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Published by the Law Offices of Carl Shusterman, 600 Wilshire Boulevard, Suite 1550, Los Angeles, California, 90017. Phone: (213)623-4592, Fax: (213) 623-3720, E-Mail: carl@shusterman.com, WWW Home Page: http://www.shusterman.com
To subscribe to SHUSTERMAN'S IMMIGRATION UPDATE, fill out the brief online form at http://www.shusterman.com/subscribe.html#subscribe or send an e-mail message to majordomo@ls.shusterman.com, with the words "subscribe visalaw" in the body of the message.
To unsubscribe, fill in your e-mail address at http://www.shusterman.com/subscribe.html#unsubscribe or send an e-mail message to majordomo@ls.shusterman.com, with the words "unsubscribe visalaw" in the body of the message.
For back issues of SHUSTERMAN'S IMMIGRATION UPDATE, see
Disclaimer: This newsletter is not intended to establish an attorney-client relationship. All information contained in this newsletter is generalized. Any reliance on information contained herein is taken at your own risk.
1. September 2001 State Department Visa Bulletin
2. Latest Governmental Processing Times
3. Legislation I: Amnesty, Guestworkers And §245i
4. Physicians: If There Were Fewer IMGs, Who Would Replace Them?
5. Immigration Trivia Quiz: Foreign-Born Members Of The Cabinet
6. Nurses: GAO Reports Nurse Shortages Due To Multiple Factors
7. Legislation II: Rural And Urban Health Care Act Of 2001
8. Regulations Issued To Change From Regular To RIR Labor Cert.
9. Chat Schedule, Transcripts, Audios & Videos
10. Answers To July's Immigration Trivia Quiz
and scroll down to "James W. Ziglar Confirmed As INS Commissioner (August 3, 2001)"
The disaster area that is officially known as the family preference categories actually advanced slightly. Although the worldwide FB numbers for two of five categories remains "unavailable" (Translation: Don't bother to apply!), both the worldwide 2A and 2B categories advanced one month. In addition, the 4th FB category for persons born in India moved forward three weeks. The shutdown of the family categories has clearly placed the ball in Congress's court. The Democrats in Congress have proposed increasing the numbers in the family-based categories. We think this is clearly required.
On the Employment side, it was a far different story as all of the EB numbers, including those for unskilled workers, remained current. Of course, backlogs will develop in the EB numbers within a few months, but for now, it is time to apply for green cards through employment.
The September 2001 Visa Numbers can be found at
For an explanation of what the categories, dates and symbols listed below mean, see
and
Check the State Department's official version to see complete information about the movement of family, employment and lottery numbers, at
Our web site contains the waiting times of each center and enumerates each state served by the center and any foreign offices within the center's jurisdiction.
The service centers periodically issue lists of their processing times for various types of applications. Our web site contains the latest list issued by each service center.
Warning: Processing times may appear faster on the official lists than they are in reality. These processing times are not recognized as official by the INS in Washington, D.C. and are not posted on the official INS web site.
To see how fast (or slow) your service center is processing a particular type of petition or application, see our "Government Processing Times Page" at
Processing times at INS District Offices may be accessed at
To check the processing times of your Department of Labor Regional Office and your State Employment Service Agency (SESA) as of May 2001, click on
and
Then, on August 2, Democratic legislators upped the ante by endorsing the following principles:
scroll down to "Legislative Developments in 2001" and click on "Congressional Democrats Call For Overhaul Of Immigration Laws".
In July, the House Appropriate Subcommittee on Commerce, Justice and State passed a permanent extension of §245i without the restrictive amendment.
Then, on July 26, the Senate Judiciary Committee unanimously backed a 12-month extension of §245i with the amendment.
Obviously, some sort of a compromise is in order. If you or a friend, employee or family member would be impacted, now is the time to lobby your senator or representative. Congress will reconvene on September 4.
A federal program that is working well, involves the states in making decisions, improves health care, and costs the taxpayers only a minimal amount. It seems too good to be true, doesn't it?
If your primary concern is the health and welfare of the American people, what reason would you have to oppose the expansion of such a program? Then why have the Council on Graduate Medical Education (COGME) and six medical associations called for a reduction in the supply of new International Medical Graduates (IMGs) into medical residency and fellowship program in the U.S.; the termination of the J-1 waiver program for foreign medical graduates; and an increased home residency requirement from two to five years?
They say that these steps are necessary to reduce the national physician oversupply. To me, this is tantamount to calling for an end to the food stamp program in order to reduce obesity in America!
Try telling an American citizen living in one of the 161 counties where there is not a single primary care physician that there is a Anational physician oversupply. The problem is that there is a maldistribution of physicians in the U.S. and most U.S. medical graduates prefer to enter a specialty field rather than engage in a less lucrative practice involving primary care. Imagine that you have just completed a medical residency or fellowship in New York or California. How likely is it that you will establish a practice in rural North Dakota or in the South Side of Chicago? The answer is painfully obvious to the residents of such localities.
However, if you are an IMG who has finished a medical residency or fellowship, these locations may be a perfect match to your needs. Why? Because, unless you work in a medically underserved area in the U.S. for a minimum of three to five years, chances are that you will be forced to leave the U.S. and return to your home country for at least two years. This is true even if your spouse and children are U.S. citizens, and yes, even if your medical skills would be useless in your native country. This is why over 2,000 IMGs obtain J waivers by practicing in medically underserved areas. And guess what? A lot of IMGs find that they like working in these areas, and settle their permanently.
Recently, the Federal Office of Rural Health Policy issued a grant to the Cecil G. Sheps Center for Health Service Research at the University of North Carolina to answer the following question:
The researchers from the Sheps Center interviewed state policy makers, health planners and physician recruiters in four states with high concentrations of IMGs in rural areas (Florida, New York, North Dakota and West Virginia). Their report raises the yellow caution flag to those who are all too eager to end the J waiver program for IMGs. Below are some of the report's major findings:
and scrolling down to "IMGs And Canadian Physicians" and clicking on "If Fewer IMGs Were Allowed In The U.S., Who Might Replace Them In Rural Areas? (PDF File)".
To learn about the J-1 programs in these states, scroll down to "J-1 Waiver Programs" and then to "Conrad State 20 Programs".
The first person to identify each of these immigrants, their countries of birth, and the Departments they head, and e-mail the correct answer to me at carl.shusterman@gte.net will be the winner of our August Immigration Trivia Quiz. The winner will receive a free 30-minute immigration consultation (either telephonic or in-person) with me before the end of the month.
(1) Whether there is evidence of a current nursing shortage;
(2) The reasons for current nurse recruitment and retention problems; and
(3) What is known about the projected future supply of and demand for nurses.
On July 10, the GAO reported to Congress that there is an "emerging shortage of nurses"; that the national unemployment rate for nurses had declined, in 2000, to one percent; that health care providers "are reporting growing difficulty recruiting nurses" and that there were "rising RN vacancy rates" around the country.
While the number of RNs per capita had steadily increased from 1980 to 1996, the number declined between 1996 and 2000. (Editor's note: The temporary visa program for nurses was phased out between 1995 and 1997. Perhaps this factor is partly responsible for the decline in the number of nurses compared to the general population which began in 1996.)
In some of the more populous states, the RN vacancy rates have reached alarming levels. For example, in 2000, California reported an average RN vacancy rate of 20%, and, in 2001, Florida's vacancy rate approached 16%.
As nurse vacancy rates rise, the report found that the number of RNs passing the national nursing exam (NCLEX) declined 23% between 1996 and 2000. Furthermore, as older nurses retire or leave the nursing profession, they are not being replaced by younger nurses. In fact, between 1983 and 1998, the number of RNs under 30 in the workforce fell by 43%!
The report found that "job dissatisfaction has...been identified as a major factor contributing to the current problems of recruiting and retaining nurses." It also found that "inadequate staffing, heavy workloads, and increased use of overtime are frequently cited as key areas of job dissatisfaction among nurses." (Editor's Note: Increasing the number of nurses by reinstating a temporary visa category for nurses would help to alleviate each of these areas of job dissatisfaction.)
Finally, and most troubling, was the GAO's finding that "demand for nurses will continue to grow as the supply dwindles." The report found that while the "population age 65 years and older will double between 2000 and 2030"..., Aduring that same period, the number of women between 25 and 54 years of age, who have traditionally formed the core of the nurse workforce, is expected to remain relatively unchanged." The report notes the "potential mismatch between future supply of and demand for caregivers".
We link to the GAO report on our "Nurse Page" at
Scroll down to "National Shortage of Nurses" and click on "Nursing Workforce: Emerging Nurse Shortages Due To Multiple Factors - GAO Report (July 10, 2001) - PDF File". We hope that Congress will respond to this important and alarming report by passing legislation to restore the temporary visa category for nurses. Prior to it's expiration in 1995, U.S. hospitals used this category to hire over 7,000 additional nurses annually.
Kaiser's bold move was criticized by a number of labor and management organizations who seldom agree with each other on anything. The California Nurses Association (CNA) which represents half of Kaiser's 18,000 RNs called Kaiser's decision a "death-bed conversion". The CNA fears that Kaiser will replace RNs with less expensive Licensed Vocational Nurses (LVNs). The California Hospital Association (CHA) also opposes Kaiser's plan. A CHA spokesperson stated, "You should be basing staffing decisions on the needs of patients", and accused Kaiser of simply caving into the demands of its labor unions.
While not wishing to become embroiled in this dispute, we note that there is a finite supply of nurses, and to the extent that Kaiser is successful in attracting additional RNs and LVNs to its workforce, vacancy rates at other hospitals will continue to increase. What is called for is governmental action to increase the overall supply of nurses. Presently, nursing schools continue to close their doors and American women, having vastly increased career options, no longer choose nursing as a profession in the same numbers as they have in the past.
Increased immigration of nurses is one of the few options that can increase the supply of nurses in the short term. See Topic #7 below.
We are pleased to have been able to contribute ideas and language which were included in the bill.
The bill would re-establish a temporary visa category for nurses as was the case between 1952 and 1995. This would enable health care providers to obtain the services of foreign-born nurses in as little as two to three months. At present, hospitals petitioning for nurses must frequently wait between one and two years to obtain permanent residence on their behalf.
Recognizing the severity of the nurse shortage, the bill would allow all health care employers to petition for H-1C nurses. Based upon the number of RNs who participated in the H-1A program in the early 1990s, we expect 5,000 - 7,000 nurses to be petitioned annually. While this, in itself, would not solve the undersupply of nurses, it would certainly help ease the crisis. In addition, the bill provides that the Secretary of Health and Human Services (HHS) "shall award grants to States, local governments and institutions of higher education...to fund training, recruitment, and other activities to increase the supply of domestic registered nurses and other needed health care providers."
In addition, the bill would modify and make permanent the Conrad State Program that permits state departments of health to sponsor foreign-born physicians for J waivers. The bill would double the number of physicians who could be sponsored.
Senator Brownback, in introducing the bill stated: "This bill does not attempt to solve all problems related to this issue... However, it is not possible in one bill to address all outstanding financial or labor issues present in today's hospitals and nursing homes. Indeed, many of these issues will have to be addressed at the State level. But simply because we cannot solve all of today's health-care problems, does not mean that we abdicate our responsibility to find practical solutions to help real people."
Read the complete text of the bill on our "Nurse Page" at
A section-by-section summary of the bill may be accessed at
Senator Brownback's introductory remarks are at
Upon its introduction, the bill was referred to the Senate Subcommittee on Immigration. We hope that consideration of the bill will be high on Chairman Kennedy's agenda when Congress returns from its summer recess on September 4.
Although this is a very welcome development, as the genie in the film "Aladdin" would say, "The regulations are subject to a few provisos":
What does this mean in the real world? Who benefits and who does not?
See the latest SESA processing times at
Read the new regulations, and weep or rejoice (as appropriate), at
In May 1999, we pioneered the concept of free online chats on various immigration topics. Our chats are always focused on a particular subject. Together with About.com's Immigration Guides, Jennifer and Peter Wipf, we have conducted over two dozen chats on a wide variety of subjects, all related to immigration laws and procedures.
We conducted regular chats on the LIFE Amendments (emphasizing §245i) starting on December 22, 2000, one day after the amendments were signed into law.
On June 7, 2001, we conducted a chat about the INS's new Priority Processing Service entitled "Paying Your Way To The Front Of The Line". It is now online.
So is our chat entitled "What To Do If You Are An H-1B And The Boss Gives You A Pink Slip".
To read the complete text of our chats, see our Chat Page at
Are your eyes getting tired from reading all of our information about immigration laws and procedures? Then sit back, close your eyes, and listen to any (or all!) of the following immigration audios:
See my testimony before the Senate Subcommittee On Immigration on May 22, 2001 regarding "Immigration Policy: Urban And Rural Health Care Needs" at
or read the complete transcript of my testimony at
Remember, you will need to download a free copy of RealPlayer 8.0 which you can find at
in order to hear the audios or to view the video.
Hi Carl,Dr. Vossough, thank you for your hard work in locating all of these web sites. We have posted links to each of these sites on our "Physician Page" atI found the information about the J-1 visa waiver requirements for each state by visiting the individual websites of the departments of health for each of the 50 states and also the federal institutes that deal with rural health. It took me almost a full day to compile the information and try to make sure nothing important was left out.
I am originally from Iran. I am a resident physician here on an H-1B. I have been a long time subscriber to the newsletter since 1998 and have used it to be kept up to date on the latest regulatory changes.
Thanks,
Arastoo Vossough
Carl Shusterman
"Power never yields without a demand. Never did, never will."
August 6, 2001