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Thursday, December 11, 2008

Retrogression Update: US relaxes visa requirements for nurses: shortage for nurses may become national security concern

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By Veronica Uy
First Posted 14:49:00 12/11/2008

MANILA, Philippines -- The US government has issued a directive to relax visa procedures for foreign nurses after the Department of Homeland Security (DHS) acknowledged the acute shortage of the health care professionals there.

The directive, Processing of "Schedule A" Nurse Visas, which can be accessed at, released on December 5, noted that "visa availability" remains the main obstacle for foreign nurses seeking work in the US, whether they intend to become immigrants or not.

The Office of the Citizenship and Immigration Services (CIS) Ombudsman of the DHS, which released the directive, said that while the Department of Labor (DoL) has already allowed employers to bypass the first step in the hiring process, it enjoins the USCIS to adjust its procedures as well.

"Specifically the USCIS should separate and prioritize, as well as centralize, its process for [Schedule A] applications in accordance with Congress' expressed concern over the national nursing shortage and to ensure consistent adjudication of applications," it said.

The DoL has designated registered nurses (RNs) as a Schedule A occupation, meaning there are insufficient US nurses able, willing, qualified, and available to fill the vacancies. The designation also means the wages and working conditions of US nurses will not be adversely affected by the employment of foreign nurses.

The CIS Ombudsman noted that all the criteria needed for automatically expediting such applications from employers apply to the US nursing shortage -- "extreme emergent situation," "humanitarian situation," and "compelling interest of the service."

It noted that the shortage will impact on the quality of patient health care in the US. "The shortage of RNs and an increased workload for current nurses is a threat to the quality of patient care," it said.

On the other hand, centralizing the applications would result in "more efficient processing times and improved consistency in the adjudications."

Lawyer Ibaro Relamida, counsel of Sentosa Recruitment Agency, said the directive will take effect right away. He said Sentosa's 600 Filipino nurses are expected to get their EB3 visas within the month.

"Last month, we were able to send only 20 nurses to the US," he told "We still have the visas of 1,000 being processed."

A 2007 study of the US Department of Health and Human Services shows that the US would need 1.2 million nurses by 2014, about half a million to meet the demand, and 700,000 more to replace those leaving the profession.

In its report, the CIS Ombudsman cited a warning from the Americans for Nursing Shortage Relief to the House Subcommittee on the Nursing Crisis that the "shortage could result in serious national security and health concerns if there is a pandemic flu or other man-made or natural disaster, and the United States does not have adequate health care resources to respond."

The CIS Ombudsman acknowledged that the US cannot expect to meet the growing demand for nurses. It also recognized that the piecemeal approach to visa applications for foreign nurses would not work.

Currently, foreign nurses can work in the US if they have any of the following visas:

* H1C non-immigrant visas, three-year visas for nurses in specified areas with nurse shortage, were issued to 49 in 2007 and 110 in 2008;

* TN non-immigrant visas, also three-year visas with an option to extend in increments of three years open to Canadians and Mexicans, were issued to 194 in 2006 and 356 in 2007;

* H1-B non-immigrant visas, for nurses in specialized occupations, were issued only to 38 in 2006, 66 in 2007, and 136 in 2008;

* EB3 immigrant visas, which gives foreign nurses permanent legal residence (the so-called "green card"), are the ones on DoL's Schedule A. Although the most common visas issued for foreign nurses, they depend on visa availability as determined by the Department of State. In 2007, a total of 9,689 such visas were issued.


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