II 

111TH CONGRESS 

2D SESSION S. 3135 

To enhance global healthcare cooperation and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 17, 2010 

Mr. DURBIN introduced the following bill; which was read twice and referred 

to the Committee on the Judiciary 

A BILL 

To enhance global healthcare cooperation and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Global Health Care 

5 Cooperation Act’’. 

6 SEC. 2. GLOBAL HEALTH CARE COOPERATION. 

7 (a) IN GENERAL.—Title III of the Immigration and 

8 Nationality Act (8 U.S.C. 1401 et seq.) is amended by 

9 inserting after section 317 the following: 


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1 ‘‘SEC. 317A. TEMPORARY ABSENCE OF ALIENS PROVIDING 

2 HEALTH CARE IN DEVELOPING COUNTRIES. 

3 ‘‘(a) IN GENERAL.—Notwithstanding any other pro4 vision of this Act, the Secretary of Homeland Security 

5 shall allow an eligible alien and the spouse or child of such 

6 alien to reside in a candidate country during the period 

7 that the eligible alien is working as a physician or other 

8 health care worker in a candidate country. During such 

9 period the eligible alien and such spouse or child shall be 

10 considered— 

11 ‘‘(1) to be physically present and residing in the 

12 United States for purposes of naturalization under 

13 section 316(a); and 

14 ‘‘(2) to meet the continuous residency require15 ments under section 316(b). 

16 ‘‘(b) DEFINITIONS.—In this section: 

17 ‘‘(1) CANDIDATE COUNTRY.—The term ‘can18 didate country’ means a country that the Secretary 

19 of State determines to be— 

20 ‘‘(A) eligible for assistance from the Inter21 national Development Association, in which the 

22 per capita income of the country is equal to or 

23 less than the historical ceiling of the Inter24 national Development Association for the appli25 cable fiscal year, as defined by the International 

26 Bank for Reconstruction and Development; 


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1 ‘‘(B) classified as a lower middle income 

2 country in the then most recent edition of the 

3 World Development Report for Reconstruction 

4 and Development published by the International 

5 Bank for Reconstruction and Development and 

6 having an income greater than the historical 

7 ceiling for International Development Associa8 tion eligibility for the applicable fiscal year; or 

9 ‘‘(C) qualified to be a candidate country 

10 due to special circumstances, including natural 

11 disasters or public health emergencies. 

12 ‘‘(2) ELIGIBLE ALIEN.—The term ‘eligible 

13 alien’ means an alien who— 

14 ‘‘(A) has been lawfully admitted to the 

15 United States for permanent residence; and 

16 ‘‘(B) is a physician or other healthcare 

17 worker. 

18 ‘‘(c) CONSULTATION.—The Secretary of Homeland 

19 Security shall consult with the Secretary of State in car20 rying out this section. 

21 ‘‘(d) PUBLICATION.—The Secretary of State shall 

22 publish— 

23 ‘‘(1) not later than 180 days after the date of 

24 the enactment of this section, a list of candidate 

25 countries; 


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1 ‘‘(2) an updated version of the list required by 

2 paragraph (1) not less often than once each year; 

3 and 

4 ‘‘(3) an amendment to the list required by 

5 paragraph (1) at the time any country qualifies as 

6 a candidate country due to special circumstances 

7 under subsection (b)(1)(C).’’. 

8 (b) RULEMAKING.— 

9 (1) REQUIREMENT.—Not later than 180 days 

10 after the date of the enactment of this Act, the Sec11 retary of Homeland Security shall promulgate regu12 lations to carry out the amendments made by this 

13 section. 

14 (2) CONTENT.—The regulations promulgated 

15 pursuant to paragraph (1) shall— 

16 (A) permit an eligible alien (as defined in 

17 section 317A of the Immigration and Nation18 ality Act, as added by subsection (a)) and the 

19 spouse or child of the eligible alien to reside in 

20 a foreign country to work as a physician or 

21 other healthcare worker as described in sub22 section (a) of such section 317A for not less 

23 than a 12-month period and not more than a 

24 24-month period, and shall permit the Sec25 retary to extend such period for an additional 


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1 period not to exceed 12 months, if the Sec2 retary determines that such country has a con3 tinuing need for such a physician or other 

4 healthcare worker; 

5 (B) provide for the issuance of documents 

6 by the Secretary to such eligible alien, and such 

7 spouse or child, if appropriate, to demonstrate 

8 that such eligible alien, and such spouse or 

9 child, if appropriate, is authorized to reside in 

10 such country under such section 317A; and 

11 (C) provide for an expedited process 

12 through which the Secretary shall review appli13 cations for such an eligible alien to reside in a 

14 foreign country pursuant to subsection (a) of 

15 such section 317A if the Secretary of State de16 termines a country is a candidate country pur17 suant to subsection (b)(1)(C) of such section 

18 317A. 

19 (c) TECHNICAL AND CONFORMING AMENDMENTS.— 

20 (1) DEFINITION.—Section 101(a)(13)(C)(ii) of 

21 the Immigration and Nationality Act (8 U.S.C. 

22 1101(a)(13)(C)(ii)) is amended by adding ‘‘except in 

23 the case of an eligible alien, or the spouse or child 

24 of such alien, who is authorized to be absent from 

25 the United States under section 317A,’’ at the end. 


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1 (2) DOCUMENTARY REQUIREMENTS.—Section 

2 211(b) of such Act (8 U.S.C. 1181(b)) is amended 

3 by inserting ‘‘, including an eligible alien authorized 

4 to reside in a foreign country under section 317A 

5 and the spouse or child of such eligible alien, if ap6 propriate,’’ after ‘‘101(a)(27)(A),’’. 

7 (3) INELIGIBLE ALIENS.—Section 

8 212(a)(7)(A)(i)(I) of such Act (8 U.S.C. 

9 1182(a)(7)(A)(i)(I)) is amended by inserting ‘‘other 

10 than an eligible alien authorized to reside in a for11 eign country under section 317A and the spouse or 

12 child of such eligible alien, if appropriate,’’ after 

13 ‘‘Act,’’. 

14 (4) CLERICAL AMENDMENT.—The table of con15 tents of such Act is amended by inserting after the 

16 item relating to section 317 the following: 

‘‘Sec. 317A. Temporary absence of aliens providing health care in developing 

countries.’’. 

17 SEC. 3. ATTESTATION BY HEALTH CARE WORKERS. 

18 (a) ATTESTATION REQUIREMENT.—Section 

19 212(a)(5) of the Immigration and Nationality Act (8 

20 U.S.C. 1182(a)(5)) is amended by adding at the end the 

21 following: 

22 ‘‘(E) HEALTH CARE WORKERS WITH

23 OTHER OBLIGATIONS.— 


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1 ‘‘(i) IN GENERAL.—An alien who 

2 seeks to enter the United States for the 

3 purpose of performing labor as a physician 

4 or other health care worker is inadmissible 

5 unless the alien submits to the Secretary of 

6 Homeland Security or the Secretary of 

7 State, as appropriate, an attestation that 

8 the alien is not seeking to enter the United 

9 States for such purpose during any period 

10 in which the alien has an outstanding obli11 gation to the government of the alien’s 

12 country of origin or the alien’s country of 

13 residence. 

14 ‘‘(ii) OBLIGATION DEFINED.—In this 

15 subparagraph, the term ‘obligation’ means 

16 an obligation incurred as part of a valid, 

17 voluntary individual agreement in which 

18 the alien received financial assistance to 

19 defray the costs of education or training to 

20 qualify as a physician or other health care 

21 worker in consideration for a commitment 

22 to work as a physician or other health care 

23 worker in the alien’s country of origin or 

24 the alien’s country of residence. 


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1 ‘‘(iii) WAIVER.—The Secretary of 

2 Homeland Security may waive a finding of 

3 inadmissibility under clause (i) if the Sec4 retary determines that— 

5 ‘‘(I) the obligation was incurred 

6 by coercion or other improper means; 

7 ‘‘(II) the alien and the govern8 ment of the country to which the alien 

9 has an outstanding obligation have 

10 reached a valid, voluntary agreement, 

11 pursuant to which the alien’s obliga12 tion has been deemed satisfied, or the 

13 alien has shown to the satisfaction of 

14 the Secretary that the alien has been 

15 unable to reach such an agreement 

16 because of coercion or other improper 

17 means; or 

18 ‘‘(III) the obligation should not 

19 be enforced due to other extraordinary 

20 circumstances, including undue hard21 ship that would be suffered by the 

22 alien in the absence of a waiver.’’. 

23 (b) EFFECTIVE DATE.—The amendment made by 

24 subsection (a) shall take effect on the date that is 180 

25 days after the date of the enactment of this Act. 


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1 (c) APPLICATION.—Not later than the effective date 

2 described in subsection (b), the Secretary of Homeland Se3 curity shall begin to carry out subparagraph (E) of section 

4 212(a)(5) of the Immigration and Nationality Act, as 

5 added by subsection (a), including the requirement for the 

6 attestation and the granting of a waiver described in 

7 clause (iii) of such subparagraph (E), regardless of wheth8 er regulations to implement such subparagraph have been 

9 promulgated. 

Æ 


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