By Jennifer Larson, NurseZone feature writer 

For the second year in a row, Rep. Sheila Jackson Lee of Texas has introduced in Congress a piece of legislation to expand one of the temporary visas available to foreign nurses coming to the United States.

The Rural and Urban Health Care Act of 2003 would significantly expand the H-1C temporary visa currently available to nurses willing to work in underserved areas of the nation. It is also similar to a piece of legislation introduced in the Senate in 2001.

Nkenge Harmon, Jackson Lee’s spokeswoman, noted that Rep. Jackson Lee believes the bill could help satisfy some of the demand for more nurses to provide quality health care during the current nursing shortage.

But the American Nurses Association, the largest organization of registered nurses in the United States, strongly disapproves of the bill.

“We have not yet gone on the record with the bill in this Congress,” said Erin McKeon, associate director for government affairs for the ANA. “However, we do still oppose it for all of the same reasons that we opposed it last year.”

The H-1C visa was created by the Nursing Relief for Disadvantaged Areas Act of 1999 to allow foreign-born registered nurses to work for up to three years in government-designated Health Professional Shortage Areas. Only certain hospitals that serve HPSAs, which include size, Medicaid and Medicare requirements, may sponsor nurses on this type of visa.

Only a handful of H-1C visas is issued each year. According to Carl Shusterman, an immigration attorney in Los Angeles, California, the upper limit is 500. Other foreign nurses must obtain a different type of visa if they wish to work in the United States.

McKeon explained the ANA is apprehensive that H-1C visa changes could result in the possible exploitation of foreign nurses. In the past, some foreign nurses have been forced to work unreasonable hours or work as nurse’s aides, she said, and the ANA does not want more cases in the future.

However, immigration attorney Gregory Siskind speculated the ANA is concerned with protecting the interests of its members.

“Limiting competition is certainly consistent with this mission,” said Siskind, founding partner of Siskind Susser Haas & Devine in Memphis, Tennessee.

“As for any influx of foreign nurses, we can only hope this would be the case,” he added. “With a desperate shortage of nurses in this country, I’d consider a rapid migration of nurses here to be like the coming of the calvary.”

The United States has at least 126,000 unfilled hospital nursing positions, according to American Hospital Association estimates.

But McKeon maintains the ANA is invested in the fair treatment of all nurses, American and foreign. "We're equally concerned about how the immigrant nurses who are brought into this country are treated," she said.

The legislation does contain a provision that specifies the foreign nurse with an H-1C visa must be paid the same wage rate as other registered nurses employed by the facility.

The ANA also asserts that the United States should not rely on foreign nurses to solve its problems.

“We believe that the causes for and the answers to the domestic nursing shortage should be addressed here, not by looking outside,” McKeon said. “Also, we believe that there are ethical implications…with brining in nurses from around the world and looking outside of this country to meet our shortage when there is a worldwide shortage.”

The legislation does provide protections to prevent health care employers from bringing in more foreign nurses than the health care system can support, according to Siskind.

The bill is now before the House Committee on the Judiciary. 

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