Text: S.1979 — 112th Congress (2011-2012)All Information (Except Text)

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Introduced in Senate (12/12/2011)


112th CONGRESS
1st Session
S. 1979


To provide incentives to physicians to practice in rural and medically underserved communities and for other purposes.


IN THE SENATE OF THE UNITED STATES

December 12, 2011

Mr. Conrad (for himself and Mr. Moran) introduced the following bill; which was read twice and referred to the Committee on the Judiciary


A BILL

To provide incentives to physicians to practice in rural and medically underserved communities and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. Short title.

This Act may be cited as the “Conrad State 30 Improvement Act”.

SEC. 2. Elimination of sunset provision of Conrad State 30 Program.

Section 220(c) of the Immigration and Nationality Technical Corrections Act of 1994 (8 U.S.C. 1182 note) is amended by striking “and before September 30, 2012”.

SEC. 3. Retaining physicians in medically underserved communities.

Section 203(b)(1) of the Immigration and Nationality Act (8 U.S.C. 1151(b)(1)) is amended—

(1) in the matter preceding subparagraph (A), by striking “(A) through (C):” and inserting a colon; and

(2) by adding at the end the following:

    “(D) CERTAIN PHYSICIANS WHO HAVE SERVED IN MEDICALLY UNDERSERVED COMMUNITIES UNDER SECTION 214(l).—

    “(i) PHYSICIANS DESCRIBED.—An alien is described in this subparagraph if the alien has completed service requirements of a waiver or exemption requested under section 214(l), plus an additional 2 years at the location identified in the section 214(l) waiver or exemption or in an area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals, including alien physicians who completed such service before the date of enactment of the Conrad State 30 Improvement Act.

    “(ii) CONSTRUCTION.—Nothing in this subparagraph may be construed—

    “(I) to prevent the filing of a petition with the Secretary of Homeland Security for classification under section 204(a) or the filing of an application for adjustment of status under section 245 by an alien physician described in this subparagraph prior to the date by which such alien physician has completed the service described in section 214(l) or worked full-time as a physician for an aggregate of 5 years at the location identified in the section 214(l) waiver or exemption or in an area or areas designated by the Secretary of Health and Human Services as having a shortage of health care professionals; or

    “(II) to permit the Secretary of Homeland Security to grant such a petition or application until the alien has satisfied all the requirements of the waiver or exemption received under section 214(l).”.

SEC. 4. Incentives for physicians to practice in medically underserved communities.

Section 214(g) of the Immigration and Nationality Act (8 U.S.C. 1184(g)) is amended, by adding at the end the following:

“(12) An alien physician described in section 212(j)(2)(B) who entered or is seeking to enter the United States as a nonimmigrant described in section 101(a)(15)(H)(i)(b) to pursue graduate medical education or training shall not be subject to the limitations described in paragraph (1) or (4), provided that the period of authorized admission of such alien as an H–1B nonimmigrant may not extend beyond the 6-year period beginning on the date on which the alien receives the exemption described in subparagraph (A), other than extensions authorized by section 104 or 106 of the American Competitiveness in the Twenty-First Century Act of 2000 (Public Law 106–313; 114 Stat. 1251) or an amendment made by such section, if an interested State agency submits a request for an exemption under section 214(l)(1)(B), but not 1 of the 10 waivers or exemptions described in subsection (l)(1)(D)(ii).”.

SEC. 5. Restrictions on waivers and physician protections.

(a) In general.—Section 214(l)(1) of the Immigration and Nationality Act (8 U.S.C. 1184(l)(1)) is amended—

(1) by amending the matter preceding subparagraph (A) to read as follows:

“(1) In the case of a request by an interested State agency, or by an interested Federal agency, for a waiver by the Secretary of Homeland Security of the 2-year foreign residence requirement under section 212(e) on behalf of an alien described in clause (iii) of such section or in the case of a request to the Secretary of State for certification of an exemption from the limitation described in paragraphs (1) and (4) of subsection (g) on behalf of an alien described in paragraph (12) of such subsection, the Secretary of Homeland Security and the Secretary of State shall not grant such waiver or exemption certification unless—”;

(2) in subparagraph (A), by striking “United States Information Agency” and inserting “Secretary of State”;

(3) in subparagraph (B), by striking “would not cause the number of waivers allotted for that State for that fiscal year to exceed 30;” and inserting “or exemption would not cause the total number of waivers plus the total number of exemptions allotted for that State for that fiscal year to exceed 30, unless such allotment is increased pursuant to paragraph (4);”;

(4) in subparagraph (C), by striking clauses (i) and (ii) and inserting the following:

“(i) the alien demonstrates a bona fide offer of full-time employment, at a health care organization, which employment has been determined by the Secretary of Homeland Security to be in the public interest;

“(ii) the alien agrees to begin employment with the health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals by the later of the date that is 90 days after receiving such waiver or exemption, 90 days after completing graduate medical education or training under a program approved pursuant to section 212(j)(1), or 90 days after receiving nonimmigrant status or employment authorization, and agrees to continue to work for a total of not less than 3 years in any status authorized for such employment under this subsection unless—

“(I) the Secretary determines that extenuating circumstances exist that justify a lesser period of employment at such facility or organization, in which case the alien shall demonstrate another bona fide offer of employment at a health facility or health care organization, for the remainder of such 3-year period;

“(II) the interested State agency that requested the waiver or exemption attests that extenuating circumstances exist that justify a lesser period of employment at such facility or organization in which case the alien shall demonstrate another bona fide offer of employment at a health facility or health care organization so designated by the Secretary of Health and Human services, for the remainder of such 3-year period; or

“(III) if the alien elects not to pursue a determination of extenuating cir­cum­stan­ces pursuant to subclause (I) or (II), the alien terminates the alien’s employment relationship with such facility or organization, in which case the alien shall be employed for the remainder of such 3-year period, and 1 additional year for each termination, at another health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals;”; and

(5) in subparagraph (D)—

(A) in clause (ii), by striking “would not cause the number of the waivers” and inserting “or exemption would not cause the total number of waivers and exemptions”; and

(B) in clause (iii), by inserting “or exemption” after “waiver”.

(b) Change of status.—Section 214(l)(2)(A) of the Immigration and Nationality Act (8 U.S.C. 1184(l)(2)(A)) is amended—

(1) by striking “Attorney General” and inserting “Secretary of Homeland Security”; and

(2) by inserting “described in section 212(e)(iii)” after “status of an alien”.

SEC. 6. Allotment of waivers and extensions; limitation of waivers of period of authorized admission; other physician protections.

Section 214(l) of the Immigration and Nationality Act (8 U.S.C. 1184(l)) is amended by adding at the end the following:

“(4) (A) (i) All States shall be allotted a total of 35 waivers and exemptions under paragraph (1)(B) for a fiscal year if, during the previous fiscal year, the total number of waivers and exemptions awarded to all the States is at least 90 percent of the total number of the waivers and exemptions available to the States that received 5 or more such waivers or exemptions.

“(ii) When an allocation has occurred under clause (i), all States shall be allotted an additional 5 waivers and exemptions under paragraph (1)(B) for each subsequent fiscal year if, during the previous fiscal year, the total number of waivers and exemptions awarded to all the States is at least 90 percent of the total number of the waivers and exemptions available to the States that received 5 or more such waivers or exemptions.

“(B) Any increase in allotments under subparagraph (A) shall be maintained indefinitely, unless in a fiscal year, the total number of such waivers and exemptions granted is 5 percent lower than in the last year in which there was an increase in the number of waivers and exemptions allotted pursuant to this paragraph, in which case—

“(i) the number of waivers and exemptions allotted shall be decreased by 5 for all States beginning in the next fiscal year; and

“(ii) each additional 5 percent decrease in such waivers and exemptions granted from the last year in which there was an increase in the allotment, shall result in an additional decrease of 5 waivers and exemptions allotted for all States, provided that the number of waivers and exemptions allotted for all States shall not drop below 30.

“(5) An alien granted a waiver or exemption under paragraph (1)(C) shall enter into an employment agreement with the contracting health facility or health care organization that—

“(A) specifies the maximum number of on-call hours per week (which may be a monthly average) that the alien will be expected to be available and the compensation the alien will receive for on-call time;

“(B) specifies whether the contracting facility or organization will pay for the alien’s malpractice insurance premiums, including whether the employer will provide malpractice insurance and, if so, the amount of such insurance that will be provided;

“(C) describes all of the work locations that the alien will work and a statement that the contracting facility or organization will not add additional work locations without the approval of the Federal agency or State agency that requested the waiver or exemption; and

“(D) does not include a non-compete provision.

“(6) An alien granted a waiver or exemption under paragraph (1)(C) whose employment relationship with a health facility or health care organization terminates during the 3-year service period required by such paragraph—

“(A) shall have a period of 120 days beginning on the date of such termination of employment to submit to the Secretary of Homeland Security applications or petitions to commence employment with another contracting health facility or health care organization in a geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals; and

“(B) shall be considered to be maintaining lawful status in an authorized stay during the 120-day period referred to in subsection (A).

“(7) Notwithstanding paragraph (1)—

“(A) an alien that terminates the alien's employment relationship with a health facility or health care organization, except under paragraph (1)(C)(ii)(III), shall not be eligible for an exemption from the limitations described in paragraphs (1) and (4) of subsection (g); and

“(B) if such an alien was previously granted such exemption, the Secretary of Homeland Security shall rescind such exemption.”.