IB
Union Calendar No. 376
105TH CONGRESS
2D SESSION
H. R. 2759
[Report No. 105–668]
To amend the Immigration and Nationality Act with respect to the require-
ments for the admission of nonimmigrant nurses who will practice in
health professional shortage areas.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 29, 1997
Mr. RUSH introduced the following bill; which was referred to the Committee
on the Judiciary
AUGUST 3, 1998
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on October 29, 1997]
A BILL
To amend the Immigration and Nationality Act with respect
to the requirements for the admission of nonimmigrant
nurses who will practice in health professional shortage
areas.
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 ‘‘Health Professional
Shortage Area Nursing Relief Act of 1998’’.
SEC. 
2. 
REQUIREMENTS 
FOR 
ADMISSION 
OF 
NON-
IMMIGRANT NURSES IN HEALTH PROFES-
SIONAL SHORTAGE AREAS DURING 4-YEAR
PERIOD.
(a) ESTABLISHMENT OF A NEW NONIMMIGRANT CLAS-
SIFICATION FOR NONIMMIGRANT NURSES IN HEALTH PRO-
FESSIONAL SHORTAGE AREAS.—Section 101(a)(15)(H)(i)
of the Immigration and Nationality Act (8 U.S.C.
1101(a)(15)(H)(i)) is amended by striking ‘‘; or’’ at the end
and inserting the following: ‘‘, or (c) who is coming tempo-
rarily to the United States to perform services as a reg-
istered nurse, who meets the qualifications described in sec-
tion 212(m)(1), and with respect to whom the Secretary of
Labor determines and certifies to the Attorney General that
an unexpired attestation is on file and in effect under sec-
tion 212(m)(2) for the facility (as defined in section
212(m)(6)) for which the alien will perform the services;
or’’.
(b) REQUIREMENTS.—Section 212(m) of the Immigra-
tion and Nationality Act (8 U.S.C. 1182(m)) is amended
to read as follows:
‘‘(m)(1) The qualifications referred to in section
101(a)(15)(H)(i)(c), with respect to an alien who is coming
to the United States to perform nursing services for a facil-
ity, are that the alien—
‘‘(A) has obtained a full and unrestricted license
to practice professional nursing in the country where
the alien obtained nursing education or has received
nursing education in the United States;
‘‘(B) has passed an appropriate examination
(recognized in regulations promulgated in consulta-
tion with the Secretary of Health and Human Serv-
ices) or has a full and unrestricted license under
State law to practice professional nursing in the
State of intended employment; and
‘‘(C) is fully qualified and eligible under the
laws (including such temporary or interim licensing
requirements which authorize the nurse to be em-
ployed) governing the place of intended employment
to engage in the practice of professional nursing as a
registered nurse immediately upon admission to the
United States and is authorized under such laws to
be employed by the facility.
‘‘(2)(A) The attestation referred to in section
101(a)(15)(H)(i)(c), with respect to a facility for which an
alien will perform services, is an attestation as to the fol-
lowing:
‘‘(i) The facility meets all the requirements of
paragraph (6).
‘‘(ii) The employment of the alien will not ad-
versely affect the wages and working conditions of
registered nurses similarly employed.
‘‘(iii) The alien employed by the facility will be
paid the wage rate for registered nurses similarly em-
ployed by the facility.
‘‘(iv) The facility has taken and is taking timely
and significant steps designed to recruit and retain
sufficient registered nurses who are United States
citizens or immigrants who are authorized to perform
nursing services, in order to remove as quickly as rea-
sonably possible the dependence of the facility on non-
immigrant registered nurses.
‘‘(v) There is not a strike or lockout in the course
of a labor dispute, the facility has not laid off reg-
istered nurses within the previous year other than ter-
minations for cause, and the employment of such an
alien is not intended or designed to influence an elec-
tion for a bargaining representative for registered
nurses of the facility.
‘‘(vi) At the time of the filing of the petition for
registered nurses under section 101(a)(15)(H)(i)(c),
notice of the filing has been provided by the facility
to the bargaining representative of the registered
nurses at the facility or, where there is no such bar-
gaining representative, notice of the filing has been
provided to registered nurses employed at the facility
through posting in conspicuous locations.
‘‘(vii) The facility will not, at any time, employ
a number of aliens issued visas or otherwise provided
nonimmigrant 
status 
under 
section
101(a)(15)(H)(i)(c) that exceeds 33 percent of the
total number of registered nurses employed by the fa-
cility.
‘‘(viii) The facility will not, with respect to any
alien issued a visa or otherwise provided non-
immigrant status under section 101(a)(15)(H)(i)(c)—
‘‘(I) authorize the alien to perform nursing
services at any worksite other than a worksite
controlled by the facility; or
‘‘(II) transfer the place of employment of
the alien from one worksite to another.
Nothing in clause (iv) shall be construed as requiring a fa-
cility to have taken significant steps described in such
clause before the date of the enactment of the Health Profes-
sional Shortage Area Nursing Relief Act of 1998. A copy
of the attestation shall be provided, within 30 days of the
date of filing, to registered nurses employed at the facility
on the date of filing.
‘‘(B) For purposes of subparagraph (A)(iv), each of the
following shall be considered a significant step reasonably
designed to recruit and retain registered nurses:
‘‘(i) Operating a training program for registered
nurses at the facility or financing (or providing par-
ticipation in) a training program for registered
nurses elsewhere.
‘‘(ii) Providing career development programs
and other methods of facilitating health care workers
to become registered nurses.
‘‘(iii) Paying registered nurses wages at a rate
higher than currently being paid to registered nurses
similarly employed in the geographic area.
‘‘(iv) Providing adequate support services to free
registered nurses from administrative and other non-
nursing duties.
‘‘(v) Providing reasonable opportunities for
meaningful salary advancement by registered nurses.
The steps described in this subparagraph shall not be con-
sidered to be an exclusive list of the significant steps that
may be taken to meet the conditions of subparagraph
(A)(iv). Nothing in this subparagraph shall require a facil-
ity to take more than one step if the facility can dem-
the facility’s attestation under subparagraph (A) (and ac-
companying documentation) and each such petition filed
by the facility.
‘‘(ii) The Secretary of Labor shall establish a process,
including reasonable time limits, for the receipt, investiga-
tion, and disposition of complaints respecting a facility’s
failure to meet conditions attested to or a facility’s mis-
representation of a material fact in an attestation. Com-
plaints may be filed by any aggrieved person or organiza-
tion (including bargaining representatives, associations
deemed appropriate by the Secretary, and other aggrieved
parties as determined under regulations of the Secretary).
The Secretary shall conduct an investigation under this
clause if there is reasonable cause to believe that a facility
fails to meet conditions attested to. Subject to the time lim-
its established under this clause, this subparagraph shall
apply regardless of whether an attestation is expired or un-
expired at the time a complaint is filed.
‘‘(iii) Under such process, the Secretary shall provide,
within 180 days after the date such a complaint is filed,
for a determination as to whether or not a basis exists to
make a finding described in clause (iv). If the Secretary
determines that such a basis exists, the Secretary shall pro-
vide for notice of such determination to the interested par-