HR Pulse - Spring 2009 - (Page 44) EASING THE HEALTH CARE WORKER CRUNCH By automating tasks such as scheduling, absence management, shift bidding, and callback procedures, among others, administrators can help optimize the workforce. United States to work in a specialty occupation. • H-1C: Allows foreign nationals to enter into the United States to perform temporary services in a health professional shortage area as determined by the U.S. Department of Labor. Legislation Changes Are on the Horizon With the introduction of recent legislation, changes to the limiting immigration process for foreign employees of hospitals and other medical facilities may soon be on the way. For example, The Emergency Nursing Supply Relief Act would remove registered nurses and physical therapists from the current green card caps—allowing for an additional 20,000 available applicants per year. In addition, the legislation would require the USCIS to review the I-140 of the nurse petitions within 30 days of submission. Currently, that review process is averaging eight to 12 months. This bill is a significant step in the right direction for hospitals that struggle with staffing. The requirement of an expedited review process by the USCIS and the removal of these applications from the current green card caps indicate that the severity of this challenge is understood by some in Washington. Ideally, this initial proposal will lead to a workable solution that will address the growing staffing challenge for hospitals and medical centers allowing for continuation of the expected levels of care in these facilities. Although many foreign physician, nursing, and physical therapy students study and graduate in the United States, they often are unable to work following the expiration of their visas due to limited immigration options. One example is in the nursing industry, where candidates who file for U.S. permanent residency to secure a green card and the ability to gain legal employment, may have to wait two to three years for approval of their cases. To manage the process more efficiently, health care providers need to develop talent-management strategies that incorporate a flexible immigration management plan as well as innovative technology tools. A Fresh Look at Immigration Strategies Although navigating the immigration process remains a significant challenge, and securing visas for foreign nationals can be met with many obstacles, options do exist in the health care industry. The H-1B visa, designed for applicants qualified to fill a specialty occupation on a temporary basis, is by far the most well known temporary visa. The annual mandated cap of 65,000 available visas has made it a less viable option in recent years because this quota typically is met on the first day of the filing period. The H-1B visa cap remains a critical issue for employers as discussions continue regarding a possible increase in the annual allotment. However, there are a number of alternatives to the H-1B visa, and some are processed much more quickly, including: • TN Visa: Based on the North American Free Trade Agreement, it is available only to Canadian and Mexican professionals coming to the United States to perform professional activities. The TN visa was recently extended from a one-year to a three-year term and also can be renewed indefinitely. There is no cap on the number of TN visas allotted. • J-1: Issued to an Exchange Visitor who is participating in an established, pre-approved program such as medical residents or interns receiving medical training in the United States. • E-3: Available only to Australian citizens who are going to the 44 HR Pulse Spring 2009
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