Ten Steps USCIS Can Take To Fight COVID-19

It is no secret that a large percentage of U.S. health care workers are noncitizens. We routinely assist health care facilities, physicians, nurses and other health care professionals with their immigration needs. For the past few weeks, I’ve been working with my colleagues on the IMG Taskforce to advocate for much needed changes in the immigration system, which will help in the fight against coronavirus and COVID-19. I’m pleased to see some of our suggestions are receiving Congressional and media attention. Health care is one area where smart immigration reforms can make America stronger, in this time of need.

Here is a list of ten things U.S. Citizenship and Immigration Services can do right now, to help with the fight against COVID-19.

  1. Lift restrictions on H-1B worker and J-1 Exchange Visitor mobility, so that H-1B and J-1 physicians can provide services where and when needed, without first getting approval from USCIS. H-1B and J-1 statuses are inherently restricted by their terms to employer , location and duties. Our noncitizen doctors need more flexibility in their immigration authorizations, to be best deployed to help with the COVID-19 crisis. Several members of Congress, including Senators Klobuchar, Durbin, Harris, Feinstein and others have signed on to a letter to USCIS suggesting the same.
  2. Resume premium processing and waive the fees for it for health care workers.  The Premium Processing program is currently suspended. For better or worse, employers have come to depend on paying $1440 to receive adjudications in 15 days.  The option is not present for any business right now. A letter has been sent to USCIS, signed by many members of Congress, but so far USCIS has taken no action.
  3. Establish a dedicated Health Care Worker Liaison within the agency, to address case specific and policy issues for health care facilities and their noncitizen employees. The Liaison should be empowered to cut through the wait times and red tape, so that meritorious petitions get immediate attention.  USCIS needs to elevate health care worker immigration in this time of need, and a dedicated liaison or team would be big help in doing so.
  4. Expedite employment authorization documents and petition processing for health care workers, including international medical graduate physicians, nurses, medical technologists, researchers, and health care information technology workers.
  5. Confirm that telecommuting and telemedicine care will not adversely impact H-1B status.  H-1B statuses are governed by very particular rules as to location, duties and employer. In this unprecedented time, telemedicine has quickly come into focus as an important tool for safely delivering health care services. Foreign health care workers should not fear that rendering such services from different locations, or the manner of such delivery, will potentially impact their eligibility for future immigration benefits.
  6. Accept digital signatures on all applications. The agency still requires an original wet signature on applications, which typically means additional people interactions, for finalizing petitions.  For an agency which is trying to increase its on-line submission profile, allowing digital signatures is an obvious step forward.
  7. Approve H-1Bs before licensing.  Health care workers will not be employed by facilities without licenses.  USCIS can safely approve credentials and let licensing be handled at the state level.
  8. Allow H-4 spouses to apply for employment authorization documents.  There are many, many J-4 holders who are unable to work, such as spouses formerly on J-2 status, that could help with the fight against coronavirus.
  9. Waive interviews for employment based adjustment of status interviews, generally. Until a few years ago, USCIS almost always waived these interviews. While USCIS Field Offices are closed now, if they waived these interviews, health care workers would secure their permanent residence, which would help in many ways for the fight. We are actually hearing this is happening in some cases, though the agency has not announced the change.
  10. Expedite J-1 waiver processing.  Many international medical graduates have July 1st, 2020 start dates related to J-1 waiver applications. The agency needs to process the J-1 waivers, which are recommended by State Departments of Health and interested federal agencies. It is vital that these physicians be able to start work on time.

Hopefully USCIS acts on at least some of these suggestions, soon. It may be necessary to include language specific to health care immigration in the next round of Congressional relief bills. Ultimately, it is on Congress to act, but there are many things federal agencies can do in the meantime, to improve access to health care. We will be following such developments closely, and keeping folks informed.