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1. Bill seeks visa expansion
2. UT enforcement under fire
3. AZ House considers bill
4. AZ hospital markets services
5. WI activists seek benefits

1.
Immigration: More Foreign Nurses Needed?
The U.S. nurse shortage is getting worse, but are more visas the answer—or would improved training capacity, working conditions, and pay do the trick?
By Moira Herbst
Businessweek, June 21, 2009

For more than a decade, the U.S. has faced a shortage of nurses to staff hospitals and nursing homes. While the current recession has encouraged some who had left the profession to return, about 100,000 positions remain unfilled. Experts say that if more is not done to entice people to enter the field—and to expand the U.S.'s nurse-training capacity—that number could triple or quadruple by 2025. President Barack Obama's goal of expanding health coverage to millions of the uninsured could also face additional hurdles if the supply of nurses can't meet the demand.

Some lawmakers are looking to the immigration pipeline as one means to raise staffing levels. In May, Representative Robert Wexler (D-Fla.) introduced a bill that would allow 20,000 additional nurses to enter the U.S. each year for the next three years as a temporary measure to fill the gap. If the bill doesn't pass on its own, lawmakers may include it in a comprehensive immigration reform package. Obama is slated to meet with congressional leaders on June 25 to discuss reforming U.S. immigration laws.

Hospital administrators such as William R. Moore in El Centro, Calif., a sparsely populated town 100 miles east of San Diego, see the Wexler bill as a potential life raft. Moore is chief human resources director at El Centro Regional Medical Center, a 135-bed public hospital that typically has 30 open positions for registered nurses (RNs). While it's hard to lure nurses from nearby big cities (San Diego is 100 miles west), Moore says he could quickly recruit dozens of eager, qualified nurses from the Philippines if the government allocated more visas. "All we want is temporary relief," says Moore. "Let us get a group of experienced RN hires from the Philippines, and we won't ask for more."

Obama begs to differ

Wexler's bill is opposed by labor unions, whose leaders say it would undermine efforts to produce a steady domestic workforce while sapping other nations' nurses. Obama has also expressed skepticism about the idea that the U.S. needs to import nurses, in particular because the U.S. unemployment rate continues to rise. "The notion that we would have to import nurses makes absolutely no sense," Obama said at a health-care forum in March. "There are a lot of people [in the U.S.] who would love to be in that helping profession, and yet we just aren't providing the resources to get them trained—that's something we've got to fix." The $787 billion economic stimulus bill included $500 million to address shortages of health workers in the U.S., with about $100 million to promote nursing and increase capacity at U.S. nurse-training schools.

The nursing shortage has a number of causes, including an aging workforce, difficult working conditions coupled with stagnating pay, and a lack of capacity at U.S. nursing schools. Peter I. Buerhaus, professor of nursing at Vanderbilt University Medical Center, says the recession has eased the nurse shortage in some areas of the U.S. as more Americans seek out the field's relative job security. Some hospitals also see less need for staff as more Americans lose health insurance and fewer people spend money on elective surgery and doctor visits. But Buerhaus estimates that by 2025 the nurse deficit will be twice as severe as the last major staffing shortage in the mid-1960s, after Congress passed the Medicare and Medicaid programs.

As openings have become more difficult to fill domestically, more foreign-born nurses have entered the workforce, most commonly through green cards that lead to permanent residency. In 1994, 9% of the total registered nurse workforce was composed of foreign-born RNs; by 2008 that percentage had risen to 16.3%, or about 400,000 RNs, according to Buerhaus' research. Of those 400,000 nurses, about 10% had immigrated to the U.S. within the previous five years. About one-third of the increase in RNs from 2001 to 2008 was composed of foreign-born RNs.
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http://www.businessweek.com/bwdaily/dnflash/content/jun2009/db20090619_9...

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2.
Utah immigration law under fire even before it's on the books
Attorneys say some provisions are unconstitutional; defenders say economics is behind new law.
By Sheena Mcfarland
The Salt Lake Tribune (Salt Lake City), June 22, 2009

Utah's new immigration law, SB81, takes effect July 1. But several attorneys who belong to the American Immigration Lawyers Association say they're not waiting.

They plan to file a lawsuit later this week challenging various portions of the law.

"There are a number of provisions we think are unconstitutional," said Hakeem Ishola, one of the attorneys filing the suit.

The attorneys, who say federal law should supersede state law in several areas, are focusing on four main areas: new identity document laws, the requirement for businesses with government contracts to use E-Verify, local enforcement of immigration law and a provision making it illegal to harbor an undocumented immigrant.

Defenders of the law, though, say many of its provisions are aimed at preserving precious taxpayer resources for those who follow the rules.

"In these times we are currently looking at, with shortfalls in services, we should provide those services to those who are here legally," said Rep. Mike Noel, R-Kanab, who co-sponsored the bill.

"My issue is, many people out there come to this country and go through the process to get here," Noel said. "The rule of law needs to be applied, and the federal government caused this problem and has not taken the necessary steps to fix it."

Attorney General Mark Shurtleff said he has known about a possible lawsuit since the end of the legislative session and plans to defend the law. He couldn't comment, though, because of the pending litigation.
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http://www.sltrib.com/ci_12660285

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3.
Immigration enforcement in Arizona could toughen
By Jacques Billeaud
The Associated Press, June 21, 2009

Phoenix (AP) -- As America's busiest immigrant smuggling hub, Arizona has earned the distinction as a place that's tough on people who sneak across the border.

That reputation would harden if the Legislature and governor approve a proposal that would draw local authorities deeper into immigration enforcement and further reject the notion that immigration is the sole responsibility of the federal government.

The proposal, which has cleared the state Senate and is being considered by the House, would require police to try to determine people's immigration status when they have reasonable suspicions that a person doesn't have legal status.

And, if approved, Arizona would become the only state to criminalize the presence of illegal immigrants through an expansion of its trespassing law.

While the practical effect of such a law is yet unclear, immigrant rights advocates predict it would lead to racial profiling that would target thousands of Latinos who are U.S. citizens.

And the proposal's constitutionality is also a source of contention.

A few years ago, police chiefs in two communities in New Hampshire charged illegal immigrants with trespassing for being in the state. A local judge in 2005 dismissed the charges as an unconstitutional attempt to apply state laws to a federal issue.

But supporters of the proposal say that on top of inadequate federal border efforts, many local police departments have turned a blind eye to illegal immigrants.

Some local politicians "don't have the courage to stand up for their citizens," said state Sen. Russell Pearce of Mesa, the bill's sponsor.

The measure cleared the Senate on a 16-12 vote on June 15 and is being considered by the House. The proposed trespassing provision is similar to proposals vetoed in 2006 by then-Gov. Janet Napolitano, who said she opposed turning all immigrants who sneaked into the state into criminals.

Republican Jan Brewer, former secretary of state for Arizona, became governor in January upon the resignation of the Democrat Napolitano, who quit to head the Homeland Security Department in the Obama administration.
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http://www.google.com/hostednews/ap/article/ALeqM5jzyXtsrCHoiBv_kNFp2XCo...

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4.
Citizenship for sale?
TMC offering maternity packages to Mexican women, raising questions on birthright
By Mariana Alvarado
The Arizona Daily Star (Tucson), June 21, 2009

A Tucson hospital's health-care package promises affluent Mexican women the chance to have their babies in posh surroundings with access to the latest medical equipment.

But the marketing materials leave out a key draw in the arrangement: U.S. citizenship for the newborn.

Tucson Medical Center's "birth package" gives an official nod to a generations-old practice of wealthy Mexican women coming to U.S. hospitals to give birth. Mexican families do the same thing at all local hospitals, but TMC is the only one actively recruiting their business.

The practice is legal, but offensive to some advocates of tougher U.S. immigration standards.

"What it really amounts to," said Mark Krikorian, executive director of the Center for Immigration Studies, "is buying U.S. citizenship."

"This is different from any other kind of medical treatment," said Krikorian, whose Washington, D.C.-based think tank studies the impact of immigration on the United States. "If you come for cancer treatment … there's no consequence for the United States. You pay your money, you go home."

The Mexican consul general in Tucson said parents naturally want to give their children every advantage and securing U.S. citizenship is something a small percentage of Mexican families can afford.

"This is not a new phenomena," said Juan Manuel Calderón Jaimes, who says he's seen the practice for almost 30 years. "Many families of means in Sonora send their wives here to give birth because they have the resources to pay for the services."

Expectant mothers can either schedule a Caesarean section or arrive a few weeks before their due dates to give birth at TMC. It is one of 13 packages aimed at Mexican families, some of which include a stay at a local resort and shopping excursion.

TMC's maternity package costs $2,300 for a vaginal birth with a two-day stay and $4,600 for a Caesarean section and a four-day stay, assuming no complications. That includes exams for the newborn and a massage for the new mother. There is a $500 surcharge per additional child.
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http://www.azstarnet.com/sn/metro/297932.php

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5.
Immigrant groups seek driver's card, tuition break
The Associated Press, June 22, 2009

Madison, WI (AP) -- Advocates are making a final push to convince Wisconsin lawmakers to cut tuition rates and create a new driver's card for illegal immigrants.

Supporters plan a press conference and a rally at the Capitol on Monday as lawmakers consider whether to include those provisions in the final state budget.

The Assembly budget would allow illegal immigrants who graduate from Wisconsin high schools to be eligible for in-state tuition and would create a special driver's card for those who can't prove they are U.S. citizens.
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http://www.chicagotribune.com/news/chi-ap-wi-wisconsinbudget-i,0,4357822...