I 
111TH CONGRESS 
1ST SESSION H. R. 1001 
To create a new nonimmigrant visa category for registered nurses, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 11, 2009 
Mr. SHADEGG (for himself, Mr. FLAKE, and Mr. PASTOR of Arizona) intro-
duced the following bill; which was referred to the Committee on the Ju-
diciary 
A BILL 
To create a new nonimmigrant visa category for registered 
nurses, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Nursing Relief Act 
of 2009’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—The Congress finds the following: 
(1) There are more vacant nursing positions in 
the United States than there are qualified registered 
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nurses and nursing school candidates to fill those 
positions. 
(2) According to the Department of Labor, the 
current national nursing shortage exceeds 126,000. 
(3) States in the West and Southwest have a 
disproportionate number of nursing vacancies be-
cause of rapid population growth, which exacerbates 
a widening gap in the number of facilities and staff 
compared to patients that need care. 
(4) Foreign countries such as the Philippines, 
India, and China have an oversupply of nurses. 
(5) Major hospital systems in the United States 
spend hundreds of millions of dollars every year re-
cruiting foreign nurses under our current immigra-
tion system. 
(6) Current law, with certain limited exceptions, 
requires health care providers to sponsor desired 
nurses for permanent resident status while the 
nurses remain outside of the United States, which 
can take as much as 3 years. 
(7) This cost is passed on to consumers and 
adds to the rising cost of health care. 
(8) Health care providers cannot efficiently and 
effectively recruit qualified foreign nurses through 
the existing immigration process. 
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(9) Our health care system requires an imme-
diate modification of Federal laws relating to re-
cruitment of qualified foreign nurses in order to op-
erate at an efficient and effective level. 
(b) PURPOSE.—The purpose of this Act is to create 
a new nonimmigrant visa category for registered nurses 
and establish admission requirements for such non-
immigrants. 
SEC. 
3. 
REQUIREMENTS 
FOR 
ADMISSION 
OF 
NON-
IMMIGRANT NURSES. 
(a) ESTABLISHMENT
OF
A NEW NONIMMIGRANT 
CATEGORY.—Section 101(a)(15) of the Immigration and 
Nationality Act (8 U.S.C. 1101(a)(15)) is amended— 
(1) by striking ‘‘or’’ at the end of subparagraph 
(U), 
(2) by striking the period at the end of sub-
paragraph (V) and inserting ‘‘; or’’; and 
(3) by adding at the end the following: 
‘‘(W) an alien who is coming temporarily to the 
United States to perform services as a professional 
nurse, as described in section 212(v)(1)(A), who 
meets 
the 
qualifications 
described 
in 
section 
212(v)(1)(B), and with respect to whom the Sec-
retary of Labor determines and certifies to the Sec-
retary of Homeland Security and the Secretary of 
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State that the intending employer has filed with the 
Secretary of Labor an attestation under section 
212(v)(2), and the alien spouse and children of any 
such principal alien, if accompanying or following to 
join the principal alien.’’. 
(b) REQUIRING
PETITION
OF
IMPORTING
EM-
PLOYER.—Section 214(c) of the Immigration and Nation-
ality Act (8 U.S.C. 1184(c)) is amended by adding at the 
end the following:. 
‘‘(15)(A) The question of importing any alien as a 
nonimmigrant under section 101(a)(15)(W) in any specific 
case or specific cases shall be determined by the consular 
officer, after consultation with appropriate agencies of the 
Government, upon petition of the importing employer. 
Such petition shall be made and approved before the visa 
is granted. The petition shall be in such form and contain 
such information as the Secretary of Homeland Security 
shall prescribe by regulation. The approval of such a peti-
tion shall not, of itself, be construed as establishing that 
the alien is a nonimmigrant. 
‘‘(B) The following petitions shall be determined by 
the Secretary of Homeland Security, after consultation 
with appropriate agencies of the Government: 
‘‘(i) A petition for an alien lawfully present in 
the United States to be initially granted non-
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immigrant 
status 
described 
in 
section 
101(a)(15)(W). 
‘‘(ii) A petition for an alien having such status 
to obtain an extension of stay. 
‘‘(iii) A petition to obtain authorization for an 
alien having such status to change employers.’’. 
(c) SHIFTING
BURDEN
OF
PROOF
FOR
NON-
IMMIGRANT STATUS.—Section 214(b) of the Immigration 
and Nationality Act (8 U.S.C. 1184(b)) is amended by 
striking ‘‘(L) or (V)’’ and inserting ‘‘(L), (V), or (W)’’. 
(d) ALLOWING PETITION FOR PERMANENT RESI-
DENCE
WHILE
IN
NONIMMIGRANT
STATUS.—Section 
214(h) of the Immigration and Nationality Act (8 U.S.C. 
1184(h)) is amended by striking ‘‘(L), or (V)’’ and insert-
ing ‘‘(L), (V), or (W)’’. 
(e) OTHER ADMISSION REQUIREMENTS.—Section 
212 of the Immigration and Nationality Act (8 U.S.C. 
1182) is amended— 
(1) by redesignating the second subsection (t) 
(added by section 1(b)(2)(B) of Public Law 108–449 
(118 Stat. 3470)) as subsection (u); and 
(2) by adding at the end the following: 
‘‘(v)(1)(A) For purposes of section 101(a)(15)(W) 
and this subsection— 
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‘‘(i) the term ‘professional nurse’ means a 
person who applies the art and science of pro-
fessional nursing in a manner that reflects com-
prehension of principles derived from the phys-
ical, biological, and behavioral sciences; and 
‘‘(ii) the term ‘professional nursing’ in-
cludes— 
‘‘(I) making clinical judgments involv-
ing the observation, care, and counsel of 
persons requiring nursing care; 
‘‘(II) administering of medicines and 
treatments prescribed by the physician or 
dentist; and 
‘‘(III) participation in the activities 
for the promotion of health and prevention 
of illness in others. 
‘‘(B) The qualifications referred to in section 
101(a)(15)(W) are that the alien is qualified, under the 
laws (including such temporary or interim licensing provi-
sions or nurse licensure compact provisions which author-
ize the nurse to be employed) governing the place of in-
tended employment, to engage in the practice of profes-
sional nursing as a registered nurse immediately upon ad-
mission to the United States and is authorized under such 
laws to be employed, except that if the alien has completed 
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all licensing requirements except for submission of a social 
security account number, the alien may provide a letter 
from the State Board of Nursing of the State of intended 
employment which confirms that the alien is eligible for 
license issuance upon presentation of such number. 
‘‘(2)(A) The attestation referred to in section 
101(a)(15)(W) is an attestation by the employer to the 
following: 
‘‘(i) The employer is offering and will offer dur-
ing the period of authorized employment to aliens 
admitted 
or 
provided 
status 
under 
section 
101(a)(15)(W) wages that are at least— 
‘‘(I) the actual wage level paid by the em-
ployer to all other individuals with similar expe-
rience and qualifications for the specific em-
ployment in question; or 
‘‘(II) the prevailing wage level for the occu-
pational classification in the area of employ-
ment; 
whichever is greater, based on the best information 
available as of the time of the attestation. 
‘‘(ii) The employment of the alien will not ad-
versely affect the wages and working conditions of 
registered nurses similarly employed at the worksite. 
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‘‘(iii) The alien will be paid the wage rate for 
registered nurses similarly employed at the worksite. 
‘‘(iv) There is not a strike or lockout in the 
course of a labor dispute in the registered nurse 
classification at the worksite. 
‘‘(v) The employer has provided notice of the 
filing of the attestation to the bargaining representa-
tive of the registered nurses at the worksite or, if 
there is no such bargaining representative, notice of 
the filing has been provided to the registered nurses 
employed at the worksite through physical posting in 
a conspicuous location at the worksites. 
‘‘(vi) The number of workers sought, the work 
locations, and the wage rate and conditions under 
which they will be employed. 
‘‘(B) The employer shall make a copy of the attesta-
tion available for public examination, within 10 working 
days after the date on which the attestation is filed, at 
the employer’s principal place of business or worksite 
(along with such accompanying documents as are nec-
essary). 
‘‘(C) The Secretary of Labor shall review the attesta-
tion only for completeness and obvious inaccuracies. Un-
less such Secretary finds that the attestation is incomplete 
or obviously inaccurate, the Secretary shall provide the 
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certification described in section 101(a)(15)(W) within 7 
days of the date of the filing of the attestation. 
‘‘(D) An attestation under subparagraph (A)— 
‘‘(i) shall expire on the date that is the later 
of— 
‘‘(I) the end of the 3-year period beginning 
on the date on which it is filed; or 
‘‘(II) the end of the period of admission 
under section 101(a)(15)(W) of the last alien 
with respect to whose admission it applied (in 
accordance with clause (ii)); and 
‘‘(ii) shall apply to petitions described in section 
214(c)(15) filed during the 3-year period beginning 
on the date on which it is filed if the employer states 
in each such petition that it continues to comply 
with the conditions in the attestation. 
‘‘(E) An employer may meet the requirements of this 
paragraph with respect to more than one professional 
nurse in a single attestation. 
‘‘(F) An employer may meet the requirements of this 
paragraph with respect to more than one work location 
in a single attestation. 
‘‘(3)(A) The Secretary of Labor shall compile, and 
make available for public examination in a timely manner, 
a list identifying employers that have filed attestations 
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under paragraph (2)(A). Such list shall include, with re-
spect to each attestation, the wage rate, number of aliens 
sought, and period of intended employment. 
‘‘(B) The Secretary of Labor shall establish a process 
for the receipt, investigation, and disposition of complaints 
respecting an employer’s failure to meet a condition speci-
fied in an attestation submitted under paragraph (2)(A) 
or a misrepresentation of a material fact in an attestation. 
Complaints may be filed by any aggrieved person or orga-
nization (including bargaining representatives). The Sec-
retary shall conduct an investigation under this subpara-
graph if there is reasonable cause to believe that an em-
ployer willfully failed to meet a condition or willfully mis-
represented a material fact. No investigation or hearing 
shall be conducted on a complaint concerning such a fail-
ure or misrepresentation unless the complaint was filed 
not later than 12 months after the date of the failure or 
misrepresentation, respectively. 
‘‘(C) Under such process, the Secretary of Labor 
shall provide, within 30 days after the date such a com-
plaint is filed, for a determination as to whether or not 
a basis exists to make a finding described in subparagraph 
(B). If the Secretary determines that such a basis exists, 
the Secretary shall provide for notice of such determina-
tion to the interested parties and an opportunity for a 
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hearing on the complaint within 60 days of the date of 
the determination. If such a hearing is requested, the Sec-
retary of Labor shall make a finding concerning the mat-
ter by not later than 60 days after the date of the hearing. 
In case of similar complaints respecting the same appli-
cant, the Secretary of Labor may consolidate the hearings 
under this clause on such complaints. 
‘‘(D) If the Secretary of Labor finds, after notice and 
opportunity for a hearing, that an employer has willfully 
failed to meet a condition specified in an attestation or 
that there was a willful misrepresentation of material fact 
in the attestation, the Secretary shall notify the Secretary 
of State and the Secretary of Homeland Security of such 
finding and may, in addition, impose such other adminis-
trative remedies (including civil monetary penalties in an 
amount not to exceed $1,000 per nurse per violation, with 
the total penalty not to exceed $10,000 per violation) as 
the Secretary determines to be appropriate. Upon receipt 
of such notice, the Secretary of Homeland Security shall 
not approve petitions described in section 214(c)(15) by 
the employer during a period of at least 1 year for nurses 
to be employed by the employer. 
‘‘(4)(A) A nonimmigrant alien described in subpara-
graph (B) who was previously issued a visa or otherwise 
provided 
nonimmigrant 
status 
under 
section 
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or an application for adjustment of status under section 
245 to accord the alien status under section 203(b), has 
been filed, if 365 days or more have elapsed since the fil-
ing of such petition or application. 
‘‘(ii) The Secretary of Homeland Security shall ex-
tend the stay of an alien who qualifies for an exemption 
under clause (i) in 1-year increments until such time as 
a final decision is made on the alien’s lawful permanent 
residence. 
‘‘(iii) Notwithstanding subparagraph (A) and clause 
(ii), any alien who is the beneficiary of an approved peti-
tion filed under section 204(b) for a status under para-
graph (1), (2), or (3) of section 203(b), and who is eligible 
to be granted that status but for application of the per- 
country limitations on immigrants under such paragraph, 
may apply for, and the Secretary of Homeland Security 
may grant, one or more extensions of nonimmigrant status 
under section 101(a)(15)(W) until such time as an immi-
grant visa is immediately available to the alien and a deci-
sion on the alien’s application for adjustment of status is 
made. 
‘‘(6) In the case of an alien spouse, who is accom-
panying or following to join a principal alien admitted 
under section 101(a)(15)(W), the Secretary of Homeland 
Security shall authorize the alien spouse to engage in em-
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ployment in the United States and shall provide the 
spouse with an ‘employment authorized’ endorsement or 
other appropriate work permit. 
‘‘(7)(A)(i) The total number of aliens who may be 
issued visas or otherwise provided nonimmigrant status 
under section 101(a)(15)(W) during any fiscal year is 
50,000. 
‘‘(ii) If the numerical limitation in clause (i)— 
‘‘(I) is reached during a fiscal year, the numer-
ical limitation applicable to the subsequent fiscal 
year shall be 120 percent of the preceding numerical 
limitation; or 
‘‘(II) is not reached during a fiscal year, the 
numerical limitation shall remain the same during 
the subsequent fiscal year. 
‘‘(B) Notwithstanding subparagraph (A), aliens may 
be issued visas or otherwise provided nonimmigrant status 
under such section without regard to numerical limitation 
if they are only working in the geographic area or areas 
which are designated by the Secretary of Health and 
Human Services as having a shortage of health care pro-
fessionals. 
‘‘(C) The numerical limitations in subparagraph (A) 
shall only apply to principal aliens and not to the spouse 
or children of such aliens.’’. 
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SEC. 4. REGULATIONS; EFFECTIVE DATE. 
(a) REGULATIONS.—Not later than 90 days after the 
date of the enactment of this Act, the following shall pro-
mulgate regulations to carry out the amendments made 
by section 3: 
(1) The Secretary of Labor, in consultation 
with the Secretary of Health and Human Services 
and the Secretary of Homeland Security. 
(2) The Secretary of Homeland Security, in 
consultation with the Secretary of State. 
(b) EFFECTIVE DATE.—Notwithstanding subsection 
(a), the amendments made by section 3 shall take effect 
90 days after the date of the enactment of this Act, re-
gardless of whether the regulations promulgated under 
subsection (a) are in effect on such date. 
SEC. 5. SPECIFICATION OF CONSTITUTIONAL AUTHORITY 
FOR ENACTMENT OF LAW. 
This Act is enacted pursuant to the power granted 
to Congress under article I, section 8, clause 4, to estab-
lish an uniform rule naturalization, and under article I, 
section 8, clause 18, of the United States Constitution. 
Æ 
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