Healthcare Blog

The situation is this. Long term we should be in fine shape. The STRIVE Act (Comprehensive immigration Reform) has been proposed in the House and may be proposed in the Senate in the near term. The conventional wisdom is that CIR will not be finalized and signed until this fall. However we talked to one senior staffer in DC who told us that “I wouldn’t be so sure.” Her implication was that political pressure may be such that CIR may get done before Congresses’ summer break.

More immediately we are seeking “bridge” legislation (which will likely take the form of a recapture of older, authorized but unused visas) to help the cause between now and whenever CIR is passed. It was with that in mind that we went to Washington.

We’re running into two problems:

First, there is pressure from one Senator to institute a $1500 training fee. Understandably, this is not something that the industry supports. It would serve as an additional cost on top of what is already an excessively costly process.

Second, there is a general tenor in DC that everyone with an immigration issue should wait for CIR. When one group finds out about another’s issue moving down the road, they complain. As a result no one immigration issue is moving.

All of that having been said, there is still a very realistic chance (50%) that there is a bridge/recapture legislation before Congress breaks for the summer. We, along with a lot of others, are continuing to push this issue.

What can you do to help?

If you or any of your clients, friends, or relatives who work for Hospitals. The TIME IS NOW to get them to talk to their Hospital Executive team. We need these Hospital Executives to call on their Senators and let them know a simple message. If Hospital Executives do not call, the Congress will not hear the message.

1. The nursing and PT shortage in this country is untenable.
2. Foreign-trained nurses and PTs are all English fluent and pass the identical exams as their US counterparts.
3. Foreign-trained nurses and PTs (who make up about 15% of all new nurses and PTs) MUST be part of the solution.

If your Hospitals Executives would like help reaching out to your Congressional Representatives, please contact Chris Musillo (cmusillo@hammondlawfirm.com) or the HLG attorney that you ordinarily work with.

HLG is again attending meetings in Washington DC. The purpose of the meetings is to persuade US Congressional Senior Staff that there is an urgent need for a Schedule A retrogression cure NOW. We will continue to push for a recapture provision, much like the 2005 effort.

Our message will be that while we are very willing to “wait our turn” and that we fully back the STRIVE Act, this specific issue cannot wait for Congress to debate the many complicated issues involved with enacting STRIVE.

We leave tomorrow – Tuesday – and will post once we return – Thursday.

Unfortunately, we will miss this Blog’s one year anniversary, which is Tuesday March 27. When we first starting posting we had no idea that the Blog would need to last for a year. In hindsight, while we’re disappointed that Schedule A retrogression has yet to be solved, we’ve created a great little corner of the internet with some fantastic posters. Thanks for everyone who contributes.

Since this Blog is really everyone’s, feel free to post YOUR birthday wish for Year 2 of the HLG Healthcare & Immigration Blog.

The STRIVE Act has been introduced and includes a section that makes Schedule A applicants (and their families) quota-free! That section is Sec. 504. It is labeled the “Nursing Shortage,” but the actual text of the Section includes Physical Therpaists.

The Act still has a long way to go until it is enacted into law. But this is exceptional news.

At least one newspaper, the LA Times, is reporting that the House will introduce their Comprehensive Immigration Reform bill. HLG understands that it will be called, Security Through Regularized Immigration and a Vibrant Economy Act of 2007 (STRIVE ACT).

The bill is co-sponsored by Jeff Flake (R-Az) (who also introduced last year’s SKIL Bill) and Luis Gutierrez (D-IL). The Strive Act was apparently the work of these two in concert with the Senate leadership’s CIR bill, which may follow shortly thereafter. It is expected (although we have not confirmed it) that the Schedule A exemption should be part of the Strive Act. (It was part of Rep. Flake’s SKIL Bill and the Senate’s CIR).

In other news we are still pushing for an amendment for a quicker bill that would exempt Schedule A occupations from the immigrant visa quota. There is no news on this front. Everyone in DC is keeping their strategy quiet. Whenever we get additional information we will promptly post.

My apologies for not updating sooner, but I (Chris) have been stranded in Washington DC for the last two days. As some of you may know, a major ice/snow storm blanketed most of the US’ east coast. My original flight home was for Friday evening. I finally managed to get a flight out Sunday morning – about 40 hours after my original flight!

Last week’s Washington trip was very interesting. Sherry and Chris haven’t had a chance to compare notes, but I can say that there is definitely support for a Nurse Recapture visa amendment outside of the CIR legislation. There is a good shot (50-50?) that we get our amendment attached to some piece of legislation in the next 60-90 days. Success probably will depend more on whether the Democratic leadership allows amendments to be attached to omnibus bills. There is no real animosity for our bill, outside of one or two isolated politicos, and those few can probably be swayed. We still missed a big chance with the 9/11 legislation, but the opportunity for relief is still very real.

S.4 was passed without the Hutchison amendment. A senator who holds a lot of power prohibited any immigration amendments from being attached to S.4.

However, HLG has learned that this delay shouldn’t be a major setback and we could have a new amendment attached to another bill in place by Easter.

More news after we get back from Washington.

HLG’s Sherry Neal and Chris Musillo are heading to Washington DC on Wednesday. We have several meetings set-up with a variety of Congressional staffers on Thursday and Friday. You can be sure that that we will post any information/news that we receive. Expect an update on Friday or Saturday.

For now, the situation is that Sen. Hutchison has introduced her amendment and Sen. Durbin has introduced an amendment to that amendment. Congress is expected to shortly consider these amendment proposals once it has finished the debate and amendment process for S.4. This process could end quickly or take awhile; the timing is unknown at this point.

In related news, there are some hot rumors that CIR may get introduced quickly, but that it could take until the fall until it is actually voted into law.

It’s been a busy week and it is being topped off with the best news that we’ve published in a very long time: Sen. Hutchison has formally introduced a provision to recapture about 90,000 visas for Schedule A nurse and PTs. This is a major piece of news.

The “Hutchison amendment” has been anticipated for a few weeks. If the Hutchison amendment passes retrogression is over.

Procedurally we have two hurdles. First, Sen. Durbin has introduced an amendment to Sen. Hutchison’s amendment; however the details of this Durbin amendment are unpublished at this time. Second, the amendment must survive review and remain attached to Senate Bill #4. S.4 is expected to pass.

Even with the hurdles this is a major step forward. We’re getting closer.

UPDATE: The language of Sen. Durbin’s amendment has been found. It contains three provisions:

1. A $1,500 “training fee”is attached to each nursing case (not PTs).
2. Healthcare workers, including MDs, who travel overseas for extended periods of time do not lose their US Permanent Residency if they are working in select (unnamed) countries.
3. Healthcare workers, including MDs, are inelgible for US Permanent Residency if they have a “financial obligation” to their home country.

The Nursing Relief Act of 2007 has been introduced into the House of Representatives as bill HR 1358. The bill is a very good one for nurses and US patients. HLG has worked with this group in the past and we know how much hard work they have put into making this bill. Unfortunately, we are a little skeptical that such a bill can survive the legislation process since the sponsors and co-sponsors are in the minority Republican Party. Nevertheless, we are encouraged by activity and we applaud the sponsors and co-cosponsors of the bill and the underlying facilities that pushed for the bill.

Here is a rough summary of the bill:

1. Create a new nonimmigrant visa, the W-1.
2. Gives approval authority to the Consular official, after “consultation” with DHS.
3. Allows the nurse to have dual intent / ability to petition for an IV
4. The nurse must have a state license (or an eligible-but-for-the-SSN)
5. The employer must attest and the DOL must certify to a variety of LCA-type provision (wage will be greater than actual or prevailing, etc.), although the language appears to be a little weaker than the LCA provisions in an H-1.
6. Employer must put together a Public Access File.
7. Employers can be fined for a variety of willful violations of the certification/attestation requirement
8. W-1’s are for 3 years at a time; not more than 6, but it gives the nurses AC21-like 7th year extension protection for long-delayed GCs/
9. Spouses can get EADs
10. Cap of 50,000 per year, but cap can rise if demand calls for it.

There has understandably been a lot of anxiety in our community. Take this post to be a summary of where we are in the lobbying effort.

First, keep in mind that NO laws have been passed by this Congress this year. NOTHING. IN ANY AREA OF LAW. Please do not take the inaction on the Schedule A retrogression front as the US’ lack of recognition of the contributions of foreign trained healthcare workers. Instead you should understand that the Congress is still trying to prioritize its issues and work on procedural issues. Essentially our problem right now isn’t so much convincing Congressmen about the merits of Schedule A. Our problem is overall Congressional inaction. HLG is still very positive that once the log-jam in Congress is solved that we can look forward to helpful retrogression legislation.

In any event, there are two different types of bills, BOTH of which are being pushed:

CIR – Comprehensive Immigration Reform. This bill seeks to massively overhaul the US’ immigration laws. Last year a version that was passed by the Senate included an amendment by Sen. Brownback. The Brownback Amendment called for Schedule A occupations to be quota-free for 10 years. While this is the preferred legislation (since it solves our problem until 2017), it is the more challenging piece of legislation.

Recapture - Therefore we are also actively pushing a smaller piece of legislation (often called a “recapture”), which is designed to grant Schedule A occupations a special allotment of visas. This is the same process that we used in 2005.

Now the real question that everyone should be asking themselves is: how can I help?

Here is what you can do:

1. If you are a nurse in Illinois and/or have friends and family members who are in Illinois, please raise this issue with your Chief Nursing Officer or the Recruiting staff at your hospital. Explain the retrogression to them and how it is directly impacting Illinois’ ability to attract skilled foreign-trained nurses.

2. If your CNO or Recruiting Staff are willing to help, please have them contact Chris Musillo (cmusillo@hammondlawfirm.com). Chris will explain what they can do to help.

Thanks for everyone’s kind words and continued help. While this blog has been a lot of fun, we look forward to the day that we can post: RETROGRESSION FIXED!