Hello and welcome to the Immigration Compliance Group December InFOCUS news.

Join our worldwide readership and sign up to receive our newsletter in the top right hand corner here. You can follow us on LinkedIn and Twitter and sign up to receive our weekly Blog posts and Podcasts below.

• Blog
• Podcasts
• Follow us on Twitter
• LinkedIn
• For our Sports, Arts & Entertainment News
• For back Issues of our news, articles, publications and NewsFLASHES

If you are interested in becoming an Immigration Compliance Group client, please call our office at 562 612.3996 and request a consultation. We handle a broad range of business related immigration matters and have an active employer compliance practice and consult on proper I-9 (Employment Eligibility Verification) best practices, auditing, training, and work with our clients to develop compliant immigration policies and procedures. We offer these services, as well, to government contractors and advise on FAR E-Verify enrollment and compliance issues.

Major news this year was the passage of the Healtlhcare Reform Bill signed by President Obama on March 23, 2010 amidst a crowd in the Interior Department of more than 500 cheering doctors, nurses, patients and federal employees, stating, “The bill I'm signing will set in motion reforms that generations of Americans have fought for and marched for and hungered to see.”

The big question has been: What does this mean for the healthcare industry and for healthcare workers in this country? The bill’s broader intentions are to expand access to health care and to increase efficiency in the medical world. In the coming years, the bill attempts to increase the number of primary care doctors, re-work how doctors get paid, and establish monetary incentives for physicians who provide quality, low-cost care. The new health care bill creates a whole new pool of patients that need doctors. This pool of the formerly uninsured contains many low-income individuals and families who will be coming into doctor’s offices looking for basic care. Instead of waiting in an emergency room to get a sick infant a check up or to learn how to care for hypertension, these people will need their own primary care physician.

This new demand for primary care doctors will change how many doctors end up in higher-paying specialized fields. Primary care doctors make a lot less than those who specialize; because of this, the number of medical school grads becoming primary care doctors has dropped to all time lows in recent years.

The health care bill is trying to counter this relatively low salary and meet the coming demand for physicians by creating a primary care training program that gives a 10% increase in pay to new primary care doctors. The bill also provides for increased medical school scholarships and loan repayment help, in order to keep new doctors from feeling pressured to enter more lucrative specialized fields. Even with these incentives, the average salary for a doctor will be significantly lowered as these new primary physician spots become filled. Factors putting a strain on the healthcare workforce include:

• As mentioned above, the advent of healthcare reform could add as many as 30 million additional people to the insurance rolls, which would drive up demand for healthcare.
• The general population is continuing to age, which also is likely to increase the demand for healthcare.
• There are not enough physicians, particularly primary care doctors, in the pipeline to address the growing need.
• The nursing shortage, which eased a bit in some areas because of the recession, could return to the critical level as soon as this year, depending on the pace of the economic recovery.
• The allied health professions are also experiencing shortages, although not as well publicized as the doctor and nurse shortages.

Four of the next decade's top 10 occupations with the largest growth are in health care, according to a Bureau of Labor Statistics study reported by National Public Radio.

Leading the pack is Registered Nursing. The US economy expects to demand over a half million RNs (22%) in the next ten years, at an average salary over $60,000 per year. Immigration traditionally has been used to fill obvious US supply shortages. American opinions on immigration differ, but after looking at the employment numbers, liberalized immigration for healthcare workers ought to be something everyone can agree on.

It has been said that there must be a change in the design and delivery of services with a greater collaboration of physicians and healthcare professionals. Expanding the capacity of nursing schools is an essential element in preparing the workforce for coming changes, especially if the healthcare system evolves to the point where it needs more advanced practice nurses. There will be a need to educate even more nurses, and capacity would continue to be a problem. That means that many healthcare organizations may be scrambling to fill vacancies and to develop creative and efficient strategies to deliver patient care. Planning becomes essential.

The National Academies Press (NAP) in their 2010 Forum on The Future of Nursing stated: At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year... To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles -- including limits on nurses' scope of practice -- should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care.

Nurse immigration presents numerous challenges at the present time and backlogs remain at all-time highs. Nurses awaiting green-cards from the Philippines are waiting 5 years, from India 8 years, with the rest of the world backlogged for more than 5 years. It is unpredictable at this time when Congress will act upon either a comprehensive immigration bill or tackle piecemeal legislation to reform the employment-based immigration system. Thus, the number of immigrating nurses to the US has exceedingly declined in recent years due to these problems - with no sign of reform in sight at this time.

We have written several articles in the past on the immigration options available to nurses and other healthcare occupations which we link to below.

H-1Bs for Nurses, Part 1
Part 2 Nurse Practitioners
Part 3 Clinical Nurse Specialists
H-1Bs for Healthcare Occupations Clarified by USCIS
Top 10 Healthcare Occupations

In closing, we would like to remind you that H-1B visas and Canadian and Mexican TNs are excellent options for Physicians, OTs, PTs, Med Techs, Pharmacists, Speech Pathologists and many other healthcare occupations that require a minimum of a bachelor’s degree.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

NurzeZone recently published the top salaries in the nursing profession and stated that they are earned by nurses in an advanced practice specialty or, in some cases, in higher-level management positions, according to the recently released National Sample Survey of Registered Nurses.

That’s logical, noted Joanne Spetz, Ph.D, a health economist, labor expert and faculty researcher at the Center for the Health Professions at UCSF. Typically, a graduate degree means higher earnings, and with the exception of nursing faculty, that’s generally true for nurses.

Peter McMenamin, Ph.D., senior policy fellow for the American Nurses Association, agreed.

“It looks like supply and demand to me,” he said. “The advanced practice nurses are fewer. They have more education. They can also do more under their own authority.”

In fact, even staff nurses garner higher wages if they have more education under their belts; the survey found that staff nurses with a master’s or doctorate degree made, on average, $69,616 in 2008, while nurses with an associate degree made $59,310. The average RN, working as a staff nurse, made $61,706 in 2008. The top ten nursing salaries, according to the 2008 National Sample Survey of Registered Nurses, include:

1. Nurse Anesthetist: $154,221
2. Management/administration: senior management: $96,735
3. Nurse practitioner: $85,025
4. Nurse midwife: $82,111
5. Management/administration: $78,356
6. Consultant: $76,473
7. Informatics nurse: $75,242
8. Management/administration: middle management: $74,799
9. Clinical nurse specialist: $72,856
10. Management/administration: first-line management: $72,006

“We project RNs from 2008 to 2018 to add more jobs in that profession than any other profession,” said Adam Bibler, economist for the Office of Occupational Statistics and Employment Projections with the BLS.

And with an increased demand for primary care in a post-health care reform era, there may also be an even higher demand for advanced practice nurses, McMenamin said. The big question is whether most states will expand their scopes of practice to allow nurse practitioners to practice more independently, as recommended recently by the Institute of Medicine.

But if there is increased demand for these graduate-prepared nurses, their wages will likely increase, too, he added. And that, in turn, could drive more nurses toward seeking out graduate degrees.

“It’s going to avalanche,” he said.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Follow these steps to ensure proper registration for the NCLEX examinations:

1. Submit an application for licensure to the board of nursing where you wish to be licensed. Then, verify that you meet all of the board of nursing eligibility requirements to take the NCLEX examination.
2. Register for the NCLEX with Pearson VUE via the Internet, telephone or by mailing in a registration form obtained from your board of nursing (photocopies of the registration form are not accepted).
3. Receive an acknowledgement of receipt of registration from Pearson VUE.
4. Receive an Authorization to Test (ATT) letter from Pearson VUE once eligibility is granted by the board of nursing.
5. Schedule to take the exam.
6. You will receive your results approximately one month after taking the examination. Please note, some boards of nursing allow candidates to access their unofficial results 48 hours after the examination via the Quick Results Service for a fee. Contact your board of nursing for more information about this service.

Additional important information for candidates taking the NCLEX examination is available online here.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

The National Council of State Boards of Nursing, Inc. (NCSBN) voted on Dec. 8, 2010, to raise the passing standard for the NCLEX-PN Examination (the National Council Licensure Examination for Practical Nurses). The new passing standard is -0.27 logits on the NCLEX-PN logistic scale. The new passing standard will take effect on April 1, 2011, in conjunction with the 2011 NCLEX-PN Test Plan. We link to the test plan.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

New State Board of Nursing Requirements Page on www.cgfns.org

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

CGFNS announced today that its exam for foreign educated nurses will become internet-based in 2011, beginning with the March 2011 exam. Over 500,000 foreign-educated nurses have taken the paper-and-pencil format during the last 30 years and CGFNS decided that moving to Internet-based testing expands their reach to the global community.

Applicants who are approved to take the Internet-based exam in March 2011 will be notified in January about the scheduling instructions. Upcoming Exam Dates

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

The Federation of State Boards of Physical Therapy (FSBPT) recently announced that the new redesigned NPTE-i (formerly NPTE-YRLY) for Physical Therapists will be offered twice in 2011 for PT candidates - May and December 2011. Registration opens on November 1, 2010 with FSBPT. For a detailed schedule visit the FSBPT website.

The exam will be given in all 50 states, along with the District of Columbia, Puerto Rico and the Virgin Islands. The NPTE-i is expected to be quite similar to the regular NPTE, and the registration fee will remain the same as the NPTE registration fee, which is currently at $370.00.

It was also announced earlier in the month that the PTA NPTE testing restrictions will be removed for graduates of Egypt, India, Pakistan and the Philippines effective November 1, 2010.

In revisiting its previous decision, the FSBPT Board of Directors concluded that there is not a sufficiently high level of forensic irregularity to justify any further temporary suspension of graduates from Egypt, India, Pakistan and the Philippines from sitting for the PTA NPTE.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

The AAIHR supported lawsuit over the actions of the FSBPT regarding the NPTE is proceeding and has a State court hearing scheduled for Dec 20, 2010 in Atlanta, GA. We link to the press release.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Changes in the processing of both NIV and IV visas were recently implemented at the U.S. Consulate in Manila. These changes impact payment of fees, scheduling of appointments and access to the Consulate.

NONIMMIGRANT VISAS:

• MRV fee collection must be made over the counter or online at any branch of the Bank of the Philippine Islands (BPI) or online through Bancnet.
• Appointments must be scheduled through the new call center or online. The call center number is 982-555 from the Philippines or 214-571-1600 from mainland U.S.

IMMIGRANT VISAS:

• Immigrant visa applicants who have been scheduled for appointment by NVC are required to go online to register their delivery address.
• Applicants who receive notification from NVC regarding eligibility for an interview, must schedule the interview date online or by calling 632-982-5555.

For both nonimmigrant visa and immigrant visa applicants who receive a 221(g) notice of insufficient documentation, the requested documentation has to be submitted through a 2G0 courier service - but first the applicant must go online to register before submitting the documents to the courier service.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

During this holiday season when travel increases, it's important to remember what the process is for international travelers when you're inspected at the airport or on land by Customs and Border Protection(CBP) officers. They have posted a very informative list of FAQ's which we link to.

The most important thing to remember if you are a non-citizen is the CBP Officer must determine why you are coming to the United States, what documents you may require, if you have those documents, and how long you should be allowed to initially stay in the United States. These determinations usually take less than one minute to make. If you are allowed to proceed, the officer will stamp your passport and customs declaration form and issue a completed Form I-94 to you. A completed form I-94 will show what immigration classification you were given and how long you are allowed to stay.

Note that completion of the paper Form I-94W remains a requirement at the port of entry for Visa Waiver Travelers even if a travel authorization has been obtained via the Electronic System for Travel Authorization. For more information on ESTA visit the Electronic System for Travel Authorization page.

Should you have any questions about business or tourist visas, please contact our office.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

It’s common knowledge that the U.S. government has been performing widespread investigations and audits of employers to crack down on employment of undocumented non-citizens. Immigration and Customs Enforcement (“ICE”) recently reported record-breaking figures citing the highest deportation numbers and the most employer audits in our nation’s history, and states: “Since January 2009, ICE has audited more than 3,200 employers suspected of hiring illegal labor, debarred 225 companies and individuals, and imposed approximately $50 million in financial sanctions-more than the total amount of audits and debarments than during the entire previous administration.”

Because of this, employer compliance is becoming more complex and enforcement activities are increasing at record pace. The days of thinking that immigration enforcement is only targeting industries that employ a diverse workforce, such as healthcare, hospitality, restaurants, garment and the construction business, are long gone. Every employer must be aware of immigration laws as they relate to the processing and management of their I-9 forms and have a trained staff for those charged with the responsibility of managing I-9’s. Many audits have resulted in fines for well known and respected employers, for those that employ foreign workers, as well as businesses, both large and small, that unintentionally filled out I-9 forms incorrectly. Document mistakes - missing signatures, dates, over-documentation problems on I-9’s, have resulted in fines from $110 to $1,100 per mistake.

Recent examples of I-9 violations and penalties involve:

1. A Colorado restaurant franchise who was fined $32K after an ICE inspection - not for hiring any illegal workers, but for I-9 document errors.
2. The clothing giant, Abercrombie & Fitch was recently fined over $1 Million when an I-9 audit revealed multiple technology errors with the electronic I-9 system they were using, shedding light on the fact that employers are not only responsible for the people that they hire, but also for the internal systems that they choose to use to verify the eligibility of their workforce.
3. The Department of Justice recently settled with Catholic Healthcare West, the 8th largest hospital provider in the nation, on discrimination against work-authorized individuals. CHW agreed to pay $257,000 in civil penalties, the largest amount ever paid to resolve such allegations. This settlement sends a strong message to all employers how important it is to have a staff properly trained on I-9 regulations and on all sections of the form. All workers who are authorized to work in the USA have the right to look for a job without encountering discrimination because of their immigration status or national origin”, said Thomas E. Prerez, Asst. Attorney General for the Justice Department’s Civil Rights Division.

The key to I-9 compliance for most organizations starts with a thorough self-examination of existing paper I-9’s, E-Verify submissions (if applicable), standard operating procedures, and past practices. While there are many checklists and do-it-yourself guides and Podcasts available on the Internet and elsewhere, consulting a licensed immigration or employment lawyer who is familiar with I-9 and E-Verify compliance issues can save employers hours of research, provide a solution tailored to the organization and save the employer thousands of dollars in fines and penalties.

Visit our new I-9 Employer Resource Center and contact our office. We work proactively with our clients to provide comprehensive, and cost-efficient assistance in developing and maintaining best practices necessary to assure compliance with USCIS and Department of Labor regulations.

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

The following web pages provide information on the latest immigration news:

AILA.org Press Page - The American Immigration Lawyers Association (AILA) Press Page has the latest information on immigration topics, including press releases and Congressional testimonies. Spanish information is also available.

FAIR What’s New Page - The Federation for American Immigration Reform (FAIR), a restrictionist organization, has information on all Congressional activity that relates to immigration, including summaries of recently introduced bills and congressional hearings.

ILW.com’s Immigrant’s Weekly - ILW.com provides a free, weekly newsletter geared towards immigrants with articles on the latest immigration information, letters to the editor, help finding an immigration attorney and classified advertisements.

National Immigration Forum’s Current Immigration Issues Page - The National Immigration Forum’s Current Immigration Issues Page provides links to articles on the latest immigration news.

Immigration Compliance Group Blog - We publish free newsletters, articles and news alerts. Take a look at our websites and sign up:

www.immigrationcompliancegroup.com
www.I-9Audits.com
www.employer-compliance.com

Follow Us:

:::::::::::::::::::::::::::::::::::::::::::

What can Immigration Compliance Group do for your organization?

We can consult with you to determine that the nature of the position and the prospective employee’s background are appropriate for an H-1B or any other nonimmigrant visa (O or P visas, TN, L-1A or L-1B, E visas, etc.). We can also process green-card cases for your employees if you are interested in obtaining legal permanent residency for them. We can advise both the employer and prospective employee regarding documentation requirements as well as legal issues, and will make recommendations on the most appropriate process for your company to pursue. We will handle the entire process for you with some of the industry’s best and most experienced licensed immigration attorneys and case managers. Our clients know that our flexibility at designing and personalizing a business model unique to them and their needs that impacts their ability to grow and develop their business, sets us apart from other business immigration service providers.

:::::::::::::::::::::::::::::::::::::::::::

Disclaimer/Reminder: This newsletter does not constitute direct legal advice and is for informational purposes only. The information provided should never replace informed counsel when specific immigration-related guidance is needed.

Back to Top

Copyright © 2011 Immigration Compliance Group.