CGFNS Prices Increase

CGFNS announced a new pricing structure for its core services and several ancillary services effective January 1, 2010.

The new fee structure includes increases to almost all programs. Included in the price increase are Applications for the Certification Program, the Credentials Evaluation Service, the Visa Credentials Assessment program, the Credential Verification Service for New York State and other ancillary services.

The standard Visa Screen price increases to $540, from $498. The renewal Certificate price is increasing from $250 to $275.

H-1 Cap Has Been Reached

The H-1 cap has been reached. As of December 21, 2009, USCIS has received sufficient petitions to reach the statutory cap for FY2010. USCIS has also received more than 20,000 H-1B petitions on behalf of persons exempt from the cap under the advanced degree exemption. USCIS will reject cap-subject petitions for new H-1B specialty occupation workers seeking an employment start date in FY2010 that are received after December 21, 2009. USCIS will apply a computer-generated random selection process to all petitions that are subject to the cap and were received on December 21, 2009.

Employees that may need an H-1B visa include:

- International students working on an EAD card under an OPT or CPT program after having attended a U.S. school;
- International employees working on a TN may need an H-1B filed for them in order for them to pursue a permanent residency (green card) case;
- Prospective international employees in another visa status e.g. H-4, L-2, J-1, F-1;- H-1B workers with a cap exempt organization; and
- Prospective international employees currently living abroad.

International workers who are working here in the U.S. on an H-1B visa with another cap-subject employer are not subject to H-1B cap. These cases are commonly referred to as “transfer” cases and may be filed at any time throughout the year.

Holiday Reading

CIR ASAP (HR 4321) has been published. I have uploaded a copy of it to my docstoc page. Please feel free to download, share, print out, or otherwise distribute. At 640+ pages, it is lengthy.

The Library of Congress’ Thomas database has a hyperlinked version that is better to use if you’re just trying to focus on any one section. The important sections for Healthcare immigration are Chapter I, Title III.

Sec. 301 – Recaptures past unused visa numbers
Sec. 302 – Exempts LPR dependents from the IV quotas.
Sec. 303 – Slightly increases the per country quotas.
Sec. 320 – Provides IV cap exemptions for certain STEM and shortage occupations
Sec. 321 – Allows those with pending IVs to file Adjustment of Status even if their priority date is not current.

Happy Holiday reading!

Summary of CIR ASAP

Both Reform For America and the Immigration Policy Center have summarized CIR ASAP. According to the IPC summary, the ENSRA has been included in CIR ASAP. This means that nursing petitions will be exempt from the Immigrant Visa numbers, which is the legislation that groups such as the AAIHR have been pushing all along.

Here are the other highlights for Healthcare workers and Employers:

- Recapture of all Immigrant Visas (Family & Employment) from 1998-2008. Unfortunately this does not include the largest numbers from the 1990s; (UPDATE- The IPC summary says that the recapture is 1992-2008, which makes more sense and is better)

- STEM occupations exempt from the Immigrant Visa numbers.

- Immediate relatives exempt from Immigrant Visas quotas (this could be enormous and would be responsible for slicing the immigrant visa retrogression backlogs);

- Increases the per country visa cap, thus ameliorating the Indian, Chinese, and Mexican retrogressions;

- Spouses and Children of LPRs are Immediate Relatives and therefore IV quota-free;

- Employers have affirmative obligation to report recruiters working on their behalf and can be held liable for the crimes of the recruiter;

- Before an employer can hire an H-1B worker, the employer must meet strict requirements for the recruitment of American workers. This would also likely help Healthcare Petitions since the Healthcare staffing shortages are well-documented.

Updated from prior posting.

The CIR Battle Begins

On Tuesday, Rep. Luis Gutierrez will unveil his version of Comprehensive Immigration Reform, which he calls CIR ASAP (Comprehensive Immigration Reform for America's Security and Prosperity Act of 2009). CIR ASAP immediately has 10+ co-sponsors.

Rep. Gutierrez has long been a pro-immigration stalwart. The initial version of CIR ASAP is likely more liberal than any future bill. The initial list of co-sponsors does not include any Republican members of Congress.

It will be interesting to see if the Obama Administration comments on CIR ASAP or whether they wait for the Senate version of the bill to weigh in. It is assumed that Sen. Schumer’s office has been working on a tamer version of CIR.

Once CIR ASAP is published, I will review it for impact on Healthcare occupations. CIR ASAP comes on the heels of an impressive study by the Immigration Policy Center that highlights the critical role immigrants play on US healthcare.

The Most Important Visa Bulletin Ever

The January 2010 Visa Bulletin has just been released and it is the most important Visa Bulletin ever released. For the first time, the Department of State has projected future months’ visa numbers.

Based on current indications of demand, the best case scenarios for cut-off dates which will be reached by the end of FY-2010 are:

EB2:
China: July through October 2005
India: February through early March 2005

EB3:
Worldwide: April through August 2005
China: June through September 2003
India: January through February 2002
Mexico: January through June 2004
Philippines: April through August 2005


FY2010 runs until September 30, 2010. Based on these projections, EB3 priority dates should move to mid-2005 by the end of FY-2010. This means that there is a five year processing time for EB3 professions, such as most nursing positions. This is a horrendous processing time. Congress plainly has to enact positive legislation aimed at progressing processing times for shortage occupations such as nursing.

The consolation is that intending immigrants can now plan for when their immigrant visa number will come. Those with EB3 priority dates beyond Summer 2005 should not expect their IV appointment in 2010. Charlie Oppenheim and the Visa Bulletin team deserve credit for producing these estimates. The fault for the long retrogression is with Congress, not with the DOS.

The Visa Bulletin also contains an explanation of the visa number calculation that is required reading for anyone interested in immigrant visa allocation.

H-1 Cap at 61,500 (12/8 Update)

As of December 8, 2009, there are approximately 3,000 H-1Bs still available, which is when the USCIS last updated their page. MU is predicting that the H-1B cap will be reached by next week. Accordingly all MU clients are encouraged to send us their H-1B cap-subject filings ASAP.

Employees that may need an H-1B visa include:

- International students working on an EAD card under an OPT or CPT program after having attended a U.S. school;

- International employees working on a TN may need an H-1B filed for them in order for them to pursue a permanent residency (green card) case;

- Prospective international employees in another visa status e.g. H-4, L-2, J-1, F-1;- H-1B workers with a cap exempt organization; and

- Prospective international employees currently living abroad.International workers who are working here in the U.S. on an H-1B visa with another cap-subject employer are not subject to H-1B cap. These cases are commonly referred to as “transfer” cases and may be filed at any time throughout the year.

Many healthcare professions ordinarily qualify for H-1(b) status, including Physical Therapists, Occupational Therapists, Speech Language Therapists, and some Registered Nursing jobs.

From USCIS:

As of December 8, 2009, approximately 61,500 H-1B cap-subject petitions had been filed. USCIS has approved sufficient H-1B petitions for aliens with advanced degrees to meet the exemption of 20,000 from the fiscal year 2010 cap. Any H-1B petitions filed on behalf of an alien with an advanced degree will now count toward the general H-1B cap of 65,000. USCIS will continue to accept both cap-subject petitions and advanced degree petitions until a sufficient number of H-1B petitions have been received to reach the statutory limits, taking into account the fact that some of these petitions may be denied, revoked, or withdrawn.

The DOL Takes One Step Forward, Two Steps Back

The US Department of Labor (DOL) is about to roll out a new Prevailing Wage Determination (PWD) system that centralizes the process. Unfortunately, the DOL is unable to process electronic forms or even faxes. The new process calls for employers to mail in the PWD to the central office. The new regulation, which goes into effect on January 1, 2010, is available on-line.

The PWD is a mandatory part of the immigrant visa process (permanent residency or green card). While employers must still pay a prevailing wage in the nonimmigrant process (e.g. H-1B), it is not a mandatory part of the nonimmigrant process; employers are afforded safe harbor benefits by using the PWD process in nonimmigrant matters.

The present PWD process is straightforward. Employers (or their attorneys) file a PWD with the State Workforce Agency (SWA) that controls the worksite. This has not been ideal. Different states have different processing times, different forms, and different processes. For many years the DOL has contemplated a centralized program.

PWDs will be submitted directly to the new National Prevailing Wage and Helpdesk Center (NPWHC) in Washington D.C. starting January 1, 2010. This should improve the process by adding consistency and uniformity.

The new PWD is the Form ETA-9141, the Application for Prevailing Wage Determination. The PWD must be sent by mail or delivery service to: U.S. Department of Labor-ETA, National Prevailing Wage and Helpdesk Center, Attn: PWD Request; 1341 G Street, NW., Suite 201, Washington, DC 20005- 3142.

The DOL indicated that it is developing an on-line PWD, but it did not commit to a date when the on-line PWD will be available. It is expected that until the on-line Form is ready, the PWD process will slow, perhaps quite considerably if past history is any guide. This is especially disheartening for green card cases, whose processing times have dramatically risen in recent years.

H-1B Cap Running Out

The latest H-1B cap numbers show yet another dramatic uptick in filings. There are approximately 6,000 H-1Bs still available as of November 27, which is when the USCIS last updated their page.

MU is predicting that the H-1B cap will be reached in the next 2 weeks, perhaps sooner. Accordingly all MU clients are encouraged to send us their H-1B cap-subject filings ASAP.

USCIS is allowed to approve 65,000 H-1B visas, but they have to withhold 6,800 visas for the special Singapore and Chile H-1B1 visas. This leaves 58,200 H-1B visas

USCIS then adds back any unused Singapore and Chile H-1B1 visas. In most years, this is 6,500+ visas. In other words there are only a few hundred Singapore/Chile H-1B1s used every year. So then we add 57,800 + 6,500 and this means that the actual H-1B cap is around 64,000 H-1Bs.

Employees that may need an H-1B visa include:

- International students working on an EAD card under an OPT or CPT program after having attended a U.S. school;
- International employees working on a TN may need an H-1B filed for them in order for them to pursue a permanent residency (green card) case;
- Prospective international employees in another visa status e.g. H-4, L-2, J-1, F-1;
- H-1B workers with a cap exempt organization; and
- Prospective international employees currently living abroad.

International workers who are working here in the U.S. on an H-1B visa with another cap-subject employer are not subject to H-1B cap. These cases are commonly referred to as “transfer” cases and may be filed at any time throughout the year.

Many healthcare professions ordinarily qualify for H-1(b) status, including Physical Therapists, Occupational Therapists, Speech Language Therapists, and some Registered Nursing jobs.

From USCIS:

As of November 27, 2009, approximately 58,900 H-1B cap-subject petitions had been filed. USCIS has approved sufficient H-1B petitions for aliens with advanced degrees to meet the exemption of 20,000 from the fiscal year 2010 cap. Any H-1B petitions filed on behalf of an alien with an advanced degree will now count toward the general H-1B cap of 65,000. USCIS will continue to accept both cap-subject petitions and advanced degree petitions until a sufficient number of H-1B petitions have been received to reach the statutory limits, taking into account the fact that some of these petitions may be denied, revoked, or withdrawn.

CGFNS Reauthorized

CGFNS was reauthorized by the Department of Homeland Security to issue Visa Screens and Healthcare Worker Certificates, effective November 19, 2009. The reissuance is valid for seven years and covers all seven occupations covered under INA 212(a)(5)(C). The seven occupations are: registered and licensed vocational nurses, physical therapists, speech language pathologists, audiologists, medical technologists, medical technicians, occupational therapists, and physicians assistants.

The full press release is available on CGFNS’ website.

H-1B Cap at 56,900

The H-1B cap of 65,000 may be reached before the end of the year. Historically, H-1B cap-subject cap filings have increased as we have gotten closer to the H-1B cap limit. MU employers are encouraged to ready any H-1B cap-subject as soon as possible.

Employees that may need an H-1B visa include:
- International students working on an EAD card under an OPT or CPT program after having attended a U.S. school;
- International employees working on a TN may need an H-1B filed for them in order for them to pursue a permanent residency (green card) case;
- Prospective international employees in another visa status e.g. H-4, L-2, J-1, F-1;
- H-1B workers with a cap exempt organization; and

- Prospective international employees currently living abroad.

International workers who are working here in the U.S. on an H-1B visa with another cap-subject employer are not subject to H-1B cap. These cases are commonly referred to as “transfer” cases and may be filed at any time throughout the year.

Many healthcare professions ordinarily qualify for H-1(b) status, including Physical Therapists, Occupational Therapists, Speech Language Therapists, and some Registered Nursing jobs.

From USCIS:

As of November 20, 2009, approximately 56,900 H-1B cap-subject petitions had been filed. USCIS has approved sufficient H-1B petitions for aliens with advanced degrees to meet the exemption of 20,000 from the fiscal year 2010 cap. Any H-1B petitions filed on behalf of an alien with an advanced degree will now count toward the general H-1B cap of 65,000. USCIS will continue to accept both cap-subject petitions and advanced degree petitions until a sufficient number of H-1B petitions have been received to reach the statutory limits, taking into account the fact that some of these petitions may be denied, revoked, or withdrawn.

End of the H-1C

On December 20, 2009, the H-1C Nursing Relief for Disadvantaged Areas visa program will expire unless Congress takes further action. All H-1C petitions must be filed before the December 20, 2009 expiration. At this point, it is unexpected that Congress will take the necessary action. The program was first authorized in 1999 and was last reauthorized in 2006. The H-1C is an H-1B-like visa program specifically for Registered Nurses.

While the H-1C program could be an excellent visa option for some, legacy regulation and interpretation has limited the application of the H-1C to just 14 facilities in the United States. While the H-1C expiration may be devastating for these 14 facilities, it will have no effect on any other facilities in the United States.

Embracing Sec. Napolitano's Message

Last week DHS Secretary Napolitano implied that immigration reform is the next challenge that the administration will tackle. The Secretary’s vision of Comprehensive Immigration Reform is a “three legged stool,” where the three legs are:

- a commitment to serious and effective enforcement;
- improved legal flows for families and workers; and
- a firm but fair way to deal with those who are already here.

It is the second leg of the chair that appeals to those interested in liberalized Schedule A visa numbers. A law such as HR 2536 will allow for a steady flow of internationally trained nurses and physical therapists and also compel the recruitment community to fund domestic nurse education programs through additional filing fees for visas.

The popular press is beginning to pick up on Sec. Napolitano’s message. In the last few days, I have seen these stories and editorials:

New York Times: Their Future Is Ours

Washington Times: Will Democrats Err in Immigration Reforms?

WSJ: Immigration Reform is back on the table (confirms that Sen. Schumer’s office is working on producing a “firm but fair bill”)

Dallas Morning News: Time hasn't made immigration reform easier

Newsweek: Rosier Prospects for Immigration Reform

McClatchy: Immigration Reform is Long Overdue

All of the editorials and articles focus on the third leg: a firm but fair way to deal with those who are already here. That aim is important. But the failings of the Immigration and Reform Control Act (IRCA) of 1986 were that it failed to deal with the immigration problems on an on-going basis. IRCA solved the problems of the past, but did nothing to solve the problems of the future.

Toward that end, Sen. Schumer and his staff reportedly are also rewriting part of the Immigration and Nationality Act to provide for improved worker flows, including perhaps a progressive nurse visa policy in line with HR 2536. Legislators and the media should keep in mind that the stool has three legs.

DHS Secretary says Obama "Fully Committed" to CIR

Regular readers of this blog know that the best chance for liberalization of Schedule A visas – registered nurses and physical therapists -- is for the language of HR 2536 to be folded into next year’s Comprehensive Immigration Reform. Sen. Schumer has taken the lead on this issue and is rumored to be working on a CIR bill.

Nevertheless there has been some skepticism about whether CIR will ever be introduced. Some, like Rep. Gutierrez are getting anxious.

This week we saw the best indication that CIR is still on schedule. In prepared remarks to the Center for American Progress, DHS Secretary Napolitano said,

“the President continues to be fully committed to reforming our immigration laws, and why he asked me to take a lead role in this effort.”

Sec. Napolitano’s plan calls for a “three-legged stool”. She continued,

“Let me be clear: when I talk about “immigration reform,” I’m referring to what I call the “three-legged stool” that includes a commitment to serious and effective enforcement, improved legal flows for families and workers, and a firm but fair way to deal with those who are already here.”

Legal changes to employment-based immigration, including improved legal flows for workers, is the only way that Schedule A visa reform can happen. We’ve seen a few indications that CIR is still set to move early next year. The Secretary’s remarks are the clearest indicated yet.

December 2009 Visa Bulletin

At some point MU expects that the Visa Bulletin numbers will progress in a meaningful way, but this month is not the month.

The December 2009 Visa Bulletin has no change in any Employment Based Visa Category, except for a slight uptick in India EB3. In the November 2009 Visa Bulletin showed 22APR01. It moved a week.

EB1: All Current
EB2: All Current, except China (01APR05) and India (22JAN05)
EB3: All 01JUN02, except India (01May01).

The one silver lining may be that, unlike in November 2009, the December 2009 did not include an explanation in the bulletin for the lack of progression in the dates. Here is November’s explanation:

E. EMPLOYMENT PREFERENCE VISA AVAILABILITY
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.

Increasing demand for Advance Practice Nurses

The NY Times Prescriptions blog is an excellent source for information on the Healthcare debate that is raging in the US. Congress and the President presently are debating who will qualify for health issuance, how the insurance will be funded, and how health services will be delivered.

Today’s Prescriptions’ post highlights that Nurse Practitioners will surely be a growing field in the US. As noted in the NYT blog, “the American Academy of Family Practitioners projects a shortfall of 40,000 physician generalists — family practitioners, pediatricians, general internists and geriatricians — by 2020, even without significant changes to the current health care system.” Other graduate level nursing education is also likely to be in greater demand in the next decade.

Because of this demand, and because of the relatively easy H-1B nonimmigrant visa option for Advance Practice Nurses, the safest path to US immigration is to obtain Advance Practice Certification. For staffing companies and recruiters, Advance Practice Nursing is the next need.

H-1B Cap at 53,800

The H-1B Petition is still a valid option for many healthcare workers including PTs, OTs, SLPs, Pharmacists and some nurses. Seven months into this term’s fiscal year quota, the H-1B cap has not been reached. But that may not be the case for long.

The USCIS has reported a jump in cap-subject approvals in October. As of October 30, 2009, approximately 53,800 H-1B cap-subject petitions and approximately 20,000 petitions qualifying for the advanced degree cap exemption have been filed. The Masters quota cap effectively has been reached, although a few “extra” numbers may be released if the USCIS denies some pending Masters cap-subject cases.

Going forward, any H1-B petitions filed on behalf of an alien with an advanced degree will now count toward the general H1-B cap of 65,000. USCIS will continue to accept both cap-subject petitions and advanced degree petitions until a sufficient number of H-1B petitions have been received to reach the statutory limits, taking into account the fact that some of these petitions may be denied, revoked, or withdrawn.

Also, the USCIS just has announced that it will continue to accept the old Form G-28.

U.S. Jobs Outlook (Finally) Improving

Post written by Cindy Unkenholt

According to an article earlier this week that was featured on CNNMoney.com, 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.

FCCPT News

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.

MU at ASHHRA

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.

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.

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.

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:

E. EMPLOYMENT PREFERENCE VISA AVAILABILITY
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.

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.

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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.

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.

Legislative Update for MDs

Last week the House of Representatives passed a continuing resolution that if passed will extend the doctor’s Conrad 30 program, which provides a common path for doctor immigration. The Conrad 30 program provides each U.S. state with 30 waivers for J-1 physicians each fiscal year.

The legislation also includes extensions of the EB-5. E-Verify, and Religious Worker programs. These extensions, which are embedded in the annual government funding legislation is now headed to the Senate where it is expected to be considered today. The legislation is expected to pass before October 1, 2009, or else the government’s funding will dry up.

The legislation does not contain any “new” legislation, such as H.R.2536 - Emergency Nursing Supply Relief Act. Nursing and allied healthcare occupational visa reform is more likely to happen in early 2010.

New USCIS Site

On Tuesday I was asked to participate in a call with USCIS Director Alejandro Mayorkas. The Director reached out to several prominent bloggers. The purpose of the call was to get feedback on the new USCIS website. To the Director's credit, he participated directly on the call. He answered questions directly from the bloggers and had several USCIS officials there to help him with some of the details that the director of a huge agency could not possibly know.

The new site has some very nice features. The most immediate improvement is that the site is clean and user-friendly. The updates to the Case Status section are commendable. Looking ahead, the Director explained that in May 2010 the site will alllow for interactive email service queries.

The site is still buggy. Many of the new links are not operable at this time; USCIS expects to fix the bugs in the next few days/months. Curiously the webpage URL’s are still unusually long. In the future, USCIS expects simplified URLs (e.g. www.uscis.gov/forms instead of http://www.uscis.gov/portal/site/uscis/menuitem.eb1d4c2a3e5b9ac89243c6a7543f6d1a/?vgnextoid=db029c7755cb9010VgnVCM10000045f3d6a1RCRD&vgnextchannel=db029c7755cb9010VgnVCM10000045f3d6a1RCRD. This URL is not a joke!).

The Director showed a self-deprecating sense of humor. After acknowledging that the link to the Leadership Biography page was not yet fully operable, he coyly remarked that the reason for the delay was because his biography was lengthy and he had not yet finished it.

But the best message that I heard is that the USCIS took the time to reach out to the community. In the past, USCIS announcements often come with a simple Press Release. This “new” USCIS approach to community outreach is laudable. The Director and his team deserves kudos.

Fewer International Nurses Interested in the US

During most of the 2000s, internationally trained nurses made up about 10-15% of all new RNs that came on-line in the US. These numbers disappeared with the onset of retrogression in January 2008. In spite of the retrogression, internationally-trained and educated nurses remained faithful to the US, as evidenced by the fact that internationally-trained RNs continued to take the NCLEX in great numbers.

In 2006, about 20,907 internationally educated RNs passed the NCLEX exam. In 2007, the volume jumped; 22,827 internationally educated nurses passed the NCLEX exam. With the onset of retrogression, 2008 saw a slight decline; 18,905 internationally educated RNs passed the exam.

But the latest numbers point to a massive drop in the numbers of internationally educated nurses passing NCLEX. Through June 30, 2009, only 7,236 have passed the exam, which annualizes to 14,472.

While the US nursing shortage certainly has eased in recent months, economists and government officials all agree that this is a temporary condition. By the end of the next decade the US could be short 250,000 to 1 million nurses, depending on whose estimates you read.

It is obvious that reasonable visa opportunities for international nurses must happen or else the US is going to find that it has a massive nursing shortage and international nurses are no longer there to fill the gap.

All statistics in this posting are from the NLCEX Fact Sheets, which are published on NCSBN’s webpage.

The Most Optimistic Scenario

I was recently asked by a client to offer my opinion on the most optimistic scenario of when we might see healthcare visa reform in the US.

Sen. Schumer (D-NY) is one of the Senate’s leading members and has long made immigration reform a legislative priority. With Sen. Kennedy’s passing, the Democratic leadership informally has tapped Sen. Schumer to draft the Comprehensive Immigration Reform (CIR) bill. Earlier this summer, he listed his principles for comprehensive immigration.

Sen. Schumer has long been a proponent of sensible immigration reform, including liberalized visa numbers in occupations that have been in short supply. In 2005 he helped pass the EX visa, which offered 50,000 visas for applicants holding Schedule A occupations and their immediate family members. Schedule A occupations are those occupations that have been certified in short supply by the Department of Labor (DOL). The DOL takes its role seriously and looks long-term before it lists and delists occupations from Schedule A. Schedule A presently includes Physical Therapists and Registered Nurses.

Democratic leadership already has decided that CIR will not be on the agenda until 2010. Whether that happens largely is dependent on President Obama and the Democratic leadership’s popularity ratings at the end of 2009. Both ratings have slipped in recent months.

If the Democrats and Pres. Obama can stabilize or improve their popularity, then it seems likely that they will be able to pass CIR in early 2010. US mid-term elections will take place in November 2010, and so any CIR bill must be done by the spring. No politician will want a CIR bill to drag into the summer of 2010.

Given that Sen. Schumer’s historical position on employment based immigration, it seems more likely than not that the CIR bill will include nurse visa reform. But there still are many hurdles to clear before we get to spring 2010.

October Visa Bulletin Released

The October Visa Bulletin has been released. This is the first quarter of the 2010 US Fiscal Year. The news is not positive.

EB1: All Current
EB2: All Current, except China (22MAR05), India (22JAN05)
EB3: All 01JUN02, except China (22FEB02), India (15APR01), Mexico (01MAY02).

Based on these processing times, a typical EB3 Nurse takes over 7 years to arrive in the United States, and even longer if the nurse was born in China, India, or Mexico. The US nursing shortage certainly has abated in the last few months, but all credible economists opine that the nursing shortage will reemerge with a vengeance shortly after the economy turns and employment numbers stabilize.

MU calls on Congress to review the employment based visa immigration policy in this country and offer up an alternative to these ridiculous processing times. There is an excellent piece of legislation that, if passed, will create a special immigrant visa category for nurses. The legislation is H.R.2536 - Emergency Nursing Supply Relief Act and is sponsored by Rep. Wexler (D-FL) and Rep. Sensenbrenner (R- WI). The ENSRA is a good place to start.

FCCPT Type II Suspended

On September 1, the FCCPT suspended the FCCPT Type II Visa Screen process. FCCPT has determined that the original purpose of the Type II had been accomplished. The idea behind the Type II was to streamline the process for applicants already in the US. The streamlined process under Type II did not include an educational credential review.

Applicants with Type II Applications that are pending before FCCPT may complete the Type II service or they may change to the Type I service, prior to December 31, 2009. More information on the suspension of the Type II program is available at the FCCPT website.

Must I Pay Unlicensed H-1B Workers?

A client of mine recently asked me an interesting question. This client recruits Physical Therapists, although the lesson applies to all licensed occupations. They are getting ready for their H-1B hires to enter the US in October. But they have a question about when they need to pay these workers, many of whom have not yet received their licenses.

First a little background. The National Physical Therapy Exam (NPTE) is not offered overseas. Accordingly, all PTs must enter the US in order to sit for the licensing exam. The USCIS often approves unlicensed PTs for H-1B visa status, and there is ample Guidance to support these decisions.

My client’s approved PTs must then come into the US, sit for the NPTE, and then obtain their state license. Once they obtain the state license, they can begin their PT work.

The problem is that this plan bumps up against the Department of Labor’s rules on salaries to H-1B workers. 20 CFR 731(c)(6) and (7) say that H-1B workers must be paid their salaries within 30 days of entering the US. This may be problematic because it is rare that the worker enters the US, sits for the exam, and is granted the license in just 30 days.

Subsections (c)(6) and (7) also says that worker must be paid once s/he “enters into employment,” which includes “reporting for orientation” and “studying for licensing examinations”.

There are a few solutions to this dilemma, although none of them are ideal from the employer or employee’s perspective (my experience is that the H-1B workers would be willing to sacrifice all or some of their pay while waiting for the results of their licensing exam):

One solution that is in compliance with (6) and (7) is to make sure that the PT is fully ready to take the licensing exam when the PT enters the US so that you can use the full 30 day period before entering the employee into employment. If at all possible, training, and orientation should be done outside the US.

Another solution is to bring the H-1B worker into the US to take the licensing exam, and then immediately cycled back out of the US while waiting for the remainder of the licensing process. H-1B workers who aren’t in the US aren’t subject to (6) and (7).

A last strategy is initially to file the workers for part-time or hourly H-1B status. This doesn’t obviate the need to pay the wages, but can reduce the salary obligation.

AAIHR Annual Meeting

The AAIHR is holding its Annual Meeting of Members September 16, 2009 in Washington DC. The agenda includes the election of the next term’s Directors. On September 17, 2009 the AAIHR members will be walking the halls of Congress and will be promoting the ENSRA for inclusion in the CIR. Staffing companies and recruiters are invited to join via the AAIHR’s webpage.

H-1B For Nurses

I often am asked by employers and nurses, whether they can be sponsored for an H-1B visa.

There are two key concepts:

1. The nurse must hold at least a Bachelors degree in nursing (e.g. BSN); AND
2. The position must normally require a Bachelors degree.

MU has seen the most success in these scenarios:

A. The hospital is offering the nurse a position as a Clinical nurse specialist (CNS), Certified registered nurse anesthetist (CRNA), Certified nurse-midwife (CNM), or a Certified nurse practitioner (APRN-certified) Critical care and the nurse holds the certification;

B. If the nurse will be working in an Administrative position ordinarily associated with a Bachelors degree, such as Charge Nurse or Nurse Manager;

C. If the nurse will be working in one of these specialties: peri-operative, school health, occupational health, rehabilitation nursing, emergency room nursing, critical care, operating room, oncology and pediatrics. And the hospital will attest that these roles are only offered to those with Bachelors degrees. Some magnet hospitals have the BSN as its standards, and these make great destination hospitals for H-1 RNs.

Reform Minded?

Late last week Homeland Security Secretary Janet Napolitano hosted 130 immigration reform leaders at the White House. The purpose of the meeting was to tamp down the growing chorus that the administration was ignoring immigration reform. The President even dropped in. The plan may have worked. Many would-be critics of any CIR legislative delay went and released positive messages shortly after the meeting.

For those interested in healthcare immigration reform, the next few months are critical. If you are interested in liberalizing needed visas for US healthcare workers, now is a good time to meet with your local Congressional delegation, as they are all in their home districts until early September.

Meeting with Congressional representatives is surprisingly easy. All that one needs to do is to place a simple call to the Representative’s office. These phone numbers are readily available on Representatives’ webpage. Everyone who is interested in the US should take the time to contact their Congressional representatives and/or have their friends and family in the US do so.

The message is a simple one:

1. The Department of Labor predicts that the Registered Nurse occupation will grow faster than any other job in the next seven years. (Chart at Table 8 of link).

2. There are not enough US nurse educators to train the next generation of nurses.
3. There is an excellent piece of legislation that, if passed, will create a special immigrant visa category for nurses. The legislation is H.R.2536 - Emergency Nursing Supply Relief Act and is sponsored by Rep. Wexler (D-FL) and Rep. Sensenbrenner (R- WI).

4. The legislation calls for 20,000 nurses per year, for three years. An additional $1,500 is added to visa fee. The $90 million that this legislation raises goes directly to US nursing schools who can use the funds to train the next generation of US nurses.

H-1B Cap History

The recent economic downturn greatly has impacted H-1 filings. As I have explained in the past, these lower 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.

In the first five days of this H-1B season in April, the USCIS says that it received 42,000 H-1B petitions. The total is now about 45,000. This tiny increase in number is attributed to two factors: (i) the tougher measures being employed by both USCIS and the DOS; and (ii) the current economic condition in the US.

H-1B History:

(Note- Fiscal Year runs from October 1 of the prior year until September 30 of the next year. You may file for an H-1B 6 months in advance of the October 1 start of the fiscal year. In other words, the FY2010 H-1B “season” began on April 1, 2009).

FY 2009: Immediate (First week of April 2008)
FY 2008: Immediate (First week of April 2007)
FY 2007: April 1, 2006 - May 26, 2006
FY 2006: April 1, 2005 - August 12, 2005
FY 2005: April 1, 2004 - October 1, 2004
FY 2004: April 1, 2003 - Feb 17, 2004
FY 2003: Not reached (Cap was 195,000)
FY 2002: Not reached (Cap was 195,000)
FY 2001: Not reached (cap was 195,000)

Politics in the Spotlight

President Obama has just announced that the CIR bill, which is long-desired by immigration reformists, will be pushed off until 2010. The President remains committed to the cause but he is concerned that his efforts on health care, global warming, and the financial crisis will be hampered by another major issue like immigration. This strikes a blow against the healthcare immigration community, who was hoping that a CIR bill could be the force behind liberalized healthcare visa reform.

The other political issue in the spotlight is the resignation of Sen. Sen. Martinez (R-FL) and Sen. Bailey-Hutchinson (R-TX). On one hand these two Senators have been general supporters of immigration reform and so their resignations are unwelcome. Sen. Bailey-Hutchison particularly has been a leader on healthcare visa reform.

On the other hand, since both are Republicans, their influence in Senatorial matters is negligible at this point. Also, since they both are from states with increasing immigration populations, it is expected that any replacements will be unlikely to hinder any CIR legislation. To do so would alienate their constituency.

My thoughts on the chances of retrogression relief

As readers of my blog surely are aware, retrogression has made it difficult for nurses to enter the US on the immigrant visa because of the long processing times. There is an excellent piece of legislation that, if passed, will create a special immigrant visa category for nurses. The legislation is H.R.2536 - Emergency Nursing Supply Relief Act and is sponsored by Rep. Wexler (D-FL). The bill should allow for nurses to enter the US in about one year's time once the program is up and running.

The key question is whether the ENSRA will ever be acted upon. Presently, the legislation, like all immigration related legislation that isn't deemed critical, has an effective hold on it. Congress would like to address all special immigration at once in a massive Comprehensive Immigration Reform bill (CIR). And they would like to do it this fall. Sen. Schumer is taking the lead. The hope is that Sen. Schumer (D-NY) can craft a piece of legislation that will not suffer the same fate as CIR did when it was last offered.

The good news for those in favor of increased nurse visa numbers is that Sen. Schumer has long been a champion of increased nurse visa numbers. In 2005 he led the charge for a special Nurse Exempt visa that was signed into law in May 2005. That bill provided 50,000 visas for nurses and their families. Sen. Schumer is expected to introduce the bill this fall. Because of Sen. Schumer's past work on liberalized nurse visa numbers, I am optimistic that he will either encompass Rep. Wexler's ENSRA or use the principles behind the ENSRA in his CIR.

End of the Summer Session

The US House has adjourned and will reconvene on Tuesday, September 8. The Senate will adjourn at the end of this week, and return on Monday, September 7. No immigration-related activities are planned for this week, as Sen. Schumer has cancelled the employment-based immigration hearing. The hearing would have spoken to supply shortages. Sen. Schumer has long been a nurse visa bill champion.

When the two houses of Congress return there will be a big push to finalize the Healthcare bill, which isn’t about immigration, but likely will lead to increased demand for healthcare services in the US. How Congress deals with liberalized healthcare visa rules is an open question at this point. The next few months will shape America’s nurse visa policy for years to come.

Pres. Arroyo Meets Pres. Obama

Yesterday Philippines President Gloria Macapagal-Arroyo’s met with US President Barack Obama in Washington DC. Ms. Arroyo was the first Southeast Asian President to be greeted at the White House. Ms. Arroyo sought to discuss economic, diplomatic and national security issues.

Philippine Senate Minority Leader Aquilino Q. Pimentel Jr urged Ms. Arroyo to press Mr. Obama on nurse immigration issues. GMANews reports that Sen. Pimentel said that if Ms. Arroyo can get "a quota of 20,000 nurses a year, that would be a great economic bonanza for our nurses and their families."

Ms Arroyo’s other engagements on Friday called for meetings with Rep. Sheila Jackson Lee, who has repeatedly called for increased nursing and healthcare visa quotas.


Note on the Death of Fmr. Pres. Aquino. As Philippine readers of this Blog surely know, Former President Corazon Aquino died Friday (Saturday in the Philippines). The Musillo Unkenholt firm recognizes the great leadership that Ms. Aquino played in the “people power” movement in the 1980s and would like Philippine readers to know that we will keep the Aquino family and the Philippine people in our thoughts and prayers.

H-1 Update and a note

The USCIS’ latest H-1B count update shows that as of July 10, 2009, approximately 44,900 H-1B cap-subject petitions had been filed. In mid-May the USCIS reported that approximately 45,000 H-1B cap-subject petitions had been filed. A recent article in the IT trade journal Computerworld explains that the retreat in H-1B numbers is due to the fact that USCIS is actually denying more cases than they are receiving. Anecdotal reports are that immigration attorneys are seeing many more denials than in years past.

For the healthcare occupations this may be a good sign. Physical and Occupational Therapy positions are being approved without much incident, now that the Masters Degree issue has been resolved. The USCIS seems to be willing to accept the argument that certain nursing positions are eligible for H-1B visas as well, provided that the proffered positions are normally ones for which bachelor degrees are required.

Note- Our MU email server is having some problems. We should have it resolved in the next few days. If you have emailed me and I haven’t responded, odds are that I did not receive it. Once the email is fixed, you should re-send the email.

Guidance on PT/OT Masters denied cases

The USCIS has just released a Guidance Memorandum for those Physical Therapists and Occupational Therapists who had their H-1B petitions denied this spring before the issuance of the Velarde Guidance Memorandum. Those cases that were denied solely because ether H-1B worker did not have a Masters degrees should send an email to the Service Center that issued the denial. Special email addresses have been created to handle these cases:

California Service Center: csc-ncsc-followup@dhs.gov

Vermont Service Center: vsc.ncscfollowup@dhs.gov

The email should explain how the particular case meets the standards set forth in the Velarde Guidance Memorandum.

See also my July 7 post on this issue.

August VB released

The Department of State has released the August Visa Bulletin. The Visa Bulletin is the listing of processing dates for immigrant visas (Green cards). As expected there are no changes in the August Bulletin, as all visas has been exhausted for the usual categories (EB3) for RNs, PTs, OTs and other allied positions.

The EB2 category remains “current” for natives of most countries. Cases filed under EB2 are eligible for immediate processing and should expect approval in the near future. The two major EB2 exceptions are China and India. Chinese and Indian cases are only being processed for those with priority dates before October 1, 2003.

The September Visa Bulletin will be released in mid-August. The September VB will likely have the same dates as the August Visa Bulletin, at least with respect to the categories discussed in this post.

The next major Visa Bulletin will be the October VB, which should be published in mid-September. The US fiscal year runs from October 1 – September 30, and so the 2010 US fiscal year begins October 1, 2009. Preliminary expectations are that the DOS will start the dates off slowly, and then progress them in a systematic process throughout the year. My sense is that the EB3 dates will be in the 2003-05 time frame. Depending on demand in October and November, I could see those dates aggressively moving ahead.

Predicting the progression of Visa Bulletin dates is a somewhat impossible exercise. No one knows just how many 2003-05 visas remain unused, and no one knows how many of those people no longer want their visas.

Masters PT / OT H-1B Update

Back in the spring, the USCIS routinely was denying PT and OT H-1B cases in instances in which the PT /OT did not hold a Masters Degree. This was wrong. Many clients filed appeals to the Administrative Appeals Office (AAO). Eventually, several staffing and recruiting clients bandied together and filed a lawsuit against the USCIS. Cindy and I were pleased to take a leading role in the direction of that lawsuit.

In direct response to the lawsuit, USCIS’ Service Center Operations Officer Barbara Velarde issued a May 22, 2009 Guidance Memorandum clarifying the point that there was no Masters Degree rule. Instead, the Guidance directs all USCIS officers to approve all H-1B cases for PT/OTs as long as the worker holds a license in the state of intended employment.

Since that time all of MU’s post-May 22 cases have been approved, save one unusual case. We are working directly with the California Service to have that one case overturned.

At the AILA Annual Convention, the USCIS said that there would be a forthcoming Guidance explaining how to overturn previously denied H-1B cases. None has been published. That having been said, we have begun to see the USCIS, on its own volition, take some action. This week we received our first AAO approval; the case appears to have never actually been sent to the AAO, it was just approved by the California Service Center (CSC).

I’ve also seen a communication in which the CSC confirmed to a House of Representatives’ staffer, that “the California Service Center will commit to an answer in 30 to 60 days.” Hopefully, we all can put an end to this unfortunate tale in the near future.

Following the Blog

There are several ways to follow the posts on this Blog.

1. Read me on ILW.com. As I have done for the past three and a half years, I expect to post 2-3 times a week with updates targeted to Healthcare Immigration, focusing on RNs, PTs, OTs, SLPs, and other allied occupations.

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Welcome to MusilloUnkenholt LLC

I am pleased to announce the launch of MusilloUnkenholt Immigration Law! Cindy Unkenholt and I combine decades of experience with a sincere passion for immigration law. I wanted to take a moment to express our gratitude that you have followed all of my Blog postings over the years. I will no longer be posting to the previous Blog site. I would also like to thank Sam and the ILW.com for their continued production of this Blog, which focuses its postings on the intersection of nursing, allied healthcare and immigration.

Cindy and I are pleased that we're being joined by our dedicated and knowledgeable staff. The partners and staff of MusilloUnkenholt believe that the practice of immigration law is unlike any other!

My new contact information is:

Christopher T. Musillo, Esq.
MusilloUnkenholt LLC
3400 Carew Tower
441 Vine Street
Cincinnati, OH 45202

c.musillo@muimmigration.com
voice: 513.744.4080
main voice: 513.381.8472
fax: 513.322.0045

ILW.com

A syndication of this site is also here: Chris Musillo's Nurse and Allied Healthcare Immigration Blog on ILW.com.

-Chris Musillo