H-1C Visa for Nurses

An H-1C visa, or H-1C work permit is a visa for nurses who want to work in health professional shortage areas. This visa is based on the former H-1A category visa for nurses which was created to address spot shortages of labor in the nursing field but which expired on September 30, 1997.

The law limits the number of H-1C visas that can be issued to 500 per year. A nurse who comes to the United States on a H-1C visa may practice in the U.S. for 3 years. The visa cannot be extended.

It is important to note that United States immigration laws only permit foreign nurses to work in the U.S. if they are classified as registered nurses. Licensed practical nurses, licensed vocational nurses, nursing aids, and other nursing related professionals are not permitted to work in the U.S. as there are no visa classifications available for those positions.

What are the Requirements for Obtaining an H-1C Visa?

In order to qualify for a H-1C visa, an applicant must meet the following requirements:

• The applicant must have a full and unrestricted nurse’s license in their home country, or have received their nursing education in the United States;
• The applicant must pass an appropriate examination that is determined by the U.S. Department of Health and Human Services, or have a full and unrestricted license to practice as a registered nurse in the state of their intended employment; and
• The applicant must 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.

The nurse applicant can satisfy the H-1C requirements by obtaining a certified statement from the Commission on Graduates of Foreign Nursing Schools (CGFNS). The applicant may also satisfy the requirements by obtaining certification from an independent credentialing organization.

The organization must be approved by the Attorney General and the Secretary of the Department of Health and Human Services. The applicant must also pass the National Council Licensure Examination for registered nurses (NCLEX-RN) examination.

How Can I Hire Foreign Workers Using an H-1C Visa?

If an employer wishes to hire a foreign nurse in the United States on a H-1C visa, the employer must file an attestation with the Employment and Training Administration (ETA) of the United States Department of Labor. The employer must indicate the following:

• The facility is at a hospital located in a designated health professional shortage area as of March 31, 1997. Additionally, for the fiscal year 1994, it 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. By satisfying these requirements, the facility meets the definition of a subsection D hospital found in the Social Security Act;
• The employment of the H-1C nurse will not adversely affect the working conditions and wages of similarly employed nurses;
• The H-1C nurse will be paid the same wages as other similarly employed nurses;
• The facility is taking and has taken timely and significant steps to recruit and retain U.S. citizens or eligible immigrant nurses;
• There are no lockouts or strikes in the course of labor disputes. Additionally, the facility did not and will not lay off a registered nurse that is employed by the employer within the 90 day period before or after the filing of the H-1C petition, and the employment of the H-1C nurse is not designed or intended to influence the election for a bargaining representative for registered nurses at that facility;
• A notice of the H-1C petition has been provided to the designated union representative, or, in the absence thereof, has been posted in multiple conspicuous places within the facility;
• The H-1C nurses employed at the facility will never total more than one-third of the total registered nursing staff; and
• The H-1C nurse will not work at any worksite other than the worksite controlled by the petitioning facility or transfer from one worksite to another.

What Facilities are Eligible to Employ H-1C Nurses?

The United States Department of Labor (DOL) identified 14 hospitals that are currently eligible to participate in the H-1C program. These include:

• Beverly Hospital in Montebello, California;
• Doctors Medical Center in Modesto, California;
• Elizabeth General Medical Center in Elizabeth, New Jersey;
• Fairview Park Hospital in Dublin, Georgia;
• Lutheran Medical Center in St. Louis, Missouri;
• Mercy Medical Center in Baltimore, Maryland;
• St. Bernard Hospital in Chicago, Illinois;
• Peninsula Hospital Medical Center in Far Rockaway, New York;
• Southeastern Regional Medical Center in Lumberton, North Carolina;
• McAllen Medical Center in McAllen, Texas;
• Beaumont Regional Medical Center in Beaumont, Texas;
• Mercy Regional Medical Center in Laredo, Texas;
• Southwest General Hospital in San Antonio, Texas; and
• Valley Baptist Medical Center in Harlingen, Texas.

The DOL has indicated that there may be other hospitals that are eligible to participate in the H-1C visa program.

What about Spouses and Children of H-1C Visa Holders?

The spouse and children of a H-1C visa holder may enter and remain in the United States with a H-4 visa. A H-4 visa holder may attend school in the United States but cannot accept employment.

Are There Any Other Options for Nurses Who Wish to Come to the United States?

Yes, there may be other options available for nurses that want to come to the U.S. for work. Since the number of H-1C visas is so low, many nurses choose to skip the H-1c visa and apply for a nurse green card.

It is important to note that the nurse must have arranged employment in the United States in a hospital or healthcare facility that is willing to offer them a job as a registered nurse. That facility must be aware that the process will take at least a year before the nurse can begin working.

Starting the process to file for a permanent residence in the United States does not authorize an individual to work in the U.S. unless they fit into a nonimmigrant category. Because of this, most nurses will be required to wait outside of the United States until the immigration process is complete.

Many employers will not want to wait an entire year before hiring a registered nurse. However, some facilities and hospitals recognize that there is a chronic shortage of registered nurses at their facility and are planning ahead and willing to wait for a qualified registered nurse to obtain their permanent residence.

The Department of Labor provides a list of full-time nursing occupations that will qualify. These include:

• General duty nurses;
• Nurse instructors;
• Nurse practitioners; and
• School nurses.

Do I Need an Attorney to Get an H-1C Visa?

It is essential to have the assistance of an experienced immigration lawyer with any H-1C visa issues you may have. The application process for a H-1C visa can be extremely complex, whether you are a foreign nurse or an employer.
Your attorney can assist you in determining your eligibility as well as recommending what steps to take. Your attorney can also assist you with each step of the process. In addition, there may be alternative options available for you that your attorney can discuss with you.