Need to employ registered nurses? Try the H-1C visa

Not many employers are aware that the US offers a separate temporary work visa category for Registered Nurses – the H1-C Visa. For employers, H1-C is a more immediate relief then the Schedule A category which often has long waiting lists.

What is H1-C Program?

The H1-C program was established by the Nursing Relief for Disadvantaged Areas Act of 1999 and came into effect in 2000. and was set to expire in 2005. However, it has been extended till December 20, 2009, as US continues to face severe shortage of nursing staff.The H1-C program allows foreign registered nurses to work in the US for up to three years only in designated health professional shortage areas (HPSAs). Once the three period is over, the status cannot be extended. The cap for H1-C is set at 500 per year, and has a set allowance of 25 nurses per state.

Beneficiary Eligibility Criteria

To qualify for H1-C Visa, the beneficiary must meet the following criteria:

1.      Either be a Licensed Nurse in his or her home country, or have a nursing degree from a US institute

2.      Either have passed the Commission on Graduates of Foreign Nursing Schools (CGFNS) Qualifying Examination or have a full and unrestricted license to practice as a registered nurse in the state of intended employment

3.      Be fully qualified and eligible under all state laws and regulations to practice as a registered nurse in the state of intended employment immediately upon admission to the United States.

Employer’s eligibility Criteria

Because of the restrictive nature of the Act regarding the HPSA clause, facilities or institutes interested in hiring H-1C employees are required to file an attestation with the Employment and Training Administration (ETA) of the U.S. Department of Labor (DOL) before they can qualify under the H1-C program.

In the attestation form ETA 9081, the employer must attest that:

1.      The facility is a hospital that falls in a designated HPSA as of March 31, 1997, and can prove that since FY 1994, had at least 190 licensed acute care beds with at least 35 percent of its acute care patients entitled to Medicare, and at least 28 percent entitled to Medicaid, thereby meeting the definition of “subsection (d) hospital” found in the Social Security Act. A copy of this paperwork must also be kept in a public access file.

2.      The employment of H-1C nurses will not adversely affect the wages or working conditions of similarly employed nurses.

3.      The facility will pay the H-1C nurse the usual facility wage rate for all nurses.

4.      The facility has taken and is taking timely and significant steps to recruit and retain US candidates as nurses in order to reduce dependence on immigrant nurses.  The facility should provide proof of at least two such steps taken, which may include but is not limited to:

a.     Running a training program either at the facility or elsewhere or financing the participation in such a program else where.

b.     Providing career development programs to encourage health care workers to become registered nurses.

c.     Paying registered nurses wages at a rate at least 5% higher than the prevailing wage.

d.     Providing reasonable opportunities for meaningful salary advancement.

5.      The facility has not and will not face a strike or lockout owing to labor disputes

6.      The facility did not and will not lay off an RN within the 90 day period before and after the date of filing an H-1C petition

7.      The facility is not and will not hire a H-1C nurse with the intention or designed to influence an election for a union representative at the facility.

8.      The employer will notify the union representative or other workers as well as provide a copy or email this attestation to every nurse employed at the facility within 30 days of filing.

9.      The number of H1-C nurses employed will never be more then one third of the total number of nurses employed by the facility.

10.   The facility will not authorize H-1C nurses to work at any worksite not under its control or transfer H-1C nurses from one worksite to another.The attestations filed by an employer expire either one year from the date of filing with the DOL or at the end of the period of admission of the H1C nurse, whichever is later. The initial attestation can be used to support all petitions filed during the one-year period beginning on the date of its first filing with the DOL, provided the facility maintains the conditions of the original attestation throughout this period.

H1-C Filing process

The H1-C filing process is quite similar to the H1-B filing process. The employer needs to file the Form ETA 9081 complete with all attestations, supporting paperwork and the filing fee of $250 with the DOL. In addition, the employer also needs to file a petition with the INS. A single petition can be filed for multiple candidates. If the attestation is approved by the DOL, it can be used in support of the H-1C petition filed with USCIS. On approval from USCIS, a copy of the H-1C petition and USCIS approval letter is send back to the Labor Department.  The employer is required to maintain a public access file with all the documents.

NB: The attestation process is administered by the Employment and Training Administration at the Department of Labor.  Enforcement of the attestations is overseen by the Employment Standards Administration’s Wages and Hours Division.

Advantage of H1-C

The alternate visa programs available to registered nurses are H1B and Schedule A, of which the former has cap issues and the latter has a long wait to naturalization. The H1-C is perfect for facilities looking to make up for shortage in nursing stuff immediately.