Licensing halt a bitter pill; 2 DACA women facing closed door in Arkansas nursing field

Rosa Ruvalcaba Serna, who is pursuing a nursing degree at the University of Arkansas for Medical Sciences with the help of her mother’s savings, says she’ll get her degree even though she cannot be licensed in Arkansas. “That’s really important to me because I will be the first in my family,” she said.
Rosa Ruvalcaba Serna, who is pursuing a nursing degree at the University of Arkansas for Medical Sciences with the help of her mother’s savings, says she’ll get her degree even though she cannot be licensed in Arkansas. “That’s really important to me because I will be the first in my family,” she said.

Marisol Rodriguez drained her personal savings -- accumulated from grueling 12-hour shifts at a De Queen chicken plant -- and still needed a loan to pay for the nursing degree she received in June. Rosa Ruvalcaba Serna is tapping into her mom's life savings in pursuit of a nursing career.

Both Arkansas women, who arrived in the U.S. from Mexico as children, have learned that they cannot work as nurses in this state because the Arkansas State Board of Nursing has begun denying licenses to applicants who have federal Deferred Action for Childhood Arrivals status.

The nursing board's shift aligns with long-standing laws that apply to Arkansas professional licensing. Nonetheless, unknowing students have enrolled in programs that, when they graduate, will require licenses that they are not eligible to receive, even when they disclosed their statuses.

"I wouldn't have wasted all my time and my money to do something that's never going to pay it back for me," said Rodriguez, a 31-year-old graduate of Cossatot Community College of the University of Arkansas, who was denied access to an Arkansas license in August.

"I was shocked. I asked them, 'Are you sure?'"

Rodriguez said she does not know if she'll ever work as a nurse.

The change, announced to nursing educators Sept. 29, has spotlighted people like Rodriguez, Ruvalcaba Serna and other students who have spent time and money in pursuit of degrees they won't be able to use unless they uproot their lives.

It has prompted some schools to begin writing new notices for course catalogs that advise students to ensure their eligibility with licensing boards before they enroll, and it has raised questions about how other Arkansas licensing authorities have handled students who have deferred statuses.

"In light of recent actions by the Nursing Board, [the Arkansas Department of Health] is reviewing how professional licenses are issued to ensure compliance with current state law," department spokesman Meg Mirivel said Friday.

Nursing Board staff emails released to the Arkansas Democrat-Gazette under the Arkansas Freedom of Information Act reveal how the agency reached its decision and what prompted it. The emails also show that two Missouri students were similarly surprised this summer when they were informed just before graduation that they were ineligible to receive licenses.

At least nine nursing students at four Arkansas universities and colleges have deferred statuses. The number is likely higher because several campuses don't track their students' immigration statuses, according to educators' responses to a survey by the newspaper. One of the nine affected students withdrew from classes after learning about the Nursing Board change.

"It is a very unfortunate situation in which these students got an education in good faith, and our communities depend on them," Gov. Asa Hutchinson said Friday. "This is another example of why Congress needs to pass comprehensive immigration reform."

Deferred status is a federal designation created in 2012 for foreigners who arrived in the U.S. as children and were living in the country illegally. Recipients are permitted to stay in the U.S. for two years at a time, attend college, buy homes, drive, work and obtain Social Security cards as long as they meet eligibility requirements, pass background checks and don't commit crimes.

Deferred status falls short of "legal status," and federal law does not consider recipients to be "qualified aliens" eligible for public "benefits" handled at the statewide level, such as professional licenses. Legislatures may grant people with deferred status access to those benefits, but most states, like Arkansas, have not.

Looming over the issue is the broader lack of certainty about what will happen to the federal Deferred Action for Childhood Arrivals program, frequently called DACA. President Donald Trump's administration announced last month that it would stop granting deferred status to new applicants and end renewals.

Trump has called on Congress to pass a law to help DACA recipients, who are sometimes referred to as Dreamers, in reference to a congressional bill called the Dream Act that was introduced 16 years ago but never became law.

Ruvalcaba Serna, a junior at the University of Arkansas for Medical Sciences, disclosed that she had deferred status before she enrolled at UAMS. She said she does not blame the university for the licensing snag because she believes university officials also were unaware of the restriction.

"Obviously, DACA is very new," she said. "We're some of the first students that they're having to learn how to deal with."

Ruvalcaba Serna, who said she will finish pursuing her degree at UAMS, is hopeful that either the Arkansas Legislature or Congress will pass legislation to allow her to practice her profession after she graduates in 2019.

"I want a bachelor's degree," Ruvalcaba Serna said. "If I'm able to sit for [the Nursing Board exam] in Arkansas or not, I still will have a bachelor's degree. That's really important to me because I will be the first in my family. If I need to move to another state to be able to practice, it's just a part of life. It's not a reason to give up when there are opportunities."

WORK DOESN'T PAY OFF

To get a nursing degree, Rodriguez had to first improve her English, finish a high school education she had set aside, overcome rejection, work longer hours and then take on debt that her family is still repaying.

Rodriguez has lived in Horatio, just south of De Queen, since she arrived in the U.S. as a 15-year-old in 2000. She long wanted to be a nurse -- the small Mexico town she grew up in had little medical care, she said -- but that desire intensified after her mom died from a stroke when Rodriguez was 16.

"I can do nothing for her," she remembers thinking.

A mother of two boys, 13 and 8 years old, Rodriguez worries about the future of the federal deferred status program. She's fearful that she will be deported to Mexico if the program isn't restored before her status expires in 2019.

Moving to another country would be culture shock for her sons, similar to what she experienced when she came to Arkansas and failed to complete high school in large part because she couldn't learn English quickly enough, she said.

Rodriguez and her sister hesitated when former President Barack Obama established the deferred action program by executive action. Ultimately, Rodriguez applied for it in 2014 -- the same year she obtained the equivalency of a high-school diploma -- but her older sister, who was eligible, did not.

They talked frequently -- and still do -- about the merits of submitting personal information to the federal government without any guarantees, Rodriguez said.

Before applying to Cossatot Community College, Rodriguez asked for additional hours at the De Queen chicken plant where she earned less than $11 an hour removing wings from breasts, over and over. She worked up to 60 hours per week, she said.

She then applied for the nursing program but was rejected. "'If they don't accept you in the program, it's maybe because you're not made for that,'" Rodriguez said her friends and family told her. But she applied again and was accepted.

She graduated this year with a 3.0 grade-point average, she said. Rodriguez, who would not have enrolled in a nursing program if she had known she could not receive an Arkansas nursing license, is now determined to take the nationally standardized licensing test regardless of whether she's eligible for a license.

"I want to feel myself complete," Rodriguez said. "I want to tell my kids, 'I'm a real nurse.'"

MISSOURI LICENSING

A pair of June 6 emails from Missouri prompted Arkansas' Nursing Board to review whether it should be licensing students who have deferred statuses.

The first email was written by a frustrated student, Juan Nunez Gomez, whom Missouri officials told they could not license because the state had not passed a law to expand public benefits beyond what federal law prescribes.

Nunez Gomez, at the time, was a student at the Ozarks Technical Community College campus in Hollister, Mo., just north of the Arkansas border. He was scheduled to graduate soon. So he called Arkansas' Nursing Board. A staff member told him he could receive an Arkansas license even though he had deferred status.

"They were very puzzled," Nunez Gomez said in an interview. "They said, 'Yes,' but their tone said, 'I don't know.'"

After the conversation, he fired off an email to Missouri State Board of Nursing Executive Director Lori Scheidt.

"If it's federal law, why would Arkansas allow me to test and grant me a license if passed," Nunez Gomez wrote. "Also, why would my college allow me to get an education I'm never gonna be able to use?"

Thirteen minutes after receiving the message, Scheidt forwarded Nunez Gomez's email to Arkansas Nursing Board Executive Director Sue Tedford: "FYI."

It is the earliest record concerning deferred action that was released through an open-records request for all emails sent and received by Arkansas Nursing Board staff members about the issue since Jan. 1, 2017.

Also on June 6, Nunez Gomez's teacher reached out to the Arkansas Nursing Board.

Vicki Underhill, director of the practical nursing program at Ozarks Technical Community College's Hollister campus, wrote that two students set to graduate in July "just found out that Missouri will not allow them to test." She asked if they could obtain licenses in Arkansas.

Tammy Claussen, the Arkansas Nursing Board's program coordinator, forwarded the email to a Missouri nursing board official, pointing out that students with deferred status have Social Security numbers, so "what is the reasoning behind denying licensure?"

Over the next several days, Missouri's nursing board exchanged information with Arkansas, including a May 2 decision by the state's Administrative Hearing Commission that found that applicants with deferred status were not eligible to receive professional licenses in Missouri.

The Arkansas Nursing Board by June 22 decided to stop issuing licenses, according to an internal email.

"Just to make sure we are all on the same page," Claussen wrote in an email that day, saying the board would "deny DACA applicants the ability to submit an application or be licensed in Arkansas, just like Missouri has already done."

Four days later, Claussen informed Underhill that the Missouri students could not obtain an Arkansas license.

Rodriguez was denied in August when she tried to sign up for the licensing test. The Nursing Board informed her that there was an "issue" with her Social Security number, she said, so she sent the board a copy of her Social Security card, which includes a message that says "valid for work only...." The next day, the board called Rodriguez and asked her a question.

"Are you a DACA student?" Rodriguez said she was asked. She said "yes."

REINING IN LICENSING

Tedford, the Arkansas Nursing Board's executive director, said she is working with the governor's office to determine how to ensure it stops licensing people who are ineligible.

The board has long required applicants to provide their Social Security numbers, but that won't necessarily alert the board that an applicant has deferred status, she said.

"We really don't have a way to know," Tedford said. "But we know we cannot license them."

The only way to know for certain, as of now, Tedford said, is if a candidate discloses the information.

Officials at five other state licensing boards said they were not familiar with the issue. They could not immediately say whether they license applicants who have deferred statuses or how they verify someone's legal status.

"We do not issue without a Social Security number," said Nancy Worthen, executive director of state boards over physical therapy and athletic training. "Otherwise, there's nothing else in place."

The Arkansas Department of Education does not grant teaching licenses to applicants with deferred statuses, a spokesman said.

Agencies within the state Health Department, which is reviewing its licensing process, issue licenses for about a dozen professions, including cosmetology, and heating and air conditioning system workers, Mirivel, the spokesman said.

Other licensing authorities will have to abide by the same rules as the nursing board, Hutchinson said. He has no intention of asking them to review previously issued licenses, he said.

Officials have told nursing students that three coastal states -- California, New York and Washington -- are licensing applicants who have deferred statuses, but Arkansans may find relief closer to home.

The Oklahoma State Board of Nursing grants licenses to candidates with deferred statuses, executive director Kim Glazier said Thursday. Glazier said applicants must apply in person, sign an affidavit and provide documents associated with their deferred statuses. The state uses a federal immigration-verification program to screen applicants.

"It will say 'DACA, employment authorization,'" Glazier said. "We know we are able to license that individual."

Rodriguez said she looked into a nursing license from Oklahoma, but she declined to fill out the application because it asked for legal status and did not include a space for deferred status.

"I made an assumption that I was not able to get it," she said.

CONTINUING, HOPING

Ruvalcaba Serna, the UAMS student, arrived in the U.S. the same year as Rodriguez. Both came from Mexico, but they've lived far different lives.

Ruvalcaba Serna, now 23, was 6 years old and learned English fairly quickly when she got here. While still in elementary school, she translated parent-teacher meetings for her mother.

"I would answer questions for my mom about myself," she said.

Ruvalcaba Serna, who has lived in central Arkansas since 2005, said she excelled in math and science, and developed a yearning to make "a difference in somebody's life, whether it is very small or saving someone's life."

So she decided to pursue nursing, also realizing that she can make Spanish-speaking patients more comfortable by conversing with them in their language.

Neither of her parents finished high school. Ruvalcaba Serna and her younger brothers, both U.S. citizens, have lived with her mother since their parents split up in 2004. She remembers that when she was 12, her mom worked three jobs and was rarely home. She grew frustrated at times but took care of her siblings.

"Then it became, I have to excel because of all the sacrifice that she's had to go through to be able to give myself and my brothers that opportunity to be something more than [my parents] were," she said.

Ruvalcaba Serna worked at a nonprofit mental health clinic to pay for prerequisite classes at the University of Arkansas-Pulaski Technical College. Her mom is helping pay her UAMS tuition.

Ruvalcaba Serna said she met with the director of the College of Nursing on Monday to discuss the Board of Nursing's change. She was given the opportunity to withdraw but never seriously considered it, particularly after speaking with her mom.

"She said if you're able to continue, then just keep going because we never know what's going to happen," Ruvalcaba Serna said.

Information for this article was contributed by Doug Thompson of the Northwest Arkansas Democrat-Gazette.

A Section on 10/15/2017

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