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).

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.

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.


FREQUENTLY ASKED QUESTIONS

What is the H-1C visa?
The H-1C visa is a non-immigrant visa for nurses to temporarily work in "healthcare shortage areas" in the United States. A nurse may practice in the U.S. for three years under the H-1C visa.

Who is eligible for an H-1C visa?
The Immigration and Naturalization Service (INS) will determine who receives an H-1C visa based on the following requirements. A nurse must: have a full and unrestricted license to practice professional nursing in the country where they obtained their nursing education or have received nursing education in the United States; have passed an appropriate examination (determined by the Department of Health and Human Services), or have a full and unrestricted license to practice as a registered nurse in the state of intended employment; and be fully qualified and eligible under the state laws and regulations of the state of intended employment to practice as a registered nurse immediately upon admission to the United States.

How can I satisfy the requirements for the H-1C visa?
Nurses may satisfy the H-1C visa requirements by obtaining a certified statement from CGFNS, or by obtaining certification from an independent credentialing organization approved by the Attorney General and the Secretary of the Department of Health and Human Services; and passing the NCLEX-RNŽ examination.

What will CGFNS be screening for in its certification for the H-1C visa?
CGFNS will be certifying that the nurse:
already possesses a valid and unencumbered licenses as a nurse in a state where the alien intends to be employed and such state verifies that the foreign license of alien nurses are authentic and unencumbered;
has already passed the National Council Licensure Examination for registered nurses (NCLEX-RNŽ); and
is a graduate of a nursing program (a) in which the language of instruction was English, (b) located in a country designated by CGFNS within 30 days of the date of enactment of P.L. 106-95, based on CGFNS’ assessment that the quality of nursing education in that country, and the English language proficiency of those who completed English-language-medium programs in that country justify the country’s designation, and (c) if that nursing program was in operation before November 12, 1999, or is subsequently designated by CGFNS and any equivalent credentialing organizations approved for the credentialing of nurses under subsection 212(a)(5)(C).

Which countries were designated by CGFNS?
CGFNS, with the authority conferred on it by P.L. 106-95, designated the following countries: Australia, Canada, Ireland, New Zealand, South Africa, the United Kingdom and the United States.

I am a Canadian nurse, must I be screened by CGFNS for the H-1C visa?
No. Canadian nurses applying for the H-1C visa or any temporary visa do not have to be certified by CGFNS. Under the NAFTA trade agreement, Canadian nurses only have to take and pass the NCLEX-RNŽ examination, and have been instructed in English during their schooling. However, Canadian nurses applying for a permanent immigrant visa must go through the same process as all foreign-educated nurses, which is obtaining certification from CGFNS, passing the NCLEX-RNŽ examination and, if from a non-English-speaking country, passing the TOEFL or MELAB English proficiency exams.

How do I apply for certification for the H-1C visa with CGFNS?
Complete the VisaScreen application, marking "H-1C" in the other box on the application, and marking "Attn: Amos Sydnor, H-1C" on the outside of the envelope. You must also indicate which U.S. state(s) you are currently licensed in on the application form. Fill out the application completely, mail your application with the appropriate fee and send your records, transcripts and validations request forms to the proper schools/licensing authorities. School transcripts and records, and all past and current license validations must come directly from the schools/licensing authorities to CGFNS.

Do I need to have a validation form completed for every license I’ve ever held?
Yes. CGFNS needs validations on every license, past and present, foreign and U.S.
SECTION 212(r)

I understand that the recent legislation regarding H-1C visas for nurses also made some changes in the processing of certifications for foreign nurses, as required by section 343 of the 1996 immigration act and section 212(a)(5)(C) of the Immigration and Nationality Act. Can you please describe those changes?
The principal change is that CGFNS or any other credentialing organization certifying foreign nurses will, in the case of certain nurses trained in certain designated countries, issue "certified statements" within 35 days of application for such a certified statement. A new certificate indicating that the individual has met the requirements of section 212(r) of the Immigration and Nationality Act was created.

Who can apply for, and what are the criteria for the issuance of these "certified statements?"
A nurse applying for a "certified statement" must demonstrate that he or she:
already possesses a valid and unencumbered licenses as a nurse in a state where the alien intends to be employed and such state verifies that the foreign license of alien nurses are authentic and unencumbered;
has already passed the National Council Licensure Examination for registered nurses (NCLEX-RNŽ); and
is a graduate of a nursing program (a) in which the language of instruction was English, (b) located in a country designated by CGFNS within 30 days of the date of enactment of P.L. 106-95, based on CGFNS’ assessment that the quality of nursing education in that country, and the English language proficiency of those who completed English-language-medium programs in that country justify the country’s designation, and (c) if that nursing program was in operation before November 12, 1999, or is subsequently designated by CGFNS and any equivalent credentialing organizations approved for the credentialing of nurses under subsection 212(a)(5)(C).

How were the countries listed as part (b) of the third criterion above, selected?
Public Law 106-95 (the 1999 law regarding H-1C visas) conferred on CGFNS the authority to designate certain countries on the basis of CGFNS’ assessment that the quality of nursing education in that country, and the English language proficiency of those who completed English-language nursing education programs in that country, justify that country’s nursing graduates as qualifying for the "certified statement" process.

How long will it take to obtain a "certified statement" from CGFNS?
CGFNS is dedicated to processing all H-1C visa certification applications within 35 days from receipt of a complete application.

How do I apply for a "certified statement" from CGFNS?
Complete the VisaScreen application, marking "Certified Statement" in the other box on the application, and marking "Attn: Amos Sydnor, H-1C" on the outside of the envelope. You must also indicate which U.S. state(s) you are currently licensed in on the application form. Fill out the application completely, mail your application with the appropriate fee and send your records, transcripts and validations request forms to the proper schools/licensing authorities. School transcripts and records, and all past and current license validations must come directly from the schools/licensing authorities to CGFNS.

Do I need to have a validation form completed for every license I’ve ever held?
Yes. CGFNS needs validations on every license, past and present, foreign and U.S.

I am a Canadian nurse; do I need either a VisaScreen (ICHP) certificate or a "certified statement" from CGFNS?
It depends on whether you are coming to the United States as a temporary worker or are applying for a "green card" as a permanent resident. Canadian nurses coming to work temporarily in the United States do not at the present time have to be certified by CGFNS. However, Canadian nurses applying for a "green card," i.e., for permanent immigrant status, must go through the same process as all foreign-educated nurses, which means obtaining certification from CGFNS, passing the NCLEX-RN examination and, if from a non-English speaking country, passing the TOEFL or MELAB English proficiency exams. If you were educated in Canada, however, or in one of the other countries designated by CGFNS as described in an earlier question, then you may qualify for a "certified statement" and may not have to obtain an ICHP certificate.

14 Hospitals that qualify for the H1C visa:

According to the Labor Department, it is aware of only 14 hospitals that
qualify to apply for H-1C nurses because of restrictions in both the statute
and regulations. These facilities are:

1. Beaumont Regional Medical Center, Beaumont, TX
2. Beverly Hospital, Montebello, CA
3. Doctors Medical Center, Modesto, CA
4. Elizabeth General Medical Center, Elizabeth, NJ
5. Fairview Park Hospital, Dublin, GA
6. Lutheran Medical Center, St. Louis, MO
7. McAllen Medical Center, McAllen, TX
8. Mercy Medical Center, Baltimore, MD
9. Mercy Regional Medical Center, Laredo, TX
10. Peninsula Hospital Center, Far Rockaway, NY
11. Southeastern Regional Medical Center, Lumberton, NC
12. Southwest General Hospital, San Antonio, TX
13. St. Bernard Hospital, Chicago, IL
14. Valley Baptist Medical Center, Harlingen, TX


News Articles:

Proposed H1C program - Nurses for Medically Underserved Areas

Representatives Rush and Hyde have introduced a bill in the House of Representatives to establish a new H1C non-immigrant visa program for nurses. Unlike the previous H1A nurse program, the H1C program would require the nurses to work in locations designated as Health Professional Shortage Areas. Health care facilities employing H1C nurses need to have at least 190 acute care beds, and there are other requirements, including attestations that are similar to some of the previous H1A attestations and the existing H1B attestations. Usage of this category will be limited to 500 nurses per year.

INS Issues Regulations for H1C Nurse Category – June 11, 2001

An overview of the H1C temporary visa category for nurses to work in medically underserved areas. There are specific requirements with respect to the type of health care facility that is eligible to petition for H1Cs, as well as with regard to the qualifications of the beneficiary. For details on those requirements, kindly refer to our May 11, 2001 article entitled Overview : H1C Visas for Registered Nurses. The H1C visa category was established by the Nursing Relief for Disadvantaged Areas Act of 1999 (NRDAA) (Pub. L. No. 106-95).

Finally, on June 11, 2001, after about one and half years, the INS issued regulations, effective immediately, to implement the H1C category. The regulation instructs employers that all H1C petitions are to be filed exclusively at the Vermont Service Center (VSC), regardless of the location of the employment. VSC's difficulty in keeping up with the H1B caseload does not bode well for the timely processing of H1C petitions. The H1C petition is submitted on the same form used for the other temporary work visas.

Information to be included in the package is proof of having filed the required "attestation" with the U.S. Department of Labor (DOL). This attestation is not the same as the Labor Condition Application used for H1Bs; rather it is similar to the attestations used for the now-expired H1A nurse category. It is also necessary to include information on state licensing requirements and proof of the beneficiary's credentials. More than one nurse can be included in a petition.

Only 500 H1C visas can be issued in a given fiscal year (October 1 through September 30). There are also caps imposed on individual states. States with a larger population will receive a larger allocation than states with less population.

The maximum period of stay in H1C status is three years. Temporary absences abroad count toward that limit, so it would not be possible to "recapture" time spent abroad during the H1C period. Also, unlike the H1B, a person who has been in the U.S. for three years in H1C status could not return home for some period of time and later reapply for H1C. (H1Cs who wish to remain longer in the United States would be well advised to file for permanent residency. There is a streamlined process to file for permanent residency, known as Schedule A, for nurses.)

Please note that the H1C category is scheduled to expire on June 13, 2005, so all H1C petitions must be filed by that date.

See the Nursing Kit