South Florida Hospital News
Tuesday August 4, 2020

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July 2005 - Volume 2 - Issue 1

Foreign Recruitment a Feasible Strategy Once More: A New Law Provides Thousands of Visas for Foreign Nurses

In recent news coverage of changes to our immigration laws, you may have missed little reported but important good news for healthcare facilities. The influx of foreign nurses to the United States from certain countries, which had been cut off in January of this year, was restored with the enactment of a law that will provide badly needed immigrant visas for foreign registered nurses.

President Bush signed the Emergency Supplemental Appropriations Act for Defense, the Global War on Terror, and Tsunami Relief of 2005 (P.L. 109-13) into law on May 11, 2005. Section 502 of the Act makes up to 50,000 unused employment-based visas from 2001 through 2004 available for "Schedule A" occupations, which include foreign nurses, physical therapists and performing artists of exceptional ability. Because the majority of applicants under the affected category are RNs, the visa numbers will benefit healthcare facilities.

The nursing shortage has reached crisis proportions. Nurse recruiters in South Florida along with their counterparts nationwide employ multiple strategies to recruit registered nurses, including sponsorship of foreign nurses for immigrant visas ("green cards"). Statistics show that 10% of applicants to state nursing boards each year are foreign nurses. The percentage is even higher in states that attract large immigrant populations. A great number of nurses being recruited were born in the Philippines and India, two of the countries affected by the cutoff of immigrant visas.

Why was there a cutoff? Annual quotas for immigrant visas from the affected countries were reached in January 2005. As a result, immigrant visas for workers born in these countries whose employers petitioned after 2002 were put on hold. This shut down the pipeline of nurses from those countries to the United States and created a projected three-year delay.

The root of this delay appears to have resulted from a congressional mandate to the U.S. Citizenship and Immigration Services (USCIS, formerly the INS) to reduce the backlog of pending visa cases. However, as the USCIS processed the backlog, it filled country quotas for green cards. Under the quota system for immigrant visas, unused numbers from previous years (during which time a case may have remained unadjudicated due to the backlogs) cannot be recaptured once the fiscal year ends.

Section 502 creates a welcome fix to this problem by allowing unused employment-based visas from 2001-2004 to become available to immigrants under the Department of Laborís "Schedule A," which includes registered nurses.

A great deal of misinformation exists about the recruitment of foreign nurses from abroad. As an attorney with a longstanding interest in assisting healthcare systems with their immigration needs, I counsel employers on the many requirements to sponsor foreign nurses for green cards. U.S. employers must pay foreign workers prevailing wages. The foreign recruits must go through a rigorous credentialing process in which they must pass substantive professional predictor exams and pass standardized tests for written and spoken English. Multiple federal, state and professional organizations and licensing bodies are involved in a single application. Under normal processing, it can take up to two years to fill one position with a nurse from abroad. With the cutoff of available visas, facilities were looking at a five-year process.

When news of the cutoff and a prospective additional three-year delay reached foreign nurses waiting to come to the United States, many began to panic. They started looking for positions in other countries, such as the United Kingdom and Saudi Arabia, which compete with the United States for the available pool of registered nurses. Many healthcare facilities feared that they would lose the foreign nurses, despite having done everything properly to go through the process.

Even healthcare facilities that did not actively recruit from abroad were projected to feel the long-term impact of the cutoff. Because it decreased the supply of available nurses, with no decrease in demand, the cost of obtaining nurses would increase.

Under Section 502, unused visa numbers from previous years will now be recaptured. Foreign recruitment will once again be a feasible means of meeting the demand for nurses. South Florida healthcare facilities will be able to fill nursing positions as expected, and foreign recruits will once again look to the United States as their country of choice.

Sarah Lea Tobocman, chair of the Immigration Practice Group in the Miami office of Gunster, Yoakley & Stewart, can be reached at (305) 376-6065 or
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