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H-1C Nurses in Disadvantaged Areas

Law Offices of Yu & Associates

What is the H-1C Visa Category?

The Nursing Relief for Disadvantaged Areas Act of 1999 and its reauthorization in December of 2006 allows qualifying hospitals in healthcare shortage areas with disadvantaged populations to employ temporary foreign workers (nonimmigrants) as Registered Nurses (RNs) for up to three years under H-1C visas. Only 500 H-1C visas can be issued each year during the three year period of the H-1C program (2006-2009). The sponsoring employer must pay a filing fee of $250 for each Attestation for certification filed with the Department of Labor (DOL).

What are the Qualifying Criteria for H-1C Sponsoring Hospitals?

The sponsoring employer is required to meet strict criteria to employ foreign RNs under the H-1C program. These include:

  1. be a "subpart D" hospital under the Social Security Act;
  2. be located in a Health Professional Shortage Area as of March 31, 1997; (Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas)
  3. have at least 190 acute care beds according to the 1994 cost report;
  4. have a Medicare population of 35% according to the 1994 cost report; and
  5. have a Medicaid population of 28% according to the 1994 cost report.

What are the Qualifying Criteria for Nurses under the H-1C Program?

The qualifying nurse must:

  1. have obtained a full and unrestricted license to practice in the country where the nursing education was obtained, or have received a nursing education in the U.S.;
  2. (a) have passed the examination given by the Commission on Graduates for Foreign Nursing Schools (CGFNS); or (b) have a full and unrestricted license to practice as an RN in the state where the RN will work; or (c) have a full and unrestricted RN's license in any state and have received temporary authorization to practice as an RN in the state where the RN will work; and
  3. be fully qualified and eligible under the laws governing the place where the RN is to work to practice as an RN immediately upon admission to the U.S., and be authorized under such laws to be employed by the hospital.

What is the Filing Process for an H-1C Application?

To file an attestation for an H-1C visa, the sponsoring hospital must:

  1. Complete DOL Employment and Training Administration Form ETA 9081, Attestation for H-1C Nonimmigrant Nurses, which contains the required attestation elements. If it is the first attestation filed by the hospital under H-1C, copies of the hospital's Form HCFA 2552 from the 1994 cost reporting period filed with HHS, which provides information on acute care beds and percentage of Medicare/Medicaid patients, must accompany the Form ETA 9081. The form also requires an attestation by the hospital that it has taken timely and significant steps to retain sufficient registered nurses who are U.S. citizens or immigrants who are authorized to perform nursing services.

  2. The labor certification shall be signed by the chief executive officer of the facility and must be submitted to:

    National Certifying Officer
    Office of Foreign Labor Certifications
    Employment Training Administration
    U.S. Department of Labor, Room C-4312
    200 Constitution Avenue, NW
    Washington, DC 20210

  3. A filing fee of $250 per attestation must be included.

  4. After the DOL accepts the application, the hospital will be notified. The hospital can then file a Petition for Nonimmigrant Worker with the U.S. Citizenship and Immigration Services.

If I am a Nurse Who Does Not Meet the H-1C Requirements, Do I Have Other Choices?

Employers that do not qualify for the H-1C program may hire nurses directly by applying for permanent residence/green card or H-1B status. Since a professional nurse is a Schedule A occupation, employers may file a labor certification directly with USCIS. Employers may also hire a nurse as an H-1B worker. However, the H-1B program requires that a nurse applicant have a bachelor's degree, and the job that the nurse is hired to perform must require a bachelor's degree. USCIS ultimately makes the decision as to whether or not a job qualifies for an H-1B visa.


The above is intended as a general introduction and should not be construed as legal advice or legal opinion for your particular case. Please contact the Law Offices of Yu & Associates with any specific questions. Tel: (301) 838-8986, Email:, Address: 110 N Washington St., Suite 328E, Rockville, MD 20850.

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