EDUCATIONAL COMPARABILITY AND ENGLISH LANGUAGE REQUIREMENTS FOR ALIEN HEALTH CARE WORKERS

EDUCATIONAL COMPARABILITY AND ENGLISH LANGUAGE REQUIREMENTS FOR ALIEN HEALTH CARE WORKERS

By: Roman P. Mosqueda, Esq.

An alien who seeks admission to the United States for the primary purpose of performing labor as a health care worker, other than a physician, is inadmissible, unless he or she presents a certificate from the Commission on Graduates of Foreign Nursing Schools (CGFNS) or an equivalent credentialing organization.

A health care worker certification issued by CGFNS or an organization with equivalent credentials, identifies and documents that a foreign health care worker has met the minimum requirements for training, licensure and English proficiency in order to be able to fulfill his or her professional role.

The seven (7) health care occupations requiring such certification under Section 212(a)(5)(C) of the Immigration and Nationality Act are:

1. Licensed Practical Nurses, Licensed Vocational Nurses, and Registered Nurses;

2. Occupational Therapists;

3. Physical Therapists;

4. Speech Language Pathologists and Audiologists;

5. Medical Technologists (Clinical Laboratory Scientists);

6. Physician Assistants; and

7. Medical Technicians (Clinical Laboratory Technicians). See 8 CFR 212.15(c).

Aliens Covered By Certification Requirement:

As of July 26, 2004 (one year after the date of publication [July 25, 2003] of the final rule requiring aforestated certification), nonimmigrants seeking to be admitted to the United States, or are changing status, or requesting an extension of stay, must provide health care worker certification, if the primary purpose is employment in the aforestated seven health care occupations.

Aforestated final rule, based on Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), became effective on September 23, 2003. But the Department of Homeland Security and the State Department waived the health care worker certification for nonimmigrants from September 23, 2003 to July 25, 2004.

Certain aliens are not covered by the certification requirements. They are:

1. foreign-educated physicians;

2. non-clinical health care workers, such as:

a. medical teachers,

b. medical researchers, and

c. managers of health care facilities.

3. H-3 trainees, and F or J nonimmigrants receiving training;

4. spouses and dependent children of immigrant or nonimmigrant health care workers;

5. health care workers seeking admission as the spouse or child of a principal alien; and

6. aliens in an uncovered profession. See 8 CFR 212.15(b).

Coverage And Validity Of Health Care Worker Certification:

The aforestated final rule covers all temporary (nonimmigrant) and permanent employment based (immigrant) visas, as well as, Trade NAFTA (TN) health care workers from Mexico and Canada.

CGFNS, through its division, International Commission on Healthcare Professions (ICHP), is authorized to certify all the above-stated health care workers: 3600 Market Street, Suite 400, Philadelphia, PA 19104-2651, Tel: (215) 349-8767, Fax: (215) 662-0425, Website: www.cgfns.org.

The required certification issued by CGFNS/ICHP, called ICHP VisaScreen Certificate, verifies that:

1. the alien’s education, training, license, and experience are comparable with that required for an American health care worker of the same type;

2. the alien’s education, training, license, and experience are authentic and, in the case of a license, unencumbered;

3. the alien’s education, training, license, and experience meet all applicable statutory and regulatory requirements for admission into the United States;

4. either the alien has passed a test predicting success on the occupation’s licensing or certification examination (such as the CGFNS Qualifying Examination for registered nurses given also in Manila, Cebu City and Cagayan de Oro City), or the alien has passed the occupation’s licensing or certification examination (NCLEX-RN for registered nurses given also in Guam and Saipan, by the National Council of State Boards of Nursing, III East Wacker Drive, Suite 2900, Chicago, IL 60601, Tel: (312) 525-3600, Fax: (312) 279-1032, Website: http://www.ncsbn.org/.); and

5. the alien has met certain English language requirements. See 8 CFR 212.15(f).

The health care worker certification is valid for five (5) years and must be renewed before the end of that time. It is presented to the consular officer at the time of visa issuance, or to the Department of Homeland Security at the time of admission, change of status, or request for extension of stay. See 8 CFR 212.15(n) (4) and 8 CFR 214.1(i) and (j).

Organizations Authorized To Issue Certification:

Three organizations have been authorized to issue certificates for the following health care occupations:

1. CGFNS for all seven health care occupations;

2. The National Board for Certification in Occupational Therapy for occupational therapists; and

3. The Foreign Credentialing Commission on Physical Therapy for physical therapists.

And three testing services have also been approved to conduct English language proficiency examination, to wit:

1. Educational Testing Service (ETS) for Test of English as a Foreign Language (TOEFL), Test of Written English (TWE), and Test of Spoken English (TSE): PO Box 6151, Princeton, NJ 08541-6151, Tel: (609)771-7100, Website: www.ets.org;

2. Test of English in International Communication (TOEIC): Rosedale Road, MS 10-P, Princeton, NJ 08541, Tel: (609) 734-1540, Fax: (609) 734-1560, Website: www.toeic.com; and

3. International English Language Testing System (IELTS): 100 East Corson Street, Suite 200, Pasadena, CA 91103, Tel: (626) 564-2954, Website: www.ielts.org. See 8 CFR 212.15(g)(3).

Registered nurses and other health care workers requiring the attainment of a baccalaureate degree must obtain one of the following combinations of English language test scores to obtain a certificate:

1. ETS: TOEFL: Paper-Based 560, Computer-Based 220; TWE: 4.5, TSE:50; or

2. TOEIC: 725, plus TWE: 4.0 and TSE: 50; or

3. IELTS: 6.5 overall with a spoken band score of 7.0, requiring the Academic module. See 8 CFR 212.15(g)(4)(ii).

Exemptions From Health Care Certification:

Alien health care workers trained in the United States or in possession of valid state licenses are still subject to the health care certification requirements.

Section 212(r) of the Act, however, provides an alternate certification process for nurses. CGFNS is authorized to issue a Section 212(r) “certified statement” to a foreign-educated nurse who:

1. has a valid and unrestricted license as a nurse in a state where the alien intends to be employed, and such state verifies that the foreign licenses of alien nurses are authentic and unencumbered;

2. has passed the National Council Licensure Examination for Registered Nurses (NCLEX-RN);

3. is a graduate of a nursing program in which the language of instruction was English;

4. the nursing program was located in Australia, Canada (except Quebec), Ireland, New Zealand, South Africa, the United Kingdom, or the United States, or in any other country designated by unanimous agreement of CGFNS and any equivalent credentialing organizations approved for certification of nurses; and

5. the nursing program was in operation on or before November 12, 1999, or has been approved by unanimous agreement of CGFNS and any equivalent credentialing organizations approved for certification of nurses. See 8 CFR 212.15(h)(2).

Foreign-educated registered nurses who qualify for such Section 212(r) certified statement are exempt from the English language proficiency examination requirement.

Alien health care workers are also exempt from the English language requirements, if they have graduated from a college, university, or professional training school located in Australia, Canada (except Quebec), Ireland, New Zealand, the United Kingdom, or the United States. See CFR 212.15(g)(2).