Thursday, October 29, 2009

U.S. Jobs Outlook (Finally) Improving

Post written by Cindy Unkenholt

According to an article earlier this week that was featured on, the National Association for Business Economics is reporting that for the first time in nearly two years more employers are planning to hire, rather than cut, staff. Similarly, it was noted that more companies increased their capital spending than the number that cut spending. Unemployment is still at historically high levels, but this report is one of many signals that the worst may be over.

While this is clearly good news -- demand for Physical Therapy, Registered Nursing, Occupation Therapist, Speech Langauge Pathologists and other healthcare occupations still expect to be in great demand -- a word of caution may also be in order. An improving job market in the U.S. will likely eventually be reflected in an increase in H-1B petitions filed with the USCIS. Among the top twenty occupations predicted for significant growth were several in IT and healthcare, including: Systems Engineers, Physical Therapists, Computer/Network Security Consultants, Software Developers, and Occupational Therapists. These occupations have been common users of the H-1B program in the United States. Physical Therapists, for example, have long been designated by the U.S. Department of Labor as a national shortage occupation and recruited from abroad.

The USCIS last updated the 2010 H-1B "Cap Count" on September 25, 2009. At that time, there had been approximately 46,700 H-1B petitions filed towards the annual quota of 65,000. Most casual observers see that this is only a few thousand more than were filed as of April 1, 2009, the first day employers were able to file H-1B petitions for the current fiscal year. However, insiders believe that while the economy has significantly reduced the number of H-1B petitions being filed. There has also been a large increase in denials which has impacted the overall number of petitions counted against the quota.

As the U.S. economy and job market continue to improve, the number of H-1B filings may begin to steadily increase. In the short term, there appears to be no cause for alarm. However, if you anticipate any key hires or significant staffing increases, it may be prudent to keep your eye on the cap count in the first quarter of 2010.

Monday, October 26, 2009


The Foreign Credentialing Commission on Physical Therapy (FCCPT) is one of the two US government-approved organizations that are authorized to evaluate the educational credentials of internationally-trained Physical Therapists. FCCPT has just launched a new website which is easier to use than their prior website. The new site allows for electronic tracking and reporting.

In other FCCPT news, FCCPT recently discontinued use of the Type II Certification. Now all applicants to FCCPT must obtain the Type I Certificate. FCCPT has also announced the implementation of the most current Coursework Evaluation Tool-5, for use as of July 1, 2009. Any evaluations for current standards begun after July 1, 2009 will reflect the requirements on the new tool CWT-5.

Thursday, October 22, 2009


MU’s Chris Musillo has been selected as a Speaker at the American Society for Healthcare Human Resources Administration’s (ASHHRA) 45th Annual Conference in Chicago. ASHHRA is the US’ premier organization exclusively dedicated to meeting the professional needs of human resources leaders in health care. More than 3,350 human resources professionals across the US are members.

The Annual Conference takes place in Chicago and runs from November 1-3, 2009. Chris’ session is Monday at 4:45 and is one of the Learning Sessions.

Chris’ talk will be on Strategic Healthcare Immigration. He will demonstrate the best practices in recruiting foreign trained RNs, PTs and other allied professionals. The session will highlight pitfalls in the process, and advise human resource professionals on how to avoid such pitfalls.

If you are attending the conference, please contact Chris if there are any specific items that you would like him to address.

Sunday, October 18, 2009

The pieces are being put on the chessboard

Sometime in the next few months, the US is going to revisit its ongoing discussion on immigration reform. The leading plan seems to be for Congress to address the issue via a Comprehensive Immigration Reform (CIR) package. CIR is expected to address many issues, including hot-button issues such as undocumented workers.

The big question is how Congress will remedy its immigration policy for healthcare workers. For some occupations, the current program is unworkable. For instance, it presently takes about 7 years for a fully qualified nurse to enter the US.

These RNs are fully qualified. They have graduated from international schools and had their education validated by US states' Boards of Nursing. They have taken and passed the US NCLEX licensure exam, and met all other individual state requirements for licensure, including passing English fluency exams. Every single RN in the queue has been offered a job by a US employer.

There is no debate that these RNs are needed in the US, in spite of the current employment condition in the US. The predictions for US nursing supply over the next decade are disastrous.

The IT community recognizes a similar set of fundamentals in their industry. Recently, the Semiconductor Industry of America (SIA) and the Institute of Electrical and Electronics Engineers (IEEE) co-authored a letter to the ranking members of the Congressional Subcommittee on Immigration. The letter calls for sensible immigration reform, including reforming quotas to match the needs of all interested parties. One of the aims is to reduce the enormous visa wait times for green cards for qualified workers. These reforms will also help healthcare workers, such as RNs. The healthcare industry continues to work the issue as well.

Thursday, October 15, 2009

Wexler to resign

Rep. Wexler (D-FL) is expected to resign his Congressional seat. He expected to leave Congress in order to work for a nonprofit whose aim is to promote peace in the Middle East.

Rep. Wexler is the primary sponsor of HR 2536, the Emergency Nursing Supply Relief Act. HR 2536 has failed to gain traction in Congress this term, garnering only 4 co-sponsors. Last term a similar bill had over 20 co-sponsors.

The news isn’t as dire as it might seem. The most likely positive scenario is that the ENSRA is folded into Comprehensive Immigration Reform. Senate Judiciary Immigration Subcommittee Chairman Charles Schumer (D-NY) had planned to introduce CIR legislation in September. He has since changed tact and wants to first get GOP support for a possible bipartisan bill. He is working behind the scenes to do so.

Monday, October 12, 2009

November 2009 Visa Bulletin

The November 2009 Visa Bulletin has been released. There have been some small changes from the October 2009 Visa Bulletin, but no major changes.

EB1: All Current
EB2: All Current, except China (01APR05) and India (22JAN05)
EB3: All 01JUN02, except India (22APR01).

The November Bulletin did contain this note:

The receipt of demand from Citizenship and Immigration Services Offices has far exceeded their earlier indications of cases eligible for immediate processing. As a result, it has been necessary to hold most of the Employment cut-off dates for November. At this time, it is not possible to provide any estimates regarding future cut-off date movements.

Friday, October 9, 2009

Three "Americans" win the Nobel Prize

Earlier today President Obama was awarded the Nobel Peace Prize. The award was a surprise; few pundits had tapped Obama for the honor.

Of lesser apparent newsworthiness, earlier in the week, three
Americans shared the Nobel Prize in Medicine. Although none of the three are nurses or allied workers , two of the three Americans were immigrants to this country. Since this Blog focuses on the intersection of healthcare and visa policy, this is the story that I will highlight.

One of the winners, Dr. Blackburn, came to the United States in the 1970s because it was “notably attractive” as a place to do science. America is still a magnet for foreign scientists, she said, “but one shouldn’t take that for granted.”

There is a parallel to America’s current policy with respect to healthcare professionals, which presently is broken. While few immigrants, or Americans for that matter, make the kinds of these contributions that these two have made, thousands of foreign trained healthcare workers have made the kinds of day-to-day contributions that enormously enhance America. By enacting sensible healthcare visa reform, the US can insure that America remains a magnet for the best and brightest.

Thursday, October 8, 2009

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Monday, October 5, 2009

CIR's chances improving

Last week, the
New York Times reported that new USCIS Director Alejandro Mayorkas is preparing for Comprehensive Immigration Reform (CIR). The Director's preparations aren't wishcasting, but are directives from the President himself. The odds of CIR may increase if the President takes a personal interest in the issue.

For members of the healthcare industry, this is a welcome bit of news. Sen. Schumer's staff is said to be working on a CIR bill. The Senator has long been a friend of reasonable healthcare visa numbers. If CIR can gain momentum, there is a good chance that the long retrogression may be over.

Saturday, October 3, 2009

What Sen. Grassley Should Not Do on the H-1B Visa

Last week Sen. Grassley continued his passionate cry against the H-1B program with a public letter to brand-new USCIS Director Mayorkas. Rather than furthering the discussion, his comments were loose with facts and do not survive serious analysis. His authority for the “substantial fraud” (his words) is weak.

Almost exactly one year ago, the USCIS produced the “H-1B Benefit Fraud & Compliance Report.” According to Sen. Grassley, the Report alleges that 20.7% of all visa cases reviewed were identified as having “outright fraud or other program violations associated with them.” The Senator’s use of the statistical ".7%" is unfortunate. This precision gives the Report a degree of credibility and meticulousness that it does not deserve. Even the Report itself rounded off to 21% in its conclusion. Similarly, the Senator’s use of the phrase “outright fraud” is exaggerated. “Fraud” is fraud; there is no such thing as “outright fraud”. His aim seems to be to incite.

The Senator’s letter purposefully attempts to confuse issues. In the above citation, note that the Senator says “…or other violations associated with them.” The Report purposefully mixed technical violations and fraud findings. This is akin to mixing drunken driving fatalities and parking tickets in a report on motor vehicle violations. The Senator should be above this kind of word-smithing.

The Senator also casually dismisses one of the Reports key findings: that Staffing Companies and IT Companies are not the types of organizations that are committing the fraud. Specifically, the Report’s fourth finding was that the fraud was more likely in fields such as “accounting, human resources, business analysts, sales and advertising.” Since this finding doesn’t fit Sen. Grassley’s theme, he ignores it.

The Report itself was so poorly researched as to be virtually worthless. The sample used in the Report was 51 cases, which is a statistically insignificant number in a world where at least 100,000 H-1Bs are filed in any given year.

In the year since the publication of the Report, none of the fraud implied in the Report has been acted upon. No arrests have been made and no convictions have occurred. All of the investigations including the much heralded Vision Systems indictments were independent of the Report. It is also worth noting that the government recently amended their indictment in that case, lowering the damages sought. This reduction in allegation received far less press than the initial story.

As I have argued in the past, H-1B fraud likely is overblown. Here is what I said in April,

In prior years we have seen more than twice as many H-1B cases accepted. These numbers provide compelling evidence against the argument that internationally-trained workers are being used to displace American workers and lower US workers salaries. That argument just doesn’t jibe with what is actually happening.

If H-1B visa labor was being used primarily to lower US workers salaries, the H-1B filing numbers wouldn’t be impacted to any meaningful degree. Why? Because the incentive to reduce workers’ salaries is likely greater in a recessed economy, not less. This logic is straightforward and convincing.

The H-1B program surely has problems that legislation could cure. As an experienced Senator, Mr. Grassley knows that reasonable fixes to the H-1B program are attainable. Instead it appears as if the Senator is more interested in inciting a base level voter. The Senator’s aims would be better served by seeking out those organizations that are engaging in fraud, instead of broadly condemning the entire H-1B program. A good start would be to recognize the weak analysis in the "H-1B Benefit Fraud & Compliance Report”. When the Senator relies on the Report and plays politics with his language, his argument rings hollow.