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Arizona State 30 J-1 Visa Waiver Program
 
HSD Contact: Fabian Valle (Contact Us)
  
 

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NEWS:

The Arizona Department of Health Services J-1 Visa Waiver program will begin accepting a second cycle of applications for the 2010 program on Feb 15, 2010 for Primary Care Physicians and Specialists requesting consideration for a letter of support. Submit applications post-marked no later than Monday, March 15, 2010.

The application review process will take approximately 5 weeks from the closing of the application date. In the event additional information is required from applicants, decisions may be delayed. ADHS advises all applicants to ensure only complete applications are submitted to minimize any delay in decisions. Please include the case number on every page of a submitted application.

New Prioritized Service Sites/Partners to the AZ J-1 visa waiver program:

  • Pertaining to Specialists
    Arizona Fit at Fifty HealthCheck Colorectal Cancer Screening Program Partner - A Physician who will provide Colorectal Cancer Screening on behalf of a Practice or Facility who is contracted or has an agreement to provide colorectal cancer screening services with the ADHS Fit at Fifty Program. For example, this would be Gastroenterologist who will conduct an endoscopy or colonoscopy for an individual referred by a Fit at Fifty Program Partner. See AZ J-1 Visa Waiver 2010 Specialist Guidance Item 8 (page 7) "A description of the J-1 Physician’s proposed responsibilities and schedule" and Specialist Scoring Criteria. Contact Fabian Valle vallef@azdhs.gov or 602-542-1066 for further discussion.

  • Pertaining to Specialists/Primary Care
    Arizona Department of Corrections Facility: any portion of a state prison complex with a discipline appropriate Federal Health Professional Shortage Facility Designation. For recruitment information contact Interim Medical Director Dr. Michael Adu-Tutu madututu@azcorrections.gov or 602-228-4843.

To determine if a site is designated as a Health Professional Shortage Area (HPSA) or Medically Underserved Area/Population (MUA/P), enter the complete street address of the location on the Shortage Designation Advisor website.

Requests for site eligibility determination must be made in writing and submitted to the program manager or specialist as noted on the Contact Us webpage.

Sliding discount-to-fee schedules must be based on current Federal Poverty Guidelines and adhere to A.A.C. R9-1-504 sliding fee schedule submission and content.

The Department of Health and Human Services also has a J-1 waiver program available. For more information visit their website at: http://www.globalhealth.gov/exchangevisitorprogram/

   
    The following links are in PDF format.  To download, Acrobat Reader™ is required.  
       
Applications:  2010 J-1 Visa Waiver Program Info:  
  
2010 Primary Care PhysiciansPDF  
2010 SpecialistsPDF  
2010 Primary Care Scoring CriteriaPDF  
2010 Specialist Scoring CriteriaPDF  
2010 Contract GuidelinesPDF  
2010 Provider ApplicationPDF  
2010 Service Site ApplicationPDF  
   
Reporting:

The Arizona Department of Health Services requests that physicians who have received support for their J-1 Visa Waiver submit an Encounter Form quarterly. Reporting is submitted on a predetermined schedule as indicated below:

Reporting Period Submitted by 10th business day of:
January 1 – March 31 April
April 1 – June 30 July
July 1 – September 30 October
October 1 – December 31 January

If your start or end employment date falls between these reporting dates, use the date and indicate employment begin or employment end, as appropriate.

  
  J-1 Visa Waiver Encounter FormPDF  

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