This practice advisory is designed to recap the strategies discussed during the phone conference so healthcare recruiters and employers can prepare for the retrogression in green card numbers.

• Begin filing I-140 petitions as soon as possible for nurses and physical therapists:  The receipt date provides the "priority date" which is the persons ticket in the waiting line, so to speak.

• Expand the countries from which you recruit: historically the countries that have had backlogs in green card processing have been India, China and the Philippines and it is expected that these countries will again experience backlogs.

•  Consider nonimmigrant options: consider TN options for Canadian and Mexican citizens and H-1b options for occupations which qualify.  Nurses, in limited circumstances, may qualify for H-1b.  Also consider a J-1 training program for healthcare workers.

• Expand recruitment efforts to healthcare occupations other than nursing: There are 12 healthcare occupations under NAFTA including registered nurse, recreational therapist/physiotherapist, physical therapist, occupational therapist, medical laboratory technologist, pharmacist, psychologist, physician for teaching only, nutritionist, dietician, dentist, and veterinarian.  Only four of those (registered nurses, physical therapists, occupational therapists, and medical laboratory technologists) require a healthcare certificate ("VisaScreen").  Several occupations qualify for H-1b including but not limited to physical therapists, occupational therapists, medical technologists, speech language pathologists and audiologists.

• Expand the sales base to other countries:  this will help retain the healthcare worker while he or she is waiting for the U.S. green card and can also provide additional revenue for the staffing agency who places a healthcare worker in another country

• Plan for a disruption of the concurrent I-140/I-485 filing (the "walk-in" system): since the I-485 application can't be filed unless the priority date is current there will be many cases where the healthcare worker will have to file the I-140 separately and wait to file the I-485 possible months or a year later.  This will end the ability of the healthcare worker to obtain an Employment Authorization Document.  It will primarily affect nurses and physical therapists who enter on a visitor visa or a student visa through a language training program.

• Consider the country of birth for the healthcare workers spouse: the immigration laws provide for "alternate chargeability" which allows an employment based person to proceed on the basis of the spouses country of birth, which may not backlogged as other countries.

• Check the expiration of the healthcare certificate (VisaScreen): the Visascreen is valid for five years and with the retrogression on green cards there will be cases where the VisaScreen has to be renewed before the green card is approved.

• Check the age of the children of the healthcare worker: the children of a healthcare worker can receive a green card with the healthcare worker so long as the child is still under the age of 21.  The Child Status Protection Act stops the age of the child for green card purposes in some cases; however, the delay in green card processing will be cause some cases to not be protected under the Child Status Protection Act.  Consult with your attorney on any cases where the child is within 1-2 years of turning 21.

• Get involved in advocacy:  Now, more than ever, we need to become active in lobbying Congress to create a nonimmigrant visa option for nurses and other healthcare workers and provide relief in the green card processing for nurses.  Consult with a Hammond Law Group attorney on how you can become active in our lobbying efforts.