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Visa uncertainty worries Canadian nurses, and the Michigan hospitals that rely on them

Mar 17, 2017

It appears some Canadian nurses who work in southeast Michigan hospitals may not be able to do so for much longer.

That’s  because some U.S. Customs and Border Protection agents seem to have changed their longstanding interpretation of a NAFTA provision allowing those nurses special work visas—though it’s apparently not an agency-wide change in policy.

The NAFTA treaty allows Canadian and Mexican citizens in certain occupations, including registered nurses, specific work visas called TN visas.

Those visas allow them to work in U.S. hospitals. Canadian nurses have helped fill critical shortages in some hospitals along the northern border, particularly in the Detroit area.

Mark Topoleski, an immigration attorney who represents Henry Ford Hospital in Detroit, said that historically, that same visa status applied to all registered nurses, regardless of their skill level.

But when a Canadian nurse practitioner tried to renew her TN visa last week, “she was denied,” Topoleski said, “and the CBP indicated that the reason for their denial was a change in the interpretation of NAFTA, and that basically advanced practice nurses, in their opinion, no longer qualify under the registered nurse category.”

That left Henry Ford “scrambling to look to other categories to move them into, so they don’t have a lapse in their work authorization here in the United States,” Topoleski said.

One option is another visa for highly-skilled workers, known as H-1B visas. "But we would need to do that on an expedited process, and the US Immigration Service announced that they are suspending the premium process processing, or expedited service,” for that type of visa on April 3rd, Topoleski said.

“If this can’t get done before this expedited processing goes away, then we may have a situation where we have nurses out of work for up to six months at a time.”

That would be a big problem for Henry Ford Health System, which relies on more than 300 Canadian nurses, about 30 of them “advanced practice” nurses.

They include Patti Kunkel, who lives in LaSalle, Ontario. She’s been a nurse practitioner in Henry Ford’s cardiac intensive care unit since 2009, and has worked in Detroit hospitals for the past 17 years.

Her current position isn’t one that can be filled quickly—Kunkel says the orientation process alone took a year. She’s worried about what would happen if her visa isn’t renewed.

“We are already over-worked because of being short-staffed,” Kunkel said. “So going down one more is going to be very difficult on my team.”

But CBP spokesman Kristoffer Grogan said in a written statement that “U.S. Customs and Border Protection has not had any policy changes that would affect TN status.”

There are some “common issues” with improper paperwork or a lack of required documents among some applicants, Grogan said. But ultimately, “Each application for TN status is evaluated by the inspecting officer, and the decision is made on the totality of the evidence provided. Every application for TN status is a separate inspection, and the decision to approve or deny is based on the merits of that individual case.”

The agency adds that it is "currently working closely with U.S. Citizenship and Immigration Services for greater clarity in regards to specialized categories that fall under the registered nurse classification."