California Condor Scavenges for H-1B visas
California Condor Scavenges for H-1B visas
Date: Friday, February 11, 2005 2:01 PM
JOB DESTRUCTION NEWSLETTER
by Rob Sanchez
February 11, 2005 No. 1194
If you have you ever watched a flock of vultures while they pick apart
a maggot-infested piece of rotting flesh from a decaying carcass, you
will understand why the caricature below is a good way to depict Rep.
Tom Lantos of California.
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`"`| |';-;_` California Condor - Rep. Tom Lantos
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Lantos recently introduced a bill to Congress to scavenge for unused
H-1Bs visas by recapturing visas that weren't issued from 2001 to the
present. According to immigration attorney Shusterman this will amount
to over 130,000 visas!
The demagogic Democrat calls his bill the "Health Improvement and
Professionals Act of 2005" (H.R. 139). It purports to address the
so-called nursing shortage by using reclaimed H-1B visas. The text of
his bill only mentions nurses but that's just smoke-and-mirrors to hide
the fact that the visas can be used just like any other H-1B. Lantos
probably cloaked the bill in the guise of a health bill because
everyone is worried about health care. He probably made a cynical
calculation that very few nurses in his district are as angry about
H-1B as the high-tech workers that clog the Bay Area unemployment
office.
Lantos quietly slipped this bill into Congress while the U.S. media
focused on more titillating issues such as the Michael Jackson trial.
The foreign media in contrast has obviously analyzed the bill. In case
you are not a nurse and feel like this newsletter can be shrugged off,
perhaps the Filipino Express will jog you out of your stupor:
Known as the "Health Improvement and Professionals Act of 2005,"
the bill is expected to ease considerably the backlog in the
employment-based third preference for the Philippines, China
and India which has resulted in retrogression to Jan. 1, 2002.
Filipino nurses were among the hardest hit by the regression.
The employment-based third preference refers to professionals
and skilled workers. Included under this category are teachers,
accountants, therapists and computer professionals who will
also benefit from the bill.
Lantos was very clever to avoid mention of computer professionals in
his bill because he knows full-well how angry his constituents are
getting over the continued replacement of their high-tech workers with
H-1Bs. It's surprising how few protests we hear from nurses considering
the following:
More than 50,000 Filipino nurses have found employment in the U.S.
in the past four years, according to a study issued last November
by the University of the Philippine's National Institute of Health
Care in Manila.
One of my contentions has always been that employers would be forced to
hire domestic workers and pay better salaries if the H-1B spigot was
shut off. Nurses don't seem to understand this but the hospital
spokesman quoted below does!
said Bruce Morrison, chairman of the Bethesda, MD-based Morrison
Public Affairs Group. "So if California, New York, Florida and
Texas are not getting foreign nurses, then they will be working
that much harder to attract domestic nurses, and that will affect
supply and demand everywhere."
I suspected that those 130,000 extra visas weren't going to all be used
for nurses but the Lantos bill obscures that fact. Here is the smoking
gun:
Employment-Based Visas Defined- For purposes of this section,
the term `employment-based visa' means an immigrant visa which
is issued pursuant to the numerical limitation under section
203(b)
of the Immigration and Nationality Act (8 U.S.C. 1153(b)).
This doesn't seem very important until you read what's in USC 1153.
Here are some of the professions mentioned in 1153: aliens "whose
services in the sciences, arts, professions, or business are sought by
an employer". Perhaps this is where President Bush got the idea of
"matching willing workers with willing employers".
The 130,000 or so visas that Lantos will scrounge up for greedy
employers will be in addition to the 20,000 that were approved in the
Omnibus spending bill of 2004. An additional 130,000 visas with the
65,000 allocated for 2005 adds up to 195,000 which is the same number
that has been in place since the year 2000. It's hard to believe Lantos
was that smart, so perhaps this is just a weird coincidence, or perhaps
he is getting advice from immigration attorneys like Shusterman.
Add in the extra 20,000 and that means that if the California condor
gets his way, up to 215,000 visas will be available for 2005!
Material Used for this Newsletter
http://www.shusterman.com/siu.html
Representative Lantos' remarks upon introducing H.R.139
http://thomas.loc.gov/cgi-bin/query/z?c109:H.R.139.IH:
Health Improvement and Professionals Act of 2005 (Introduced in House)
HR 139 IH
http://www.fourmilab.ch/uscode/8usc/www/t8-12-II-I-1153.html
Sec. 1153. Allocation of immigrant visas
http://www.filipinoexpress.com/19/03_news.html
NURSING SHORTAGE GETS CLOSER LOOK
http://www.hospitalconnect.com/ahanews/jsp/display.jsp?dcrpath=AHANEWS/AHANewsArticle/data/AHA_News_050110_Clampdown&domain=AHANEWS
Clampdown on visas for overseas RNs spurs calls for Congress to act
+++++++++++++++++++++++++++++++++++++++++++++++++++
http://www.shusterman.com/siu.html
3. Legislation: Bill Introduced To Fix EB-3 Backlogs
The three-year retrogression in EB-3 numbers for persons born in India,
China and the Philippines did not just happen by accident. It is the
direct result of the CIS not approving a sufficient number of
adjustments of status applications in 2001, 2002 and 2003 to fill the
legal quotas despite an overwhelming number of applicants.
For most EB-3 adjustment applicants whose cases are pending, the
backlog merely results in a slight delay and some inconvenience.
However, for patients in U.S. hospitals who press a buzzer for help,
and no nurse comes, the backlog could be a matter of life and death.
The nursing shortage in the U.S. is severe, and grows daily. A couple
of years ago, the American Hospital Association (AHA) reported that
126,000 RN jobs at U.S. hospitals were going begging. A recent report
predicts that, with the demand for nursing services growing, and many
American nursing schools closing their doors, the nursing shortage may
grow to 600,000 by 2020.
This growing shortage contributes to the number of patient injuries and
deaths due to medical errors at U.S. hospitals. These unnecessary
deaths now exceed the number of deaths caused by automobile accidents.
In California, the only state with mandatory nurse-to-patient ratios,
an inspection of 28 hospitals recently found that over 50% were
violating nurse staffing ratio rules.
It is no secret that our country has heavily relied on foreign-born
RNs, particularly those born in the Philippines, to help staff our
hospitals for more than 50 years.
Since 1952, most of these nurses were able to enter the U.S. in a
matter of weeks using temporary working visas. Congress allowed this
important program to expire in 1995. The next year, Congress passed a
law which required nurses to have a VisaScreen Certificate to enter the
U.S. Because there were no agency regulations regarding the VisaScreen
requirements, nurses were effectively prohibited from obtaining
permanent residence in the U.S. from 1996 to 1998.
Despite numerous bureaucratic obstacles placed in their way, U.S.
hospitals immigrated many thousands of RNs during the past few years.
However, this came to an abrupt halt on January 1, 2005 when the EB-3
category (professionals and skilled workers, including registered
nurses) for persons born in the Philippines, India and mainland-China
backlogged three years.
This is a problem which must be addressed by Congress. On January 4,
the AHA addressed letters to all members of Congress. Here is an
excerpt from this letter:
"The nursing shortage is directly affecting patient care. An AHA survey
of hospitals across the nation concluded that nursing shortages are
contributing to emergency department overcrowding, emergency department
diversions, increased wait times for surgery, discontinued patient care
programs or reduced service hours, delayed discharges, and cancelled
surgeries. The imminent change in immigration processing threatens to
needlessly exacerbate the problem."
The letter concluded by requesting "immediate" congressional action to
"help insure that hospitals can continue to rely on highly qualified
foreign nurses as they work to address their serious staff shortages
and meet the needs of their patients and communities."
The next day, Representative Tom Lantos (D-CA) introduced the "Health
Improvement and Professionals Act of 2005" (H.R. 139). The bill
proposes to "recapture" over 130,000 immigrant visas lost due to
bureaucratic inertia during 2001, 2002, 2003 and 2004.
Below, we reprint Representative Lantos' remarks upon introducing
H.R.139:
* Mr. LANTOS. Mr. Speaker, it is well documented that many states,
including my home state of California, are currently suffering from a
nursing shortage that, if left unchecked, will quickly reach epidemic
proportions. More than 126,000 nursing positions in hospitals around
the country are unfilled, according to the Joint Commission on
Accreditation of Healthcare Organizations. In addition, the workforce
is shrinking, because it's aging (and retiring) at twice the rate of
other occupations. While the problem of nursing shortages will require
a multifaceted solution, I was shocked to learn recently that entry
into the United States by many qualified nurses was being delayed
because of an easily correctable bureaucratic regulation. We cannot
simply stand by and allow the nursing shortage to ensnarl the quality
of American health care, and that is why I am introducing the Health
Improvement and Professionals Act (HIPA) of 2005.
* Due to a change in procedures by the Citizenship and Immigration
Services (CIS) of the Department of Homeland Security, the federal
agency responsible for processing citizenship and immigration
applications, it became necessary to impose a cut- off date in order to
process a backlog of work-related immigration applications. As a
result, CIS recently announced that it would no longer consider
employment-based visa applications from the Philippines, India or China
that were filed after January 1, 2002. Due to the unfortunate shortage
of American nurses, many of our nation's hospitals are dependent on
filling their nursing ranks with new workers from these countries. My
legislation, the Health Improvement and Professionals Act of 2005,
would provide a common-sense, short- term solution to the problems
caused by the CIS policy change, while still allowing the agency to do
the necessary and important work of processing its backlog.
* Mr. Speaker, my legislation simply allows CIS to recapture unused
work-based immigration quota numbers from countries that have
undersubscribed their own allowable visa numbers. By reassigning unused
quota allotments from previous years, we would allow more qualified
nurses to come to this country, bringing their crucially needed skills
with them. Let me be clear, the HIPA Act of 2005 does not increase the
number of immigrants allowed into our country. Instead, my legislation
ensures that we are putting to full use the number of workers' visas
currently allowed by law, in order to fulfill a crucial and
exponentially increasing worker shortage.
* The HIPA Act is modeled directly on the American Competitiveness in
the Twenty-First Century Act, which Congress passed, and President
Clinton signed into law nearly five years ago, in response to the
shortage of highly skilled computer programmers and information
technology workers needed to fuel the Internet boom of the late 1990's.
Like the HIPA Act of 2005, that law allowed for the recapture of unused
employment-based visas to fill a necessary labor shortage.
* The growth of the nursing shortage is easily traceable--one only has
to look to the fact that in 2002, 30 states were reportedly
experiencing some level of nursing shortages. This number is expected
to rise to 45 states by 2012. The scope of this problem is compounded
by the fact that many of today's nurses are nearing retirement, and so
our country is facing the compounded problem of increased retirements
coupled with increased demand. This problem is well known to the
federal government, as the Department of Labor has noted that one
million new nurses will be needed by 2012 to meet the growing health
needs of our country.
* Some many criticize my legislation for bringing nurses into the
country instead of training American men and women to do the job.
Unfortunately, enrollments in baccalaureate nursing programs at
colleges and universities across the United States have declined for
five consecutive years. Even in states where the programs are full, as
in my state of California, nearly 70% of all nurses are trained by
community colleges. Many of the programs at these schools in California
are full, and some even have substantial waiting lists of eager
students ready to learn about the exciting and rewarding profession of
nursing. I will continue to work to expand the capacity of nurse
training programs in our country to help relieve this shortage.
However, the shortage in California is so severe that even if all of
the nursing programs in the state were to double their enrollments,
California would still not be able to meet her nursing needs in the
year 2010.
* Mr. Speaker, the lack of nurses in our hospitals has a direct effect
on the quality of the health care these facilities can provide. The
shortages currently experienced in 30 states affects all patients, from
those in operating rooms and intensive care units to those who treat
children and cancer patients. In fact, according to a study conducted
by the Harvard School of Health and the Henry J. Kaiser Family
Foundation, over 50% of physicians surveyed believed that the nursing
shortage is a leading cause of medical error. Additional studies and
surveys published in the New England Journal of Medicine, Journal of
the American Medical Association, and by the Joint Commission on
Accreditation of Healthcare Organizations all confirm that the shortage
of RNs is influencing the delivery of health care in the United States
and negatively affecting patient outcomes. It is completely
unacceptable in 21st century America that these preventable deaths are
occurring. I hope my colleagues are as appalled about this as I am and
that they will join me in supporting this common sense and critically
important legislation. While we search for a longer-term solution to
the problems as well as the causes of this nursing shortage crisis, the
Health Improvement and Professionals Act of 2005 will provide a
desperately needed injection of health care professionals into this
country.
We link to the "Health Improvement and Professionals Act of 2005" from
our "Immigration Legislation" page at
http://shusterman.com/toc-leg.html#6D
How likely is it that the Lantos' bill will be enacted into law? One
would think that it would pass Congress unanimously. Surprisingly, the
word from Beltway insiders is that without a Republican cosponsor, the
Lantos' bill is Dead on Arrival. Because the nurse shortage is truly a
matter of life or death for thousands of American patients, hopefully,
Congress will get serious about approving backlog reduction
legislation.
+++++++++++++++++++++++++++++++++++++++++++++++++++
http://thomas.loc.gov/cgi-bin/query/z?c109:H.R.139.IH:
Health Improvement and Professionals Act of 2005 (Introduced in House)
HR 139 IH
109th CONGRESS
1st Session
H. R. 139
To provide for the recapture of unused employment-based immigrant visa
numbers in order to facilitate improved health care for all persons in
the United States.
IN THE HOUSE OF REPRESENTATIVES
January 4, 2005
Mr. LANTOS introduced the following bill; which was referred to the
Committee on the Judiciary
A BILL
To provide for the recapture of unused employment-based immigrant visa
numbers in order to facilitate improved health care for all persons in
the United States.
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 `Health Improvement and Professionals Act
of 2005'.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) The United States is in the midst of a nursing shortage that is
expected to intensify as the need for health care services increases.
(2) The Department of Labor has identified registered nurses has one of
the top 5 job growth occupations in the United States, and that more
than 1,000,000 new and replacement nurses will be needed by 2012.
(3) By the year 2012, at least 44 States and the District of Columbia
will be experiencing a nursing shortage.
(4) According to surveys conducted by the Harvard School of Public
Health and the Henry J. Kaiser Family Foundation, over 50 percent of
physicians have indicated that the nursing shortage is a leading cause
of medical error
(5) The New England Journal of Medicine has reported that a higher
proportion of nursing care is associated with better outcomes for
hospitalized patients.
(6) In spite of this documented need for registered nurses, enrollments
in baccalaureate nursing programs at colleges and universities across
the United States have declined for 5 consecutive years.
(7) Because of an important and overdue effort by the Department of
Homeland Security to clear a backlog of adjustments of status from
nonimmigrant employment-based visas to immigrant employment-based
visas, the number of employment-based visas available to certified
nurses living abroad who want to come to the United States has declined
to virtually zero.
(8) The adjustment of status program will not bring new medical
personnel to the United States.
(9) In 2000, Congress passed the American Competitiveness in the
Twenty-first Century Act of 2000, which, in part, recaptured unused
employment-based visas from previous years in order to increase the
number of medical and other personnel available to fill critical jobs
in the United States.
(10) Since the passage of that legislation, because of ongoing
backlogs, a large number of employment-based visas have not been used,
including more than 50,000 visas in fiscal year 2003 alone.
SEC. 3. RECAPTURE OF UNUSED EMPLOYMENT-BASED IMMIGRANT VISAS.
(a) In General- Notwithstanding any other provision of law, the number
of employment-based visas (as defined in subsection (c)) made available
for a fiscal year (beginning with fiscal year 2005) shall be increased
by the number described in subsection (b). Visas made available under
this section shall only be available in a fiscal year to
employment-based immigrants under paragraph (1), (2), or (3) of section
203(b) of the Immigration and Nationality Act (8 U.S.C. 1153(b)).
(b) Number Available-
(1) IN GENERAL- Subject to paragraph (2), the number described in this
subsection is the difference between the number of employment-based
visas that were made available in fiscal years 2001, 2002, 2003, and
2004 and the number of such visas that were actually used in such
fiscal years.
(2) REDUCTION- The number described in paragraph (1) shall be reduced,
for each fiscal year after fiscal year 2005, by the cumulative number
of immigrant visas actually used under subsection (a) for previous
fiscal years.
(3) CONSTRUCTION- Nothing in this subsection shall be construed as
affecting the application of section 201(c)(3)(C) of the Immigration
and Nationality Act (8 U.S.C. 1151(c)(3)(C)).
(c) Employment-Based Visas Defined- For purposes of this section, the
term `employment-based visa' means an immigrant visa which is issued
pursuant to the numerical limitation under section 203(b) of the
Immigration and Nationality Act (8 U.S.C. 1153(b)).
+++++++++++++++++++++++++++++++++++++++++++++++++++
http://www.fourmilab.ch/uscode/8usc/www/t8-12-II-I-1153.html
Sec. 1153. Allocation of immigrant visas
b)
Preference allocation for employment-based immigrants
Aliens subject to the worldwide level specified in section 1151(d) of
this title for employment-based immigrants in a fiscal year shall be
allotted visas as follows:
(1)
Priority workers
Visas shall first be made available in a number not to exceed 28.6
percent of such worldwide level, plus any visas not required for the
classes specified in paragraphs (4) and (5), to qualified immigrants
who are aliens described in any of the following subparagraphs (A)
through (C):
(A)
Aliens with extraordinary ability
An alien is described in this subparagraph if -
(i)
the alien has extraordinary ability in the sciences, arts, education,
business, or athletics which has been demonstrated by sustained
national or international acclaim and whose achievements have been
recognized in the field through extensive documentation,
(ii)
the alien seeks to enter the United States to continue work in the area
of extraordinary ability, and
(iii)
the alien's entry into the United States will substantially benefit
prospectively the United States.
(B)
Outstanding professors and researchers
An alien is described in this subparagraph if -
(i)
the alien is recognized internationally as outstanding in a specific
academic area,
(ii)
the alien has at least 3 years of experience in teaching or research in
the academic area, and
(iii)
the alien seeks to enter the United States -
(I)
for a tenured position (or tenure-track position) within a university
or institution of higher education to teach in the academic area,
(II)
for a comparable position with a university or institution of higher
education to conduct research in the area, or
(III)
for a comparable position to conduct research in the area with a
department, division, or institute of a private employer, if the
department, division, or institute employs at least 3 persons full-time
in research activities and has achieved documented accomplishments in
an academic field.
(C)
Certain multinational executives and managers
An alien is described in this subparagraph if the alien, in the 3 years
preceding the time of the alien's application for classification and
admission into the United States under this subparagraph, has been
employed for at least 1 year by a firm or corporation or other legal
entity or an affiliate or subsidiary thereof and the alien seeks to
enter the United States in order to continue to render services to the
same employer or to a subsidiary or affiliate thereof in a capacity
that is managerial or executive.
(2)
Aliens who are members of the professions holding advanced
degrees or aliens of exceptional ability
(A)
In general
Visas shall be made available, in a number not to exceed 28.6 percent
of such worldwide level, plus any visas not required for the classes
specified in paragraph (1), to qualified immigrants who are members of
the professions holding advanced degrees or their equivalent or who
because of their exceptional ability in the sciences, arts, or
business, will substantially benefit prospectively the national
economy, cultural or educational interests, or welfare of the United
States, and whose services in the sciences, arts, professions, or
business are sought by an employer in the United States.
(B)
Waiver of job offer
The Attorney General may, when he deems it to be in the national
interest, waive the requirement of subparagraph (A) that an alien's
services in the sciences, arts, professions, or business be sought by
an employer in the United States.
(C)
Determination of exceptional ability
In determining under subparagraph (A) whether an immigrant has
exceptional ability, the possession of a degree, diploma, certificate,
or similar award from a college, university, school, or other
institution of learning or a license to practice or certification for a
particular profession or occupation shall not by itself be considered
sufficient evidence of such exceptional ability.
(3)
Skilled workers, professionals, and other workers
(A)
In general
Visas shall be made available, in a number not to exceed 28.6 percent
of such worldwide level, plus any visas not required for the classes
specified in paragraphs (1) and (2), to the following classes of aliens
who are not described in paragraph (2):
(i)
Skilled workers
Qualified immigrants who are capable, at the time of petitioning for
classification under this paragraph, of performing skilled labor
(requiring at least 2 years training or experience), not of a temporary
or seasonal nature, for which qualified workers are not available in
the United States.
(ii)
Professionals
Qualified immigrants who hold baccalaureate degrees and who are members
of the professions.
(iii)
Other workers
Other qualified immigrants who are capable, at the time of petitioning
for classification under this paragraph, of performing unskilled labor,
not of a temporary or seasonal nature, for which qualified workers are
not available in the United States.
(B)
Limitation on other workers
Not more than 10,000 of the visas made available under this paragraph
in any fiscal year may be available for qualified immigrants described
in subparagraph (A)(iii).
(C)
Labor certification required
An immigrant visa may not be issued to an immigrant under subparagraph
(A) until the consular officer is in receipt of a determination made by
the Secretary of Labor pursuant to the provisions of section
1182(a)(5)(A) of this title.
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http://www.filipinoexpress.com/19/03_news.html
NURSING SHORTAGE GETS CLOSER LOOK
First bill to ease backlogs introduced
NEW YORK, January 14, 2005 --- To address the present nursing shortage
in the country, the first bill was introduced last week in US Congress.
Known as the "Health Improvement and Professionals Act of 2005," the
bill is expected to ease considerably the backlog in the
employment-based third preference for the Philippines, China and India
which has resulted in retrogression to Jan. 1, 2002. Filipino nurses
were among the hardest hit by the regression.
The employment-based third preference refers to professionals and
skilled workers. Included under this category are teachers,
accountants, therapists and computer professionals who will also
benefit from the bill.
The bill also seeks to recapture unused employment-based immigrant visa
numbers from 2001 to the present to facilitate improved health care for
all the persons in the US.
"It is ridiculous that amid a nursing shortage, the US is turning away
large numbers of registered nurses from abroad due to bureaucratic
constraints," Rep. Tom Lantos (D-Calif.), who introduced the bill.
Lantos said that aside from the bill, he will also explore longer term
solutions to the shortage.
Backed by immigrant workers and advocates, the American Hospital
Association (AHA) expressed a strong support for the bill.
"Act immediately to help ensure that hospitals can continue to rely on
highly qualified foreign RNs as they work to address their serious
staff shortages and meet the needs of their patients and communities,"
AHA said in a statement.
The association directed its plea for immediate legislation to the
Congress.
"I hope this bill will be approved. Many of the Filipino nurses'
working visa applications are now hanging. The US is obviously in need
of more foreign nurses. I don't see any reason that Congress will deny
the bill," said Linda Co, a Filipino nurse based in California.
The American Hospital Association (AHA) in a recent statement urged
Congress to The association directed its plea for immediate legislation
to the 109th Congress.
The bill is similar to a law passed four years ago called the American
Competitivenes in the 21st Century Act. This law allowed unused visa
numbers from 1999 to 2000 to be used by 3rd preference visa applicants
and has been the reason why the visa numbers for the Philippines has
remained current until recently.
Since the passage of that law, a large number of employment-based visas
have not been used, including more than 50,000 visas in fiscal year
2003 alone. -- with reports from Reuben S. Seguritan, Esq.
(For comments about this article e-mail the author at
seguritanlaw@yahoo.com, or call (212) 695 5281.)
+++++++++++++++++++++++++++++++++++++++++++++++++++
http://www.hospitalconnect.com/ahanews/jsp/display.jsp?dcrpath=AHANEWS/AHANewsArticle/data/AHA_News_050110_Clampdown&domain=AHANEWS
Clampdown on visas for overseas RNs spurs calls for Congress to act
January 10, 2005
Glendale (CA) Adventist Medical Center will need 90 new nurses when the
hospital opens a new patient wing early in 2007. Located just north of
Los Angeles, the hospital is collaborating with area hospitals and
community colleges to expand the local nursing supply, but believes it
also will need to look overseas for registered nurses (RN).
Hospital senior vice president Gwen Matthews was counting on recruiting
nurses from the Philippines, U.S. hospitals' primary overseas source of
RNs. But she worries that the hospital may not be able to meet its
staffing needs, given the State Department's recent announcement that
it has put on hold visas for RNs from the Philippines. The action will
sharply curtail the number of Filipino RNs entering the U.S. during the
next several years.
"We need to keep the door open to recruitment of nurses from the
Philippines," Matthews said. "With the current nursing shortage, and
the demographics pointing to growing patient volume ... an aging Baby
Boomer generation and increased demand for services, hospitals should
not be hampered from recruiting overseas to help them address their
workforce and patient care concerns."
In a letter last week to lawmakers on Capitol Hill, AHA Executive Vice
President Rick Pollack urged Congress to move quickly to re-open the
flow of foreign RNs into this country, saying the "change in
immigration processing threatens to needlessly exacerbate" the nation's
nursing shortage.
Heeding hospitals' concerns, Rep. Tom Lantos, D-CA, introduced an
AHA-backed bill, H.R. 139, to allow more employment-based visas to go
to the Philippines and other countries affected by the State
Department's action.
More than 50,000 Filipino nurses have found employment in the U.S. in
the past four years, according to a study issued last November by the
University of the Philippine's National Institute of Health Care in
Manila. America's hospitals and health systems look to Filipino RNs,
because of the two countries' similar university health care curriculum
and teaching methods. Many Filipino schools train nurses to work in the
U.S.
But the supply of Filipino RNs is drying up because the U.S.
Citizenship and Immigration Service (CIS) on Jan. 1 stopped processing
visa applications filed after January 2002 for professionals from the
Philippines, India and China. The rule blocks a shortcut that allowed
thousands of nurses - mostly from the Philippines, to a lesser extent
India - to get fast-track work permits. A U.S. admissions process
that had taken just 60 days for many foreign RNs, could now drag on for
three or more years.
With the nation facing an estimated shortage of up to 275,000 nurses by
2010, according to the Health Resources and Services Administration,
hospital leaders said the workforce implications for America's health
care could be severe.
"It makes no sense at all to stop the flow of foreign-trained nurses,"
said Rhonda Spiegel, Community Memorial Hospital's vice president of
patient care services in Ventura, CA. About 15% of the hospital's RNs
are foreign born; most are from the Philippines. "We would be lost
without them," Spiegel said.
The immigration policy increases staffing pressure on California's
hospitals, which must comply with state-mandated nurse-patient ratios.
"This is one of the most ill-conceived bureaucratic snafus that I've
ever run across," said Claudia Rosenfeld, the Los Angeles-based
Hospital Association of Southern California's vice president of human
resources. She estimates that as many as 50% of foreign nurses coming
into the U.S. end up in California.
The state is bracing for a nursing deficit of 30,000 by 2006 and
109,000 by 2010, said Rosenfeld, who noted that each of the 11
California hospitals that have closed in recent years cited
understaffing as a serious issue. "We train 5,500 nurses a year in
California," she said. "The rest come from everywhere else," including
the Philippines. "You can't open enough nursing programs, given the
state's fiscal problems, to make up the shortfall."
The curbs on visas for Filipino and Indian RNs result indirectly from a
more efficient immigration process. Legislation establishing the
Department of Homeland Security mandates that CIS move aggressively to
reduce a longstanding backlog in employment-based visas or "green card"
applications. As the government waded through the backlog, many foreign
RNs got by on temporary work permits as they waited for their green
cards.
Now, those cases are being processed and, in clearing the backlog, the
government is no longer issuing new visa for professionals, including
RNs, from countries like the Philippines that have exceeded their
annual quotas.
Health care immigration experts warn of a nationwide impact on
hospitals. "Whether you hire foreign nurses or not, your ability to get
nurses depends on the overall supply," said Bruce Morrison, chairman of
the Bethesda, MD-based Morrison Public Affairs Group. "So if
California, New York, Florida and Texas are not getting foreign nurses,
then they will be working that much harder to attract domestic nurses,
and that will affect supply and demand everywhere."
Because CIS is carrying out a policy mandated by Congress, it will take
action on Capitol Hill to fix the problem. Hospital and health system
leaders said Congress can keep the overseas RN pipeline open by passing
legislation that allows the government to reclaim unfilled visas from
other countries and assign them to the Philippines and India.
Lantos' bill, the Health Improvement and Professionals Act, seeks to
address that need by letting CIS reassign unused work-based immigration
visas to those countries. He said the bill "ensures that we are putting
to full use the number of workers' visas currently allowed by law, in
order to fulfill a crucial and exponentially increasing health care
worker shortage."
That's good news for hospital executives like Peter Resnick, CEO of
Dearborn County Hospital in Lawrenceburg, IN, who has called on his
representative and senators to push for "common-sense" legislation on
the RN immigration process. "Let's urge Congress to fix it now so we
can continue to get nurses from the Philippines, India and China," he
said.
Dearborn County Hospital has four Filipino RNs "caught in this
administrative boondoggle," Resnick said. "We're a 90-bed hospital and
four RNs is a significant number for us." Given the serious nursing
shortage, he said legislators should be "working to make the pipeline
work better, rather than shutting it off. Why are we shooting ourselves
in the foot?"
Community Memorial Hospital's Spiegel agreed. "Our legislators should
not allow this wall to be put in place at a time of such a significant
national crisis in health care," she said.
Prospects for prompt congressional action "depend 100% on how much
legislators hear from their constituents," said health care immigration
expert Morrison, a former Democratic representative from Connecticut
and one-time chairman of the House Immigration, Refugees and
International Law Subcommittee. If hospitals start turning up the
volume, "quick action is likely," he said. "Without it, quick action is
impossible."
This article 1st appeared in the January 10, 2005 issue of AHA News
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