Nursing schools peddle dreams

Nursing schools peddle dreams

By RN

Conclusion

SMACK in the heart of downtown Manila and around the Professional Regulatory Commission can be found the country’s export processing zone for nurses. There, a dozen or so nursing schools and training centers have somehow converged and are thriving, mining the dreams of those aspiring to work overseas.

In one of these schools, students called upon to recite are admonished by the teacher to speak in English. “How can you work abroad if you can’t even answer in English?” the teacher tells them.

Soon, the same school will also introduce a new subject: Trans­cultural Nursing, which will teach students how to practice their profession in countries whose culture and environment differ vastly from the one they had always known.

Throughout the country, nursing education is being retrofitted to meet the demands of the global market. A surge in demand for nurses among health institutions overseas—particularly in the United States and the United Kingdom—is fueling a boom in nursing schools. But as in any other boom, quality has suffered as the numbers increase, in large part because of skewed priorities.

In the 1970s there were 40 nursing schools in the country. Today there are about 350, including many that are focusing more on reaping profits from people dreaming of high-earning jobs overseas than on preparing students for an exacting profession that provides care for ailing patients and technical support for doctors.

Many of these schools lack up-to-date facilities, qualified faculty or affiliation with a hospital, all of which are supposed to be in place before these institutions are allowed to operate.

Yet instead of attending to these problems, many nursing schools have busied themselves adjusting their requirements to fit the needs of a new type of students: middle-age professionals seeking a new career. Called “second-coursers,” they include doctors as well as accountants, clerks, teachers, journalists, government employees and secretaries. All of them hope to become nurses, preferably in a foreign land. More often than not, such students enjoy a shorter term since their basic science subjects in their first course are credited.

But Rita Tamse of the Technical Committee on Nursing Education of the Commission on Higher Education (CHED) urges students to first scrutinize a school’s credentials and past performance before parting with their often hefty tuition. She notes, for instance, that 23 of the current number of nursing schools have failed to meet the requirements set by the government for them to operate. These schools are supposed to have until this month to stop operating and start transferring their students, but they have appealed to CHED to let them continue for one more year. They have also sought the help of congressmen to avoid closure.

To help students avoid the duds among the schools, CHED has issued a list showing the performance of various schools in the Nursing Board Exam. CHED divided the schools into five categories, with those that have 90 percent or more of their examinees passing the Board in the last five years classifying as institutions that had “outstanding performance.” The bottom category is for “very low performing” schools, or those with 29 percent or below of their students passing the exams. (Check out www.pcij.org for the list of schools.)

Very low performers made up 21 percent of the total schools listed by CHED. The bulk, or 36 percent, of the total belongs to the “low-performing” category, or schools that saw 30 percent to 49 percent of their students passing the Board.

Only 12 nursing schools—a mere 6 percent of the total—made it to the outstanding category: University of the Philippines-Manila, Saint Paul College (Iloilo), Silliman University, Saint Louis University, Mindanao State University-Marawi City, Saint Paul College (Dumaguete), Paman­tasan ng Lungsod ng Maynila, Saint Mary’s University (Bayombong), Saint Paul College (Manila), and University of the East Ramon Magsaysay Memorial Medical Center.

Of the 94 schools that had less than five years of Board performance, 42 had zero passing rates, meaning none of their graduates passed the national exam.

Under the law, a nursing school must have a passing rate of 5 percent to be able to continue operating. CHED wants to push the rate up to 30 percent, a level that could close down many of the nursing schools.

To certain schools, CHED might appear to be a villain. But the government and even recruiters know that in the end, having high-quality graduates is the best way the country could stay in the business of exporting nurses.

Requirements not being met

For almost a year CHED’s technical committee monitored nursing schools for their compliance with five requirements: adherence to the nursing curriculum, availability of facilities, ratio of faculty to students, affiliation with or existence of an active tertiary hospital to serve as base for students, and a qualified faculty.

Tamse notes that many schools “are really having trouble with the last three requirements.” Depending on the year level of the students, a school is supposed to observe a teacher-student ratio. In the subject on Related Learning Experience, for example, there should be one teacher for just eight students.

A school must also have a dean—a requirement that seems reasonable enough but which nursing schools find hard to meet. “It’s very easy for them to have facilities because they have lots of money,” says Tamse. “They can build a school, put up air-conditioned classrooms, a nursing laboratory and all that.” But one apparently cannot buy something that’s simply not available, such as qualified teachers and a dean.

Base hospitals are also a problem. “We have too many nursing schools for the number of qualified training hospitals available all over the country,” says Tamse. Not just any hospital can qualify as a base. It has to have the major departments—surgical, obstetric-gynecological and pediatric wards. It should be a tertiary hospital accredited by the Department of Health. And it must have an occupancy rate of 80 percent, which means it is an active hospital where students can be exposed and properly trained.

In addition, some schools want to offer classes in trimesters or quartermesters, a suggestion that would fast-track the course but inevitably lead to half-baked students. “In many health sciences, exposure is important because that is where skills are honed,” says the CHED consultant. “If you shorten that, you come up with graduates who are half-baked. And when they get to the hospitals to work, they’re dangerous. Talagang makakapatay [They can really kill people].”

Diploma mills

The overwhelming number of students wanting to become nurses obviously contributes to the desire of many schools to have as many graduates as they can. According to CHED, nursing schools had a total of 80,000 enrollees last year, among them “second coursers.” The steep cost of the course apparently did not faze them, perhaps because they expect a quick return in their investment once they land a job overseas.

“Nursing is not a poor man’s course,” admits a social science major, who has decided to change professional gears. He ticks off his expenses: tuition per semester is P40,000. Other costs include reading materials, about P5,000 (for books, both bought and photocopied); stethoscope, P850; white shoes, P1,500; white shoe polish, P500; food and lodging, P25,000.

For students who could not afford the full semestral payment, an installment plan is available. A down payment of P10,000 is required, with the balance paid in three “gives,” each to be given before the three major tests: prelims, midterm and finals. Inability to pay at any point would mean dropping out from class, repeating the semester and paying up once more. In the end, the poorer the student, the higher the costs incurred.

There are already schools that turn down enrollees for sheer inability to accommodate them. Far Eastern University, for example, reportedly rejected 5,000 applicants last year. In the same period, the UP College of Nursing admitted only 70 students out of 11,000 who applied. That number for admission will not increase even as 14,000 applicants have already asked to be taken in for the coming school year.

No to second-coursers

At the same time, some nursing schools do not admit second-coursers, including doctors, in their classes. The demand from regular students appears to be enough to make up for any financial gain that is given up.

Dr. Rusty Francisco, a nurse with a doctorate in nursing education and an owner of a training center for nurses bound for abroad, says many students are deluded into thinking that enrollment in a nursing school is a guaranteed passport to a job abroad.

“Passing all examinations does not make them competitive,” he says. Not many Filipino nurses are familiar with the medical equipment being used in US hospitals, he points out. Neither do they know how to operate in an environment where patients are more assertive and aware of their rights. That is why in his training center, Francisco emphasizes what Filipino nurses should expect when they are in the United States.

He adds that while Filipinos are still the preferred health workers, they may soon be facing stiff competition from the Chinese and the Indians who have come to realize the financial windfall from the export of nurses to developed countries.

Changing values of nurses

Although Filipino nurses are known for being compassionate and caring, these qualities appear to be disappearing because the goals for taking up nursing have changed. From desiring to be of service to another human being, nursing students are now primarily motivated by the need to make money.

Francisco argues that even a high-standard school may not be able to change the mindset of those already determined to earn dollars above anything else. “A school curriculum,” he says, “does not automatically turn a person into a caring, compassionate nurse with the ability to be assertive and articulate.”

Tamse agrees with the observation. “Some of them don’t even have the heart for it,” she says. “They’re just there because they know it’s a good passport for going abroad. . . . Nursing is about caring and being compassionate. It’s difficult to be compassionate if your only purpose is to earn.”

But it is also difficult to deny the validity of the economic reason behind the decisions of many who leave. At the Philippine General Hospital, says Tamse, “99 percent left because they have to finance the schooling of their brothers and sisters, the husband is unemployed or underemployed, the children need to be given quality education and so on.”

She says many of the nurses cry and tell her, “I don’t want to leave naman ma’am, eh. It’s just that I have to do it.” In one exit interview, a nurse underscored the words, “Pera lang po [It’s only the money].”

But the likes of Tan are unwilling to take all these sitting down. In a rather controversial scheme, Tan suggests the enactment of a National Health Service Act that would require health sciences education graduates of state colleges and universities to serve the equivalent number of years of study in the country. Since the state has subsidized the education of these health science graduates, he reasons, they should pay back the favor by serving in the country for a few years.

Pros and cons of mandatory service

Several bills have been filed in Congress imposing mandatory service for nurses. Predictably, these have been opposed by nurses’ organizations that say the practice is discriminatory and oppressive.

Tan believes otherwise. He points out that the current health crisis warrants compulsory service by health workers for a specified period. He also notes that countries like Indonesia and Malaysia require their medical and health science graduates to work in the country before going abroad. In fact, Tan says, the Philippines is the only country in Southeast Asia that does not have a National Health Service Act.

Dr. Irineo Bernardo of the Philippine Hospital Association, for his part, says, “We need to look at a problem from many angles.” Instead of dreading the loss of more nurses, doctors and other health workers, he suggests working harder to improve the health condition of Filipinos.

“The government keeps talking about having a strong republic,” he says. “Why not have healthy Filipinos so we can really have a strong country?”

The country’s health status

Up to now, Bernardo says, the government has not established the health status of the country. “How healthy or how sick are we?” he asks. “If the number of health providers goes down, will that make more people sick? No!”

But if the government fails to look after the health of its people—such as by making it easy for cigarette companies to sell their products—then Filipinos will get sick, he says. Educating the people on how to take care of themselves could do more to improve public health rather than having a big number of health providers, he says. Points out Bernardo: “Sickness comes from our lifestyle, from what we take in. We need food, not medicine.”

Although the disappearance of doctors and nurses is indeed a problem, Bernardo suggests taking good care of those who stay behind. “Recognize the competence of nurse anesthetists, for example, and pay them as well as a doctor,” he says. After all, surgery would be impossible if no anesthesia is administered.

There is in fact a boon for those who will remain in the country: they would now have a bigger market for themselves, since they will have fewer rivals. “There will come a time when things will not be good,” concedes Bernardo. “But they will become better. Many hospitals will close down but they will be replaced by new players. We will change.”

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Posted on Monday, March 21, 2005

Nurses lack hurts healthcare system

By RN

First of two parts

LANI, a radiology technologist in a government hospital in Que­zon City, remembers the time when she moved among the best in her department. “We used to have good senior nurses here,” she says.

Then, almost suddenly, her coworkers started leaving. “That whole year, I kept seeing resignation papers,” recalls Lani. Even the aides were disappearing, going off to London or the United States or elsewhere for good. Today, out of the 40 staff members that she had originally worked with in the department, only four have stayed behind. But even they—including Lani—have either applied or are planning to apply for work abroad.

This month, some 20,000 nursing students will graduate from 350 schools in the country. As the global health industry opens itself up to more migrant health workers, many of the new graduates will be making a beeline for jobs overseas. But many more of them will not pass the qualifying exams for nurses, thanks to a boom in nursing schools that has led to a decline in the quality of education and also of students being accepted into nursing programs. In the last few years, less than half of those taking the nursing board exams passed.

The best among the graduates, however, are often bound for abroad, many of them skipping the one- or two-year experience required by hospitals. In the last 10 years, the Philippines sent close to 90,000 nurses overseas. Today it is exporting more qualified nurses than it is producing, leading to a nursing crisis that has already diminished the quality of hospital care and even forced the closure of a number of hospitals.

A study by the National Institute of Health (NIH) describes migrant health workers (nurses, physical and occupational therapists and midwives) as generally young, from 20 to 30 years old. Migrant doctors are between 31 and 40 years old. But these figures can deceive. Now and then, hospital staffers would speak of doctors who have retired or are about to retire and taking up nursing. Age is not a hindrance to working abroad, especially in the United States where one can work for as long as one wants to.

Although the number of male nurses has been observed to be on the rise, the migrant health workers are still predominantly female, meaning more families are losing their traditional caregivers—the wives, mothers and sisters. According to a 2004 Asian Development Bank report, 65 percent of Filipino workers overseas are women.

The NIH study also warns that because the migrating nurses are usually the ones with training, experience and skill, patients in hospitals and other health institutions in the Philippines can expect a higher incidence of cross-infections, adverse events after surgery, accidents, injuries and even increased violence against the staff.

With the best among nursing students often leaving as soon as they graduate, the less skilled are taking the place of senior or relatively more experienced nurses who have also left for other shores. In a year or two, they too would be gone. The void would be filled once more by fresh graduates who would repeat the same cycle: get a few years experience in a local hospital, apply for work abroad and then leave. It is, say many health professionals, a cycle that leaves local hospitals in a state of perpetual displacement—and patients in constant danger.

Next to India, the Philippines is already the largest source of doctors in hospitals abroad. The country also supplies 25 percent of all overseas nurses worldwide. Not surprisingly, about 10 percent of the Philippines’ 2,500 hospitals have closed down in the past three years because of the loss of doctors and nurses to jobs overseas.

As more nurses leave and as fewer are qualifying for the job, the situation in hospitals can only deteriorate. But to Rita Tamse, deputy director for nursing of the Philippine General Hospital (PGH), “that worse situation is happening right now.”

The exodus continues

“Our problem is unskilled, untrained nurses,” says Dr. Irineo Bernardo, executive officer of the Philippine Hospital Association and owner of a primary-care community hospital in Tanay, Rizal. He notes that the turnover of nurses has been particularly high in the last five years.

“In a small hospital, we’d expect one or two to leave for abroad in a year,” says Bernardo. “Last year, we had five who left.”

Even the PGH, the country’s premier government hospital, is also seeing an exodus, with up to a quarter of its 2,000-nurse work force leaving in the last few years.

The preferred country of destination is the United States because of the possibility of acquiring US citizenship and all its privileges. But 57 percent of Filipino nurses abroad are in Saudi Arabia and only 14 percent are in the United States; 12 percent are in the United Kingdom.

But that may soon change. Figures vary but the United States is said to need about a million nurses over the next few years; Canada, 10,000; the Netherlands and the United Kingdom, 7,000; other countries, 27,000.

In 2001 the Philippine Overseas Employment Administration (POEA) reported that 13,536 Filipino nurses went overseas, almost double the previous year’s exodus of 7,683 nurses. The 2001 figure is the highest ever recorded. The same year, only 4,430 students passed the Nursing Board Examination.

The pattern would be repeated in 2002 when 11,911 nurses chose to work abroad as against a much smaller number of nursing students—4,228—who passed the board. Clearly, the country has been exporting more nurses than it was producing.

Falling standards

Tamse, who is also a member of the Technical Committee on Nursing Education of the Commission on Higher Education (CHED), notes that the latest Nursing Board Exam in December registered its lowest passing rate ever at 43 percent. Of the about 12,000 students who took the board, only about 5,000 made the grade.

Thus, although the PGH used to accept only the top graduates of the country’s nursing schools, it can no longer afford to stick to such standards, says Dr. Jaime Galvez Tan, vice chancellor of the University of the Philippines in Manila that is in charge of the hospital. So long as a nurse makes the minimum passing grade, an apparently desperate PGH will take the applicant.

Bernardo points out that the shortage of skilled nurses compromises the quality of patient care. He says, “It takes years for a new graduate, even for someone with good grades, to be trained.” It is not enough that a nursing graduate knows the theories, says the doctor, adding that “he or she must know the culture inside a hospital as well.”

Skilled and trained nurses are a requisite of proper health care. In some towns, small hospitals are run by nurses, not doctors. Bernardo says that if the only nurse available “is an idiot, then better not open the ward altogether. You’ll be putting the patients at risk.”

One need not even go to distant barangays to find unskilled nurses. In a top hospital in Metro Manila, Tan recalls asking for a spittoon for a patient. “The nurse,” he says, “came back with a urinal.”

I also witnessed a nurse at a government hospital using her cell phone’s calculator to compute the intake and outflow of fluid of a patient, only to come up with the wrong numbers, which were recorded in the patient’s chart. Doctors base their diagnosis and course of treatment on the patient’s chart and wrong data could lead them to make wrong conclusions.

But even doctors are fast disappearing. On the fifth floor of a busy hospital in Manila, for example, hundreds of doctors congregate from Friday to Sunday in the early evening to “learn nursing.”

Tan says that 5,500 doctors are now enrolled in 45 nursing schools in courses that were tailor-made for them. Two thousand doctors have already taken up the Nursing Board Exams, topping the test in 2003 and 2004. Last year, the topnotcher in the medical board exam announced his plans to work overseas as a nurse.

Dropping employment

Thus, even as more nursing schools pop up each year, medical schools are getting less popular. Of the 39 medical schools in the country, three have ceased operating because of steeply declining enroll­ment. One report says that only six medical schools out of 25 that it studied registered an increase in enrollment. The highest increase in enrollment, registered by Mindanao State University, was 29 percent.

This, however, is hardly encouraging compared with the decline in enrollment experienced by most schools. The Iloilo Doctors College of Medicine, for instance, reported a 74-percent decrease in enrollees. Except for the University of Santo Tomas, nearly every medical school covered by the study reported a shortfall in its enrollment quota.

Among the reasons cited by health workers bound for abroad are political instability, corruption and the need for political backing to get a job or a promotion. They also deplore the long hours of work required of them. The most common reason they give, however, is economic.

Tamse recalls that one nurse came back from the United Kingdom with P500,000 after just six months there. For those bound for the United States, there is even a signing bonus of anywhere from $2,000 to $10,000.

Paltry salaries

These figures, she says, are “a far cry” from what nurses are paid here. Those in the provinces, for instance, get as low as P2,000 a month. Ironically, government hospitals pay more than private hospitals. Nurses in public hospitals receive at least P9,000; in private hospitals, it could go down to P4,000 a month. Under the Nursing Law of 2002, an entry-level nurse should get about P13,300 a month.

“It’s such a small amount and yet the government is unable to give that,” Tamse says, citing “unavailability of funds” as the constant reason being given by the Department of Budget and Management. In the meantime, a contractual nurse without experience gets P9,930 a month; with experience, the pay goes a bit higher at P12,000.

Even recruiters are handsomely paid for every nurse they bring to a foreign-health institution. Tan says a recruiter once offered him $7,000 for every nurse that he could find for a US hospital. When the disbelieving doctor finally got the chance to talk to staff members of that hospital, he was even more surprised.

“They denied it!” cries Tan. “They weren’t giving $7,000 for every nurse. They were giving $14,000!”

Tan worries that doing nothing to stop the flow of Filipino doctors and health workers to other countries could only lead to a “health human resources disaster.” Based on the results of a project he has been conducting in the last several years, he thinks the lack of good role models is partly to blame for the exodus of health workers. Some teachers, he says, tell their students there is no hope in this country.

Grades, not values

The medical curriculum, he adds, gives premium to grades and competencies rather than values. Globalization of labor has also contributed to a materialistic attitude even among those whose profession is supposed to serve others.

Yet Tan says that medical students generally start off with the right attitude and values. But somewhere on their way to becoming doctors, something seems to happen to them, changing their goals and plans, he says.

Over the years, Tan has been monitoring the attitudes of medical students, asking them three questions: How do you describe yourself? How do you see yourself 10 years from now? What country do you want to serve?

During the first and second years, he says, a medical student would usually describe himself as “compassionate” and “humane.” The student would also see himself working in public health, community medicine, or with a nongovern­mental health organization. Those years also see all medical students replying that they would like to serve in the Philippines.

Change, however, comes by the third year onward. With students invariably describing themselves as “competent” and “skilled,” many now want to become super-specialists. And by the time they graduate, only 25 percent said they would stay.

But Tan says the outward flow of health workers, however strong it is right now, can be “tamed” and lead to a “win-win situation” for the Philippines and the importing countries.

He suggests the initiation of bilateral negotiations with countries that import Filipino health workers that would lead to the allocation of development aid or compensation to the Philippines in exchange for sending health workers abroad.

He also advises the government to create a national commission to oversee the planning, production, deployment, retention and development of health professionals. He deplores the fact that there is no single body taking charge of these matters, which explains why figures concerning health matters vary depending on which government agency is consulted.

For now, however, Filipinos who fall ill will find less skilled professionals attending to them.

Nursing Relief Actof 2009

Nursing Relief Act of 2009 (Introduced in House)

HR 1001 IH
111th CONGRESS
1st Session
H. R. 1001

To create a new nonimmigrant visa category for registered nurses, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES
February 11, 2009

Mr. SHADEGG (for himself, Mr. FLAKE, and Mr. PASTOR of Arizona) introduced the following bill; which was referred to the Committee on the Judiciary

A BILL

To create a new nonimmigrant visa category for registered nurses, and for other purposes.

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 `Nursing Relief Act of 2009'.

SEC. 2. FINDINGS AND PURPOSE.

(a) Findings- The Congress finds the following:

(1) There are more vacant nursing positions in the United States than there are qualified registered nurses and nursing school candidates to fill those positions.

(2) According to the Department of Labor, the current national nursing shortage exceeds 126,000.

(3) States in the West and Southwest have a disproportionate number of nursing vacancies because of rapid population growth, which exacerbates a widening gap in the number of facilities and staff compared to patients that need care.

(4) Foreign countries such as the Philippines, India, and China have an oversupply of nurses.

(5) Major hospital systems in the United States spend hundreds of millions of dollars every year recruiting foreign nurses under our current immigration system.

(6) Current law, with certain limited exceptions, requires health care providers to sponsor desired nurses for permanent resident status while the nurses remain outside of the United States, which can take as much as 3 years.

(7) This cost is passed on to consumers and adds to the rising cost of health care.

(8) Health care providers cannot efficiently and effectively recruit qualified foreign nurses through the existing immigration process.

(9) Our health care system requires an immediate modification of Federal laws relating to recruitment of qualified foreign nurses in order to operate at an efficient and effective level.

b) Purpose- The purpose of this Act is to create a new nonimmigrant visa category for registered nurses and establish admission requirements for such nonimmigrants.

SEC. 3. REQUIREMENTS FOR ADMISSION OF NONIMMIGRANT NURSES.

(a) Establishment of a New Nonimmigrant Category- Section 101(a)(15) of the Immigration and Nationality Act (8 U.S.C. 1101(a)(15)) is amended--

(1) by striking `or' at the end of subparagraph (U),

(2) by striking the period at the end of subparagraph (V) and inserting `; or'; and

(3) by adding at the end the following:`

(W) an alien who is coming temporarily to the United States to perform services as a professional nurse, as described in section 212(v)(1)(A), who meets the qualifications described in section 212(v)(1)(B), and with respect to whom the Secretary of Labor determines and certifies to the Secretary of Homeland Security and the Secretary of State that the intending employer has filed with the Secretary of Labor an attestation under section 212(v)(2), and the alien spouse and children of any such principal alien, if accompanying or following to join the principal alien.'.

(b) Requiring Petition of Importing Employer- Section 214(c) of the Immigration and Nationality Act (8 U.S.C. 1184(c)) is amended by adding at the end the following:.

(15)(A) The question of importing any alien as a nonimmigrant under section 101(a)(15)(W) in any specific case or specific cases shall be determined by the consular officer, after consultation with appropriate agencies of the Government, upon petition of the importing employer. Such petition shall be made and approved before the visa is granted. The petition shall be in such form and contain such information as the Secretary of Homeland Security shall prescribe by regulation. The approval of such a petition shall not, of itself, be construed as establishing that the alien is a nonimmigrant.

(B) The following petitions shall be determined by the Secretary of Homeland Security, after consultation with appropriate agencies of the Government:`

(i) A petition for an alien lawfully present in the United States to be initially granted nonimmigrant status described in section 101(a)(15)(W).`

(ii) A petition for an alien having such status to obtain an extension of stay.`

(iii) A petition to obtain authorization for an alien having such status to change employers.'.

(c) Shifting Burden of Proof for Nonimmigrant Status- Section 214(b) of the Immigration and Nationality Act (8 U.S.C. 1184(b)) is amended by striking `(L) or (V)' and inserting `(L), (V), or (W)'.

(d) Allowing Petition for Permanent Residence While in Nonimmigrant Status- Section 214(h) of the Immigration and Nationality Act (8 U.S.C. 1184(h)) is amended by striking `(L), or (V)' and inserting `(L), (V), or (W)'.

(e) Other Admission Requirements- Section 212 of the Immigration and Nationality Act (8 U.S.C. 1182) is amended--

(1) by redesignating the second subsection (t) (added by section 1(b)(2)(B) of Public Law 108-449 (118 Stat. 3470)) as subsection (u); and

(2) by adding at the end the following:

`(v)(1)(A) For purposes of section 101(a)(15)(W) and this subsection--`

(i) the term `professional nurse' means a person who applies the art and science of professional nursing in a manner that reflects comprehension of principles derived from the physical, biological, and behavioral sciences; and`

(ii) the term `professional nursing' includes--`

(I) making clinical judgments involving the observation, care, and counsel of persons requiring nursing care;`

(II) administering of medicines and treatments prescribed by the physician or dentist; and`

(III) participation in the activities for the promotion of health and prevention of illness in others.

`(B) The qualifications referred to in section 101(a)(15)(W) are that the alien is qualified, under the laws (including such temporary or interim licensing provisions or nurse licensure compact provisions which authorize the nurse to be employed) governing the place of intended employment, to engage in the practice of professional nursing as a registered nurse immediately upon admission to the United States and is authorized under such laws to be employed, except that if the alien has completed all licensing requirements except for submission of a social security account number, the alien may provide a letter from the State Board of Nursing of the State of intended employment which confirms that the alien is eligible for license issuance upon presentation of such number.

`(2)(A) The attestation referred to in section 101(a)(15)(W) is an attestation by the employer to the following:`

(i) The employer is offering and will offer during the period of authorized employment to aliens admitted or provided status under section 101(a)(15)(W) wages that are at least--`

(I) the actual wage level paid by the employer to all other individuals with similar experience and qualifications for the specific employment in question; or`

(II) the prevailing wage level for the occupational classification in the area of employment;

whichever is greater, based on the best information available as of the time of the attestation.`

(ii) The employment of the alien will not adversely affect the wages and working conditions of registered nurses similarly employed at the worksite.`

(iii) The alien will be paid the wage rate for registered nurses similarly employed at the worksite.`

(iv) There is not a strike or lockout in the course of a labor dispute in the registered nurse classification at the worksite.`

(v) The employer has provided notice of the filing of the attestation to the bargaining representative of the registered nurses at the worksite or, if there is no such bargaining representative, notice of the filing has been provided to the registered nurses employed at the worksite through physical posting in a conspicuous location at the worksites.`

(vi) The number of workers sought, the work locations, and the wage rate and conditions under which they will be employed.

`(B) The employer shall make a copy of the attestation available for public examination, within 10 working days after the date on which the attestation is filed, at the employer's principal place of business or worksite (along with such accompanying documents as are necessary).

`(C) The Secretary of Labor shall review the attestation only for completeness and obvious inaccuracies. Unless such Secretary finds that the attestation is incomplete or obviously inaccurate, the Secretary shall provide the certification described in section 101(a)(15)(W) within 7 days of the date of the filing of the attestation.

`(D) An attestation under subparagraph (A)--

`(i) shall expire on the date that is the later of--`

(I) the end of the 3-year period beginning on the date on which it is filed; or`

(II) the end of the period of admission under section 101(a)(15)(W) of the last alien with respect to whose admission it applied (in accordance with clause (ii)); and`

(ii) shall apply to petitions described in section 214(c)(15) filed during the 3-year period beginning on the date on which it is filed if the employer states in each such petition that it continues to comply with the conditions in the attestation.

`(E) An employer may meet the requirements of this paragraph with respect to more than one professional nurse in a single attestation.`

(F) An employer may meet the requirements of this paragraph with respect to more than one work location in a single attestation.`

(3)(A) The Secretary of Labor shall compile, and make available for public examination in a timely manner, a list identifying employers that have filed attestations under paragraph (2)(A). Such list shall include, with respect to each attestation, the wage rate, number of aliens sought, and period of intended employment.

`(B) The Secretary of Labor shall establish a process for the receipt, investigation, and disposition of complaints respecting an employer's failure to meet a condition specified in an attestation submitted under paragraph (2)(A) or a misrepresentation of a material fact in an attestation. Complaints may be filed by any aggrieved person or organization (including bargaining representatives). The Secretary shall conduct an investigation under this subparagraph if there is reasonable cause to believe that an employer willfully failed to meet a condition or willfully misrepresented a material fact. No investigation or hearing shall be conducted on a complaint concerning such a failure or misrepresentation unless the complaint was filed not later than 12 months after the date of the failure or misrepresentation, respectively.`

(C) Under such process, the Secretary of Labor shall provide, within 30 days after the date such a complaint is filed, for a determination as to whether or not a basis exists to make a finding described in subparagraph (B). If the Secretary determines that such a basis exists, the Secretary shall provide for notice of such determination to the interested parties and an opportunity for a hearing on the complaint within 60 days of the date of the determination. If such a hearing is requested, the Secretary of Labor shall make a finding concerning the matter by not later than 60 days after the date of the hearing. In case of similar complaints respecting the same applicant, the Secretary of Labor may consolidate the hearings under this clause on such complaints.`

(D) If the Secretary of Labor finds, after notice and opportunity for a hearing, that an employer has willfully failed to meet a condition specified in an attestation or that there was a willful misrepresentation of material fact in the attestation, the Secretary shall notify the Secretary of State and the Secretary of Homeland Security of such finding and may, in addition, impose such other administrative remedies (including civil monetary penalties in an amount not to exceed $1,000 per nurse per violation, with the total penalty not to exceed $10,000 per violation) as the Secretary determines to be appropriate. Upon receipt of such notice, the Secretary of Homeland Security shall not approve petitions described in section 214(c)(15) by the employer during a period of at least 1 year for nurses to be employed by the employer.

`(4)(A) A nonimmigrant alien described in subparagraph (B) who was previously issued a visa or otherwise provided nonimmigrant status under section 101(a)(15)(W) is authorized to accept new employment upon the filing by the prospective employer of a petition described in section 214(c)(15)(B)(iii) on behalf of such nonimmigrant. Employment authorization shall continue for such alien until such petition is adjudicated. If such petition is denied, such authorization shall cease.

`(B) A nonimmigrant alien described in this subparagraph 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; and`

(iii) who, subsequent to such lawful admission, has not been employed without authorization in the United States before the filing of such petition.

`(5)(A) The initial period of authorized admission for a nonimmigrant under section 101(a)(15)(W) may not exceed 3 years, and may be extended, except that the total period of authorized admission as such a nonimmigrant may not exceed 6 years.

`(B)(i) Subparagraph (A) shall not apply to any nonimmigrant on whose behalf a petition under section 204(b) to accord the alien immigrant status under section 203(b), or an application for adjustment of status under section 245 to accord the alien status under section 203(b), has been filed, if 365 days or more have elapsed since the filing of such petition or application

`(ii) The Secretary of Homeland Security shall extend the stay of an alien who qualifies for an exemption under clause (i) in 1-year increments until such time as a final decision is made on the alien's lawful permanent residence.

`(iii) Notwithstanding subparagraph (A) and clause (ii), any alien who is the beneficiary of an approved petition filed under section 204(b) for a status under paragraph (1), (2), or (3) of section 203(b), and who is eligible to be granted that status but for application of the per-country limitations on immigrants under such paragraph, may apply for, and the Secretary of Homeland Security may grant, one or more extensions of nonimmigrant status under section 101(a)(15)(W) until such time as an immigrant visa is immediately available to the alien and a decision on the alien's application for adjustment of status is made.

`(6) In the case of an alien spouse, who is accompanying or following to join a principal alien admitted under section 101(a)(15)(W), the Secretary of Homeland Security shall authorize the alien spouse to engage in employment in the United States and shall provide the spouse with an `employment authorized' endorsement or other appropriate work permit.

`(7)(A)(i) The total number of aliens who may be issued visas or otherwise provided nonimmigrant status under section 101(a)(15)(W) during any fiscal year is 50,000.

`(ii) If the numerical limitation in clause (i)--

`(I) is reached during a fiscal year, the numerical limitation applicable to the subsequent fiscal year shall be 120 percent of the preceding numerical limitation; or

`(II) is not reached during a fiscal year, the numerical limitation shall remain the same during the subsequent fiscal year.

`(B) Notwithstanding subparagraph (A), aliens may be issued visas or otherwise provided nonimmigrant status under such section without regard to numerical limitation if they are only working in the geographic area or areas which are designated by the Secretary of Health and Human Services as having a shortage of health care professionals.

`(C) The numerical limitations in subparagraph (A) shall only apply to principal aliens and not to the spouse or children of such aliens.'.

SEC. 4. REGULATIONS; EFFECTIVE DATE.

(a) Regulations- Not later than 90 days after the date of the enactment of this Act, the following shall promulgate regulations to carry out the amendments made by section 3:

(1) The Secretary of Labor, in consultation with the Secretary of Health and Human Services and the Secretary of Homeland Security.

(2) The Secretary of Homeland Security, in consultation with the Secretary of State.

(b) Effective Date- Notwithstanding subsection (a), the amendments made by section 3 shall take effect 90 days after the date of the enactment of this Act, regardless of whether the regulations promulgated under subsection (a) are in effect on such date.

SEC. 5. SPECIFICATION OF CONSTITUTIONAL AUTHORITY FOR ENACTMENT OF LAW.

This Act is enacted pursuant to the power granted to Congress under article I, section 8, clause 4, to establish an uniform rule naturalization, and under article I, section 8, clause 18, of the United States Constitution.

Nurses/LNCs - Recession-Proof Jobs Good News for Filipino Nurses Going Abroad USA - Forbes:

January 2009The aging baby boomer population has increased demand for nurses. Add to that the shrinking number of people who go into the profession, and there's a real shortage. Nurses: The folks at Cisco want to hear from you. A new survey commissioned by the company shows there will be a shortage of 60,000 of these workers through 2011. Nursing (No. 3) is another profession facing a shortage--due partly to aging baby boomers and, ironically, advances in medicine. Patients who wouldn't have survived cancer or HIV 10 years ago are living longer thanks to new medical breakthroughs, but they require more long-term treatment. Also, fewer women are entering the predominantly female profession these days because of growing career opportunities elsewhere.

filipino nurses, visa information

United Kingdom Visa

- Skilled Workers To see if you qualify for the Tier 2, Skilled Worker Visa, visit the UK Government Website at. http://www.ukba.homeoffice.gov.uk/pointscalculator


How to apply if you are already in the United Kingdom

The process for applying is:

Step 1: complete a self-assessment online using our points-based calculator to find out if you are likely to score enough points.Step 2: fill in the post-study worker application form.Step 3: send it to us with your fee and supporting evidence.

We strongly advise you to send all supporting documents with your application. We will not consider any evidence sent in after we have made a decision.
If you are sending any dependant applications at the same time as your own application, we encourage you to send your application and dependant applications in the same envelope.

How to apply if you are outside the United Kingdom

The process for applying if you are outside the United Kingdom is:

Step 1: complete a self-assessment online using our points-based calculator to find out if you are likely to score enough points.Step 2: go to the visa services website, which you can find on the right of this page, to find out if you must submit any personal details in the country you are applying from and to find the application form.Step 3: take or send your form(s), fee and supporting evidence to the visa application centre. You must also arrange to give your biometrics, which are usually taken at the visa application centre.

We strongly advise you to bring all supporting documents with your application. We will not consider any evidence provided after we have made a decision.
If you are granted entry clearance as a post-study worker from outside of the United Kingdom, you will be able to live and work in the United Kingdom for a maximum period of two years. When the end of this period approaches you will not be able to extend your stay, as we expect you to switch into another category of the points-based system.

How can I extend my stay as a visitor to receive private medical treatment?

This page explains what you need to do to extend your stay as a visitor to receive private medical treatment.
You can apply to extend your stay by post or in person at one of our public enquiry offices. You should apply before the date your permission to stay ends.
You should complete application form FLR(O), which you can download from the right side of this page. You should read the guidance notes before completing the form. You will need to send the following papers with your application:

• your passport;
• a letter from a general practitioner who is a consultant for the NHS or who is on the Specialist Register of the General Medical Council, confirming that satisfactory arrangements for private medical treatment have been made, how long the treatment will last and, if your treatment has already started, how it is progressing;
  
• evidence that you have paid for your treatment; and
• evidence that you have enough money to support yourself and to pay for further treatment (such as your bank statements or savings account book).
  
  How to come to the United Kingdom as a general visitor

If you are a national of the European Economic Area (EEA) or a member of their family see the for European citizens section.

To come to the United Kingdom as a general visitor you must be able to show that you:

• only want to visit the United Kingdom for up to six months;
• plan to leave the United Kingdom at the end of your visit;
• have enough money to support and accommodate yourself without working, help from public funds or you will be supported and accommodated by relatives or friends;
• do not intend to charge members of the public for services provided or goods received;
• do not intend to study; and
• can meet the cost of the return or onward journey.
• do not intend to carry out business, sport or entertainer visitor activities;
• do not intend to marry or form a civil partnership or give notice of marriage or civil partnership;
• do not intend to receive private medical treatment during your visit , and
• are not in transit to a country outside the Common Travel Area.

If you want to do business during your visit you also have to show that you:

• normally live and work abroad and you have no plans to base yourself in the United Kingdom; and
• do not plan to work, produce goods or provide services in the United Kingdom.
  
  
  
  How long will my application take?
  Applying

We will write to you to confirm that we have received your application. We aim to process:

• 70% of applications within four weeks; and
• 90% within 14 weeks.
  

Please do not contact us to ask about progress unless you have been waiting longer than 14 weeks. If there is a problem with your application, we will contact you to let you know. If you do need to contact us, you can do so by phone or letter.
Applications to replace lost documents can take much longer to process than normal applications. This is because we need to fully investigate the loss.
We deal with applications in the order in which we receive them, unless you need a travel document because of a medical emergency or a family funeral. In this case, you will need to send us your form with evidence of this emergency, such as a recent medical report, doctor's report or death certificate. You can fax this evidence to us on 020 8760 3385.
If you do not send us evidence of an emergency or we decide that it is not appropriate to give you priority for the reasons you give, your application will remain in the queue to be dealt with according to the date on which we received it.
You must not make any arrangements to travel until you have received your travel document.

US Visa Info for Filipino Nurses

The H-1B, is not generally applicable for employment of professional nurses because the H-1B program requires that a nurse on an H-1B have a bachelor's degree and the job that the nurse is hired to perform requires a bachelor's degree.

However, there are other options for individuals seeking employment as nurses.
Q: What are some visa options for foreign nurses?

Discussion:

H-1B:
“The H-1B program allows an employer to temporarily employ a foreign worker in the U.S. on a nonimmigrant basis in a specialty occupation or as a fashion model of distinguished merit and ability. A specialty occupation requires the theoretical and practical application of a body of specialized knowledge and a bachelor's degree or the equivalent in the specific specialty (e.g., sciences, medicine and health care, education, biotechnology, and business specialties, etc…). Current laws limit the number of foreign workers who may be issued a visa or otherwise be provided H-1B status to 65,000.” - U.S. Department of Labor .

The H-1B, is not generally applicable for employment of professional nurses because the H-1B program requires that a nurse on an H-1B have a bachelor's degree and the job that the nurse is hired to perform requires a bachelor's degree.

Thus, regardless of whether the nurse actually holds a Bachelor of Science in Nursing or equivalent foreign degree, because the occupation of "nurse" does not generally require a bachelor’s degree for entry into the profession, except in the state of North Dakota. Therefore, the only categories of nursing professionals who are able to obtain H-1B status are those whose positions require at least a bachelor’s degree, such as (1) nurse practitioners; (2) nurse anesthetists, and; (3) nursing professors.

H-1C:
The Nursing Relief for Disadvantaged Areas Act of 1999 and its reauthorization in December of 2006 allows qualifying hospitals (acute care facilities in medically underserved areas) to employ temporary foreign workers (nonimmigrants) as Registered Nurses (RNs) for up to three years under H-1C visas. Only 500 H-1C visas can be issued each year during the three year period of the H-1C program (2006-2009 - Expired April 2009).

Other Options For Nurses:

F-1:
The first option is to bring foreign nurses to the United States for an academic program, such as a BSN program, using the student visa (F-1). Generally, students can work part time while "on campus," and can be authorized for "practical training" at other locations during the course of their studies.
Additionally, foreign nurses may seek a BSN program to improve their credentials and take H-1B jobs that require bachelor’s degrees in nursing. Further, for licensing and immigration purposes, many foreign nurses will require some extra coursework not normally part of their country of origin’s nursing education, in order to obtain the equivalent of a U.S. nursing degree.

J-1:
The second option is to use the J-1 trainee visa, which allows entry for up to 18 months in order to receive training in a specific area. Such trainee programs are administered by outside program sponsors that approve training programs and issue visa documentation for nurses. The trainee category of J-1 visas will generally require establishing a training program of some sort (a combination of coursework at a local nursing school, hospital rotations and seminars) and limit “productive” work to that which is necessarily required for the training program.

H-2B:
The third option is the H-2B category, which is for temporary workers in occupations that do not require a bachelor’s degree for entry into the occupation. The problem with this category is that, unlike the H-1B where the position being filled by the foreign worker may be permanent, the H-2B is only for workers coming to fill a "one-time," "intermittent," "peak-load" or "seasonal" need. Assuming an employer wishes to use immigrant nurses to fill only a temporary need (generally, lasting less than 10 months), this category may be an excellent option.

How Do I Apply for Health Care Worker Certification?

What is a Health Care Worker Certification?

A health care worker certification identifies and documents that a foreign health care worker has met minimum requirements for training, licensure, and English proficiency in order to be able to fulfill their professional role as a(n):

· Licensed practical nurse, licensed vocational nurse, or registered nurse
· Occupational therapist
· Physical therapist
· Speech language pathologist and audiologist
· Medical technologist (clinical laboratory scientist)
· Physician assistant
· Medical technician (clinical laboratory technician)

Who Must Obtain a Health Care Worker Certification?

Any non-U.S. citizen coming to the United States for employment as a health care worker (other than a physician) cannot be admitted unless he or she presents a certificate from either the Commission on Graduates of Foreign Nursing Schools (CGFNS) or a certificate of equal standing from an organization with equivalent credentials. These requirements apply to both immigrant and nonimmigrant applicants. Regarding visa classification, nonimmigrant health care workers will most likely be in H-1C, H-1B, J, O, or TN non-immigrant categories. Any non-immigrants coming to receive training in a health care occupation will not be required to obtain certification. Such health care workers will most likely be in F-1, J-1 (aliens coming to undertake a training program in a medical field) and H-3 nonimmigrant classifications. Please note that each of these visa classifications has additional requirements. Please go to our Nonimmigrant Visa or our Immigrant Visa Classification pages for more information on visa categories.

Are Nonimmigrants Subject to the Health Care Worker Certification Requirements?
Yes, as of July 26, 2004, if a nonimmigrant is seeking to be admitted to the United States, is changing status, and/or is requesting an extension of stay, he or she must provide evidence of health care worker certification if the primary purpose for coming to or remaining in the United States is employment in one of the affected health care occupations. Previously, under section 212(d)(3) of the Act, the CIS and the Department of State waived Health Care Worker certification requirements for nonimmigrants, while requiring it for immigrants. After careful consideration of the statute and legislative history, it has been determined that nonimmigrants are also subject to the certification requirements.

Which Organizations Are Currently Authorized to Issue Health Care Worker Certificates?

The following organizations are authorized to issue certificates for the following health care occupations:
· The Commission on Graduates of Foreign Nursing Schools (CGFNS) is authorized to issue certificates to all 7 health care occupations.
· The National Board for Certification in Occupational Therapy is authorized to issue certificates for occupational therapists.
· The Foreign Credentialing Commission on Physical Therapy is authorized to issue certificates for physical therapists.


Which English Language Testing Organizations Are Approved for Purposes of Health Care Worker Certification?

Every alien must meet certain English language requirements in order to obtain a certificate unless otherwise exempted. The following testing services had been approved:
1. Educational Testing Service (ETS)
2. Test of English in International Communication (TOEIC)
3. International English Language Testing System (IELTS)

What are the Acceptable English Language Test Scores for Health Care Worker Certification?

The statute gives the Secretary of Health and Human Services the sole discretion to determine the minimum scores required for a Health Care Worker Certification.
· Occupational and physical therapists. An alien seeking to perform labor in the United States as an occupational or physical therapist must obtain the following scores on the English tests:ETS: Test Of English as a Foreign Language (TOEFL): Paper-Based 560, Computer-Based 220; Test of Written English (TWE): 4.5; Test of Spoken English (TSE): 50.Important: The certifying organizations shall not accept the results of the TOEIC, or the IELTS for the occupations of occupational therapy or physical therapy.
· Registered nurses and other health care workers requiring the attainment of a baccalaureate degree. An alien coming to the United States to perform labor as a registered nurse (other than a nurse presenting a certified statement under section 212(r) of the Act) or to perform labor in another health care occupation requiring a baccalaureate degree (other than occupational or physical therapy) must obtain one of the following combinations of scores to obtain a certificate:ETS: TOEFL: Paper-Based 540, Computer-Based 207; TWE: 4.0; TSE: 50;TOEIC Service International: TOEIC: 725; plus TWE: 4.0 and TSE: 50; orIELTS: 6.5 overall with a spoken band score of 7.0. This would require the Academic module.
· Occupations requiring less than a baccalaureate degree. An alien coming to the United States to perform labor in a health care occupation that does not require a baccalaureate degree must obtain one of the following combinations of scores to obtain a certificate:ETS: TOEFL: Paper-Based 530, Computer-Based 197; TWE: 4.0; TSE: 50;TOEIC Service International: TOEIC: 700; plus TWE 4.0 and TSE: 50; orIELTS: 6.0 overall with a spoken band score of 7.0. This would allow either the Academic or the General module.

Questions and Answers about Exemptions for Certain Health Care Workers
Q: Are foreign health care workers - trained in the United States or in possession of a valid state license - subject to the health care certification requirement?

A: Yes. While Congress provided certain nurses with a less rigorous, alternative certification process, it did not provide a less rigorous alternative certification option to state-licensed foreign health care workers. Possession of a state license does not exempt a foreign health care worker from compliance with the certification requirement. Similarly, health care workers who have been trained in the United States are not exempt from the certification requirement.

Q: Are there any accommodations for foreign health care workers who have been trained in the United States?

A: Yes. Foreign health care workers may be automatically deemed to have met the English language and/or educational comparability requirements if they have graduated from certain programs or from programs in certain countries. The following groups may be deemed to have met the English language requirements:

· Graduates of health professional programs in Australia, Canada (except Quebec), Ireland, New Zealand, the United Kingdom, and the United States.
· Alien nurses who are presenting the alternate certified statement under section 212(r) of the Act.
· For nurses, graduation from an entry-level program accredited by the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE);
· For occupational therapists, graduation from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA);
· For physical therapists, graduation from a program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) of the American Physical Therapy Association (APTA); and
· For speech language pathologists and audiologists, graduation from a program accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology (CAA) of the American Speech-Language-Hearing Association (ASHA).
The following groups may be deemed to have met the educational comparability requirements:
· For nurses, graduation from an entry-level program accredited by the National League for Nursing Accreditation Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE);
· For occupational therapists, graduation from a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA);
· For physical therapists, graduation from a program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) of the American Physical Therapy Association (APTA); and
· For speech language pathologists and audiologists, graduation from a program accredited by the Council on Academic Accreditation in Audiology and Speech Language Pathology (CAA) of the American Speech-Language-Hearing Association (ASHA).

Q: Are dependents subject to the health care worker certification requirement?

A: No. For example, if you are here as an L-2 nonimmigrant, your primary purpose for entering the United States is to join your spouse. Since an L-2 nonimmigrant spouse is authorized employment, you may engage in employment as a health care worker without obtaining the certification. This will also apply to other dependents who are accompanying a principal alien and who are employment authorized within their dependent status.

Issuing Health Care Worker Certificates
How does an organization apply for authorization to issue health care worker certificates? As of September 23, 2003, organizations must apply for authorization to issue health care worker certificates by filing CIS Form I-905 (Application for Authorization to issue Health Care Worker Certificates). Form I-905 is available online and at your local Field Office.

What kind of information does an organization need to provide to the CIS in order to obtain authorization to issue the certificates? The instructions to the Form I-905 list the kind of information that must be provided in support of the Form I-905. That information is also contained at 8 CFR 212.15(k). In general, the organization must demonstrate that it meets four guiding principles:
1. The organization is independent and free of material conflicts of interest regarding whether an alien receives a visa;
2. The organization has an ability to evaluate both the foreign credentials appropriate for the profession, and the results of examinations for proficiency in the English language appropriate for the health care field in which the alien will be engaged;
3. The organization can maintain comprehensive and current information on foreign educational institutions, ministries of health, and foreign health care licensing jurisdictions; and
4. If the health care field is one for which a majority of the states require a predictor examination (currently, this is done only for nursing), the organization should demonstrate an ability to conduct the examination outside the United States.

How long may an organization be authorized to issue health care worker certificates?
Authorization to issue health care worker certificates will be good for a period of 5 years from the date of approval. An organization must renew its authorization to issue certificates by filing a new application, with fee, for Form I-905.

Can an organization appeal?
If your petition is denied, the denial letter will tell you how to appeal. Generally, you may file a Notice of Appeal along with the required fee with the office that issued the denial letter within 33 days of receiving the denial. Once the fee is collected and the form is processed, the appeal will be referred to the Administrative Appeals Office (AAO) in Washington, D.C. Sending the appeal directly to the AAO will delay the process and may result in an untimely filing of the appeal. For more information, see How Do I Appeal?. Please see CIS offices for more information..

Where Can an Employer File a Petition?
An employer who is seeking authorization to employ a health care worker should file Form I-129, Petition for Nonimmigrant Worker, or Form I-140, Petition for Immigrant Worker, with the USCIS service center that serves the area where they are located. Please see our USCIS field office home page for more information on USCIS office locations. Forms and USCIS' guide to nonimmigrant and immigrant worker petitions are available by calling 1-800-870-3676, or by submitting a request through our forms by mail system.

How Does an Employer Find out the Status of a Petition?
If you are the petitioning employer, contact the USCIS Service Center that received your Form I-129 or Form I-140. You should be prepared to provide the USCIS staff with specific information about the petition. Please see finding the status of your application for additional information.

Where Can I Find the Law?
The complete requirements for health care worker certification can be found in the Immigration and Nationality Act (Act) at section 212 (a)(5)(C). The alternative requirements for nurses are at section 212 (r) of the Act. The specific eligibility requirements and procedures for applying for health care worker certification are included in the Code of Federal Regulations [CFR] at 8 CFR §212.15.

Who May Apply to Change to a New Nonimmigrant Status?

In general, you may apply to change your nonimmigrant status if you were lawfully admitted into the United States with a nonimmigrant visa, your nonimmigrant status remains valid, and you have not committed any crimes that would make you ineligible.

You may not apply to change your nonimmigrant status if you were admitted to the United States in the following visa categories:

(VWPP) - Visa Waiver Pilot Program (or the Guam Visa Waiver Program)

D - As a crewman

C - As an alien in transit or in transit without a visa

K - As a fiancé(e) or spouse of a U.S. citizen or dependent of a fiancé(e) or spouse

S - As an informant (and accompanying family) on terrorism or organized crime

If you are an international exchange visitor (J visa category) you may not change your nonimmigrant status if you were admitted to the United States to receive graduate medical training, unless you receive a special waiver. In addition, some exchange visitors must meet a foreign residence requirement before they are allowed to change status. This means that some international exchange visitors must leave the United States and go back to their home country for a minimum of two years before applying to come to the United States as a temporary worker or an immigrant. If you are an exchange visitor and are required to meet the foreign residence requirement, you must receive a waiver if you wish to change your nonimmigrant status without returning home. If you do not receive a waiver, then you may only apply to change to the A (Diplomatic and other government officials, and their families and employees) or G (Representatives to international organizations and their families and employees) nonimmigrant categories. For more information on international exchange visitors, please see How Do I Waive the Foreign Residence Requirement if I am an Exchange Visitor? . In addition, please see the Department of State, Bureau of Consular Affairs and the Department of State Websites. The applicable laws can be found at 8 CFR 214.2 and 212.7.

If you are a vocational student (M visa category), you may not apply to become an academic student (F visa category). You also may not apply to change from the vocational student visa category to a temporary worker visa category (H) if it was the training you received as a vocational student in the United States that made you qualified for the temporary worker position.
You do not need to apply to change your nonimmigrant status if you were admitted into the United States for business reasons (B-1 visa category), and you wish to remain in the United States for pleasure before your authorized stay expires.

If you are in the United States as the spouse or child of someone in the following nonimmigrant visa categories, you do not need to apply to change your status if you wish to attend school in the United States (as long as your parent or spouse maintains their original nonimmigrant status).

A - Diplomatic and other government officials, and their families and employees.

E - International Trade and Investors

G - Representatives to international organizations and their families and employees.

H - Temporary Workers

I - Representatives of foreign media and their families

J - Exchange Visitors and their families

L - Intracompany Transferees

If you are in the United States as the spouse or child of someone in the F (Academic Student) or M (Vocational Student) visa category, you do not need to apply to change your status if you wish to attend elementary, middle, or high school in the United States. If you wish to attend post-secondary school full-time, you must apply for change of status.

Temporary Benefits Employment Categories and Required Documentation
Employers may use the I-129, Petition for Nonimmigrant Worker, for the following types of workers. Click on the employment category below to find further information, and to find out what documentation must be filed with the petition.

H-1B Specialty Workers and Fashion Models P-1 Athlete, Entertainment Groups

H-1C Registered Nurses P-2 Artistic Exchange

H-2 Temporary Labor P-3 Culturally Unique Artists

H-3 Alien Trainees Q-1 International Cultural Exchange Program

L-1 Intracompany Transferee O-1 Aliens with Extraordinary Ability
The following categories do not require an I-129 petition if the worker is currently outside of the United States. Aliens in the following classifications use this form only to apply for a change of status, extension of stay, or change of employment.

E Treaty Trader or Investor TN Canadian Citizens under NAFTA

The I-129 form is currently being updated to reflect the categories listed above. Thus, the form in its present state may not have a check box corresponding to the desired category. In this case, please write in the desired category.

Treaty Traders and Investors (E’s)

The E categories are designated for aliens engaged in international trade or investment between the United States (U.S.) and the aliens’ countries of nationality, provided the U.S. has an appropriate treaty relationship with the foreign country.
A treaty country is a foreign state with which a qualifying Treaty of Friendship, Commerce, or Navigation or its equivalent exists with the U.S. A Treaty Country includes a foreign state that is accorded treaty visa privileges under section 101(a)(15)(E) of the INA by specific legislation. A listing of countries with whom the U.S. currently has treaties can be downloaded from the State Department’s Foreign Affairs Manual (select 9 FAM 41.51 Exhibit 1 to obtain the correct list).

Note: There is no petitioning process for the E categories. E-nonimmigrant classification is granted through an application process. If outside of the U.S., the alien may apply for an E-1 visa on his or her own behalf directly to a U.S. consular office abroad. If the alien is inside the U.S., the Form I-129 and E supplement is used to apply for a change of status, extension of stay, or change of employment. Applications for E-1 or E-2 status may be filed only at the Texas or California Service Centers. However, if an alien currently in E-1 or E-2 status is requesting a change of status to another nonimmigrant classification, the application for change of status must be mailed to one of the USCIS Service Center with jurisdiction over the new requested classification.

For the alien to visit the U.S. temporarily for trading or investing purposes, the requirements outlined at 8CFR 214.2(e) must be met. Potential applicants are also encouraged to consult Department of State regulations at 22CFR 41.51. A brief summary of the requirements for E-1’s and E-2’s follows.

Dependents (spouses and unmarried children under 21 years of age) of an E-1 or E-2 nonimmigrant will be admitted under same classification as the principal. The dependent spouse and child(ren) are not required to have the same nationality as the principal alien.

Effective January 16, 2002, spouses of E-1 treaty traders or E-2 treaty investors who have been admitted to the United States under sections 101(a)(15)(E) of the Act are authorized employment without restrictions. Further, an unmarried dependent son or daughter of an E nonimmigrant employee of the Taiwan Economic Cultural Representative Office (TECRO) is authorized employment without restriction. In order to obtain work authorization, the E nonimmigrant spouse must submit:

· Form I-765, Application for Employment Authorization, to the Service Center with jurisdiction over the dependent spouse’s place of residence (concurrently filed applications with Form I-129 petitions for the principals may only be filed at the appropriate service center);
· a filing fee of $340;
· evidence of the E nonimmigrant principal’s current status;
· the dependent spouse’s and the principal’s Form I-94 Arrival-Departure Records as evidence of admission or change of status; and
· a copy of the Form I-797 approval notice for the E nonimmigrant principal’s petition, if available.

E-1 Treaty Trader
The E-1 classification is authorized for a national of a country with which the United States has a commercial treaty, who is coming to the U.S. solely to engage in trade of a substantial nature principally between the United States and the alien’s country of nationality. The trade involved must be international exchange (successfully negotiated contracts binding on all parties) of items of trade between the U.S. and a treaty country. Title to the trade item must pass from one treaty party to the other.
If the alien is inside the U.S., the I-129 is used to apply for a change of status, extension of stay, or change of employment. This classification does not require a petition for employment if the alien is outside of the U.S. If outside of the U.S., the alien applies for an E-1 visa on his or her own behalf directly to a U.S. consular office abroad.

Application Document Requirements

The application must be filed with the appropriate fee payment, and evidence that:
· The applicant is a national of a country with which the U.S. has the requisite treaty or agreement;
· The activity constitutes trade as defined at 8 CFR 214.2(e)(9);
· The trade is of a substantial nature (i.e. an amount of trade sufficient to ensure a continuous flow of international trade items between the U.S. and the treaty country);
· The trade conducted by the alien is principally trade between the United States and the treaty country of which the alien is a national. Trade is deemed to be principally between the U.S. and treaty country when over 50% of the volume of international trade conducted by the treaty trader is between the U.S. and treaty country of the treaty trader’s nationality;
· If the applicant is not the principal trader, he or she must be employed in an executive or supervisory capacity, or possess special qualifications that make the applicant’s services essential to the successful and efficient operation of the enterprise.

Ordinary skilled or unskilled workers do not qualify. The applicant intends to depart the U.S. upon the expiration of E-1 status. (However, an application for initial admission, change of status, or extension of stay in E classification may not be denied solely on the basis of an approved request for permanent labor certification or a filed or approved immigrant visa preference petition.)

The employee has the same nationality as the principal alien employer.

The alien principal employer is an enterprise or organization at least 50% owned by persons having the nationality of the treaty country.

E-2 Treaty Investor

The E-2 classification is authorized for a national of a country with which the United States has a commercial treaty, who is coming to the United States solely to direct and develop the operations of an enterprise in which he or she has invested, or is actively involved in the process of investing, a substantial amount of capital.
If the alien is inside the U.S., the I-129 should be used to apply for a change of status, extension of stay, or change of employment. This category does not require a petition for employment if the alien is outside of the U.S. In that case, the alien applies for this category on his or her own behalf directly to a U.S. consular office abroad.
The investment involved must place lawfully acquired, owned, and controlled capital at commercial risk with a profit objective, and be subject to loss if the investment fails.

Application Document Requirements

The application must be filed with the appropriate fee payment, and evidence that:
The investor is a national of a country with whom the U.S. has the requisite treaty or agreement;

The alien (or in the case of an employee of a treaty investor who seeks classification as an E-2, the owner of the treaty enterprise) will direct or develop the enterprise. The alien must demonstrate that he controls the enterprise by showing ownership of at least 50% of the enterprise, by possessing operational control through a managerial position or other corporate device or by other means;

The investor has invested in or is actively in the process of investing in the enterprise; The investment is substantial, i.e. sufficient to ensure the investor’s financial commitment to the successful operation of the enterprise and big enough to support the likelihood that the investor will successfully direct and develop the enterprise; The investment enterprise is not a marginal enterprise;If the applicant is not the principal investor, he or she must be employed in an executive or supervisory capacity, or possess skills that are highly specialized and essential to the operations of the commercial enterprise. Ordinary skilled or unskilled workers do not qualify. That the applicant intends to depart the U.S. upon the expiration of E-2 status.

Specialty Workers (H-1B)

The H-1B categories apply to aliens coming temporarily to perform services in a specialty occupation, or as a fashion model of distinguished merit and ability. The FY2001, 2002, and 2003 cap on H1-B admissions is 65,000 workers.

Labor Condition Application

The first step to hiring most H-1B workers from outside the U.S. is for the employer to file a labor condition application (LCA) with the Department of Labor (DOL). Then the employer is required to file the LCA approval notice with the I-129 petition. For specific procedures on filing, please visit the Department of Labor’s Employment and Training Administration.

Some terms and conditions of the H-1B classification:
Work authorization for H-1B foreign specialty workers is employer-specific (i.e. limited to employment with the approved employer/petitioner).

A change of employer requires a new H-1B petition; under some circumstances, a nonimmigrant who was previously issued an H1-B visa or provided H1-B nonimmigrant status may begin working for a new H1-B employer as soon as the new employer files a “nonfrivolous” H1-B petition for the nonimmigrant. For more information, please go to our Changes to the HB Program page.

Multiple employers require multiple H-1B petitions.

The employer is responsible for return transportation costs for an employee terminated prior to the end of the approved period of employment.

H-1B foreign specialty workers are not required to maintain foreign residence and may seek permanent residence in the U.S.

Dependents

Dependents (spouses and unmarried children under 21 years of age) of H-1B workers are entitled to H-4 status with the same restrictions as the principal. Dependents may not be employed under the H-4 classification.

Including more than one worker in a petition

Each petition may only include one worker.

H-1B1 Specialty Occupations

The H-1B1 category applies to an alien coming temporarily to perform services in a specialty occupation which requires the theoretical and practical application of highly specialized knowledge requiring completion of a specific course of higher education.
Document Requirements for H-1B Classification PetitionThe petition (Form I-129) should be filed by the U.S. employer with:

A certified labor condition application from the Department of Labor;

Copies of evidence that the proposed employment qualifies as a specialty occupation; Evidence the alien has the required degree by submitting either:

A copy of the person's U.S. baccalaureate or higher degree which is required by the specialty occupation;

A copy of a foreign degree determined to be equivalent to the U.S. degree; or

Copies of evidence of education and experience which is equivalent to the required U.S. degree;

A copy of any required license or other official permission to practice the occupation in the state of intended employment; and

A copy of any written contract between the employer and the alien or a summary of the terms of the oral agreement under which the alien will be employed.

H-1B2 Research and Development Project

The H-1B2 category applies to an alien coming temporarily to perform services of an exceptional nature relating to a cooperative research and development project administered by the Department of Defense.

Petition Document Requirements

The petition (Form I-129) must be filed by the U.S. employer and must be filed with:
A description of the proposed employment and evidence the services and project meet the above conditions; and

A statement listing the names of all aliens who are not permanent residents who have been employed on the project within the past year, along with their dates of employment. Note: this category does not require an LCA.

H-1B3 Fashion Model

The H-1B3 category applies to a fashion model who is nationally or internationally recognized for achievements, to be employed in a position requiring someone of distinguished merit and ability.

Petition Document Requirements

The petition (Form I-129) should be filed by the U.S. employer with:
A certified labor condition application from the Department of Labor;

Copies of evidence establishing that the alien is nationally or internationally recognized in the field of fashion modeling. The evidence must include at least two of the following types of documentation which show that the person:

Has achieved national or international recognition in his or her field as evidenced by major newspaper, trade journals, magazines or other published material;

Has performed and will perform services as fashion model for employers with a distinguished reputation;

Has received recognition for significant achievements from organizations, critics, fashion houses, modeling agencies or other recognized experts in the field; and

Commands a high salary or other substantial remuneration for services, as shown by contracts or other reliable evidence.

Copies of evidence establishing that the services to be performed require a fashion model of distinguished merit and ability and either:

Involve an event or production which has a distinguished reputation; or

The services are as participant for an organization or establishment that has a distinguished reputation or record of employing persons of distinguished merit and ability.

Registered Nurses (H-1C’s)
The H-1C category applies to an alien coming temporarily to perform services as a registered nurse in a health professional shortage area as determined by the United States Department of Labor. Only 500 nurses can be granted H-1C status in a fiscal year nationally. There are also numerical limitations for each state based on the state’s population. The cap for states with populations in excess of 9 million is 50 per fiscal year. The cap on states with populations of 9 million or less is 25 per fiscal year.

How to petition for an H-1C nurse

An H-1C petition can only be filed by a United States employer hospital (facility) that has filed an attestation on Form ETA 9081, Attestation for H-1C Nonimmigrant Nurses, with the United States Department of Labor. For information on how to file an attestation with the Department of Labor, please visit the Department of Labor’s Employment and Training Administration. Petitions for an H-1C nurse must be filed on form I-129, Petition for Nonimmigrant Worker, at the Vermont Service Center.

Supporting documentation to be filed with an H-1C petition

The petition (Form I-129) should be filed by the facility with:
A current copy of the Department Labor’s acceptance of the filing of an attestation on Form ETA 9081;

A statement from the facility describing any limitation which the laws of the state or jurisdiction of intended employment place on the alien’s services;

Evidence that the alien(s) named on the petition is a person who is or will be authorized by a State Board of Nursing to engage in registered nurse practice in a state or U.S. territory or possession, and who is or will be practicing at a facility which provides health care services;Evidence that the alien(s) named on the petition has passed the examination given by the Commission on Graduates of Foreign Nursing Schools (CGFNS), or has obtained a full and unrestricted (permanent) license to practice as a registered nurse in the state of intended employment or has obtained a full and unrestricted (permanent) license in any state or territory of the United States and received temporary authorization to practice as a registered nurse in the state of intended employment;

Evidence that the alien(s) has obtained a full and unrestricted license to practice professional nursing in the country where the alien obtained nursing education or has received nursing education in the United States; and

Evidence that the alien(s) named on the petition is fully qualified and eligible under the laws (including such temporary or interim licensing requirements which authorize the nurse to be employed) governing the place of intended employment to practice as a registered nurse immediately upon admission to the United States, and is authorized under such laws to be employed by the employer.

Some terms and conditions of the H-1C classification:
Work authorization for H-1C nurses is employer-specific, i.e. limited to employment with the approved employer/petitioner.

A change of employer requires a new H-1C petition; new employment (any employment other than the originally approved employment) cannot begin until a petition for change of employment (Form I-129) is approved by the INS. If an H-1C nonimmigrant nurse will work for more than one employer, each employer must file its own H-1C petition on the alien’s behalf.

An H-1C alien is not precluded from applying for adjustment of status to permanent residence if the alien is otherwise eligible for adjustment of status.

More than one nurse may be included on an H-1C petition.

Dependents

Dependents (spouses and unmarried children under 21 years of age) of H-1C workers are entitled to H-4 status with the same restrictions as the principal. Dependents may not be employed under the H-4 classification.

Period of Admission

The maximum period of admission for an H-1C alien is three years. An alien may receive an extension of stay to complete the 3-year period of admission. However, an extension of stay may not be granted to extend the alien’s period of admission beyond the initial 3-year period of time.

Temporary Alien Labor to Meet Temporary Needs (H-2’s)

U.S. employers may petition for skilled or unskilled alien workers to meet temporary or seasonal needs in positions for which qualified U.S. workers are not available. It is important to note that the employer’s need for such services must be temporary. There is currently an annual cap of 66,000 visas for H-2B workers. There is currently no annual cap on visas for H-2A workers.

Labor Certification

The first step to hiring an H-2 worker from outside the U.S. is for the employer to apply for a temporary labor certification with the Department of Labor. These certificates are designed to ensure that the admission of aliens to work in this country on a temporary basis will not adversely affect the job opportunities, wages, or working conditions of U.S. workers. The employer is required to file the labor certification with the I-129 petition. For specific procedures on filing, please visit the Department of Labor’s Employment and Training Administration.

Dependents

Dependents (spouses and unmarried children under 21 years of age) of H-2 workers are entitled to H-4 status with the same restrictions as the principal. Dependents may not be employed under the H-4 classification.

Including more than one alien in a petition

A single petition may cover multiple workers if:

they will perform the same services

they will work in the same location

they are included on the same labor certification and,

they come from places that are served by the same U.S. consulate, or, if visa exempt, they will enter at the same port of entry.

It is not necessary to identify requested H-2A beneficiaries by name (unless only a single worker is needed) if they are unnamed on the underlying labor certification. H-2B beneficiaries must be named unless circumstances (e.g. emergencies) make identification by name impossible. The number of unnamed beneficiaries must always be stated on the petition.

H-2A Agricultural worker

The H-2A classification applies to an alien coming temporarily to engage in temporary or seasonal agricultural employment.


Petition Document Requirements

Before filing this petition an employer must first apply for a labor certification from the Department of Labor to demonstrate that U.S. workers are not available and that the wages and working conditions meet regional standards. The petition (Form I-129) must be filed by a U.S. employer or an association of U.S. agricultural producers named as a joint employer on the certification. It should be filed with:
An original valid temporary agricultural labor certification from the Department of Labor. If the application is denied because it is determined that U.S. workers are available but they do not subsequently appear at the work site, the petition should be filed with a copy of that agency's denial or a certification and appeal, and evidence that qualified domestic labor is unavailable; and

Copies of evidence that each named alien met the requirements as stated when applying for the labor certification.

H-2B Skilled or Unskilled Worker

The H-2B classification applies to an alien coming temporarily to engage in non-agricultural employment which is seasonal, intermittent, a peak load need, or a one-time occurrence.

Petition Document Requirements

Before filing this petition the U.S. employer must first apply for a temporarylabor certification from the Department of Labor to demonstrate that U.S. workers are not available and that wages and working conditions meet regional standards. The U.S. employer should file the Form I-129 petition with:
Either an original single valid temporary labor certification from the Department of Labor (or the Governor of Guam if the proposed employment is solely in Guam), indicating that qualified U.S. workers are not available and that employment of the alien will not adversely affect the wages and working conditions of similarly employed U.S. workers; or

An original notice from such authority stating that such certification cannot be made, along with evidence of the unavailability of U.S. workers and of the prevailing wage rate for the occupation in the U.S, and evidence overcoming each reason why the certification was not granted; and

Copies of evidence, such as employment letters and training certificates, demonstrating that each named alien meets the minimum job requirements stated in the certification.

Alien Trainees (H-3)

The H-3 classification applies to aliens (beneficiaries) coming temporarily to the U.S. to participate in a training program. There are general H-3’s, and those coming for special education training. There is currently no annual cap on H-3 admissions to the U.S. The petitioning employer or sponsors must demonstrate that the:
Proposed training is not available in the beneficiary’s home country.

Beneficiary will not be placed in a position which is in the normal operation of the business, and in which citizens and resident alien workers are regularly employed .

Beneficiary will not be productively employed except as incidental to training Training will benefit beneficiary in pursuing a career outside the U.S.

Note: H-3 status is not appropriate for graduate education, including medical training, except under special circumstances. Petitioning employers may not use H-3 classification for training programs primarily designed to benefit the U.S. companies and/or where U.S. workers would be employed but for the trainees’ services.


Dependents

Dependents (spouses and unmarried children under 21 years of age) of H-3 principal trainees are entitled to H-4 status with the same restrictions as the principal. Dependents may not be employed under the H-4 status.

Including more than one alien in a petition

Aliens who will apply for their visas at the same consulate or, if they do not need visas, will enter at the same port of entry may be included in one petition if
the dates of training are the same, and

they will perform the same duties.

H-3 Training

The H-3 category applies to an alien coming temporarily to receive training from an employer in any field other than graduate education or training.

Petition Document Requirements

The petition should be filed by the U.S. employer with:
A detailed description of the training program, including the number of classroom hours per week and the number of hours of on-the-job training per week;

A summary of the prior training and experience of each alien in the petition; and An explanation of why the training is required, whether similar training is available in the alien's country, how the training will benefit the alien in pursuing a career abroad, what benefits the employer will derive from the training, and why the employer will incur the cost of providing the training without significant productive labor from the trainee(s).

H-3 Special education training program

The H-3 classification also applies to an alien coming temporarily to participate in a special education training program in the education of children with physical, mental, or emotional disabilities.

Petition Document Requirements

The petition (Form I-129) must be filed by the U.S. employer who has a professional staff and a structured program for providing education to children with disabilities. The petition must be filed with:
A description of the training, staff and facilities, evidence the program meets the above conditions and details of the alien's participation in the program; and Copies of evidence the alien is nearing completion of a baccalaureate degree or higher in special education, or already holds such a degree or has extensive prior training and experience in teaching children with physical, mental, or emotional disabilities.

Intracompany Transferees (L-1’s)

The L-1 category applies to aliens who work for a company with a parent, subsidiary, branch, or affiliate in the U.S. These workers come to the U.S. as intracompany transferees who are coming temporarily to perform services either in a managerial or executive capacity (L-1A) or which entail specialized knowledge (L-1B)for a parent, branch, subsidiary or affiliate of the same employer that employed the professional abroad. The employee must have been employed abroad for the corporation, firm, or other legal entity (or an affiliate or subsidiary thereof) on a full-time basis for at least one continuous year out of the last three-year period to qualify. There is currently no annual cap on L-1 visas.

Note 1: Public Law 107-125 allowed aliens to qualify for L visas after having worked for 6 months overseas for employers if the employers had filed a blanket L petition and had met the blanket petitions' requirements.
The L-1 Visa Reform Act eliminates the 6 month exception that Public Law 107-125 implemented. All L-1 beneficiaries are now required to have been employed abroad for a 12-month period regardless of whether the beneficiary is obtaining L classification based on a blanket or as an individual. This provision applies only to initial L petitions filed after June 6, 2005. The 6 month rule should continue to be applied to cases involving extensions or changes of job duties within the L classification filed after the effective date, but in which the original status was obtained through a blanket process prior to the effective date based on the then existing eligibility requirements.
Note 2: The employer is not required to obtain a labor certification prior to petitioning in this category. Compensation level is not prescribed, but U.S. income must be sufficient to prevent the alien from becoming a public charge.

Dependents

Dependents (i.e. spouses and unmarried children under 21 years of age) of L-1 workers are entitled to L-2 status with the same restrictions as the principal. Dependents may be students in the U.S. while remaining in L-2 status. If it can be established that the spouse is accompanying or following to join the principal alien, the spouse may obtain an employment authorization under the L-2 classification. Minor children may not be employed under the L-2 classification.

Petition Document Requirements

A U.S. employer or foreign employer may file the I-129 petition, but a foreign employer must have a legal business in the U.S. The petition must be filed with:
Evidence of the qualifying relationship between the U.S. and the foreign employer which address ownership and control, such as an annual report, copies of articles of incorporation, financial statements, or stock certificates;

A letter from the alien's foreign qualifying employer detailing his or her dates of employment, job duties, qualifications and salary and demonstrating that the alien worked for the employer abroad for at least one continuous year within the three-year period before the filing of the petition in an executive or managerial capacity or in a position involving specialized knowledge; and

A detailed description of the proposed job duties and qualifications and evidence the proposed employment is in an executive or managerial capacity or in a position involving specialized knowledge.
If the alien is coming to the U.S. as a manager or executive (L-1A) to open or to be employed in a new office, also file the petition with evidence that:

Sufficient premises to house the new office have been secured;

The beneficiary has, or upon establishment will have, the qualifying relationship to the foreign employer and the qualifying position; and

The intended U.S. operation will be able to support the executive or managerial position within one year of the approval of the petition. This must be supported by information regarding: the proposed nature of the U.S. office (size and scope, organizational structure, and financial goals), financial information about the foreign entity (the size of the U.S. investment and the financial ability to remunerate the beneficiary and to commence doing business in the U.S.), and the organizational structure of the foreign entity.

If the alien is coming to the U.S. in a specialized knowledge capacity (L-1B) to open or to be employed in a new office, also file the petition with evidence that:

Sufficient premises to house the new office have been secured;

The business entity in the U.S is or will be a qualifying organization

The petitioner has the financial ability to compensate the alien beneficiary and to begin doing business in the U.S.

Extending an Individual L-1 Petition

A petitioner may apply for an extension of an individual L-1 petition using Form I-129. Supporting documentation is not required, except in those cases involving new offices or when requested. For details, please refer to 8CFR 214.2(l)(14)(i).

Blanket L Petition

Employers who regularly file L petitions may wish to consider filing for a blanket L petition in order to obtain continuing approval for itself (and some or all of its parents, branches, subsidiaries and affiliates in the U.S.). This simplifies the process of approving and admitting additional individual L-1A and L-1B workers.
The blanket L petition must be filed by a U.S. employer who will be the single representative between INS and the qualifying organizations and must be filed with copies of evidence that the:
Petitioner and its branches, subsidiaries, and affiliates are engaged in commercial trade or services;

Petitioner has an office in the United States that has been doing business for one year or more;

Petitioner has 3 or more domestic and foreign branches, subsidiaries, or affiliates;

Petitioner and its qualifying organizations have obtained approved petitions for at least ten L-1 professionals during the previous year or have U.S. subsidiaries or affiliates with combined annual sales of at least 25 million dollars, or have a U.S. work force of at least 1,000 employees.

After approval of a blanket petition, the petitioner may file for individual employees to enter as L-1 professionals under the blanket petition. If the alien is outside the U.S., submit a completed Form I-129S and a copy of the Form I-797 (INS approval notice). If the alien is already in the U.S., the petitioner may file an I-129 to request a change of status, based on this blanket petition. An I-129 petition for a change of status must be filed with:

A copy of the approval notice for the blanket petition;

A letter from the alien's foreign employer detailing the alien’s dates of employment, job duties, qualifications and salary for the 3 previous years; and

If the alien is a specialized knowledge professional, a copy of a U.S. degree, a foreign degree equivalent to a U.S. degree, or evidence establishing the combination of the beneficiary's education and experience is the equivalent of a U.S. degree.

Extending a Blanket L Petition

A petitioner may file an I-129 to extend an expiring blanket petition. The extension petition must be filed with:

A copy of the previous approval notice for the blanket petition; and

A summary of the employment of L-1 aliens admitted under the blanket petition during the preceding three years, listing, for each alien:

His or her name;

Position(s) held during the period;

Employing entity;

Date of initial L-1 admission under the blanket;

Date of final departure, if the alien has been transferred outside the United States, and;

Documentation of any changes in approved relationships and additional qualifying relationships.

Aliens with Extraordinary Ability (O’s)

The O category is reserved for:

Aliens of extraordinary ability in the sciences, arts, education, business, or athletics (O-1), the artist’s or athlete’s support staff (O-2), and the O-1’s spouse and/or child(ren) (O-3).To qualify, the alien must be coming to the U.S. to work in his or her area of extraordinary ability or achievement. There is currently no annual cap on O visas.

O-1 Extraordinary Ability (Science, Education, Business, or Athletics)

The O-1 category applies to aliens coming temporarily who has extraordinary ability in the sciences, education, business, or athletics (not including the arts, motion pictures or television).

Petition Document Requirements

A U.S. employer should file the petition (Form I-129) with:
A written advisory opinion from a peer group (including labor organizations) or a person designated by the group with expertise in the alien's area of ability;

A copy of any written contract between the employer and the alien or a summary of the terms of the oral agreement under which the alien will be employed;

Evidence that the alien has received a major, internationally-recognized award, such as a Nobel Prize, or evidence of at least three of the following:

Receipt of nationally or internationally recognized prizes or awards for excellence in the field of endeavor;

Membership in associations in the field for which classification is sought which require outstanding achievements, as judged by recognized international experts;

Published material in professional or major trade publications, newspapers or other major media about the alien and his work in the field for which classification is sought;

Original scientific, scholarly, or business-related contributions of major significance in the field;

Authorship of scholarly articles in professional journals or other major media in the field for which classification is sought;

A high salary or other remuneration for services as evidenced by contracts or other reliable evidence;

Participation on a panel, or individually, as a judge of the work of others in the same or in a field of specialization allied to that field for which classification is sought;

Employment in a critical or essential capacity for organizations and establishments that have a distinguished reputation.If the above standards do not readily apply to the alien's occupation, the petitioner may submit comparable evidence in order to establish the alien's eligibility.

O-1 Extraordinary Ability (Arts, Motion Picture, or Television)

The O-1 category also applies to aliens who are coming temporarily and have extraordinary ability in the arts or extraordinary achievement in the motion picture or television industry.

Petition Document Requirements

A U.S. employer should file the I-129 petition with:
A written advisory opinion, describing the alien’s ability as follows:

If the petition is based on the alien's extraordinary ability in the arts, the consultation must be from a peer group (including labor organizations) in the alien's field of endeavor; or a person or persons designated by the group with expertise in the alien's area of ability.

If the petition is based on the alien's extraordinary achievements in the motion picture or television industry, separate consultations are required from a labor and a management organization with expertise in the alien's field of endeavor.

A copy of any written contract between the employer and the alien or a summary of the terms of the oral agreement under which the alien will be employed;

Evidence the alien has received, or been nominated for, significant national or international awards or prizes in the particular field, such as an Academy Award, Emmy, Grammy or Director's Guild Award, or evidence of at least three of the following:

Performed or will perform services as a lead or starring participant in productions or events which have a distinguished reputation as evidenced by critical reviews, advertisements, publicity releases, publications, contracts or endorsements;

Achieved national or international recognition for achievements, as shown by critical reviews or other published materials by or about the individual in major newspapers, trade journals, magazines, or other publications;

A record of major commercial or critically acclaimed successes, as shown by such indicators as title, rating or standing in the field, box office receipts, motion picture or television ratings and other occupational achievements reported in trade journals, major newspapers or other publications;

Received significant recognition for achievements from organizations, critics, government agencies or other recognized experts in the field in which the alien is engaged, with the testimonials clearly indicating the author's authority, expertise and knowledge of the alien's achievements;

A high salary or other substantial remuneration for services in relation to others in the field, as shown by contracts or other reliable evidence; orIf the above standards do not readily apply to the alien's occupation, the petitioner may submit comparable evidence in order to establish the alien's eligibility.

O-2 Support Personnel

The O-2 category applies to aliens accompanying an O-1 artist or athlete to assist in a specific event or performance. This person would be acting as an essential and integral part of the artistic or athletic performance of an O-1 artist or athlete because he or she performs support services which cannot be readily performed by a U.S. worker and which are essential to the successful performance of the O-1.

Petition Document Requirements

The petition must be filed by a U.S. employer in conjunction with the filing of the O-1 alien petition and must be filed with:

A written advisory opinion.

If the O-2 petition is for an alien accompanying an O-1 alien of extraordinary ability in the arts, the opinion must be from a labor organization with expertise in the skill area involved.

If the O-2 petition is for an alien accompanying an O-1 alien of extraordinary achievement in the field of motion picture or television, the opinion must be from a labor organization and a management organization with expertise in the skill area involved.

Evidence of the current essentiality, critical skills, and experience of the O-2 alien with the O-1 alien, and that the alien has substantial experience utilizing the critical skills and essential support services for the O-1. In the case of a specific motion picture or television production, the evidence shall establish that significant production has taken place outside the U.S., and will take place inside the U.S. and that the continuing participation of the alien is essential to the successful completion of the production.

O-3 Dependents

Spouses and minor children (dependents) of O-1’s are admitted under O-3 status with the same restrictions as the principal. They may not work in the U.S. under this classification.

Athletes, Entertainment Groups, Artists (P’s)

P-1 Athlete

The P-1 classification applies to an alien coming to the U.S. temporarily to perform at a specific athletic competition as an athlete, individually or as part of a group or team, at an internationally recognized level of performance.

Petition Document Requirements

A U.S. employer should file the I-129 petition with:
A written advisory opinion from an appropriate labor organization:

A copy of the contract with a major U.S. sports league or team or a contract in an individual sport commensurate with international recognition in the sport, if such contracts are normally utilized in the sport;

Copies of evidence of at least two of the following:

Significant participation in a prior season with a major United States sports league;

Participation in international competition with a national team;

Significant participation in a prior season for a U.S. college or university in intercollegiate competition

A written statement from an official of the governing body

of the sport which details how the alien or team is internationally recognized;

A written statement from a member of the sports media or a recognized expert in the sport which details how the alien or team is internationally recognized;

The individual or team is ranked, if the sport has international rankings; or The alien or team has received a significant honor or award in the sport.

P-1 Entertainment Group

The P-1 classification also applies to an alien coming temporarily to perform as a member of a foreign-based entertainment group that has been recognized internationally as outstanding in the discipline for a sustained and substantial period of time. This person also must have had a sustained and substantial relationship with the group (ordinarily for at least one year) and/or provide functions integral to the group’s performance.

Petition Document Requirements

The petition should be filed by a U.S. employer with:
A written advisory opinion from an appropriate labor organization;

A statement that the group has been established and performing regularly for at least one year;

Evidence the group is internationally recognized as outstanding in the discipline for a sustained and substantial period of time as demonstrated by evidence of the group's receipt of, or nomination for, significant international awards or prizes for outstanding achievement in the field, or evidence of at least 3 of the following:

The group has performed and will perform as a starring or leading entertainment group in production or events which have a distinguished reputation as evidenced by critical reviews, advertisements, publicity releases, publications, contracts, or endorsements;

The group has achieved international recognition and acclaim for outstanding achievement in its field as evidenced by reviews in major newspapers, trade journals, magazines or other published material;

The group has performed and will perform services as a leading or starring group for organizations and establishments that have a distinguished reputation as evidenced by articles in newspapers, trade journals, publications, or testimonials;

The group has a record of major commercial or critically acclaimed successes, as evidenced by indicators such as ratings, box office receipts, record, cassette or video sales, and other achievements as reported in trade journals, major newspapers or other publications;

The alien has received significant recognition for achievements from critics, organizations, government agencies or other recognized experts in the field in which the alien is engaged, with the testimonials clearly indicating the author's authority, expertise and knowledge of the alien's achievements; or

The group has commanded and will command a high salary or other substantial remuneration for services comparable to others similarly situated in the field, as evidenced by contracts or other reliable evidence.

P-2 Artistic Exchange

The P-2 classification applies to an alien coming temporarily to perform as an artist or entertainer individually or as part of a group, who will perform under a reciprocal exchange program between an organization in the U.S. and an organization in another country.

Petition Document Requirements

The I-129 petition must be filed by the sponsoring organization, an employer in the U.S., or the U.S. labor organization that negotiated the agreement. The petition must be filed with:
A written consultation by an appropriate labor organization;

A copy of the formal reciprocal exchange agreement between the U.S. organization(s) sponsoring the alien and the organization(s) in a foreign country which will receive the U.S. artist or entertainer;

A statement from the sponsoring organization describing the reciprocal exchange of U.S. artists or entertainers as it relates to the specific petition for which classification is sought;

Evidence the alien and the U.S. artist or entertainer subject to the reciprocal exchange agreement are artists with comparable skills and that the terms and conditions of employment are similar.

Evidence that an appropriate labor organization in the U.S. was involved in negotiating, or has concurred with, the reciprocal exchange of U.S. and foreign artists or entertainers.

P-3 Culturally Unique Artists

The P-3 classification applies to aliens coming temporarily to perform, teach or coach as artists or entertainers, individually or as part of a group, under a program that is culturally unique.

Petition Document Requirements

The petition should be filed by the sponsoring organization or employer in the U.S. with:
A written consultation from an appropriate labor organization;

Affidavits, testimonials or letters from recognized experts attesting to the authenticity of the alien's or group's skills in performing, presenting, coaching or teaching the unique and traditional art forms and giving the credentials of the expert including the basis of his or her knowledge of the alien’s or group’s skills.

Documentation that all of the performances or presentations will be culturally unique events, and;

Documentation that the performance of the alien or group is culturally unique as evidenced by reviews in newspapers, journals or other published materials.

P-1, 2, or 3 (Accompanying Support Personnel)

This category applies to accompanying support personnel who are highly skilled aliens coming temporarily as an essential and integral part of the competition or performance of a P-1, P-2, or P-3. Essential support personnel must perform support services which cannot be readily performed by a U.S. worker and which are essential to the successful performance or services of the athlete or entertainer.

Petition Document Requirements

The petition must be filed in conjunction with the petition for a P-2 alien by a U.S. employer and must be filed with:
A written consultation with a labor organization in the skill in which the alien will be involved;

A statement describing the alien's prior and current essentiality, critical skills and experience with the principal alien;

A copy of any written contract between the employer and the alien or a summary of the terms of the oral agreement under which the alien will be employed.

International Cultural Exchange Program Participants (Q-1’s)

The Q-1 classification applies to participants in an international cultural exchange program approved by the Attorney General for the purpose of providing practical training, employment, and to share the history, culture, and traditions of the alien's home country.

Including more than one alien in a petition

Aliens who will apply for their visas at the same consulate or, if they do not need visas, will enter at the same port of entry may be included in one petition if they will be involved in the same international cultural exchange program.

Petition Document Requirements

A U.S. employer or foreign employer may file the I-129 Q-1 petition; however, a foreign employer's petition must be signed by a U.S. citizen or permanent resident employed by the qualified employer on a permanent basis in an executive, managerial, or supervisory capacity for the prior year. The petition must be filed with evidence the employer:
Maintains an established international cultural exchange program. This may be demonstrated by submitting copies of catalogs, brochures or other types of material which illustrate that:

The cultural component of the program is designed to give an overview of the attitude, customs, history, heritage, philosophy, tradition and/or other cultural attributes of the participant's home country, and;

The program activities take place in a public setting where the sharing of culture can be achieved through direct interaction with the American public or a segment thereof. Has designated a qualified employee to administer the program and serve as liaison with INS; Will offer the alien wages and working conditions comparable to those accorded local domestic workers similarly employed; and

Has the financial ability to compensate the participant(s), as shown by a copy of the employer's most recent annual report, business income tax return or other form of certified accountant's report.

Religious Worker (R’s)

The R-1 classification applies to a religious worker. This is an alien coming to the U.S. temporarily to work:

As a minister of religion,

As a professional in a religious vocation or occupation, or

For a bona fide nonprofit religious organization at the request of the organization, in a religious occupation which relates to a traditional religious function.

The applicant (religious worker) must have been a member of a religious denomination having a nonprofit religious organization in the United States for at least the two years immediately prior to the application date. To be eligible, the U.S. petitioning organization must be a nonprofit religious organization granted (or eligible for) tax exempt status, and must demonstrate that it can and will provide for all of the R-1 beneficiary’s financial and physical needs.If the alien is outside the U.S., he or she may apply directly to a consulate for an R visa. If visa exempt, the alien may apply at a port of entry.

If the alien is inside the U.S., the religious organization may use the I-129 to petition for a change of status, extension of stay, or change of employment.

Dependents

Dependents (spouses and unmarried children under 21 years of age) of R-1 workers are entitled to R-2 status with the same restrictions as the principal. Dependents may be students in the U.S., but may not be employed under the R-2 classification. Note: Dependents should file for a change of status or extension of stay on Form I-539 (Application to Extend/change Nonimmigrant Status).


Petition Document Requirements

The I-129 petition may be filed by an authorized official of the U.S. organization and must be filed with:
A written statement from an authorized official of the religious organization that will be employing the alien establishing that the alien has been a member of the denomination for the required two years, a description of the proposed position, and that the alien is qualified for the position, the arrangements, if any, for salary, benefits, and other compensation the name and location of the place the alien will provide the services the organization’s affiliation with the denomination (note: if the alien is to be employed, the INS requires that this letter be from the organizational unit responsible for maintaining I-9’s);

Evidence showing that the religious organization or any affiliate which will engage the alien’s services is a bona fide nonprofit, religious organization in the U.S. and is exempt from taxation in accordance with section 501(c)(3) of the Internal Revenue Code of 1986.

Employing Canadian and Mexican Professionals Under NAFTA

The 1994 North American Free Trade Agreement (NAFTA) makes temporary employment in the U.S. easier for certain Canadian and Mexican workers. NAFTA created a new classification, “TN,” for eligible Canadian and Mexican professional workers and also affected terms of admission for Canadians admitted to the U.S. under other nonimmigrant classifications.TN employment must be in a profession listed in Appendix 1603.0.1 to NAFTA and the TN employee must possess the credentials required. There is no annual limit on TN-1 admissions from Canada or Mexico.

Dependents

Dependents (spouses and unmarried children under 21 years of age) of TN professionals are entitled to TD status with the same restrictions as the principal. Dependents may be students in the U.S., but may not be employed under the TD status.

TN Canadian or Mexican Citizen under NAFTA

The TN classification applies to a Canadian or Mexican citizen seeking admission as a professional temporarily under the North American Free Trade Agreement.

Petition Document Requirements

For a Canadian citizen:

This classification does not require a petition for employment if the alien is a Canadian citizen and is outside of the U.S. Canadian citizens need not obtain TN-1 consular visas, and may apply directly at Class A U.S. ports of entry. They must provide:
A statement from the employer with a full description of the nature of the duties the beneficiary will be performing, the anticipated length of stay, and the arrangements for pay or reward;

Evidence that the beneficiary meets the education and/or alternative credentials for the activity;

Evidence that all licensure requirements, where applicable to the activity, have been satisfied;

Evidence of Canadian citizenship.

For a Mexican citizen:

This classification does not require a petition for employment if the alien is a Mexican citizen and is outside the U.S. However, Mexican citizens are still required to obtain TN visas at the U.S. consulate abroad. They must provide:

A statement from the employer with a a full description of the nature of the duties the beneficiary will be performing, the anticipated length of stay, and the arrangements for pay or reward;

Evidence that the beneficiary meets the education and/or alternative credentials for the activity;

Evidence that all licensure requirements, where applicable to the activity, have been satisfied;

Evidence of Mexican citizenship;

(a) Definitions .

(1) Registered Nurse . In order to obtain a visa as an H-1C nurse, a nurse must:
• Be licensed where he or she was educated or have received nursing education in the United States;

• Pass an approved examination (currently CGFNS) or hold full and unrestricted (U.S.) state license; and

• Be immediately eligible and qualified to engage in professional nursing immediately upon entering the United States.

(2) Attestation . The petition must include an “attestation” which has been reviewed and stamped as approved by the Department of Labor. (There is no USCIS adjudicative role in the attestation process, we merely verify that it contains the DOL stamp.) An attestation for purposes of an H-1C petition is a guarantee signed by the facility which will employ the registered nurse that:

• The facility is located in a “health shortage area” and is otherwise “qualified” as defined in section 212(m)(6) of the Act;

• The proposed H-1C employment will have no adverse effect on wages and working conditions of nurses at the facility;

• The wages offered to H-1C nurses are the same as those offered to U.S. citizen or resident alien nurses at the facility;

• The facility is taking significant steps (defined in section 212(m)(2)(B)) of the Act to recruit and retain nurses to reduce its dependance on H-1C nurses;

• There is no strike, or lockout in progress and there has not been a layoff of nurses in the last 90 days nor will there be such a layoff during the 90 days following submission of the petition; • Notice has been provided to the bargaining unit (or posted if there is no bargaining unit) in advance of the submission of the H-1C petition;

• No more than 1/3 of the nurses at the facility are nonimmigrants;

• The facility will not transfer any H-1C nurses to a different facility or authorize the nurse to accept employment at another facility.

(b) Decision Procedures .

(1) Approval . If you are satisfied that the attestation and all other required documents are present and the petition is approvable, endorse the approval block. The initial petition approval may be for a period of up to three years, not to exceed the period of time requested on the petition or the validity of the beneficiary’s license. The beginning date for a petition should be the date requested by the petitioner or the approval date, whichever is later. Approval may occur no more than six months earlier than the dat e of need. If the alien is present in the United States and requires a change of status, follow procedures described in Chapter 30.3 . If the alien is present in the United States and requires an extension of stay, follow procedures described in Chapter 30.2 . Notify the petitioner of the action taken using CLAIMS Form I-797 , Notice of Action. If action is completed in a local office on an emergent basis, the file must be returned to the appropriate service center for storage.

(2) Denial . Prepare a notice of denial, also on Form I-797. Advise the petitioner of the right of appeal to the Administrative Appeals Office. Retain the file, in accordance with local procedures, until the appeal period expires or the appeal is received.

(c) Transmittal of Petition .

(1) Visa Applicants . If the beneficiary requires a visa, the duplicate of the approved petition, with the supporting documents, shall be sent to the appropriate consul. When advance notice of approval (via fax or cable) is directed to a consul, the petitioner shall be instructed promptly to have the beneficiary contact the consul. The petition, before being mailed, shall be stamped "Approval previously forwarded".

(2) Visa-exempt Applicants . When the beneficiary does not require a visa, the duplicate petition, without supporting documents, shall be forwarded to the appropriate port of entry.

(d) Adjudicative Issues

What does “no strike/lockout or layoff” mean?
(a) The fifth attestation element requires that the facility attest that “there is not a strike or lockout in the course of a labor dispute, the facility did not lay off and will not lay off a registered nurse employed by the facility within the period beginning 90 days before and ending 90 days after the date of filing of any visa petition, and the employment of such an alien is not intended or designated to influence an election for a bargaining representative for registered nurses of the facility.” Labor disputes for purposes of this attestation element relate only to those involving nurses providing nursing services; other health service occupations are not included. A facility which has filed a petition for H-1C nurses is also prohibited from interfering with the right of the nonimmigrant to join or organize a union.
(b) Notice of strike or lockout. In order to remain in compliance with the no strike or lockout portion of this attestation element, the facility must notify ETA if a strike or lockout of nurses at the facility occurs during the one year validity of the Attestation. Within three days of the occurrence of such strike or lockout, the facility must submit to the Chief, Division of Foreign Labor Certifications, Office of Workforce Security, Employment and Training Administration, Department of Labor, 200 Consti tution Avenue N.W., Room C-4318, Washington, D.C. 20210, by U.S. mail or private carrier, written notice of the strike or lockout. Upon receiving a notice described in this section from a facility, ETA will examine the documentation, and may consult with the union at the facility or other appropriate entities. If ETA determines that the strike or lockout is covered under 8 CFR 214.2(h)(17), INS's Effect of strike regulation for “H” visa holders, ETA must certify to INS, in the manner set forth in that regul ation, that a strike or other labor dispute involving a work stoppage of nurses is in progress at the facility. (c) Lay off of a U.S. nurse means that the employer has caused the nurse's loss of employment in circumstances other than where-- (1) A U.S. nurse has been discharged for inadequate performance, violation of workplace rules, or other reasonable work-related cause; (2) A U.S. nurse's departure or retirement is voluntary (to be assessed in light of the totality of the circumstances, under established principles concerning “constructive discharge” of workers who are pressured to leave employment); (3) The grant or contract under which the work performed by the U.S. nurse is required and funded has expired, and without such grant or contract the nurse would not continue to be employed because there is no alternative funding or need for the position; or (4) A U.S. nurse who loses employment is offered, as an alternative to such loss, a similar employment opportunity with the same employer. The validity of the offer of a similar employment opportunity will be assessed in light of the following factors:
(i) The offer is a bona fide offer, rather than an offer designed to induce the U.S. nurse to refuse or an offer made with the expectation that the worker will refuse; (ii) The offered job provides the U.S. nurse an opportunity similar to that provided in the job from which he/she is discharged, in terms such as a similar level of authority, discretion, and responsibility, a similar opportunity for advancement within the organization, and similar tenure and work scheduling; (iii) The offered job provides the U.S. nurse equivalent or higher compensation and benefits to those provided in the job from which he/she is discharged. (d) Documentation. The facility must include in its public access file, copies of all notices of strikes or other labor disputes involving a work stoppage of nurses at the facility (submitted to ETA under paragraph (b) of this section). The facility must retain in its non-public files, and make available in the event of an enforcement action pursuant to subpart M of this part, any existing documentation with respect to the departure of each U.S. nurse who left his/her employment with the facility in the per iod from 90 days before until 90 days after the facility's petition for H-1C nurse(s). The facility is also required to have a record of the terms of any offer of alternative employment to such a U.S. nurse and the nurse's response to the offer (which may be a note to the file or other record of the nurse's response), and to make such record available in the event of an enforcement action pursuant to subpart M.

CANADA VISA INFO

Becoming a citizen
If you want to become a Canadian citizen, you must follow several steps:
1. Determine if you are eligible to become a citizen.
2. Apply for citizenship.
3. Take the citizenship test, if you are between the ages of 18 and 54.
4. Attend a citizenship ceremony, if you are 14 or older.

Becoming a Canadian citizen: Who can apply
To be eligible to become a Canadian citizen, you must meet the requirements in all of the following area
Age
Permanent resident status
Time lived in Canada
Language abilities

Age
You must be at least 18 years old to apply for Canadian citizenship.
To apply for citizenship for a child under 18, make sure the following conditions are met:
· the person applying is the child’s parent, adoptive parent or legal guardian
· the child is a permanent resident, but does not need to have lived in Canada for three years and
· one parent is already a Canadian citizen or is applying to become a citizen at the same time. This also applies to adoptive parents.

Permanent resident status
To become a Canadian citizen, you must have permanent resident status in Canada, and that status must not be in doubt. This means you must not be the subject of an immigration investigation, an immigration inquiry or a removal order (an order from Canadian officials to leave Canada).

Time lived in Canada
To become Canadian citizens, adults must have lived in Canada for at least three years (1,095 days) in the past four years before applying. Children do not need to meet this requirement.
You may be able to count time you spent in Canada before you became a permanent resident if that time falls within the four-year period.

Language abilities
Canada has two official languages—English and French. You need to be able to speak one of these two languages well enough to communicate with people. In other words, you must know enough English or French to understand other people and for them to understand you.

Becoming a citizen: How to apply
To become a Canadian citizen, you must do the following:
1. Obtain an application package.
2. Read the guide.
3. Complete the application form and attach the necessary documents.
4. Pay the fee and get the necessary receipt.
5. Mail the application form and documents.

1. Obtain an application package.
If you are an adult (age 18 or older), you need this form:
· Application for Canadian Citizenship – Adults
If you are applying for your children (under age 18), you need this form:
· Application for Canadian Citizenship – Minors
You can apply for your children at the same time as you apply for yourself, or after you have become a citizen.

2. Read the guide.
Read the guide carefully before you complete the citizenship application form. The fee for processing your form and your children’s forms is not refundable, so make sure you are eligible and ready to become a citizen before you apply.

3. Complete the application form and attach the necessary documents.
The application form contains instructions. Read those instructions, complete the form and attach photocopies of your documents. Do not send the originals. You will have to show the originals when you come for your test or interview, so remember to bring them with you.
If your documents are not in English or French, you can provide a photocopy of the originals, a translation of them and an affidavit from the person who did the translation. Translations by family members are not acceptable.
To apply as an adult, you will need to include the following with your application:
· proof of permanent residence
· A Record of Landing (IMM 1000)—a document that is sometimes folded and stapled into your passport—if you became a permanent resident before June 28, 2002; or your Confirmation of Permanent Residence (IMM 5292 or 5509)—if you became a permanent resident on or after June 28, 2002
· A permanent resident card, a copy of both sides, if you became a permanent resident after June 28, 2002, or if you obtained a permanent resident card as an existing permanent resident
· two pieces of identification (for example, a passport, a driver’s licence, or a provincial/territorial health card), at least one of which contains your photo
· two signed citizenship photos, done according to the instructions in the guide and
· the receipt of payment (form IMM 5401—see below) showing that you have paid the $200 fee (which includes a $100 right of citizenship fee and a $100 processing fee).
To apply on behalf of your child, you will need to include:
· your child’s long-form birth certificate or the child’s adoption order showing the names of the adoptive parents
· your child’s Record of Landing (IMM 1000) or Confirmation of Permanent Residence (IMM 5292 or 5509)
· your child’s permanent resident card, a copy of both sides, if your child has one
· two pieces of identification for the child, such as school records, a provincial/territorial health card, or an immunization record
· two citizenship photos of the child, done according to directions in the guide and signed by the child if he or she is aged 14 or older and
· the original receipt of payment (form IMM 5401—see below) showing that you have paid the $100 fee.
If you are a legal guardian applying on behalf of a child, you must also provide legal documentation proving guardianship.

4. Pay the fee and get the necessary receipt.
You can pay fees:
· at most banks. If you use this method, you must get an original receipt of payment (form IMM 5401) to bring with you when you pay. This form is not available online. You must have it mailed to you. See Order a receipt of payment (IMM 5401) under Related Links at the bottom of the page.
· online through Pay my application fees in the I Need To… section on the right-hand of this page. Once you have paid your fees online, you must print a receipt of payment form and include it with your application. Be sure to print the actual receipt, not the “payment confirmation form” page. See Payment of fees on the Internet under Related Links at the bottom of the page for more information.
You can use one receipt for your entire family as long as you send all the application forms in the same envelope.

5. Mail the application form and documents.
If you apply for more than one person and want your applications processed together, you can submit all the forms and documents in the same envelope. If the applications are sent in different envelopes, they will be processed separately.
Remember to:
· sign and date the application form
· sign your photos
· have any child who is 14 years of age or older sign her or his photos and countersign the application form
· include the photos
· include the receipt of payment (IMM 5401)
· include the completed and signed application form and
· include photocopies of all documents.
Mail your completed application form, along with the required documents, to
Citizenship and Immigration Canada

Case Processing Centre - Sydney

P.O. Box 7000

Sydney, Nova Scotia B1P 6V6

If your application is signed more than three months before we receive it or if it is dated into the future, we will send it back to you.

Becoming a citizen: After applying
Once we have received your application for Canadian citizenship, we will send you a notice confirming receipt.
You can check the status of your application by contacting the Citizenship and Immigration Canada Call Centre or by going to Check My Application Status in the I Need To… section on the right-hand side of this page.
When we send you the notice confirming that we have received your application, we will also send you a copy of the booklet A Look at Canada. Study the booklet carefully. You will need to know the information in it for the citizenship test.
When you sent us your application, you provided a photocopy of some original documents (for example, your record of landing or your confirmation of permanent residence, your permanent resident card, and your passport, if you have one). Keep the originals of those documents together. You will need to bring them with you to your citizenship test or interview.

Learn about:
· The citizenship test
· The citizenship ceremony