Overview : H1C Visas for Registered Nurses
Posted May 11, 2001

This article is another in our series presenting an overview of U.S. immigration law. We continue with the nonimmigrant (temporary) visa categories, the next one being the "H1C" category for registered nurses. This visa category was established by the Nursing Relief for Disadvantaged Areas Act of 1999 (NRDAA) (Pub. L. No. 106-95) and is designed for registered nurses working in health professional shortage areas (HPSAs).

Employee Requirements

To qualify for H1C status, the beneficiary must:

a. have a full and unrestricted nurse's license in his or her home country, or have received nursing education in the United States;

b. have passed an appropriate examination (as determined by the U.S. Department of Health and Human Services (HHS)), or have a full and unrestricted license to practice as a registered nurse in the state of intended employment; and

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

Employer's Responsibilities

Facilities wishing to hire H1C nurses must file an attestation with the Employment and Training Administration (ETA) of the U.S. Department of Labor (DOL) indicating the following:

1. the facility was a hospital located in a designated health professional shortage area as of March 31, 1997, and (for the cost-reporting period beginning during fiscal year 1994) had at least 190 licensed acute care beds with at least 35 percent of its acute care patients entitled to Medicare, and at least 28 percent entitled to Medicaid, thereby meeting the definition of "subsection (d) hospital" found in the Social Security Act;

2. employment of the H1C nurse will not adversely affect the wages and working conditions of similarly employed nurses;

3. the H1C nurse will be paid the same wages as other similarly employed nurses;

4. the facility has taken and is taking timely and "significant steps" to recruit and retain U.S. citizen or eligible immigrant nurses;

5. there is no strike or lockout in the course of a labor dispute, the facility did not and will not lay off a registered nurse employed by the employer within the 90-day period before or after the filing of the H1C petition, and the employment of the H1C nurse is not intended or designed to influence an election for a bargaining representative for registered nurses at the facility;

6. notice of the H1C petition has been provided to the designated union bargaining representative or, if there is no bargaining representative, has been posted in conspicuous places within the facility;

7. H1C nurses at the facility will never number more than one-third of the total registered nursing staff; and

8. the H1C nurse will not work at a worksite other than a worksite controlled by the petitioning facility, or transfer from one worksite to another.

Under the NRDAA, "significant steps," as used in item 4 above, may include, but are not limited to, the following:

1. establishing a training program for nurses at the facility or participating in a program elsewhere;

2. providing career development programs to encourage other health care workers to become registered nurses;

3. paying registered nurses at a rate higher than the prevailing wage; and

4. providing registered nurses with reasonable opportunities for meaningful salary advancement.

An attestation by an employer expires at the end of the one-year period beginning on the date of filing with the DOL, or the end of the period of admission of the last H1C nurse with respect to whose admission the attestation was filed, whichever is later. The attestation applies to petitions filed during the one-year period beginning on the date of its filing with the DOL if the facility states in each petition that it continues to comply with the conditions of the attestation. The filing fee for the attestation may not exceed $250 per application.

Basic Information

The procedure for an H1C is somewhat similar to the procedure for an H1B. In addition to the attestation that must be filed with the DOL, a petition must also be submitted to the INS. More than one nurse may be included on a petition. H1C nurses may be approved for a period of admission to the United States of up to three years. Upon the expiration of the admission period, the status may not be extended. 

Five hundred H1C visas may be issued each fiscal year. States with a population of less than 9 million as of 1990 may have no more than 25 H1C visas annually. States with more than 9 million may have no more than 50 H1C visas annually. If all available visas in a fiscal year quarter are not used, the visas may be issued to states regardless of population or the state cap during the last fiscal year quarter.

The H1C visa category is based on the former H1A visa category for nurses, which expired on September 30, 1997. The H1C classification is more restrictive due to its numerical cap on the number of visas issued annually and its application only to underserved areas. The NRDAA, the law that created the H1C classification, expires in 2003. By 2003, HHS and DOL must jointly submit to Congress a report of recommendations on a program to eliminate the dependence of understaffed facilities on H1C nurses. The report is supposed to provide a permanent solution to the shortage of registered nurses in the U.S. and also recommend a method of enforcing the requirements imposed on facilities by filing more effective attestations for H1C nurses.