Health Care Law Blog

Visa Options for Foreign Nurses and Legislative Update

Curiously, traditional registered nurses ("RNs"), excepting Canadian and Mexican RNs under NAFTA, lack a general temporary visa category to work in the United States. While there are favorable provisions for an RN to obtain permanent resident status (a “Green Card”) based upon employment, the lengthy eligibility wait time for the permanent visa category limits the practical usefulness of these provisions in many cases. Currently, temporary visa options for nurses are limited to the following.

H-1B Specialty Occupation Workers

(limited to advanced practice nurses)

The H-1B is a commonly utilized visa in high demand for professionals who hold at least a bachelor’s degree in a specialty occupation. Unfortunately for foreign nurses and their prospective employers, earlier rulings that nursing is a professional occupation for visa purposes were nullified by the Immigration Act of 1990. Since many employers and state licensing boards do not typically require a Bachelor of Science in Nursing to perform services as an RN, standard RN positions do not meet the definition of a specialty occupation. Therefore, only certain “advanced practice nurse” positions requiring a minimum four-year Bachelor of Science in Nursing or related advanced degrees may qualify for H-1B status. These include the following positions:

• Clinical Nurse Specialists (CNS)
• Nurse Practitioners (NP)
• Certified Registered Nurse Anesthetists (CRNA)
• Certified Nurse Midwives (CNM)
• nurse managers
• nursing administrators
• other advanced practice positions

Furthermore, the H-1B is generally subject to a numerical limitation on the number of visas available each year (the “H-1B Cap”). The H-1B Cap has already been reached this year. However, filing for the next fiscal year opens on April 1, 2013 – those interested in H-1B’s should begin the planning process for an April 1 filing soon.

TN Registered Nurses

(limited to Canadian and Mexican citizens)

Registered nurses are included in the list of professions eligible for NAFTA Professional ("TN") Visa status under North American Free Trade Act ("NAFTA"). In comparison to most types of visas, the application, adjudication, and U.S. entry processes for TN Visa Applicants in the RN category are relatively simple and quick. However, the applicant eligibility pool is limited to Canadian and Mexican nurses.

H-1C Nurses in Medically Underserved Areas

(expired; renewal legislation pending)

The H-1C visa classification enabled foreign nurses to work as a RN in a U.S. health “professional shortage area,” as determined by the U.S. Department of Labor, for a period of 3 years. This visa category was created to address the shortage of nurses in designated disadvantaged areas throughout the U.S., including inner cities and certain rural locations. However, this visa program ended on December 20, 2009.

Since that time, the U.S. House of Representatives has proposed and passed a bill, H.R. 1933, seeking to amend the Nursing Relief for Disadvantaged Areas Act of 1999 and reauthorize the H-1C visa program. The bill passed the House by a vote of 407 to 17. Following its passage by the House, the bill has been pending before the U.S. Senate Judiciary Committee since August 1, 2011. Time is running out for action to be taken on this bill, especially in an election year.

For more information on visa options for nurses or help applying for a visa, contact Ryan at 616.796.2503 or by using the email form below.

Categories: Employment, Hospitals, Physicians