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‘‘SEC. 833. DOMESTIC NURSING ENHANCEMENT ACCOUNT. 
‘‘(a) ESTABLISHMENT.—There is established in the 
general fund of the Treasury a separate account which shall 
be known as the ‘Domestic Nursing Enhancement Account.’ 
Notwithstanding any other provision of law, there shall be 
deposited as offsetting receipts into the account all fees col-
lected under section 106(d)(5) of the American Competitive-
ness in the Twenty-first Century Act of 2000 (Public Law 
106–313; 8 U.S.C. 1153 note). Nothing in this subsection 
shall prohibit the depositing of other moneys into the ac-
count established under this section. 
‘‘(b) USE OF FUNDS.—Amounts collected under section 
106(d)(5) of the American Competitiveness in the Twenty- 
first Century Act of 2000, and deposited into the account 
established under subsection (a) shall be used by the Sec-
retary of Health and Human Services to carry out section 
832. Such amounts shall be available for obligation only 
to the extent, and in the amount, provided in advance in 
appropriations Acts. Such amounts are authorized to re-
main available until expended.’’. 
(c) GLOBAL HEALTH CARE COOPERATION.— 
(1) IN GENERAL.—Title III of the Immigration 
and Nationality Act (8 U.S.C. 1401 et seq.) is amend-
ed by inserting after section 317 the following: 
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‘‘SEC. 317A. TEMPORARY ABSENCE OF ALIENS PROVIDING 
HEALTH CARE IN DEVELOPING COUNTRIES. 
‘‘(a) IN GENERAL.—Notwithstanding any other provi-
sion of this Act, the Secretary of Homeland Security shall 
allow an eligible alien and the spouse or child of such alien 
to reside in a candidate country during the period that the 
eligible alien is working as a physician or other health care 
worker in a candidate country. During such period the eli-
gible alien and such spouse or child shall be considered— 
‘‘(1) to be physically present and residing in the 
United States for purposes of naturalization under 
section 316(a); and 
‘‘(2) to meet the continuous residency require-
ments under section 316(b). 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) CANDIDATE COUNTRY.—The term ‘candidate 
country’ means a country that the Secretary of State 
determines to be— 
‘‘(A) eligible for assistance from the Inter-
national Development Association, in which the 
per capita income of the country is equal to or 
less than the historical ceiling of the Inter-
national Development Association for the appli-
cable fiscal year, as defined by the International 
Bank for Reconstruction and Development; 
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‘‘(B) classified as a lower middle income 
country in the then most recent edition of the 
World Development Report for Reconstruction 
and Development published by the International 
Bank for Reconstruction and Development and 
having an income greater than the historical 
ceiling for International Development Associa-
tion eligibility for the applicable fiscal year; or 
‘‘(C) qualified to be a candidate country 
due to special circumstances, including natural 
disasters or public health emergencies. 
‘‘(2) ELIGIBLE ALIEN.—The term ‘eligible alien’ 
means an alien who— 
‘‘(A) has been lawfully admitted to the 
United States for permanent residence; and 
‘‘(B) is a physician or other healthcare 
worker. 
‘‘(c) CONSULTATION.—The Secretary of Homeland Se-
curity shall consult with the Secretary of State in carrying 
out this section. 
‘‘(d) PUBLICATION.—The Secretary of State shall pub-
lish— 
‘‘(1) not later than 180 days after the date of the 
enactment of this section, a list of candidate coun-
tries; 
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‘‘(2) an updated version of the list required by 
paragraph (1) not less often than once each year; and 
‘‘(3) an amendment to the list required by para-
graph (1) at the time any country qualifies as a can-
didate country due to special circumstances under 
subsection (b)(1)(C).’’. 
(2) RULEMAKING.— 
(A) REQUIREMENT.—Not later than 180 
days after the date of the enactment of this Act, 
the Secretary of Homeland Security shall pro-
mulgate regulations to carry out the amendments 
made by this subsection. 
(B) CONTENT.—The regulations promul-
gated pursuant to paragraph (1) shall— 
(i) permit an eligible alien (as defined 
in section 317A of the Immigration and 
Nationality Act, as added by paragraph 
(1)) and the spouse or child of the eligible 
alien to reside in a foreign country to work 
as a physician or other healthcare worker as 
described in subsection (a) of such section 
317A for not less than a 12-month period 
and not more than a 24-month period, and 
shall permit the Secretary to extend such 
period for an additional period not to ex-
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ceed 12 months, if the Secretary determines 
that such country has a continuing need for 
such a physician or other healthcare worker; 
(ii) provide for the issuance of docu-
ments by the Secretary to such eligible 
alien, and such spouse or child, if appro-
priate, to demonstrate that such eligible 
alien, and such spouse or child, if appro-
priate, is authorized to reside in such coun-
try under such section 317A; and 
(iii) provide for an expedited process 
through which the Secretary shall review 
applications for such an eligible alien to re-
side in a foreign country pursuant to sub-
section (a) of such section 317A if the Sec-
retary of State determines a country is a 
candidate country pursuant to subsection 
(b)(1)(C) of such section 317A. 
(3) 
TECHNICAL
AND
CONFORMING
AMEND-
MENTS.— 
(A) DEFINITION.—Section 101(a)(13)(C)(ii) 
of the Immigration and Nationality Act (8 
U.S.C. 1101(a)(13)(C)(ii)) is amended by adding 
at the end the following: ‘‘except in the case of 
an eligible alien, or the spouse or child of such 
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299 
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alien, who is authorized to be absent from the 
United States under section 317A,’’. 
(B) DOCUMENTARY
REQUIREMENTS.—Sec-
tion 211(b) of such Act (8 U.S.C. 1181(b)) is 
amended by inserting ‘‘, including an eligible 
alien authorized to reside in a foreign country 
under section 317A and the spouse or child of 
such 
eligible 
alien, 
if 
appropriate,’’ 
after 
‘‘101(a)(27)(A),’’. 
(C) 
INELIGIBLE
ALIENS.—Section 
212(a)(7)(A)(i)(I) 
of 
such 
Act 
(8 
U.S.C. 
1182(a)(7)(A)(i)(I)) is amended by inserting 
‘‘other than an eligible alien authorized to reside 
in a foreign country under section 317A and the 
spouse or child of such eligible alien, if appro-
priate,’’ after ‘‘Act,’’. 
(D) CLERICAL AMENDMENT.—The table of 
contents of such Act is amended by inserting 
after the item relating to section 317 the fol-
lowing: 
‘‘Sec. 317A. Temporary absence of aliens providing health care in developing 
countries.’’. 
(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to U.S. Citi-
zenship and Immigration Services such sums as may 
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be necessary to carry out this subsection and the 
amendments made by this subsection. 
(d) ATTESTATION BY HEALTH CARE WORKERS.— 
(1) 
ATTESTATION
REQUIREMENT.—Section 
212(a)(5) of the Immigration and Nationality Act (8 
U.S.C. 1182(a)(5)) is amended by adding at the end 
the following: 
‘‘(E) HEALTH CARE WORKERS WITH OTHER 
OBLIGATIONS.— 
‘‘(i) IN GENERAL.—An alien who seeks 
to enter the United States for the purpose of 
performing labor as a physician or other 
health care worker is inadmissible unless 
the alien submits to the Secretary of Home-
land Security or the Secretary of State, as 
appropriate, an attestation that the alien is 
not seeking to enter the United States for 
such purpose during any period in which 
the alien has an outstanding obligation to 
the government of the alien’s country of ori-
gin or the alien’s country of residence. 
‘‘(ii) OBLIGATION
DEFINED.—In this 
subparagraph, the term ‘obligation’ means 
an obligation incurred as part of a valid, 
voluntary individual agreement in which 
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the alien received financial assistance to de-
fray the costs of education or training to 
qualify as a physician or other health care 
worker in consideration for a commitment 
to work as a physician or other health care 
worker in the alien’s country of origin or 
the alien’s country of residence. 
‘‘(iii) 
WAIVER.—The 
Secretary 
of 
Homeland Security may waive a finding of 
inadmissibility under clause (i) if the Sec-
retary determines that— 
‘‘(I) the obligation was incurred 
by coercion or other improper means; 
‘‘(II) the alien and the govern-
ment of the country to which the alien 
has an outstanding obligation have 
reached a valid, voluntary agreement, 
pursuant to which the alien’s obliga-
tion has been deemed satisfied, or the 
alien has shown to the satisfaction of 
the Secretary that the alien has been 
unable to reach such an agreement be-
cause of coercion or other improper 
means; or 
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‘‘(III) the obligation should not be 
enforced due to other extraordinary 
circumstances, including undue hard-
ship that would be suffered by the alien 
in the absence of a waiver.’’. 
(2) EFFECTIVE DATE; APPLICATION.— 
(A) EFFECTIVE
DATE.—The amendment 
made by paragraph (1) shall take effect on the 
date that is 180 days after the date of the enact-
ment of this Act. 
(B) APPLICATION BY THE SECRETARY.—Not 
later than the effective date described in subpara-
graph (A), the Secretary of Homeland Security 
shall begin to carry out subparagraph (E) of sec-
tion 212(a)(5) of the Immigration and Nation-
ality Act, as added by paragraph (1), including 
the requirement for the attestation and the 
granting of a waiver described in clause (iii) of 
such subparagraph (E), regardless of whether 
regulations to implement such subparagraph 
have been promulgated. 
SEC. 535. None of the funds made available under this 
Act may be used to purchase first class or premium airline 
travel that would not be consistent with sections 301–10.123 
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and 301–10.124 of title 41 of the Code of Federal Regula-
tions. 
This Act may be cited as the ‘‘Departments of Labor, 
Health and Human Services, and Education, and Related 
Agencies Appropriations Act, 2008’’. 
Passed the House of Representatives July 19, 2007. 
Attest: 
LORRAINE C. MILLER, 
Clerk. 
Passed the Senate October 23, 2007. 
Attest: 
NANCY ERICKSON, 
Secretary. 
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