[House Report 112-153]
[From the U.S. Government Publishing Office]
112th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 112-153
======================================================================
TO AMEND THE IMMIGRATION AND NATIONALITY ACT TO MODIFY THE REQUIREMENTS
FOR ADMISSION OF NONIMMIGRANT NURSES IN HEALTH PROFESSIONAL SHORTAGE
AREAS
_______
July 19, 2011.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Smith of Texas, from the Committee on the Judiciary,
submitted the following
R E P O R T
[To accompany H.R. 1933]
[Including cost estimate of the Congressional Budget Office]
The Committee on the Judiciary, to whom was referred the
bill (H.R. 1933) to amend the Immigration and Nationality Act
to modify the requirements for admission of nonimmigrant nurses
in health professional shortage areas, having considered the
same, report favorably thereon with an amendment and recommend
that the bill as amended do pass.
CONTENTS
Page
The Amendment.................................................... 1
Purpose and Summary.............................................. 2
Background and Need for the Legislation.......................... 2
Hearings......................................................... 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 4
Committee Oversight Findings..................................... 4
New Budget Authority and Tax Expenditures........................ 4
Congressional Budget Office Cost Estimate........................ 5
Performance Goals and Objectives................................. 6
Advisory on Earmarks............................................. 6
Section-by-Section Analysis...................................... 6
Changes in Existing Law Made by the Bill, as Reported............ 6
The Amendment
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. REQUIREMENTS FOR ADMISSION OF NONIMMIGRANT NURSES IN HEALTH
PROFESSIONAL SHORTAGE AREAS.
(a) Extension of Period of Authorized Admission.--Section 212(m)(3)
of the Immigration and Nationality Act (8 U.S.C. 1182(m)(3)) is amended
to read as follows:
``(3) The initial period of authorized admission as a nonimmigrant
under section 101(a)(15)(H)(i)(c) shall be 3 years, and may be extended
once for an additional 3-year period.''.
(b) Number of Visas.--Section 212(m)(4) of the Immigration and
Nationality Act (8 U.S.C. 1182(m)(4)) is amended by striking ``500.''
and inserting ``300.''.
(c) Portability.--Section 214(n) of the Immigration and Nationality
Act (8 U.S.C. 1184(n)) is amended by adding at the end the following:
``(3)(A) A nonimmigrant alien described in subparagraph (B) who was
previously issued a visa or otherwise provided nonimmigrant status
under section 101(a)(15)(H)(i)(c) is authorized to accept new
employment performing services as a registered nurse for a facility
described in section 212(m)(6) upon the filing by the prospective
employer of a new petition on behalf of such nonimmigrant as provided
under subsection (c). Employment authorization shall continue for such
alien until the new petition is adjudicated. If the new petition is
denied, such authorization shall cease.
``(B) A nonimmigrant alien described in this paragraph is a
nonimmigrant alien--
``(i) who has been lawfully admitted into the United States;
``(ii) on whose behalf an employer has filed a nonfrivolous
petition for new employment before the date of expiration of
the period of stay authorized by the Secretary of Homeland
Security, except that, if a nonimmigrant described in section
101(a)(15)(H)(i)(c) is terminated or laid off by the
nonimmigrant's employer, or otherwise ceases employment with
the employer, such petition for new employment shall be filed
during the 45-day period beginning on the date of such
termination, lay off, or cessation; and
``(iii) who, subsequent to such lawful admission, has not
been employed without authorization in the United States before
the filing of such petition.''.
(d) Applicability.--
(1) In general.--During the 3-year period beginning on the
commencement date described in paragraph (2), the amendments
made by section 2 of the Nursing Relief for Disadvantaged Areas
Act of 1999 (Public Law 106-95), and the amendments made by
this section, shall apply to classification petitions filed for
nonimmigrant status. This period shall be in addition to the
period described in section 2(e) of the Nursing Relief for
Disadvantaged Areas Act of 1999.
(2) Commencement date.--Not later than 60 days after the date
of the enactment of this Act, the Secretary of Homeland
Security shall determine whether regulations are necessary to
implement the amendments made by this section. If the Secretary
determines that no such regulations are necessary, the
commencement date described in this paragraph shall be the date
of such determination. If the Secretary determines that
regulations are necessary to implement any amendment made by
this section, the commencement date described in this paragraph
shall be the date on which such regulations (in final form)
take effect.
Purpose and Summary
H.R. 1933 reauthorizes the H-1C nonimmigrant visa program
for nurses and makes a number of modifications to the program.
Background and Need for the Legislation
A number of hospitals with unique circumstances experience
a great difficulty in attracting American nurses. Hospitals
serving mostly poor patients have special difficulties. Some
hospitals in rural areas do also. For example:
St. Bernard [Hospital and Health Care Center] . . . is
located on the south side of Chicago in the Englewood
community. Unfortunately, high rates of crime and high
poverty rates equal 31,000 visits to our emergency room
per year, which makes us the second largest for the
Chicago Fire Department's ambulance runs in the city.
St. Bernard is Englewood's only remaining hospital and
has a patient base almost entirely of poverty care or
charity care. . . .
We are considered by the State of Illinois as one of
the safety net hospitals in Chicago, and we are one of
only a handful of hospitals recognized by the Illinois
Department of Public Aid for special financial
recognition for our role in delivering quality care to
the indigent in the inner city of Chicago.
We almost closed our doors in 1992, primarily because
of our inability to attract registered nurses.\1\
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\1\The Health Professional Shortage Area Nursing Relief Act of
1997: Hearing Before the Immigration and Claims Subcomm. of the House
Judiciary Comm., 105th Cong., 1st Sess. at 15 (Nov. 5, 1997)(statement
of Ron Campbell, Vice President, Patient Care Services, St. Bernard
Hospital and Health Care Center).
The ``Nursing Relief for Disadvantaged Areas Act of 1999''
created a new ``H-1C'' temporary visa program for registered
nurses.\2\ The program was modeled after the expired ``H-1A''
temporary nursing visa program but limited the number of visas
that could be issued to 500 per year and only allowed in-need
hospitals that met certain criteria to petition for alien
nurses. To be able to petition for an alien, an employer had to
meet four basic conditions. First, the employer must have been
located in a health professional shortage area as designated by
the Department of Health and Human Services. Second, the
employer must have had at least 190 acute-care beds. Third, a
certain percentage (35%) of the employer's patients must have
been Medicare patients. Fourth, a certain percentage (28%) of
patients must have been Medicaid patients.
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\2\See Pub. L. No. 106-95.
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Employers had to make certain attestations pertaining to
``payment of a wage which will not adversely affect wages and
working conditions of similarly employed registered nurses;
payment of wages to aliens at rates paid to other registered
nurses similarly employed by the facility; taking timely and
significant steps designed to recruit and retain U.S. nurses in
order to reduce dependence on nonimmigrant nurses; absence of a
strike/lockout or lay off of nurses; notice to workers of its
intent to petition for H-1C nurses; percentages of H-1C nurses
to be employed at the facility; and placement of H-1C nurses
within the facility.''\3\
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\3\65 Fed. Reg. 51138 (2000). For a full description of the terms
of the H-1C program, see H. Rep. No. 106-135, at 8-13 (1999).
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The Department of Labor has determined that the following
hospitals are eligible for the program: Beaumont Regional
Medical Center, Beaumont, TX; Beverly Hospital, Montebello, CA;
Doctors Medical Center, Modesto, CA; Elizabeth General Medical
Center, Elizabeth, NJ; Fairview Park Hospital, Dublin, GA;
Lutheran Medical Center, St. Louis, MO; McAllen Medical Center,
McAllen, TX; Mercy Medical Center, Baltimore, MD; Mercy
Regional Medical Center, Laredo, TX; Peninsula Hospital Center,
Far Rockaway, NY; Southeastern Regional Medical Center,
Lumberton, NC; Southwest General Hospital, San Antonio, TX; St.
Bernard Hospital, Chicago, IL; and Valley Baptist Medical
Center, Harlingen, TX.\4\
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\4\See 65 Fed. Reg. 51143 (2000); 75 Fed. Reg. 10396 (2010).
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The Nursing Relief for Disadvantaged Areas Act of 1999 was
enacted as a 4-year program (beginning on the effective date of
implementing regulations) on November 12, 1999. The program
expired in 2005 and was reauthorized in 2006 for an additional
3 years.\5\ The program expired in December 2009 (but some H-1C
nurses remain who received approval for 3-year stays before
this date).
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\5\See Pub. L. No. 109-423.
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The Department of Labor reports that 499 nurses received
visas under the program in fiscal year 2007 as did 110 in
fiscal year 2008.\6\
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\6\Information provided by the U.S. Department of Labor.
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St. Bernard Hospital has indicated that:
Because of the sunset, in combination with the extended
approval period for green cards, nurses are now forced
to leave our institution and the rate of loss continues
to increase. This loss cannot be sustained. As the only
hospital serving one of the most difficult sections of
Chicago, and perhaps the entire country, we need the
extension of the visa program to survive.\7\
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\7\Letter from Sister Elizabeth Van Straten, President-Chief
Executive Officer, St. Bernard Hospital and Health Care Center, to
Lamar Smith (Dec. 15, 2010), on file with the Committee on the
Judiciary.
H.R. 1933 reauthorizes the program for an additional 3
years. The number of visas that may be issued in each fiscal
year cannot exceed 300. An alien may be admitted for 3 years
and this stay may be extended once for an additional 3 years
(the extension is new with H.R. 1933). The bill also allows H-
1C nurses to be able to switch employment between any of the H-
1C-eligible hospitals.
Hearings
The Committee on the Judiciary held no hearings on H.R.
1933.
Committee Consideration
On June 23, 2011, the Committee met in open session and
ordered the bill H.R. 1933 reported favorably, as amended, by
voice vote, a quorum being present.
Committee Votes
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, the Committee advises that there
were no recorded votes during the Committee's consideration of
H.R. 1933. The Committee approved by voice vote an amendment by
Ms. Lofgren to allow H-1C nurses to be able to switch
employment between any of the 14 H-1C-eligible hospitals.
Committee Oversight Findings
In compliance with clause 3(c)(1) of rule XIII of the Rules
of the House of Representatives, the Committee advises that the
findings and recommendations of the Committee, based on
oversight activities under clause 2(b)(1) of rule X of the
Rules of the House of Representatives, are incorporated in the
descriptive portions of this report.
New Budget Authority and Tax Expenditures
Clause 3(c)(2) of rule XIII of the Rules of the House of
Representatives is inapplicable because this legislation does
not provide new budgetary authority or increased tax
expenditures.
Congressional Budget Office Cost Estimate
In compliance with clause 3(c)(3) of rule XIII of the Rules
of the House of Representatives, the Committee sets forth, with
respect to the bill, H.R. 1933, the following estimate and
comparison prepared by the Director of the Congressional Budget
Office under section 402 of the Congressional Budget Act of
1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, July 6, 2011.
Hon. Lamar Smith, Chairman,
Committee on the Judiciary,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 1933, a bill to
amend the Immigration and Nationality Act to modify the
requirements for admission of nonimmigrant nurses in health
professional shortage areas.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Mark
Grabowicz, who can be reached at 226-2860.
Sincerely,
Douglas W. Elmendorf,
Director.
Enclosure
cc:
Honorable John Conyers, Jr.
Ranking Member
H.R. 1933--A bill to amend the Immigration and Nationality Act to
modify the requirements for admission of nonimmigrant nurses in
health professional shortage areas.
CBO estimates that implementing H.R. 1933 would result in
no significant cost to the Federal Government. Enacting the
bill could affect direct spending; therefore, pay-as-you-go
procedures apply. However, CBO estimates that any such effects
would be insignificant for each year. H.R. 1933 would not
affect revenues.
H.R. 1933 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act and
would not affect the budgets of State, local, or tribal
governments.
Current law permits foreign nurses to work temporarily in
the United States in areas where there are shortages of
qualified applicants. No more than 500 of those individuals may
be admitted in each year, and they may remain in the United
States for 3 years. H.R. 1933 would limit annual admissions to
300 and would authorize those persons to extend their stay for
an additional 3 years.
The Department of State and the Department of Homeland
Security (DHS) collect fees to admit those individuals. The DHS
fees are classified as offsetting receipts (a credit against
direct spending) and the department is authorized to spend such
fees without further appropriation. The State Department fees
are retained and spent by the Department. CBO estimates that
enacting H.R. 1933 would have no significant effect on the
collection and spending of such fees.
The CBO staff contact for this estimate is Mark Grabowicz.
The estimate was approved by Theresa Gullo, Deputy Assistant
Director for Budget Analysis.
Performance Goals and Objectives
The Committee states that pursuant to clause 3(c)(4) of
rule XIII of the Rules of the House of Representatives, H.R.
1933 reauthorizes the H-1C nonimmigrant visa program for nurses
and makes a number of modifications to the program.
Advisory on Earmarks
In accordance with clause 9 of rule XXI of the Rules of the
House of Representatives, H.R. 1933 does not contain any
congressional earmarks, limited tax benefits, or limited tariff
benefits as defined in clause 9(e), 9(f), or 9(g) of Rule XXI.
Section-by-Section Analysis
Sec. 1. Requirements for Admission of Nonimmigrant Nurses
in Health Professional Shortage Areas.
Subsection (a) amends section 212(m)(3) of the Immigration
and Nationality Act to allow H-1C nonimmigrant nurses to
request an extension of their period of authorized admission
for an additional 3 years after the initial 3 year admission.
Subsection (b) amends section 212(m)(4) of the INA to
provide that the total number of nonimmigrant visas issued
pursuant to H-1C petitions shall not exceed 300 in each fiscal
year.
Subsection (c) amends section 214(n) of the INA to provide
that an H-1C alien (who has been lawfully admitted to the U.S.,
who has not since admission been employed without
authorization, and on whose behalf an employer has filed a
nonfrivolous petition for new employment before the date of
expiration of the authorized period of stay except that if the
alien is terminated or laid off by their employer, or otherwise
cease employment, such petition for new employment shall be
filed during the ensuing 45 day period) is authorized to accept
new employment performing services as a registered nurse at any
facility which qualifies for the H-1C program upon the filing
by the prospective employer of a new petition on behalf of the
alien. Employment authorization shall continue for such alien
until the new petition is adjudicated. Once a petition is
denied, such authorization shall cease.
Subsection (d) provides that the H-1C program is
reauthorized for the 3 year period beginning on the date (no
later than 60 days after enactment) that the Secretary of
Homeland Security determines that no regulations are necessary
to implement the bill; however, if the Secretary determines
(within this 60 day period) that regulations are necessary, the
program is reauthorized for 3 years beginning on the date on
which such regulations (in final form) take effect.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
IMMIGRATION AND NATIONALITY ACT
* * * * * * *
TITLE II--IMMIGRATION
* * * * * * *
Chapter 2--Qualifications for Admission of Aliens; Travel Control of
Citizens and Aliens
* * * * * * *
GENERAL CLASSES OF ALIENS INELIGIBLE TO RECEIVE VISAS AND INELIGIBLE
FOR ADMISSION; WAIVERS OF INADMISSIBILITY
Sec. 212. (a) * * *
* * * * * * *
(m)(1) * * *
* * * * * * *
[(3) The period of admission of an alien under section
101(a)(15)(H)(i)(c) shall be 3 years.]
(3) The initial period of authorized admission as a
nonimmigrant under section 101(a)(15)(H)(i)(c) shall be 3
years, and may be extended once for an additional 3-year
period.
(4) The total number of nonimmigrant visas issued pursuant to
petitions granted under section 101(a)(15)(H)(i)(c) in each
fiscal year shall not exceed [500.] 300. The number of such
visas issued for employment in each State in each fiscal year
shall not exceed the following:
(A) * * *
* * * * * * *
ADMISSION OF NONIMMIGRANTS
Sec. 214. (a) * * *
* * * * * * *
(n)(1) * * *
* * * * * * *
(3)(A) A nonimmigrant alien described in subparagraph (B) who
was previously issued a visa or otherwise provided nonimmigrant
status under section 101(a)(15)(H)(i)(c) is authorized to
accept new employment performing services as a registered nurse
for a facility described in section 212(m)(6) upon the filing
by the prospective employer of a new petition on behalf of such
nonimmigrant as provided under subsection (c). Employment
authorization shall continue for such alien until the new
petition is adjudicated. If the new petition is denied, such
authorization shall cease.
(B) A nonimmigrant alien described in this paragraph is a
nonimmigrant alien--
(i) who has been lawfully admitted into the United
States;
(ii) on whose behalf an employer has filed a
nonfrivolous petition for new employment before the
date of expiration of the period of stay authorized by
the Secretary of Homeland Security, except that, if a
nonimmigrant described in section 101(a)(15)(H)(i)(c)
is terminated or laid off by the nonimmigrant's
employer, or otherwise ceases employment with the
employer, such petition for new employment shall be
filed during the 45-day period beginning on the date of
such termination, lay off, or cessation; and
(iii) who, subsequent to such lawful admission, has
not been employed without authorization in the United
States before the filing of such petition.
* * * * * * *