FAQ Fridays

Every Friday, MU’s Cindy Unkenholt posts her “FAQ Friday” to MU’s Facebook page. The FAQs (Frequently Asked Questions) generally focus on healthcare immigration-related issues. For instance, last week’s FAQ Friday was:

Q: Can I nurse qualify for EB-2?

To learn the answer to this one, view past FAQs, and to get the latest quick-hit new items, become a fan of MU on Facebook. The MU Facebook page also allows Fans to comment on news stories and issues that affect US immigration.

NY considering BSN requirement for RNs

At the May 2010 meeting of the New York State Education Department, the Registered Nurse Professional Practice Committee was presented with a proposal to increase the minimum educational requirement to a Bachelors degree.

Under the recommended plan, all currently-licensed RNs would be "grandparented," and would not have to obtain the Bachelors degree. Instead, all diploma and associate degreed RNs, who obtain licenses after 2012 would need to obtain a Bachelors degree within 10 years of the initiation of their license.

Nurses who failed to obtain the Bachelors degree would have their licenses put on "hold". This “hold” is similar to the action taken when a licensee fails to meet continuing education requirements in those professions that mandate continuing education as a criterion for continued registration.

Other states such as New Jersey also are considering raising their educational requirement. Advocates for the New York plan cite recent studies that show that increasing the number of baccalaureate nurses in an acute care hospital decreases the number of patient deaths. Similar legislation was introduced into the New York legislature in 2005, but was tabled because of supply concerns.

It seems inevitable that states will raise their minimum educational requirements to the level of Bachelors degree. Many countries’ minimum educational requirement is a Bachelors degree. In the US, the only state to have had a Bachelors degree minimum was North Dakota, which lowered their requirement and joined the other 49 states in the middle part of this decade.

If any state did raise their requirement to a bachelors degree, employers in that state could more liberally use the H-1B visa as a partial solution to their expected long-term nursing supply shortages. The H-1B can be used to employ some Registered Nurses.

Visa Bulletin Analysis and Predictions

In the January 2010 Visa Bulletin, the Department of State made “best case” predictions on where the visa numbers would be in September 2010, which is the end of the Fiscal Year 2010. October 2010 is the first Visa Bulletin of Fiscal Year 2011.

In this Blog post, MU has done a analysis of the progress of these projections, including the just-released June 2010 Visa Bulletin. Most of the DOS' projections are proving to be accurate, with the notable exception of All Other EB3, including the Philippines.

India EB2
June 2010: 01FEB05.
Predicted Sept 2010: February through early March 2005
MU Comment: The India EB2 visa number is right on the mark.

China EB2
June 2010: 22NOV05.
Predicted Sept 2010: July through October 2005.
MU Comment: The China EB2 visa number has already surpassed the “best case” scenario, which is good news.

India EB3
June 2010: 22OCT01.
Predicted Sept 2010: January through February 2002.
MU Comment: The India EB3 number has steadily moved since January 2010, when the India EB3 number was 22JUN01. The number looks to be on pace to meet the predicted number.

China EB3
June 2010: 22JUN03.
Predicted Sept 2010: June through September 2003.
MU Comment: The China EB2 visa number is right on the mark.

All Other EB3 (incl. Philippines)
June 2010: 22 JUN 03.
Predicted Sept 2010: April through August 2005
MU Comment: This is the prediction that is the most disheartening. By now we would have expected the All Other EB3 to be well into 2004, and maybe even into 2005. The fact that the number is still in mid-2003 leads us to believe that the predicted date will not be reached.

That having been said, MU expects the All Other Visa Number to begin to move at a quicker pace. There does not appear too many cases that are still left that are this old on our roster of cases and on the roster of cases still with other attorneys.

June Visa Bulletin

The Department of State has just released the June 2010 Visa Bulletin

The relevant dates are:
EB1 – all current
EB2 – all current, except China (22 NOV 05) and India (01 FEB 05)
EB3 – all 22 JUN 03, except India (22 OCT 01) and Mexico (U)

This is slow progress from the last few Visa Bulletins for All Other EB3 Applications. All Other EB3 has increased 9 months since February 2010 Visa Bulletin, when it was 22 SEP 2002. India EB3 has also improved about 4 months since February’s Visa Bulletin (22 JUN 01). Mexican EB3 remains unavailable, as it is expected to be until the end of the fiscal year in September 2010.

Election Season

Two of the largest suppliers of healthcare professionals to the US are the Philippines and the UK. MU attorneys and staff have traveled on many occasions to both countries for recruiting and information sessions with our clients. This week both countries had groundbreaking elections.

Senator Benigno “Noynoy” Aquino III is poised to become the first Philippine president elected through an automated election. President-elect Aquino is the son of former President Corazon Aquino and former Senator Benigno Aquino, Jr.

In the UK, David Cameron looks to lead the first British coalition government since World War II. The coalition agreement ends a week of discussion and negotiations between Cameron’s Conservative government and the upstart Liberal Democrats.

MU congratulates nationals of both countries on their landmark elections.

And lastly, Happy Nurses Week to all of our Nurse readers!

FCCPT reapproved until 2015

The Foreign Credentialing Commission on Physical Therapy (FCCPT) has been re-approved by USCIS to issue Healthcare Worker Certificates for an additional 5 years, through 2015. FCCPT is one of two organizations that are approved to issue Healthcare Worker Certificates for Physical Therapists. The other, CGFNS, issues the Visa Screen as its Healthcare Worker Certificate. FCCPT’s Healthcare Worker Certificate is known as the Type I.

The Healthcare Worker Certificate is a prerequisite for all US visas, including the H-1B, TN, and the EB2 and EB3 green cards. Either the FCCPT or the CGFNS is sufficient.

California BRN now requires SSN

On April 26, 2010, the California Board of Registered Nursing announced that it would no longer accept applications that do not have a Social Security Number. The California BRN reasons that since the Nursing Practice Act provides for automatic issuance of the license upon approval, the Social Security Number is a prerequisite to the filing of the application. This is problematic for overseas nurses who are ineligible for Social Security Numbers by virtue of not having US visas and work authorization.

If a nurse has passed the NCLEX and the only issue holding up the issuance of the license is the lack of a Social Security Number, the USCIS should still approve the visa petition. This process would be consistent with the USCIS’ long-standing procedure on petitions solely lacking Social Security Numbers.

For instance, a November 20, 2001 INS (predecessor to the USCIS) Memo directs USCIS officers to approve petitions when the sole missing item is the social security number. Similarly a May 20, 2009 USCIS Memo reiterates this position.

Healthcare Immigration Primer: Occupational Therapists

TEMPORARY OPTIONS: Occupational Therapists are eligible for H-1B status because the position requires at least a Bachelor’s degree. H-1B status provides temporary employment authorization in the United States for individuals from any country for any specialty occupation. A Specialty occupation is one which normally requires at least a Bachelor’s degree or the equivalent.

An Occupational Therapist who is a Canadian Citizen is eligible for TN status. [Note: Residency status in Canada is not sufficient for TN eligibility.] TN status is available to Canadian citizens with an offer of employment in the United States in one of forty-three (43) listed occupations.

GREEN CARD OPTIONS: Occupational Therapists have not been designated as a Schedule A occupation, and therefore they are not exempt from the labor certification process (“PERM”). Therefore, the green card process for an Occupational Therapist will require PERM labor certification process followed by either Adjustment of Status or a Consular Interview.

Because the first professional degree required for licensure as an Occupational Therapist in the United States is evolving, some Occupational Therapist positions are eligible for EB-2 classification while others are only eligible for EB-3 classification. The EB-2 category is the immigrant visa classification for positions requiring at least an advanced degree (Master’s degree or higher) or a Bachelor’s degree and five years of progressively responsible experience. The classification is relevant to when an immigrant visa is available. Generally speaking there is no backlog for EB-2 visas for most countries (excluding India and China) and thus an immigrant visa can be obtained “immediately” as soon as the normal case processing is completed. In contrast, obtaining an immigrant visa for an individual filing in the EB-3 classification is currently a lengthy process which takes between four to seven years.

CURRENT ISSUES: Filing EB-2 applications is difficult, although these can be approved in some instances where the employer requires a Bachelors degree and five years of progressive experience or the employer requires a Masters degree.

Obama Says No

The President has sounded the death knell for immigration reform in 2010. Those expecting immigration reform this year – including nurses and other healthcare workers – should not expect any action until after the mid-term elections in November 2010.

The President’s remarks ended some speculation this week that the Senate would attempt to move on immigration. Earlier, a group of Senators released a new summary Comprehensive Immigration Reform bill -- the Real Enforcement with Practical Answers for Immigration Reform (REPAIR) bill. REPAIR was co-authored by many leading Democrats: Senators Harry Reid (D-NV), Richard Durbin (D-IL), Charles Schumer (D-NY), Patrick Leahy (D-VT), Dianne Feinstein (D-CA), and Robert Menendez (D-NJ). It provides a path forward for both political parties to come together and enact a lasting federal fix to the problem this year.

The actual bill language has yet to be released, although summaries have been published. At this point, it is unknown whether there is a specific liberalizing provision for Schedule A occupations – Registered Nurse and Physical Therapists. Past versions of CIR have included such a provision.

To some degree, it doesn’t matter. The President indicated that immigration is a secondary domestic priority and it is unlikely that immigration reform will be taken up in 2010.

Healthcare Immigration Primer: Physical Therapists

TEMPORARY OPTIONS: Physical Therapists are eligible for H-1B status because the position requires at least a Bachelor’s degree. H-1B status provides temporary employment authorization in the United States for individuals from any country for any specialty occupation. A Specialty occupation is one which normally requires at least a Bachelor’s degree or the equivalent.

A Physical Therapist who is a Canadian Citizen is eligible for TN status. [Note: Residency status in Canada is not sufficient for TN eligibility.] TN status is available to Canadian citizens with an offer of employment in the United States in one of forty-three listed occupations.

GREEN CARD OPTIONS: Because Physical Therapists have been designated by the U.S. Department of Labor as a ‘Schedule A occupation’, they are exempt from the labor certification process (“PERM”) required for most employment based immigrant visas. Therefore, the green card process for a Physical Therapist will be either the Schedule A I-140 Petition (Consular Processing) if they are outside of the United States or the Schedule A I-140 Petition (Adjustment of Status) if they are already physically present in the United States.

Because the first professional degree required for licensure as a Physical Therapist in the United States is evolving, some Physical Therapy positions are eligible for EB-2 classification while others are only eligible for EB-3 classification. The EB-2 category is the immigrant visa classification for positions requiring at least an advanced degree (Master’s degree or higher) or a Bachelor’s degree and five years of progressively responsible experience.

The EB-2 category is the immigrant visa classification for positions requiring at least an advanced degree (Master’s degree or higher) or a Bachelor’s degree and five years of progressively responsible experience. The classification is relevant to when an immigrant visa is available.

Generally speaking there is no backlog for EB-2 visas for most countries (excluding India, Mexico, and China) and thus an immigrant visa can be obtained “immediately” as soon as the normal case processing is completed. In contrast, obtaining an immigrant visa for an individual filing in the EB-3 classification is currently a lengthy process which takes between four to seven years.

CURRENT ISSUES: Filing EB-2 applications is a fairly new phenomenon. MU has had several EB-2 applications approved for applications requiring 5 years of experience.

Read the full Healthcare Immigration Primer by clicking here.

Healthcare Immigration Primer: Registered Nurses

TEMPORARY OPTIONS: Registered Nurses are generally not eligible for H-1B status because the position generally does not require at least a Bachelor’s degree or the equivalent. However, it is possible to obtain H-1B status for a Registered Nurse if the position requires a Bachelor’s degree or the equivalent. H-1B status provides temporary employment authorization in the United States for individuals from any country for any specialty occupation. A specialty occupation is one which normally requires at least a Bachelor’s degree or the equivalent.

A Registered Nurse who is a Canadian Citizen is eligible for TN status. [Note: Residency status in Canada is not sufficient for TN eligibility.] TN status is available to Canadian citizens with an offer of employment in the United States in one of forty-three listed occupations.

GREEN CARD OPTIONS: Because Registered Nurses have been designated by the U.S. Department of Labor as a ‘Schedule A occupation’, they are exempt from the labor certification process (“PERM”) required for most employment based immigrant visas. Therefore, the green card process for a Registered Nurse will be either the Schedule A I-140 Petition (Consular Processing) if they are outside of the United States or the Schedule A I-140 Petition (Adjustment of Status) if they are already physically present in the United States.

CURRENT ISSUES: Because some Employers do in fact require a Bachelors degree or the equivalent for some Registered Nurse positions, some Registered Nurses are eligible for H-1B status. The USCIS has acknowledged that certain Advanced Practice nurses as well as some specialty nurse positions (such as Critical Care and Peri-Operative) may be eligible for H-1B status.

To qualify as a specialty occupation [according to 8 CFR §214.2(h)(4)(iii)(A)], the position must meet at least one of the following criteria:

• A baccalaureate or higher degree or its equivalent is normally the minimum requirement for entry into the particular position
• The degree requirement is common to the industry in parallel positions among similar organizations or, in the alternative, the employer may show that its particular position is so complex or unique that it can be performed only by an individual with a degree
• The employer normally requires a degree or its equivalent for the position
• The nature of the specific duties are so specialized and complex that knowledge required to perform the duties is usually associated with attainment of a baccalaureate or higher degree.

The USCIS takes the position that each year of education is equivalent to three years of experience. Thus, for example, an employer that normally requires a Bachelor’s degree in Nursing or an Associate’s degree and at least six years of experience is able to attest that the position normally requires a Bachelor’s degree or the equivalent.

Read the full Healthcare Immigration Primer by clicking here.

MU Healthcare Immigration Primer: The Series

Over the next few posts MU will be posting basic US immigration information for common occupations such as Registered Nurses, Physical Therapists, and Occupational Therapists. If there are any occupations that you would like us to focus on, please let us know either via email or via the comments.

This posting will focus on some preliminary thoughts and issues that are common in most visa Petitions and Applications. The subsequent postings will highlight the specific occupations.

In all instances, there must be an employer who is the Petitioner of the visa. Generally the Beneficiary must hold the appropriate state license, although a few exceptions will be noted.

For those who are overseas, any healthcare immigration case generally starts with an immigration Petition filing in the United States. Upon approval of the Petition, the case is forwarded to the appropriate US Consulate or Embassy where the visa is issued to the beneficiary.

Upon visa issuance, the Beneficiary can enter the US. Family members generally can attend the interview and are issued derivative visas. Some derivative visas allow the derivatives work authorization and others do not.

There are two broad visa categories: nonimmigrant and immigrant visas. Nonimmigrant visas (also called NIVs or temporary visas) typically are for shorter periods of time. NIVs also tie an employer and employee. In other words if the Beneficiary wants to move to a new employer, a new NIV must be filed.

Once issued, Immigrant visas (also called IVs, green cards, or permanent residency) typically remain valid for 10 years. Immigrant visa holders also become eligible for US Citizenship, ordinarily after 5 years. IVs also may sponsor certain family members for US immigration, although the retrogression for some family categories is lengthy.

What the USCIS learned

Does the USCIS fully understand the law and the legal implications of the Neufeld Memorandum? An April 15, 2010 Executive Summary of a recent teleconference implies that the Service may be getting the message, although the Executive Summary may confuse as much as it informs.

The Neufeld Memo’s main flaw is that it misreads the underlying regulation. 8 CFR 214.2(h)(4)(ii) holds that a U.S. employer is indicated by five characteristics: hire, pay, fire, supervise, or otherwise control. This regulation is controlling. Incorrectly, the Neufeld Memo implies that “right of control” is a superior characteristic encompassing the other characteristics.

In order to attempt to get its hands around the growing confusion, the USCIS held a Listening Session on March 26, 2010. MU’s attended and participated at the Session.

The USCIS’ recently released Executive Summary from that session recognizes that “if” right of control is required, then the Neufeld Memo contradicts the existing regulation. The Executive Summary goes further and agrees that “if” right of control is only one of the five elements, then an amendment is needed to the Memo.

These are not small issues. Staffing companies use the H-1B visa to supply staff to third-party worksites, mainly where well-documented US supply is short. At this point, it simply makes sense for the USCIS to suspend or withdraw the Neufeld Memorandum. At best, the Memo makes a confusing area of law incomprehensible. At worst, it takes a simple regulation and misapplies it.

MU Comments on the Proposed I-129

To little fanfare the USCIS recently announced a new proposed Form I-129. The Form I-129 is used in many business nonimmigrant filings, including the H-1B. The USCIS asked for public comments on the proposed revisions. Musillo Unkenholt recently filed our comments with the USCIS.

While Musillo Unkenholt has several problems with the proposed revised Form I-129, MU elected to highlight the most significant change in our comments to the USCIS. Namely, the apparent new requirement that an amended H-1B Petition must be filed whenever a H-1B worker changes his geographical location. This new requirement quietly was snuck into the new Form’s instructions.

This has never been USCIS policy. The USCIS’ current policy remains unchanged since the early 1990s. In at least five prior correspondences (all referenced in the MU letter), USCIS and Legacy INS officials have determined that a simple geographic change is an immaterial change, and therefore the H-1B amendment rule is not triggered.

Practically and legally there is good reason for the existing USICS policy; a simple geographical change does not change the H-1B worker’s underlying job duties.

We invite you to read the MU letter. AILA has also published a lengthy letter that was also submitted to the USCIS as part of the comment period. AILA's letter raises a number of excellent points.

USCIS recently has begun to engage the public in advance of changes. MU applauds this effort and has actively participated in several of the USCIS’ outreach sessions. This effort to slip a massive change past the immigration bar belies that effort.

May Visa Bulletin

The Department of State has just released the May 2010 Visa Bulletin.

The relevant dates are:
EB1 – all current
EB2 – all current, except China (22 AUG 05) and India (1 FEB 05)
EB3 – all 22 APR 03, except India (01 OCT 01) and Mexico (U)

This is modest progress from the last few Visa Bulletins for All Other EB3 Applications. All Other EB3 has increased 8 months since February 2010 Visa Bulletin, when it was 22 SEP 2002. India EB3 has also improved about 4 months since February’s Visa Bulletin (22 JUN 01). Mexican EB3 has become unavailable.

H-1B numbers down dramatically

Filing for the H-1B visa cap opened on April 1, 2010, and this year the filing numbers are down dramatically. Filing numbers are about one-third of last year’s numbers and a staggering 10% from the H-1B filing numbers in the middle of the past decade.

Each year, the USCIS is allowed to approve 65,000 H-1B “regular” Petitions. USCIS is also allowed to approve 20,000 H-1B “Masters” Petitions; these are cases for foreign-workers who have graduated from a US-based University with at least a Masters degree. Any cases received at one of the two H-1B Service Centers before April 7 are treated as “Day One” filings.

Reports have indicated that the Vermont Service Center has received about 7,500 cap-subject “regular” H-1 Petitions and about 3,000 Masters Petitions. Yesterday’s report, which is from an AILA member at a Vermont Service Center meeting, indicates that there were similar numbers received at the California Service Center.

All told, this means that fewer than 15,000 regular H-1B Petitions have been received and 6,000 US Masters degree H-1Bs. Last year the USCIS received a little more than 40,000 regular H-1 filings during the first week. In the middle of the decade it was common for the USCIS to receive over 100,000 H-1B petitions.

The H-1B is a common visa for healthcare professionals such as Physical Therapists, Occupational Therapists, Speech Language Pathologists, some nursing positions, and other professions ordinarily associated with a Bachelors degree or greater. The H-1B traditionally has been in great demand by the IT community.

Schumer and Graham on CIR

This past Sunday, Sens. Schumer and Graham were featured on NBC’s Meet The Press (you can watch the four minute clip where the Senators talk immigration at NBC's website). Sen. Graham said that he would continue to work with Sen. Schumer to pass CIR. These two Senators have been leading the push for CIR. The conventional wisdom is that the House will not push forward on CIR unless the Senate acts firstly, which is why it is so important that these two are willing to move ahead.

Last week, Sen. Graham said that immigration would be the first casualty of partisanship if the Democrats pushed through the healthcare bill, which is exactly what the Democrats did. On Meet The Press, he backed off that position.

“I will keep working with Chuck on immigration [but] immigration’s tough,” said Sen. Graham. The Senator cautioned that unless President Obama leads the charge, “tough sledding lies ahead.”

Is immigration reform dead? “I don’t think so,” said Sen. Schumer. Sen. Schumer continued, “We’re real close.” The Senator then listed groups like labor, business, and religious entities that are ready to sign on.

Many are willing to come to the simple conclusion that CIR has no chance of passing in 2010. That is certainly the likely outcome. As I have said before, the pessimism may be misplaced. It helps nobody to be needlessly optimistic or pessimistic on CIR. The reality is that with hard work CIR can be passed and with targeted advocacy healthcare occupations can be part of the discussion. Have you called your Congressman?

Notes from the USCIS Session on Neufeld Memo

On Friday March 26, MU’s Cindy Unkenholt attended the USCIS’ listening session on the application of the Neufeld Memo for the Healthcare industry. MU’s Chris Musillo participated telephonically.

The USCIS was represented by several high-ranking officers including General Counsel Roxie Bacon and Barbara Velarde, Chief Service Center Operations. Oddly, Donald Neufeld, the author of the Memo, did not participate in the session.

Ms. Bacon pointed out that the approval rate for Therapists was unchanged since the publication of the Memo on January 8, 2010. This implies that the fears that the Memo would increase denial rates are overblown.

Other key points were raised by the attendees included,

- That the definition of employer-employee is established in the Memorandum. In conversations that I have had with multiple AILA attorneys all are confident in this position. USCIS did not comment on the legality of this definition. AILA spells out most of this argument in their recent letter.

- Co-employer. The USCIS seems to be taking the position that it must choose the "best employer" (either Staffing Co. or Facility). This is not how the law is to be applied in this area. Instead, the USCIS is only to analyze and see if the Petitioner has the right to control. Multiple parties (both Staffing Co. and Facility) can have a right to control. This is the legal foundation behind the co-employer doctrine, which has a long basis in law. Indeed, the DOL's own regulations contemplate co-employer doctrine in the FMLA regulations. See, e.g. 29 CFR 825.16.

- Burden of Proof. The Service has a policy on burden of proof. The policy is this: If the petitioner submits relevant, probative, and credible evidence that is more likely than not to be true, the USCIS must approve the case. All too often USCIS officers are not applying this standard or just paying lip-service to it.

- Expansion of the Neufeld Memo. There is also concern that this Memo is going to serve as the basis to be expanded to I-140's, etc. USCIS didn't even side-skirt the issue. Ms. Bacon implied that the USCIS will look to expand the logic behind the Memo in future Memos.

USCIS Session - Implications of H-1B Memo on Healthcare Industry

Tomorrow the USCIS will hold a public session on the impact of the Neufeld Memo on the Healthcare Industry. MU’s Cindy Unkenholt will be attending in person. If you would like to attend either in person or via telephone, please contact USCIS’ Suzie Clark, Suzanne.clarke@dhs.gov or (202) 272-1279. MU will publish a Blog post of any important information that comes out of the session, although none is expected since the session is limited to hearing industry concerns.

MU will or has raised several concerns with the application of the Neufeld Memo in the past. These include:

1. The issuance of the Neufeld Memorandum is a substantive change to existing law. Such changes to law by Memorandum are illegal under the Administrative Procedures Act. Under the APA, regulatory agencies like USCIS must first publish proposed rules in the Federal Register. Then, the agency must allow the public to comment on the changes. The USCIS must then consider and respond to the public comment.

2. The entire reasoning of the Neufeld Memorandum is unsound. In the Neufeld Memorandum, the USCIS found that existing law did not define “employer-employee” relationship. AILA contends, correctly MU thinks, that existing law does define “employer-employee” relationship at 8 CFR 214.2(h)(4)(ii). An “employer” is one who may “hire, pay, fire, supervise, or otherwise control the work of any such employee”. Therefore the USCIS’ use of Supreme Court cases and common-law is improper since the definition is already right there in the definition.

3. To the extent that the USCIS applies the definition, it limits its focus to one of these five characteristics -- control – and fails to explore the other four characteristics – hire, pay, fire, and supervise.

4. Even if the USCIS feels that it needs help in defining “employer-employee,” the USCIS completely misapplies the relevant Supreme Court decisions. Cases such as Clackamas speak to the idea of balancing all characteristics and not limiting the analysis to the control characteristic.

5. When Congress last amended the relevant statutes in the law IMMACT90. It expressly sought to expand the definition of employer, not restrict it. USCIS is not legally allowed to violate Congress’ express intent.

Why the Pessimism on CIR May Be Misplaced

This week President Obama is expected to sign the long-delayed Healthcare bill, thus ending one the longer American legislative dramas in recent history. Pundits have long-suspected that immigration reform would be the next domestic issue on President Obama’s list, although most expected that the President could get Healthcare and Comprehensive Immigration Reform tackled in his first year. This weekend tens of thousands turned up in Washington to kickoff the rally for CIR.

For readers of this Blog, CIR is only critical insofar as CIR includes liberalized visa quotas and procedures for healthcare occupations that have long been in short American supply – nurses, physical therapists, occupational therapists, etc. and are expected to be in short supply in the upcoming decade.

Legislators have been hesitant to pass piecemeal legislation at targeted immigration issues. The idea has been to force all immigration issues into one comprehensive bill. This strategy was unsuccessful in 2006-7.

Because of the failure of the 2006-7 effort, pundits are skeptical that any CIR bill will be finished before this November’s mid-term election. The problem with that pessimism is that it fails to consider that all legislation is a long haul. For instance, the Healthcare bill has been declared dead more times than a horror movie villain, and yet it lives!

It helps nobody to be needlessly optimistic or pessimistic on CIR. The reality is that with hard work CIR can be passed and with targeted advocacy healthcare occupations can be part of the discussion. Have you called your Congressman?