Nursing Shortage and the H-1C

Hospitals, and communities, around the country are experiencing a shortage of nurses, affecting both the efficiency of the hospitals and the care of their patients. This staffing crisis can be explained by the following three things: (1) increased demand by the aging population and workforce in the U.S.; (2) burnout for currently employed nurses following the pandemic; and (3) a lack of educators to teach new nurses.

To fill the gap left resulting from retirement and burnout, federal economists have said that the U.S. healthcare system will need, at least, 200,000 new nurses every year, all the way through 2026. With a growing disparity in the number of nurses currently employed and the demand for their services, hospitals have increasingly looked abroad to fill their vacant positions.

The way that American hospitals can partially address this issue is through the now expired H-1C. The H-1C was a nonimmigrant temporary worker classification exclusively for foreign nurses coming to the U.S. to work in a health professional shortage area as determined by the Department of Labor (DOL).

This visa was introduced in 1999 to specifically address the shortage of nurses in the country. Back then, hospitals were facing similar issues as their present nursing staff was shrinking, mainly due to an increased number of retiring nurses, and not enough new hires to fill the vacant spots. The federal government responded to this period of nursing vacancies by introducing the H-1C visa, which expired in December of 2009.

However, with the severe limitations on how many H-1C visas could have been issued each fiscal year, of only 500, this visa was nowhere near reaching its full potential. This number is even further restricted to only 50 available visas for states with a population of more than 9 million people and only 25 available visas for states with populations of 9 million or less.

To even be eligible for an H-1C visa the foreign nurse had to:

• Have a full and unrestricted nursing license in the country where your nursing education was obtained, or have received a nursing education and license in the U.S.;
• Be authorized by the appropriate U.S. State Board of Nursing to practice within the state;
• Have passed the examination given by the Commission on Graduates for Foreign Nursing Schools (CGFNS), or have a full and unrestricted license to practice as a Registered Nurse in the state where you will work, or have a full and unrestricted Registered Nurse’s license in any state and have received temporary authorization to practice as a Registered Nurse in the state where you will work. For more information, please see the Commission on Graduates for Foreign Nursing Schools (CGFNS) link to the right; and
• Have been fully qualified and eligible under the state laws of the state of intended employment to practice as a Registered Nurse immediately upon admission to the United States.

With such a high demand for foreign nurses today – and considering the countless applications and the pause for the EB-3 (aka the “nurse green card”) – the H-1C could become a necessary tool to address the issue, but it will need to be heavily reformed.

First and foremost, the number will need to be drastically increased from the miniscule current number of 500 to better address the nationwide shortage. Second, the duration of the status should also be raised. Three years of work for the foreign nurse is simply too short of a period to alleviate the stress on current nurses.

With such a pressing need for nurses in U.S. healthcare, a revived and reformed H-1C offers a solution.

For More Information:

For more information on the H-1C, you can read more here.

This blog post does not serve as legal advice and does not establish any client-attorney privilege. Do not take any action based on the information contained in this post without consulting a qualified immigration attorney. If you have any questions, please do not hesitate to contact our legal team directly.