‘‘(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 
Security shall consult with the Secretary of State in car-
rying out this section. 
‘‘(d) PUBLICATION.—The Secretary of State shall 
publish— 
‘‘(1) not later than 180 days after the date of 
the enactment of this section, a list of candidate 
countries; 
‘‘(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 
paragraph (1) at the time any country qualifies as 
a candidate 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 
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promulgate regulations to carry out the amend-
ments 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 sec-
tion 317A for not less than a 12-month pe-
riod and not more than a 24-month period, 
and shall permit the Secretary to extend 
such period for an additional period not to 
exceed 12 months, if the Secretary deter-
mines 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-
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priate, is authorized to reside in such 
country 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 Na-
tionality 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 alien, who is authorized 
to be absent from the United States under sec-
tion 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 
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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 re-
side in a foreign country under section 317A 
and the spouse or child of such eligible alien, if 
appropriate,’’ 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. 
Citizenship and Immigration Services such sums as 
may 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: 
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‘‘(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 
Homeland 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 obli-
gation to the government of the alien’s 
country of origin 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 
the alien received financial assistance to 
defray 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 
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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 
because of coercion or other improper 
means; or 
‘‘(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.— 
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(A) EFFECTIVE
DATE.—The amendment 
made by paragraph (1) shall take effect on the 
date that is 180 days after the date of the en-
actment of this Act. 
(B) APPLICATION BY THE SECRETARY.— 
Not later than the effective date described in 
subparagraph (A), the Secretary of Homeland 
Security shall begin to carry out subparagraph 
(E) of section 212(a)(5) of the Immigration 
and Nationality Act, as added by paragraph 
(1), including the requirement for the attesta-
tion and the granting of a waiver described in 
clause (iii) of such subparagraph (E), regard-
less of whether regulations to implement such 
subparagraph have been promulgated. 
SEC. 3. NURSE TRAINING AND RETENTION DEMONSTRA-
TION GRANT ACT OF 2008. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) America’s healthcare system depends on an 
adequate supply of trained nurses to deliver quality 
patient care. 
(2) Over the next 15 years, this shortage is ex-
pected to grow significantly. The Health Resources 
and Services Administration has projected that by 
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2020, there will be a shortage of nurses in every 
State and that overall only 64 percent of the de-
mand for nurses will be satisfied, with a shortage of 
1,016,900 nurses nationally. 
(3) To avert such a shortage, today’s network 
of healthcare workers should have access to edu-
cation and support from their employers to partici-
pate in educational and training opportunities. 
(4) With the appropriate education and sup-
port, incumbent healthcare workers and incumbent 
bedside nurses are untapped sources which can meet 
these needs and address the nursing shortage and 
provide quality care as the American population 
ages. 
(b) PURPOSES OF GRANT PROGRAM.—It is the pur-
pose of this section to authorize grants to— 
(1) address the projected shortage of nurses by 
funding comprehensive programs to create a career 
ladder to nursing (including Certified Nurse Assist-
ants, Licensed Practical Nurses, Licensed Vocational 
Nurses, and Registered Nurses) for incumbent ancil-
lary healthcare workers; 
(2) increase the capacity for educating nurses 
by increasing both nurse faculty and clinical oppor-
tunities through collaborative programs between 
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staff nurse organizations, healthcare providers, and 
accredited schools of nursing; and 
(3) provide training programs through edu-
cation and training organizations jointly adminis-
tered by healthcare providers and healthcare labor 
organizations or other organizations representing 
staff nurses and frontline healthcare workers, work-
ing in collaboration with accredited schools of nurs-
ing and academic institutions. 
(c) GRANTS.—Not later than 6 months after the date 
of enactment of this Act, the Secretary of Labor (referred 
to in this section as the ‘‘Secretary’’) shall establish a 
partnership grant program to award grants to eligible en-
tities to carry out comprehensive programs to provide edu-
cation to nurses and create a pipeline to nursing for in-
cumbent ancillary healthcare workers who wish to advance 
their careers, and to otherwise carry out the purposes of 
this section. 
(d) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under this section an entity shall— 
(1) be— 
(A) a healthcare entity that is jointly ad-
ministered by a healthcare employer and a labor 
union representing the healthcare employees of 
the employer and that carries out activities 
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using labor management training funds as pro-
vided for under section 302 of the Labor-Man-
agement Relations Act, 1947 (18 U.S.C. 
186(c)(6)); 
(B) an entity that operates a training pro-
gram that is jointly administered by— 
(i) one or more healthcare providers 
or facilities, or a trade association of 
healthcare providers; and 
(ii) one or more organizations which 
represent the interests of direct care 
healthcare workers or staff nurses and in 
which the direct care healthcare workers or 
staff nurses have direct input as to the 
leadership of the organization; or 
(C) a State training partnership program 
that consists of non-profit organizations that 
include equal participation from industry, in-
cluding public or private employers, and labor 
organizations including joint labor-management 
training programs, and which may include rep-
resentatives from local governments, worker in-
vestment agency one-stop career centers, com-
munity based organizations, community col-
leges, and accredited schools of nursing; and 
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(2) submit to the Secretary an application at 
such time, in such manner, and containing such in-
formation as the Secretary may require. 
(e) ADDITIONAL REQUIREMENTS FOR HEALTHCARE 
EMPLOYER DESRRIBED IN SUBSECTION (d).—To be eligi-
ble for a grant under this section, a healthcare employer 
described in subsection (d) shall demonstrate— 
(1) an established program within their facility 
to encourage the retention of existing nurses; 
(2) it provides wages and benefits to its nurses 
that are competitive for its market or that have been 
collectively bargained with a labor organization; and 
(3) support for programs funded under this sec-
tion through 1 or more of the following: 
(A) The provision of paid leave time and 
continued 
health 
coverage 
to 
incumbent 
healthcare workers to allow their participation 
in nursing career ladder programs, including 
Certified Nurse Assistants, Licensed Practical 
Nurses, Licensed Vocational Nurses, and Reg-
istered Nurses. 
(B) Contributions to a joint labor-manage-
ment or other jointly administered training 
fund which administers the program involved. 
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(C) The provision of paid release time, in-
centive compensation, or continued health cov-
erage to staff nurses who desire to work full- or 
part-time in a faculty position. 
(D) The provision of paid release time for 
staff nurses to enable them to obtain a bachelor 
of science in nursing degree, other advanced 
nursing degrees, specialty training, or certifi-
cation program. 
(E) The payment of tuition assistance to 
incumbent healthcare workers. 
(f) OTHER REQUIREMENTS.— 
(1) MATCHING REQUIREMENT.— 
(A) IN GENERAL.—The Secretary may not 
make a grant under this section unless the ap-
plicant involved agrees, with respect to the costs 
to be incurred by the applicant in carrying out 
the program under the grant, to make available 
non-Federal contributions (in cash or in kind 
under subparagraph (B)) toward such costs in 
an amount equal to not less than $1 for each 
$1 of Federal funds provided in the grant. Such 
contributions may be made directly or through 
donations from public or private entities, or 
may be provided through the cash equivalent of 
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paid release time provided to incumbent worker 
students. 
(B) DETERMINATION OF AMOUNT OF NON- 
FEDERAL
CONTRIBUTION.—Non-Federal con-
tributions required in subparagraph (A) may be 
in cash or in kind (including paid release time), 
fairly evaluated, including equipment or services 
(and excluding indirect or overhead costs). 
(C) 
SUPPLEMENT, 
NOT
SUPPLANT.— 
Funds made available under this section shall 
supplement, and not supplant, resources dedi-
cated by an entity, or other Federal, State, or 
localfunds available to carry out activities de-
scribed in this section. 
(2) REQUIRED COLLABORATION.—Entities car-
rying out or overseeing programs carried out with 
assistance provided under this section shall dem-
onstrate collaboration with accredited schools of 
nursing which may include community colleges and 
other academic institutions providing associate, 
bachelor’s, or advanced nursing degree programs or 
specialty training or certification programs. 
(g) ACTIVITES.—Amounts awarded to an entity 
under a grant under this section shall be used for the fol-
lowing: 
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(1) To carry out programs that provide edu-
cation and training to establish nursing career lad-
ders to educate incumbent healthcare workers to be-
come nurses (including Certified Nurse Assistants, 
Licensed Practical Nurses, Licensed Vocational 
Nurses, and Registered Nurses). Such programs 
shall include one or more of the following: 
(A) Preparing incumbent workers to return 
to the classroom through English as a second 
language education, GED education, precollege 
counseling, college preparation classes, and sup-
port with entry level college classes that are a 
prerequisite to nursing. 
(B) Providing tuition assistance with pref-
erence for dedicated cohort classes in commu-
nity colleges, universities, accredited schools of 
nursing with supportive services including tu-
toring and counseling. 
(C) Providing assistance in preparing for 
and meeting all nursing licensure tests and re-
quirements. 
(D) 
Carrying 
out 
orientation 
and 
mentorship programs that assist newly grad-
uated nurses in adjusting to working at the 
bedside to ensure their retention post gradua-
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tion, and ongoing programs to support nurse 
retention. 
(E) Providing stipends for release time and 
continued healthcare coverage to enable incum-
bent healthcare workers to participate in these 
programs. 
(2) To carry out programs that assist nurses in 
obtaining advanced degrees and completing specialty 
training or certification programs and to establish 
incentives for nurses to assume nurse faculty posi-
tions on a part-time or full-time basis. Such pro-
grams shall include one or more of the following: 
(A) Increasing the pool of nurses with ad-
vanced degrees who are interested in teaching 
by funding programs that enable incumbent 
nurses to return to school. 
(B) Establishing incentives for advanced 
degree bedside nurses who wish to teach in 
nursing programs so they can obtain a leave 
from their bedside position to assume a full- or 
part-time position as adjunct or full time fac-
ulty without the loss of salary or benefits. 
(C) Collaboration with accredited schools 
of nursing which may include community col-
leges and other academic institutions providing 
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associate, bachelor’s, or advanced nursing de-
gree programs, or specialty training or certifi-
cation programs, for nurses to carry out innova-
tive nursing programs which meet the needs of 
bedside nursing and healthcare providers. 
(h) PREFERENCE.—In awarding grants under this 
section the Secretary shall give preference to programs 
that— 
(1) provide for improving nurse retention; 
(2) provide for improving the diversity of the 
new nurse graduates to reflect changes in the demo-
graphics of the patient population; 
(3) provide for improving the quality of nursing 
education to improve patient care and safety; 
(4) have demonstrated success in upgrading in-
cumbent healthcare workers to become nurses or 
which have established effective programs or pilots 
to increase nurse faculty; or 
(5) are modeled after or affiliated with such 
programs described in paragraph (4). 
(i) EVALUATION.— 
(1) PROGRAM
EVALUATIONS.—An entity that 
receives a grant under this section shall annually 
evaluate, and submit to the Secretary a report on, 
the activities carried out under the grant and the 
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outcomes of such activities. Such outcomes may in-
clude— 
(A) an increased number of incumbent 
workers entering an accredited school of nurs-
ing and in the pipeline for nursing programs; 
(B) an increasing number of graduating 
nurses and improved nurse graduation and li-
censure rates; 
(C) improved nurse retention; 
(D) an increase in the number of staff 
nurses at the healthcare facility involved; 
(E) an increase in the number of nurses 
with advanced degrees in nursing; 
(F) an increase in the number of nurse 
faculty; 
(G) improved measures of patient quality 
as determined by the Secretary; and 
(H) an increase in the diversity of new 
nurse graduates relative to the patient popu-
lation. 
(2) GENERAL
REPORT.—Not later than Sep-
tember 30, 2011, the Secretary of Labor shall, using 
data and information from the reports received 
under paragraph (1), submit to Congress a report 
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