Nursing Amendments and Bills in Congress

There are a number of nurse-related bills and amendments currently being debated in Congress.

SA 3449: Amendment to HR 3043  

On October 23, 2007, a nurse immigration relief amendment was included by unanimous consent in a voice vote. The provision was eventually stripped out in a conference committee and the bill was eventually vetoed by the President. But the amendment could still end up in the omnibus appropriations bill currently under consideration in Congress.

Nursing immigration ground to a halt earlier this year because of retrogression in the EB-3 green card category, the depletion of a 2005 allotment of 50,000 green cards for nurses and the lack of a non-immigrant visa category for nurses. The Senate added the measure as an amendment to H.R. 3043, the HHS-Labor budget bill. Amendment 3404, Senator Charles Schumer's Amendment, was passed as amended by Amendment 3449, introduced by Illinois Democrat Dick Durbin. The emndment provides:

• 61,000 visas for Schedule A occupations (nurses and physical therapists) and their immediate family members
• A $1500 additional fee for each of these green cards to be paid as a condition of approval of the adjustment application by USCIS or issuance of the visa by the State Department; waiver for certain facilities in disaster areas or HHS-designated halth professional shortage areas.
• Brain drain provision one: nurses, physicians and other health care workers must attest that they do not owe their native country any financial obligation tied to their health care worker education (an exception is made if the obligation was incurred by coercion or in the case of undue hardship); this provision shall take effect 180 days after passage of the bill
• A grant program is created to allow US nursing schools to increase the number of nursing faculty and students
• Brain drain provision two: Permanent resident health care workers (including doctors and nurses) will get credit toward naturalization and not be deemed to have abandoned permanent residency during time spent working in the following countries (a list will be published by DOS within six months (and DHS must publish rules within six months) of enactment of the legislation and updated annually):

• countries eligible for International Development Association assistance or
• which are classified as "lower middle income countries" in the World Development Report for Reconstruction and Development published by the Bank for Reconstruction and Development or
• a country determined jointly by DHS and DOS to be qualified due to special circumstances such as natural disasters or public health emergencies

These ‘brain drain" provisions cover doctors as well as other health care workers. SA 1409: Amendment to S 1348  

Senator Charles "Chuck" Schumer of New York submitted an amendment to S. 1348, the Comprehensive Immigration Reform Bill of 2007, in order to resolve the disagreement over portions of the bill concerning nurses.  

The amendment, SA 1409, changes the bill to require the Department of Health and Human Services (HHS) to report to Congress on the shortage of nurses and physical therapists in the U.S.   HHS is further required by the amendment to contract with the Institute of Medicine of the National Academies to determine the level of Federal investment under the Public Health Service Act that would be necessary to eliminate the shortage of nurses and physical therapists in the United States by January 1, 2015.  HHS would also have to work with ministers of health of the five countries from which the highest number of nurses and physical therapists emigrated to the U.S.  

SA 1409 also allows for nurses to recapture approximately 90,000 unused employment-based green cards for a fee of $1,500 per application.

HR 1358  

Representative John Shedegg, an Arizona Republican, has introduced H.R. 1358, also known as the Nursing Relief Act of 2007, a bill that would create a new W visa for registered nurses.  The new visa would have the following characteristics:  

·         Spouses and children could accompany the nurse to the U.S. ;

·         Direct consular filing possible as well as processing with USCIS in the US ;

·         Provides that if only thing holding up licensure of nurse is possession of Social Security number, the nurse can instead get a letter from the licensing board confirming eligibility for a license upon submitting the number;

·         USCIS and the Department of Labor have 90 days to issue regulations, and the law would take effect automatically if no regulations are issued by these agencies.

Additionally, like an H-1B visa, employers would have to go through a labor condition application process, pay the prevailing wage and maintain a public access file and W visas will be portable.  Also, the visa would be dual intent and permanent residency processing would be permitted while in W status.  There would be a cap of 50,000 visas issued each year, but the number can grow 20% per year if the cap is hit in the prior year.

W visas would be approvable for up to three years at a time with six years maximum except: 1) extensions permitted in one year increments if green card applications are pending for more than a year, and 2) one year extensions permitted if green cards are not available due to backlogs and the I-140 is approved;  

According to Representative Shedegg, the new visa is necessary due to the following:  

1)     There are more vacant nursing positions in the United States than there are qualified registered nurses and nursing school candidates to fill those positions;

2)     According to the Department of Labor, the current national nursing shortage exceeds 126,000;

3)     States in the West and Southwest have a disproportionate number of nursing vacancies because of rapid population growth;

4)     Countries such as the Philippines , India , and China have an oversupply of nurses;

5)     Major hospital systems in the U.S. spend hundreds of millions of dollars every year recruiting foreign nurses under the current immigration system;

6)     Current law requires health care providers to sponsor nurses for permanent residence while the nurses remain outside of the U.S., which can take as much as 3 years; and

7)     Health care providers cannot efficiently and effectively recruit qualified foreign nurses through the existing immigration process.  

The bill is co-sponsored by three other Arizona Representatives - Rick Renzi (R-AZ), Jeff Flake (R-AZ) and Edward Pastor (D-AZ).

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