To amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas.

Mr. Speaker, I rise in support of H.R. 1933--To amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas.

A number of hospitals with unique circumstances experience a great difficulty in attracting American nurses. Hospitals serving mostly poor patients have special difficulties. Some hospitals in rural areas do also. For example: St. Bernard Hospital and Health Care Center is located on the South side of Chicago in the Englewood Community. It is the only remaining hospital in an area with a census in excess of 100,000 and the patient base is almost entirely poverty care or charity care. St. Bernard almost closed its doors in 1992, primarily because of its inability to attract health care professionals, most importantly registered nurses.

H.R. 1933 reauthorizes the program for an additional three years. The number of visas that may be issued in each fiscal year cannot exceed 300. An alien may be admitted for three years and this stay may be extended once for an additional three years (the possibility of an extension is new with H.R. 1933). Furthermore, H.R. 1933 allows an H-1C nurse to be able to switch employment between any of the 14 H-1C- eligible hospitals. This prevents those nurses here through this program to have some flexibility in their employment options in the event they run into any hardship at the hospital where they are employed.

The Nursing Relief for Disadvantaged Areas Act, signed into law in 1999 created a new H-1C temporary visa program for registered nurses. The program was modeled after the expired H-1A temporary nursing visa program but limited the number of visas that could be issued to 500 a year and only allowed in-need hospitals who met certain criteria to petition for alien nurses. To be able to petition for an alien, an employer had to meet four basic conditions. First, the employer must have been located in a health professional shortage area as designated by the Department of Health and Human Services. Second, the employer must have had at least 190 acute care beds. Third, a certain percentage (35 percent) of the employer's patients must have been Medicare patients. Fourth, a certain percentage (28 percent) of patients must have been Medicaid patients.

Employers had to make certain attestations pertaining to payment of a wage which will not adversely affect wages and working conditions of similarly employed registered nurses; payment of wages to aliens at rates paid to other registered nurses similarly employed by the facility; taking timely and significant steps designed to recruit and retain U.S. nurses in order to reduce dependence on nonimmigrant nurses; absence of a strike/lockout or lay off of nurses; notice to workers of its intent to petition for H-1C nurses; percentages of H-1C nurses to be employed at the facility; and placement of H-1C nurses within the facility.

This is a common sense employment-based immigration program that fills a desperate need in some of our nation's neediest hospitals. This program if very limited in who is admitted to work in this country, but fulfills a gap in our healthcare system.

The Department of Labor has determined that the following hospitals are eligible for the program, some of which are located in Texas: Beaumont Regional Medical Center, Beaumont, TX; Beverly Hospital, Montebello, CA; Doctors Medical Center, Modesto, CA; Elizabeth General Medical Center, Elizabeth, NJ; Fairview Park Hospital, Dublin, GA; Lutheran Medical Center, St. Louis, MO; McAllen Medical Center, McAllen, TX; Mercy Medical Center, Baltimore, MD; Mercy Regional Medical Center, Laredo, TX; Peninsula Hospital Center, Far Rockaway, NY; Southeastern Regional Medical Center, Lumberton, NC; Southwest General Hospital, San Antonio, TX; St. Bernard Hospital, Chicago, IL; and Valley Baptist Medical Center, Harlingen, TX.

The Nursing Relief for Disadvantaged Areas Act of 1999 was enacted as a four-year program (beginning on the effective date of implementing regulations) on November 12, 1999. The program expired in 2005 and was reauthorized in 2006 for an additional three years. The program expired in December of 2009 (but some H-1C nurses remain who received approval for three-year stays before this date). The Department of Labor reports that 499 nurses received visas under the program in fiscal year 2007 as did 110 in fiscal year 2008.

I urge all Members to join me in supporting passage of this landmark legislation.

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1933) to amend the Immigration and Nationality Act to modify the requirements for admission of nonimmigrant nurses in health professional shortage areas, as amended.

I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks and include extraneous material on H.R. 1933, as amended.

I yield myself such time as I may consume.

Mr. Speaker, I offer this legislation on behalf of myself and Representatives Cuellar, Hinojosa, Roskam, and Rush.

A number of American hospitals have great difficulty attracting nurses. These include hospitals that serve mostly poor patients in inner-city neighborhoods and some hospitals in rural areas. For example, St. Bernard Hospital in Chicago is the only remaining hospital in an area of over 100,000 people and almost all of its patients live in poverty. St. Bernard almost closed its doors in 1992 primarily because of its inability to attract registered nurses.

Congress passed the Nursing Relief for Disadvantaged Areas Act in 1999 to help hospitals like St. Bernard. It created a new H-1C temporary registered nurse visa program with 500 visas available each year that allowed nurses to stay for 3 years.

To be able to petition for a foreign nurse, an employer had to meet four conditions. First, the employer had to be located in a health professional shortage area; second, the employer had to have at least 190 acute care beds; third, a certain percentage of the employer's patients had to be Medicare patients; and fourth, a certain percentage of patients had to be Medicaid patients.

The H-1C program adopted the protections for American nurses contained in the expired H-1A nursing visa program. For instance, a hospital had to agree to take timely and significant steps to recruit American nurses. Also, hospitals had to pay the prevailing wage.

The H-1C program contained new protections such as requirements that foreign nurses could not comprise more than one-third of a hospital's registered nurses. The H-1C program was extended in 2006 but expired in December of 2009, though many nurses still remain on 3-year visas issued before that date.

Sister Elizabeth Van Straten, president of St. Bernard Hospital, wrote to me last December that ``because of the sunset, in combination with the extended approval period for green cards, nurses are now forced to leave our institution, and the rate of loss continues to increase. This loss cannot be sustained. As the only hospital serving one of the most difficult sections of Chicago, and perhaps the entire country, we need the extension of the visa program to survive.''

I introduced H.R. 1933 to help St. Bernard and other, similar hospitals. The bill reauthorizes the H-1C program for another 3 years. The number of visas that may be issued in each fiscal year cannot exceed 300. An alien may be admitted for 3 years, and this stay may be extended once for an additional 3 years.

The H-1C program ensures continued care for patients in inner-city and rural communities. I urge my colleagues to support this legislation.

I reserve the balance of my time.

Mr. Speaker, I have no requests for time, and I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

I yield myself such time as I may consume.

I will not repeat the information provided by Chairman Smith. I will simply state that the H-1C program was first created in 1999 to address shortages in both rural and inner-city hospitals. The 500 visas per year actually only go to 14 hospitals in the United States spread out across America. And of course the program has now expired.

As Chairman Smith has indicated, this bill would reauthorize but reduce the number from 500 to 300, create certain other protections as mentioned by the chairman, and allow the maximum stay to go to 6 years. Because the bill would double the duration of H-1C status, I offered an amendment in committee, which was accepted by all, to make the H-1C visas portable among the 14 hospitals authorized to employ H-1C nurses. Right now, the nurses are entirely dependent on their employers to provide them their immigration status, and visa portability would level the playing field and allow a nurse to switch employers if something was wrong.

I appreciate the Chairman's willingness to accept that, and I thank the chairman for introducing this bill and working with me to ensure that H-1C

nurses are better protected against exploitive situations.

I urge my colleagues to support the bill.

I yield back the balance of my time.

Mr. Speaker, I was absent earlier today due to a prior commitment scheduled before we knew the House would be in session. On the votes I missed, on H.R. 2715, to provide greater authority and discretion to the CPSC in enforcement of product safety laws, had I been present, I would have voted ``yes.''

On H.R. 398, to amend the Immigration and Nationality Act to toll during national and active duty service abroad in the Armed Forces, I would have voted ``yes.''

On H.R. 1933, to amend the Immigration and Nationality Act to modify requirements, I would have voted ``yes.'' While I do recognize the shortage of nurses in our country, I would hope that we should focus on providing more incentives to students here to become nurses.

On the motion on ordering the previous question on the rule for S. 365, I would have voted ``no.''

On H. Res. 384, the rule providing for consideration of S. 365, I would have voted ``no.''

On the Journal vote, I would have voted ``yes.''