1. Overview: State Office of Rural Health & Office of Workforce Development
Temi Oshiyoye, MPH, CHES
Office of Rural Health & Office of Workforce Development
Office of Population Health Improvement
Maryland Department of Health

2. Office of Workforce Development Overview

3. J-1 VISA National Interest Waiver
OPHI Workforce Development Program makes recommendations to United States Department of State for foreign-born physicians requesting waivers for their J-1 VISA.
J-1 VISA allows physicians to stay in the US after their medical training is complete; in exchange for an agreement to work in a HPSA for three years.
Maryland is granted 30 slots per federal fiscal year, primary care focus, but physicians of any specialty can apply.
NEW: Maryland J1 waiver recommendations are based on the current workforce shortage in the state.
Approximately ~40 applications per year. J-1s are awarded on a first come/first serve basis. DHMH OPHI has ability to prioritize waivers based on existing need
Federal laws allow foreign physicians who have a valid J-1 Exchange Visitor Visa to pursue and complete graduate medical education and/or training in the United States. Upon completion of their training program, the physicians must return to their home country for at least two years before they are able to return to the U.S.  To avoid returning home, physicians can apply for a J-1 Visa Waiver through the Department of Health and Mental Hygiene. MD's DHMH recommends 30 J-1 Visa Waivers annually to the United States Department of State (US DOS) for physicians who are practicing medicine in rural and underserved parts of Maryland. After the US DOS approves the J-1 Visa Waiver, physicians can then apply for the H1-B Visa, which is additionally required to continue practicing medicine. 
Appalachian Regional Commission (ARC) J-1 Visa Waiver Program
Western Maryland
Primary Care
Governor's Recommendation
Exchange Visitor’s Program (HHS) J1
HPSA score of 7 or higher
Site
Rural Health Clinic
Section 330 (FQHC)
Native American/ Native Alaskan tribe medical facility
Applicant
Research or clinical care

4. J1 Application Process Application Opens October 1st- December 1st.
Service Obligation begins July 1st
Application Materials

5. What’s Happens Next MDH Review Process- 6 Weeks
J1 wavier review Panel
Review Sheet
Applicant notification of recommendation letter sent to Department of State
DOS Process- 10 weeks
USIS- MDH Wavier acceptance letter
MDH- Welcome package to applicant

7. Federal and State Loan Repayment Programs
Maryland Loan Assistance Repayment Program: MLARP (General Funds)
Funded through Maryland Board of Physicians
Physicians, Physician Assistants, and Medical Residents
State Loan Repayment Program: SLRP (Federal Funds)
Physicians, Physician Assistants
Award Amount
Up to $50,000 per year for a 2-year obligation
Renewing an Award
A recipient may reapply for an award after completion of the first 2-year service obligation. A recipient’s total award amount cannot exceed $200,000, or two 2-year obligations at $50,000 per year.
$800,000 annually through SLRP and MLARP. Workforce development recruits and retains providers and also expands opportunities for facilities/infrastructure to provide services in shortage areas and medically underserved areas. The workforce programs require HPSA designations.
FY awards made: family medicine, psychiatry, peds, internal medicine, emergency med, ob/gyn, surgery
Awards are up to $50,000 per year (2 year obligation)

8. Eligible Applicants

9. Eligible Site
SLRP: An eligible practice site is one operated as a public clinic by any federal, state, local governmental entity or a non-profit medical care facility that
1) treats all persons regardless of ability to pay, and
2) is located in a geographic region of Maryland that the Health Resources and Services Administration has designated as a HPSA 
MLARP: An eligible practice site could be non-profit or for profit medical facility that
1) treats all persons regardless of their ability to pay and
2) is located in a Health Professional Shortage Area,
or 3) Medically Underserved Area,
or 4) site is located in one of the 18 rural counties of the State.

10. More Requirements
Have a medical (Medical Doctor or Doctor of Osteopathy) or physician assistant degree or be a medical resident specializing in primary care
Be practicing as a primary care physician (that is, general internal medicine, family medicine, general pediatrics, obstetrics and gynecology, women's health, general psychiatry, emergency medicine or geriatrics) for MD/DO or enrolled as a medical resident specializing in primary care
Have a valid unrestricted license to practice medicine in the State of Maryland at the time the service obligation begins
Be a citizen of the United States or be a U.S. National
Be employed full-time, at least 40 hours per week, at an eligible practice site and 32 hours per week must be in direct outpatient care for MD/DO or be enrolled full time as a medical resident specializing in Primary Care
Have not breached an obligation for service to a federal, state, or local governmental entity or another obligation for service even if the obligation was ultimately fulfilled
Have no judgment lien against your property for a debt to the United States
Not be excluded, debarred, suspended, or disqualified by a Federal agency
Have no un-served obligations for service to a federal, state, local government, or other entity, with the exception of the U.S. Department of Health and Human Services’ Primary Care Loans, Exceptional Financial Need Scholarships, and Financial Assistance for Disadvantaged Health Professions Students
Have no existing service obligation with any other loan repayment program
Have outstanding higher education loan debt and NOT be in default on any eligible higher education loan
Have no debts written off as uncollectible
Have no service or payment obligation waived
Have never violated court-ordered child support or been delinquent in child support payments.

11. How to Apply Application Cycle- March 1st- April 15th Obligation begins July 1st
Part I - SLRP Application (to be completed by Candidate - electronically)
Part II -SLRP - Practice Site Confirmation (to be completed by Employer)
Part III - SLRP - Site Eligibility Application (to be completed by Employer)
Part IV - SLRP - Lender Verification (to be completed by each lender)
Part V - SLRP – Official Medical School Transcript (to be completed by medical school)
Part VI - SLRP – Cultural Competency Requirements (to be completed by the Candidate and Employer)
Part VII- SLRP- Retention Study (to be read by the Candidate and Employer)
Part VIII- SLRP- Understanding Breaching of Contract (to be read by the Candidate and Employer)

12. Determining Factor
SLRP/MLARP Technical Scoring Sheet
Award Scale

13. What’s Next MDH review Process – 6 Weeks Pre-qualification Letter
MHEC Account Set up
Documentation and signatures
Award Letter and Promissory Note
Award check – provider and lender
Cultural Competency Documentations ( Site and Provider)

14. SLRP/MLARP Fiscal Year Total Data by Jurisdiction[1]
Created by State Office of Rural Health, OPHI, Maryland Department of Health. Last reviewed 10/2/2017.
FY'08
FY'09
FY'10
FY'11
FY'12
FY'13
FY'14
FY'15
FY'16
FY'17
FY '182
Allegany County 2 1
Anne Arundel County
Baltimore City 8 10 4 5 15 20 18 14
Baltimore County 3 6
Calvert County
Caroline County
Carroll County
Cecil County
Dorchester County
Frederick County
Garrett County
Harford County
Howard County
Kent County
Montgomery County
Prince George's County
Queen Anne’s County
Somerset County
St. Mary's County
Talbot County
Washington County
Wicomico County
Worcester County
Total 11 13 12 17 34 54 32

15. Preceptorship Tax Credit Nurse Practitioners and Physicians
Provides Maryland State Income tax credit for nurse practitioners and physicians who are training students without compensation in a Workforce shortage area
Student Preceptorship: Minimum of three rotations
@100 – 160 hours each; nurse practitioner and physician respectively
Credit Certificate: $1000/student preceptorship; up to $10,000
Funded through Board of Nursing licensing renewal fee and Board of Physicians
Fact Sheet
Check list
Received 54 applications for 2016 tax credit; 20 approved. Worked with Sen Eckard and Del Sample-Hughes to decrease the amount of hours per rotation to qualify – determined that this was barrier
The credit certificate will be issued by DHMH in the amount of $1000 for each student whom the Physician or Nurse Practitioner acted as a preceptor without compensation.
The tax credit amount for individual preceptor for any taxable year may not exceed $10,000.
The total amount of income tax credit certificates in total may not exceed $100,000 for any taxable year.

16. How to Apply
Part 1
Part 2
Part 3

17. What’s Next MDH Review- 6 weeks
Applicants are notified- Certificate is issued
Information is sent to Comptollor’s office

18. Tax Credit Placement History by Year
Cycle
Primary Care
Specialist
Rural
Urban
Total
2017
N/A 17 3 20
2018 13 12 25

20. Questions? Temi Oshiyoye, MPH Director, State Office of Rural Health
Director, Office of workforce Development Ph
Cell
Fax