Kate McCarroll
Kerr Russell
In a recent survey, the Journal of the American Medical Association (JAMA) estimated that 30% of physicians and 17% of registered nurses in the United States were born outside of the country. About 23% of home health providers and nursing aides are immigrants, as are 20% of pharmacists.
Never has our reliance on foreign health care workers been as apparent as during the COVID-19 pandemic. Physicians, nurses, and other healthcare professionals in the U.S., hailing from all parts of the globe, have served on the front lines fighting the pandemic, caring for patients, and tirelessly pursuing effective treatments, while putting their personal safety at risk.
While they serve our communities, many foreign-born physicians and nurses face lengthy delays in obtaining lawful permanent resident status (green cards) — sometimes waiting more than 10 years. Green cards are numerically limited, and there are many more applicants than there are available green cards, resulting in significant backlogs. Healthcare workers born in India, China and the Philippines have the longest wait times, as those countries are the birthplace of a majority of U.S. green card applicants.
While they wait for their turn in the green card “line,” healthcare workers remain in non-immigrant visa status (e.g., H-1B), which poses significant limitations on employment. For example, a foreign physician working in an area with few COVID-19 cases cannot simply travel to another state to lend assistance where she is needed. She cannot take a shift at another hospital in the same area where she works. She cannot work full-time hours to help with the pandemic, if the non-immigrant visa filing indicated she would be part-time. Each of these seemingly minor changes in employment require a filing with the U.S. Citizenship and Immigration Service, a tedious and expensive undertaking that delays healthcare professionals from working where they are critically needed. When an individual holds a green card, she has flexibility in the work location, position, hours worked and employer, allowing healthcare professionals to answer the call to serve where needed, unimpeded.
On April 30, 2020, a bipartisan group of U.S. Senators introduced a bill (The Healthcare Workforce Resilience Act) to strengthen the U.S. healthcare workforce and improve healthcare access during the COVID-19 crisis. The bill would “recapture” up to 25,000 green cards for nurses and 15,000 for physicians from a pool of unused green cards that Congress previously authorized. In addition, the bill contains the following provisions:
Unlike regular green card processing, the foreign worker’s country of birth will not matter. Green cards will be given in order of the individual’s priority date, which is her place in the green card line.
Expedited processing of qualifying cases will be required.
The filing period for green card applications under the Act will expire 90 days after the President terminates the COVID-19 emergency declaration.
Employers who have employees who will complete the process overseas must attest that the foreign national will not displace a U.S. worker.
The Healthcare Workforce Resilience Act has gained widespread support. On May 8, a bipartisan group of representatives introduced a corresponding bill in the House. The American Hospital Association (AHA), American Organization for Nursing Leadership (AONL), American Medical Association (AMA), U.S. Chamber of Commerce and numerous other organizations have expressed support. While many are optimistic that the bill will be enacted into law, it is still in the early stages of the legislative process. Many details, such as who would be eligible under the bill, how quickly the green cards would be exhausted, and the timing of the program, are still unknown.
Given our immediate and urgent need for available healthcare professionals in regions hit particularly hard by COVID-19, Congress should act quickly to pass the bill and send to President Trump for signature, so that its provisions can be implemented.
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Kate McCarroll helps lead Kerr Russell’s Immigration Law group. She has extensive experience in employment-related immigration law, including I-9 compliance and assisting corporations with government audits. Kate has also handled immigration matters involving family-based immigration and asylum proceedings and has expertise in the specialized area of physician immigration. More information about Kate and the firm can be found at www.kerr-russell.com.
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