What is a Health Care Worker Certification?
A health care worker certification identifies and documents that a foreign health care worker has met minimum requirements for training, licensure, and English proficiency in order to be able to fulfill their professional role as a:
Who Must Obtain a Health Care Worker Certification?
Any non-U.S. citizen coming to the United States for employment as a health care worker (other than a physician) cannot be admitted unless he or she presents a certificate from either the Commission on Graduates of Foreign Nursing Schools (CGFNS) or a certificate of equal standing from an organization with equivalent credentials. These requirements apply to both immigrant and nonimmigrant applicants. Health care workers in occupations covered by the health care certification requirement are not exempt from the requirement even if they possess a U.S. state license or receive their health care education in the United States. Regarding visa classification, nonimmigrant health care workers will most likely be in H-1C, H-1B, J, O, or TN non-immigrant categories. Any non-immigrants coming to receive training in a health care occupation will not be required to obtain certification. Such health care workers will most likely be in F-1, J-1 (aliens coming to undertake a training program in a medical field) and H-3 nonimmigrant classifications. Please note that each of these visa classifications has additional requirements. Please go to our Nonimmigrant Visa or our Immigrant Visa Classification pages for more information on visa categories.
Are Nonimmigrants Subject to the Health Care Worker Certification Requirements?
Yes, as of July 26, 2004, if a nonimmigrant is seeking to be admitted to the United States, is changing status, and/or is requesting an extension of stay, he or she must provide evidence of health care worker certification if the primary purpose for coming to or remaining in the United States is employment in one of the above designated occupations. Previously, under section 212(d)(3) of the Act, the CIS and the Department of State waived Health Care Worker certification requirements for nonimmigrants, while requiring it for immigrants. After careful consideration of the statute and legislative history, it has been determined that nonimmigrants are also subject to the certification requirements.
Which Organizations Are Currently Authorized to Issue Health Care Worker Certificates?
The following organizations are authorized to issue certificates for the following health care occupations:
Which English Language Testing Organizations Are Approved for Purposes of Health Care Worker Certification?
Every alien must meet certain English language requirements in order to obtain a certificate unless otherwise exempted. The following testing services had been approved:
What are the Acceptable English Language Test Scores for Health Care Worker Certification?
The statute vests the Secretary of Health and Human Services with the sole discretion to determine the minimum scores required for a Health Care Worker Certification.
The complete requirements for health care worker certification can be found in the Immigration and Nationality Act (Act) at section 212 (a)(5)(C). The alternative requirements for nurses are at section 212 (r) of the Act. The specific eligibility requirements and procedures for applying for health care worker certification are included in the Code of Federal Regulations [CFR] at 8 CFR Sec. 212.15.
Questions and Answers about Exemptions for Certain Health Care Workers
Q: Are foreign health care workers - trained in the United States or in possession of a valid state license - subject to the health care certification requirement?
A: Yes. While Congress provided certain nurses with a less rigorous, alternative certification process, it did not provide a less rigorous alternative certification option to state-licensed foreign health care workers. Possession of a state license does not exempt a foreign health care worker from compliance with the certification requirement. Similarly, health care workers who have been trained in the United States are not exempt from the certification requirement.
Q: Are there any accommodations for foreign health care workers who have been trained in the United States?
A: Yes. Foreign health care workers may be automatically deemed to have met the English language and/or educational comparability requirements if they have graduated from certain programs or from programs in certain countries. The following groups may be deemed to have met the English language requirements:
The following groups may be deemed to have met the educational comparability requirements:
Q: Are dependents subject to the health care worker certification requirement?
A: No. For example, if you are here as an L-2 nonimmigrant, your primary purpose for entering the United States is to join your spouse. Since an L-2 nonimmigrant spouse is authorized employment, you may engage in employment as a health care worker without obtaining the certification. This will also apply to other dependents who are accompanying a principal alien and who are employment authorized within their dependent status.
Validity of a Health Care Certificate
The health care certificate must be used within five years of its issue date. Otherwise a new health care certificate must be obtained. The final rule provides that the certification must be used for any admission into the United States, change of status within the United States, or adjustment of status within five years of the date that it was issued. The health care certificate is valid for visa issuance and admission to the United States more than five years after its issue date only if it was used at least once for admission to the United States, change of status, or adjustment of status during the initial five-year period. Using it to apply for a visa is insufficient.