Immigration Nursing Relief Act of 1989
PL 101-238 (H.R.3259), enacted 12/18/1989

PUBLIC LAW 101-238—DEC. 18, 1989 
103 STAT. 2099 
Public Law 101-238 
101st Congress 
An Act 
To amend the Immigration and Nationality Act to provide for adjustment of status, 
without regard to numerical limitations, for certain H-1 nonimmigrant nurses and 
to establish conditions for the admission, during a 5-year period, of nurses as 
temporary workers. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the "Immigration Nursing Relief Act of 
1989". 
Dec. 18,1989 
[H.R. 3259] 
Immigration 
Nursing Relief 
Act of 1989. 
Aliens. 
8 u s e 1101 note. 
SEC. 2. ADJUSTMENT OF STATUS FOR CERTAIN H-1 NONIMMIGRANT 8 USC1255 note. 
NURSES. 
(a) IN GENERAL.—The numerical limitations of sections 201 and 
202 of the Immigration and Nationality Act shall not apply to the 
adjustment of status under section 245 of such Act of an immigrant, 
and the immigrant's accompanying spouse and children— 
(1) who, as of September 1, 1989, has the status of a non-
immigrant under paragraph (15)(H)(i) of section 101(a) of such 
Act to perform services as a registered nurse, 
(2) who, for at least 3 years before the date of application for 
adjustment of status (whether or not before, on, or after, the 
date of the enactment of this Act), has been employed as a 
registered nurse in the United States, and 
(3) whose continued employment as a registered nurse in the 
United States meets the standards established for the certifi-
cation described in section 212(a)(14) of such Act. 
The Attorney General shall promulgate regulations to carry out this Regulations, 
subsection by not later than 90 days after the date of the enactment 
of this Act. 
(b) TRANSITION.—For purposes of adjustment of status under sec-
tion 245 of the Immigration and Nationality Act in the case of an 
alien who, as of December 31, 1989, is present in the United States 
in the lawful status of a nonimmigrant under section 101(a)(15)(H)(i) 
of such Act to perform services as a registered nurse, or who is the 
spouse or child of such an alien, such an alien shall be considered as 
having continued to maintain lawful status as such a nonimmigrant 
until the end of the 120-day period beginning on the date the 
Attorney General promulgates regulations carrying out subsection 
(a). 
(c) APPLICATION OF IMMIGRATION AND NATIONALITY ACT PROVI-
SIONS.—The definitions contained in the Immigration and National-
ity Act shall apply in the administration of this section. The fact 
that an alien may be eligible to be granted the status of having been 
lawfully admitted for permanent residence under this section shall 
not preclude the alien from seeking such status under any other 
provision of law for which the alien may be eligible. 
103 STAT. 2100 
PUBLIC LAW 101-238—DEC. 18, 1989 
(d) APPLICATION PERIOD.—The alien, and accompanying spouse 
and children, must apply for such adjustment within the 5-year 
period beginning on the date the Attorney General promulgates 
regulations required under subsection (a). 
SEC. 3. REQUIREMENTS FOR ADMISSION OF NONIMMIGRANT NURSES 
DURING 5-YEAR PERIOD. 
''" 
(a) ESTABLISHMENT OF A N E W NONIMMIGRANT CLASSIFICATION FOR 
NONIMMIGRANT NURSES.—Section 101(a)(15)(H)(i) of the Immigration 
and Nationality Act (8 U.S.C. 1101(a)(15)(H)(i)) is amended— 
(1) by inserting "(a) who is coming temporarily to the United 
i. 
States to perform services as a registered nurse, who meets the 
qualifications described in section 212(m)(l), 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 section 212(m)(2) for the facility for which the alien 
will perform the services, or (b)" after "(i)", and 
(2) by inserting "(other than services as a registered nurse)" 
after "to perform services". 
(b) REQUIREMENTS.—Section 212 of such Act (8 U.S.C. 1182) is 
amended by adding at the end the following new subsection: 
"(m)(l) The qualifications referred to in section 101(a)(15)(H)(i)(a), 
with respect to an alien who is coming to the United States to 
perform nursing services for a facility, 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 or Canada; 
"(B) has passed an appropriate examination (recognized in 
regulations promulgated in consultation with the Secretary of 
\ 
Health and Human Services) 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 au-
thorize the nurse to be employed) governing the place of in-
tended 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. 
Healthcare 
"(2)(A) The attestation referred to in section 101(a)(15)(H)(i)(a), 
facilities. 
with respect to a facility for which an alien will perform services, is 
an attestation as to the following: 
"(i) There would be a substantial disruption through no fault 
of the facility in the delivery of health care services of the 
facility without the services of such an alien or aliens. 
"(ii) The employment of the alien will not adversely affect the 
wages and working conditions of registered nurses similarly 
employed. 
"(iii) The alien will be paid the wage rate for registered nurses 
similarly employed by the facility. 
"(iv) Either (I) the facility has taken and is taking timely and 
significant steps designed to recruit and retain sufficient reg-
istered nurses who are United States citizens or immigrants 
who are authorized to perform nursing services, in order to 
remove as quickly as reasonably possible the dependence of the 
facility on nonimmigrant registered nurses, or (II) the facility is 
PUBLIC LAW 101-238—DEC. 18,1989 
103 STAT. 2101 
subject to an approved State plan for the recruitment and 
retention of nurses (described in paragraph (3)). 
"(v) There is not a strike or lockout in the course of a labor 
dispute, and the employment of such an alien is not intended or 
designed to influence an election for a bargaining representa-
tive for registered nurses of the facility. 
"(vi) At the time of the filing of the petition for registered 
nurses under section 101(aX15XH)(i)(a), 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 
bargaining representative, notice of the filing has been provided 
to registered nurses employed at the facility through posting in 
conspicuous locations. 
A facility is considered not to meet clause (i) (relating to an attesta-
tion of a substantial disruption in delivery of health care services) if 
the facility, within the previous year, laid off registered nurses. 
Nothing In clause (iv) shall be construed as requiring a facility to 
have taken significant steps described in such clause before the date 
of the enactment of this subsection. 
"(B) For purposes of subparagraph (AXiv)(I), 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 participation in) a training 
program for registered nurses elsewhere. 
"(ii) Providing career development programs and other meth-
ods 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 nonnursing duties. 
"(v) Providing reasonable opportunities for meaningful salary 
advancement by registered nurses. 
The steps described in this subparagraph shall not be considered to 
be an exclusive list of the significant steps that may be taken to 
meet the conditions of subparagraph (A)(iv)(I). Nothing herein shall 
require a facility to take more than one step, if the facility can 
demonstrate that taking a second step is not reasonable. 
"(C) Subject to subparagraph (E), an attestation under subpara-
graph (A) shall— 
"(i) expire at the end of the 1-year period beginning on the 
date of its filing with the Secretary of Labor, and 
"(ii) apply to petitions filed during such 1-year period if the 
facility states in each such petition that it continues to comply 
with the conditions in the attestation. 
"(D) A facility may meet the requirements under this paragraph 
with respect to more than one registered nurse in a single petition. 
"(EXi) The Secretary of Labor shall compile and make available 
for public examination in a timely manner in Washington, D.C., a 
list 
identifying 
facilities 
which 
have 
filed 
petitions 
for 
nonimmigrants under section 101(aX15XHXiXa) and, for each such 
facility, a copy of the facility's attestation under subparagraph (A) 
(and accompanying documentation) and each such petition filed by 
the facility. 
Public 
information. 
District of 
Columbia. 
103 STAT. 2102 
PUBLIC LAW 101-238—DEC. 18,1989 
"(ii) The Secretary of Labor shall establish a process for the 
receipt, investigation, 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. Complaints may 
be filed by any aggrieved person or organization (including bargain-
ing representatives, associations deemed appropriate by the Sec-
retary, 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. 
"(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 Sec-
retary shall provide for notice of such determination to the in-
terested parties and an opportunity for a hearing on the complaint 
within 60 days of the date of the determination. 
"(iv) If the Secretary of Labor finds, after notice and opportunity 
for a hearing, that a facility (for which an attestation is made) has 
failed to meet a condition attested to or that there was a misrepre-
sentation of material fact in the attestation, the Secretary shall 
_, 
notify the Attorney General of such finding and may, in addition, 
impose such other administrative remedies (including civil mone-
tary penalties in an amount not to exceed $1,000 per violation) as 
the Secretary determines to be appropriate. Upon receipt of such 
notice, the Attorney General shall not approve petitions filed with 
respect to a facility during a period of at least 1 year for nurses to be 
employed by the facility. 
"(v) In addition to the sanctions provided under clause (iv), if the 
Secretary of Labor finds, after notice and an opportunity for a 
hearing, that a facility has violated the condition attested to under 
subparagraph (A)(iii) (relating to payment of registered nurses at the 
prevailing wage rate), the Secretary shall order the facility to 
provide for payment of such amounts of back pay as may be 
required to comply with such condition. 
"(3) The Secretary of Labor shall provide for a process under 
which a State may submit to the Secretary a plan for the recruit-
ment and retention of United States citizens and immigrants who 
are authorized to perform nursing services as registered nurses in 
facilities in the State. Such a plan may include counseling and 
educating health workers and other individuals concerning the 
employment opportunities available to registered nurses. The Sec-
retary shall provide, on an annual basis in consultation with the 
Secretary of Health and Human Services, for the approval or dis-
approval of such a plan, for purposes of paragraph (2)(A)(iv)(II). Such 
a plan may not be considered to be approved with respect to the 
facility unless the plan provides for the taking of significant steps 
described in paragraph (2)(A)(iv)(I) with respect to registered nurses 
in the facility. 
"(4) The period of admission of an alien 
under 
section 
101(a)(15)(H)(i)(a) shall be for an initial period of not to exceed 3 
^ 
years, subject to an extension for a period or periods, not to exceed a 
total period of admission of 5 years (or a total period of admission of 
6 years in the case of extraordinary circumstances, as determined by 
the Attorney General). 
PUBLIC LAW 101-238—DEC. 18, 1989 
103 STAT. 2103 
"(5) For purposes of this subsection and section 101(aX15)(H)(i)(a), 
the term 'facility' includes an employer who employs registered 
nurses in a home setting.". 
(c) IMPLEMENTATION.—The Secretary of Labor (in consultation 
8 USC1182 note, 
with the Secretary of Health and Human Services) shall— 
(1) first publish final regulations to carry out section 212(m) of Regulations, 
the Immigration and Nationality Act (as added by this section) 
not later than the first day of the 8th month beginning after the 
date of the enactment of this Act; and 
(2) provide for the appointment (by January 1, 1991) of an 
advisory group, including representatives of the Secretary, the 
Secretary of Health and Human Services, the Attorney General, 
hospitals, and labor organizations representing 
registered 
nurses, to advise the Secretary— 
(A) concerning the impact of this section on the nursing 
shortage, 
(B) on programs that medical institutions may implement 
to recruit and retain registered nurses who are United 
States citizens or immigrants who are authorized to per-
form nursing services, 
(C) on the formulation of State recruitment and retention 
plans under section 212(m)(3) of the Immigration and 
Nationality Act, and 
(D) on the advisability of extending the amendments 
made by this section beyond the 5-year period described in 
subsection (d). 
(d) LIMITING APPLICATION OF NONIMMIGRANT CHANGES TO S-YEAR 8 USC 1182 note. 
PERIOD.—The amendments made by the previous provisions of this 
section shall apply to classification petitions filed for nonimmigrant 
status only during the 5-year period beginning on the first day of the 
9th month beginning after the date of the enactment of this Act. 
SEC. 4. FRAUD PREVENTION IN SAW PROGRAM. 
(a) Section 210(a)(3) of the Immigration and Nationality Act (8 
U.S.C. 1160(aX3)) is amended by— 
(1) inserting "(A)" before "During", and 
(2) inserting at the end of such paragraph the following new 
subparagraph: 
"(B) Before any alien becomes eligible for adjustment of 
status under paragraph (2), the Attorney General may deny 
adjustment to permanent status and provide for termination of 
the temporary resident status granted such alien under para-
graph (1) if^ 
"(i) the Attorney General finds by a preponderance of the 
evidence that the adjustment to temporary resident status 
was the result of fraud or willful misrepresentation as set 
out in section 212(a)(19), or 
"(ii) the alien commits an act that (I) makes the alien 
inadmissible to the United States as an immigrant, except 
as provided under subsection (c)(2), or (II) is convicted of a 
felony or 3 or more misdemeanors committed in the United 
States.". 
(b) Section 210(bX6XA) of the Immigration and Nationality Act (8 
U.S.C. 1160) is amended to read as follows: 
"(A) use the information furnished pursuant to an appli-
cation filed under this section for any purpose other than to 
make a determination on the application including a deter-
103 STAT. 2104 
PUBLIC LAW 101-238—DEC. 18, 1989 
8 u s e 1324a 
note. 
State and local 
governments. 
Reports. 
Grants. 
Contracts. 
California. 
8 u s e 1255a 
note. 
mination under subparagraph (a)(3)(B), or for enforcement 
of paragraph (7).". 
SEC. 5. PILOT PROJECTS FOR SECURE DOCUMENTS. 
- 
*' 
(a) CONSULTATION.—Before June 1, 1991, the Attorney General 
shall consult with State governments on any proper State initiative 
to improve the security of State or local documents which would 
satisfy the requirements of section 274A(b)(l) of the Immigration 
and Nationality Act (8 U.S.C. 1324a). The result of such consulta-
tions shall be reported, before September 1, 1991, to the Committees 
on the Judiciary of the Senate and House of Representatives of the 
United States. 
(b) ASSISTANCE FOR STATE INITIATIVES.—After such consultation 
described in subsection (a), the Attorney General shall make grants 
to, and enter into contracts with (to such extent or in such amounts 
as are provided in an appropriation Act), the State of California and 
at least 2 other States with large immigrant populations to promote 
any State initiatives to improve the security of State or local 
documents which would satisfy 
the requirements of section 
274A(b)(l) of the Immigration and Nationality Act. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to 
be appropriated to the Attorney General $10,000,000 for fiscal year 
1992 to carry out subsection (b). 
(d) REPORT REQUIRED.—The Attorney General shall report to the 
Committees on the Judiciary of the Senate and House of Represent-
atives not later than August 1, 1993, on the security of State or local 
documents which would satisfy the requirements of section 
274A(b)(l) of the Immigration and Nationality Act (8 U.S.C. 1324a), 
and any improvements in such documents that have occurred as a 
result of this section. 
SEC. 6. ADDITIONAL USES OF STATE LEGALIZATION IMPACT ASSISTANCE 
GRANT FUNDS. 
(a) IN GENERAL.—Section 204(c) of the Immigration Reform and 
Control Act of 1986 is amended— 
(1) in paragraph (1)— 
(A) by striking "and" at the end of subparagraph (B), 
(B) by striking the period at the end of subparagraph (C) 
and inserting a comma, and 
(C) by inserting after subparagraph (C) the following new 
subparagraphs: 
"(D) to make payments for public education and outreach 
(including the provision of information to individual applicants) 
to inform temporary resident aliens regarding— 
"(i) the requirements of sections 210, 210A, and 245A of 
the Immigration and Nationality Act regarding the adjust-
ment of resident status, 
"(ii) sources of assistance for such aliens obtaining the 
adjustment of status described in clause (i), including educa-
tional, informational, referral services, and the rights and 
responsibilities of such aliens and aliens lawfully admitted 
, ^ 
for permanent residence, 
"(iii) the identification of health, employment, and social 
J 
services, and 
"(iv) the importance of identifying oneself as a temporary 
resident alien to service providers, 
PUBLIC LAW 101-238—DEC. 18, 1989 
103 STAT. 2105 
except that nothing in this subparagraph may be construed as 
authorizing the provision of client counseling or anv other 
service which would assume responsibility for the alien s appli-
cation for the adjustment of status described in clause (i), 
"(EXi) subject to clause (ii), to make payments for education 
and outreach efforts by State agencies regarding unfair discrimi-
nation in employment practices based on national origin or 
citizenship status, 
"(ii) except that the State agencies shall not initiate such 
efforts until after such consultation with the Office of the 
Special Counsel for Unfair Immigration-Related Employment 
Practices as is appropriate to ensure, to the maximum extent 
feasible, a uniform program."; and 
* 
(2) in paragraph (2), by adding at the end the following new 
subparagraph: 
"(D) Of the amount allotted to a State with respect to any fiscal 
year, a State may not use more than— 
"(i) 1 percent (or, if greater, $100,000) for payments under 
• 
paragraph (1)(D), and 
"(ii) 1 percent (or, if greater, $100,000) for payments under 
paragraph (1)(E).". 
(b) EFFECTIVE DATE.—The amendments made by subsection (a) g USC 1255a 
shall apply to the use of allotments for fiscal years beginning with 
note, 
fiscal year 1989. 
Approved December 18, 1989. 
LEGISLATIVE mSTORY—H.R. 3259: 
HOUSE REPORTS: No. 101-288 (Comm. on the Judiciary). 
CONGRESSIONAL RECORD, Vol. 135 (1989): 
Oct. 17, considered and passed House. 
Nov. 20, considered and pcussed Senate, amended. 
Nov. 21, House conciured in Senate amendment.