Recommendations for Foreign Physicians program, administered by the Department of State, requesting waivers on behalf of foreign-born doctors who agree to practice in underserved areas for three to five years. In March, USDA ended its participation in the program due to security considerations in the aftermath of the Sept. 11 attacks. The USDA on April 16 temporarily reversed its decision, saying it would process 86 pending requests (California Healthline, 4/16).
In a recent letter to Agriculture Secretary Ann Veneman, a Modesto native and former secretary of the state Department of Food and Agriculture, California Reps. Cal Dooley (D) and Mike Thompson (D) wrote that permanently ending participation in the program "may have devastating consequences for rural California," adding, "Without the J-1 visa waiver program, proper health care will be even more scarce in rural California." The Bee reports that six of the 10 primary care providers that Stanislaus County recruited in recent years came through the visa waiver program. Dr. Paul Griffin of Fresno County said, "Recruiting doctors has always been a difficult thing in our area, because it's remote and it's not a glamorous location. What we can get with a J-1 (waiver) is a good doctor who's happy to be here" (Fresno Bee, 4/19). Wayne Meyers, a retired physician who recently spoke to an advisory committee on regulatory reform convened by HHS Secretary Tommy Thompson, said that if visas are revoked for foreign-born doctors currently practicing in the United States, 212 rural counties would be without a primary care physician, up from 161 currently (Snowbeck, Pittsburgh Post-Gazette, 4/18).
Although the USDA "did not intend to endanger the lives of sick poor people" in California by halting participation the J-1 visa program, "that has been the result," a Fresno Bee editorial says. The editorial states that the USDA should have "thoroughly consulted" local lawmakers and providers rather than "surpris[ing]" them with its decision to end its participation in the program. An "alternate program" should have been immediately put in place, the Bee says. Although pressure from local lawmakers, including Dooley, has Veneman and her staff "scrambling" to do "damage control," the department's recent actions are "small concessions," and the "problem for California's rural communities remains unsolved," the Bee says. The Bee concludes, "Secretary Veneman is familiar with the problems of her home region, so her weeks of silence on this issue are disappointing. While we approve the recent promise to work [on the issue] with a White House Domestic Policy Council panel, she should intervene immediately to devise an alternative that restores incentives for doctors -- foreign or domestic -- to care for the poor" (Fresno Bee, 4/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.