An immigration rule proposed by the Homeland Security Department and set to go into effect this summer will make it more difficult for foreign nurses to work in the United States and could ultimately prolong the nation's shortage of nurses, the American Hospital Association contends.
The final regulations implementing the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 will require foreign-born healthcare professionals to receive a certificate from the Commission on Graduates of Foreign Nursing Schools.
The not-for-profit organization helps ensure that foreign nurses are licensed and eligible to work in the United States. Currently, foreign nurses can practice in the United States as long as they have a valid state license.
In a letter sent earlier this month to the department's Secretary Tom Ridge, AHA Executive Vice President Rick Pollack pushed for a one-year delay in the effective date and exemptions for healthcare professionals who already hold state licenses to practice.
Delaying the start date of the regulations until July 2005 would give foreign nurses more time to receive certification and prepare for the new requirements, the AHA said.
Still, a rule on the books will have drastic consequences for the nursing workforce, the AHA said.
"We believe it will exacerbate the nursing shortage," said Carla Luggiero, senior associate director of federal relations at the AHA. "It is going to have an impact."
But the department argues the regulations are necessary to ensure that healthcare workers are properly trained for their jobs, said Chris Bentley, spokesman for the U.S. Citizenship and Immigration Services, which the Homeland Security Department oversees. Bentley said he was unsure whether the department had received the letter from the AHA. "It will allow the U.S. government to have more information on individuals who come to the U.S. to serve as healthcare workers," Bentley said. "We will know they have certification."
The AHA also wants the rule to exempt foreign healthcare workers who have received their training and graduated from U.S. training programs.
The new rule will be felt acutely in Northern states such as Maine, Michigan and New York, where thousands of Canadian residents cross the border each day to work as nurses in U.S. hospitals, Luggiero said.
Michigan, for example, is anticipating losing 3,000 commuter nurses who come from Canada to work in Detroit-area hospitals, the Michigan Health and Hospital Association said.
Nurses simply won't want to invest the time in taking exams and getting certified, said Sherry Mirasola, spokeswoman for the state hospital association.
"This regulation applies to nurses who have been practicing in the U.S. for 20 years," Luggiero said. "This is for non-U.S. citizens who come to the U.S. to work day in and day out."
The new requirements also will deflate the morale of nurses who will have to go through the certification process, she added. Taking the nursing exam costs about $300 and is time consuming, Luggiero said.
The new requirement will make nurses go through "a lot of cumbersome steps" to make sure they comply, Mirasola said. "The fear is it will slam the border shut. We can't afford that."
The Michigan Nurses Association is still reviewing the regulation and has not taken a position on the issue, said Erik Harris, director of government affairs.
The state recently enacted legislation that allowed Canadian nurses who were trained in English-speaking provinces to practice in the state without having certification from the commission.