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FLORIDA
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US IMMIGRATION UPDATES
IMMIGRATION Q AND A / MAR 2002 |
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Immigrant Processing of Foreign Nurses |
By Vanessa S. Barcelona
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It has been quite some time now since we had discussed the
immigration of foreign nurses in the United States. The critical
need for them continues. This article will attempt to provide
much needed information to assist the foreign nurse in having a
clear strategy of how to successfully navigate through the
process. |
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Foreign nurses, whether educated in the U.S. or abroad, qualify
for immigrant visas without the necessity of having a labor
certification application approved by the Department of Labor. A
labor certification application is filed with the U.S. DOL for
most employment-based petitions leading to a green card for a
foreign worker. In the case of a Registered Nurse, however, the
U.S. employment Service has already made a determination that
there are not sufficient American workers who are interested and
qualified to fill the available need for professional nursing
care. Thus, for a Registered Nurse, we can go straight to the
Immigrant Visa petition.
There are essentially 2 steps to bringing a Registered Nurse
into the U.S.:
(1) the immigrant visa petition (filed with the U.S. INS
regional office with jurisdiction over the Petitioner's
location) and
(2) consular processing, which culminates in the interview at
the U.S. Consulate abroad (if the nurse is outside the U.S.) or
adjustment of status, filed with the INS, if the nurse is in the
United States.
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Immigrant Visa
Petition:
A. Forms to be filed
This petition is filed on form I-140. In addition to the I-140,
the following forms are filed with the regional office of the
INS serving the jurisdiction of the Petitioner (the 4 regional
INS offices are: Texas, Nebraska, Vermont, and California): ETA
750 A&B. These are the forms that would have been filed with the
Department of Labor had a labor certification application been
necessary. It is only necessary, for the registered nurse
petition, to fill these forms out and submit them with the I-140.
Among other documents proving professional credentials, the
nurse will submit a copy of his or her CGFNS certificate or copy
of RN license to practice in the State of intended employment
(i.e. proof that the nurse has taken and passed the NCLEX-RN
examination). If submitting the CGFNS certificate, it is
important to remember that it is not sufficient that the nurse
provide a copy of the CGFNS letter confirming passing scores on
the CGFNS qualifying examination. While in the past,
successfully passing this examination was sufficient to obtain
the old CGFNS certificate, today the certificate cannot be
issued until the nurse has successfully passed the CGFNS and the
TOEFL exams. Note, however, that INS will accept both the old
and new CGFNS certificates.
B. Important Considerations:
The registered nurse is required to obtain a license to practice
as a registered nurse in the State where that nurse will be
placed. Passing the NCLEX-RN is a requirement for state
licensure. Note, however, that a state license is NOT REQUIRED
as a pre-requisite for entry as an immigrant. As you will note
from our discussion above, a CGFNS certificate can be submitted
in lieu of the NCLEX. A nurse can enter the United States, and
so long as steps were taken to apply for registration in
advance, that nurse can take the NCLEX within 30 days of entry
into the United States. It is important for the foreign nurse to
take the necessary steps to register for state licensure well
before entry into the United States. Some state licensing
offices are so backlogged at this time, given the high volume of
applications, that the procedure may take months and months. If
the nurse waits to take care of the registration process when
they enter the United States, then this will cause undue delays
in obtaining a license and commencing employment full time as a
licensed registered nurse.
Practically speaking, from the standpoint of the employer at
least, it is best to have the nurse enter the U.S. after they
have already taken and passed the NCLEX. A Philippine nurse
immigrating from the Philippines will have the opportunity to
take the NCLEX in either Saipan or Guam. Note, however, that
travel to Guam requires a U.S. visa while travel to Saipan does
not. The U.S. Embassy in the Philippines will issue a visa for
travel to Guam with proof of the nurse's Authority to Test,
obtained after successful registration for the NCLEX exam.
There have been sufficient cases of nurses arriving in the
United States and having difficulty passing the NCLEX the first
time. Much of this may have to do with the added pressures of
being in a foreign country and starting full-time employment in
a new environment while that nurse is studying for and taking
such an important examination. The cases have been sufficiently
numerous to be "problematic". Petitioning hospitals must keep
this in mind when deciding whether or not to require the nurse
to take the NCLEX prior to travel to the U.S. If the nurse is
not in possession of evidence of having taken and passed the
NCLEX, the contract of employment submitted at the U.S. Embassy
at the time of the interview will need to address this issue.
The Embassy Consuls in the Philippines will require that the
contract provide for employment (in a non-professional capacity
paying at least the minimum wage) until such time as the nurse
can begin full time professional work as a Registered Nurse. It
must be understood by the Petitioning hospital that
non-requirement on their part of the NCLEX prior to U.S. arrival
will entail an agreement to provide the nurse with full-time
employment prior to obtaining the RN license. On the same token,
nurses being petitioned must also clarify this matter early on,
so that the nurse can determine whether or not budgeting will
require allocating funds towards the NCLEX, an NCLEX review
course, and of course, travel to a location where the NCLEX will
be offered.
C. Processing Time
Processing time varies, depending on the INS service center
handling the case. It can run from 2-8 months. INS will issue a
Receipt Notice upon receipt of the petition. So long as the
documents submitted are complete and the forms filled out
correctly, what usually follows after the Receipt Notice is
issued is the Approval Notice. Once issued, the INS is done with
the file. If the nurse is outside the country, then INS will
forward the file to the National Visa Center (an office of the
U.S. State Department) for further processing. If on notice that
the nurse is in the U.S., INS will keep the file, in
anticipation of the nurse's application for adjustment of
status.
Consular Processing
Packet 3 documents are signed by the nurse and returned for
submission (either directly to the Embassy or to the NVC.
Consular processing steps will differ depending on which country
the nurse is located and/or will be processed. There are 10
posts designated as Alpha posts (essentially high volume posts)
where in an effort to ensure that all documents have been
correctly filed prior to issuance of the interview, the State
Department will require that documents be submitted to the NVC
for review before they are sent by the NVC to the Embassy for
interview. The Philippines is one of these posts.
There is a fee of $260 for the nurse and for each accompanying
family member if that nurse will be processed in an Alpha post
(i.e., NVC review is required). This fee is sent to the NVC
together with the Packet 3 documents once they have been signed
by the nurse. When processed in a non-Alpha post, there is no
requirement of the $260 fee. Also, packet 3 documents are sent
directly to the U.S. Embassy processing the case. NVC
involvement usually adds approximately 2-4 months to the
processing time prior to interview. So long as all documents are
complete, if requiring an interview in the Philippines, expect
an interview within 4-6 months of filing the Packet 3 with the
NVC. So long as all documents are complete, expect an interview
as early as 2 weeks following submission of documents to a
non-Alpha post. This will of course depend on the volume of
cases handled by the post at the time.
Once an interview date has been sent, the nurse will receive,
directly from the Embassy, the Packet 4 documents. This packet
will contain the appointment for the medical examination which
must be taken (and whose results must be obtained) prior to the
embassy interview. The form to be submitted to the Embassy on
that day will consist of the DS-230 Part II, also essentially
biographic in nature.
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Adjustment of
Status Processing
If in the United States, the registered nurse, upon approval of the
immigrant visa petition, will file the adjustment of status application.
All accompanying family members (spouse and unmarried minor children) in
the United States will be filing separate applications as well. The
applications for employment authorization (or work permit) can be filed at
this time. The work permit will be issued within 90 days of filing, thus
enabling the nurse to work for the Petitioning hospital while the
adjustment of status application is pending. The application will take
approximately one (1) year. The Visa Screen Certificate, while not
necessary to file the application, is a requirement for approval.
The Visa Screen Certificate is a requirement for a nurse wishing to
immigrate to the United States. VSC issuance requirements depend on the
country where the nurse was educated. Aside from submitting transcripts,
diplomas, professional documents at the time of registration (essential
for the equivalency evaluation to be performed by ICHP, a division of
CGFNS and the organization which will issue the VSC), the nurse will be
required to take and pass the following exams:
1. For English language proficiency:
MELAB (Michigan English Language Assessment Battery) or the TOEFL/TSE/TWE
" Proof of English proficiency is not required for VSC issuance if the
nurse was educated in the UK, Ireland, Canada (except Quebec), Australia,
New Zealand and the U.S.
2. Nursing proficiency
CGFNS or NCLEX
Contact
information for registration and inquiries regarding processing times,
exam dates, etc. can be made with the following:
For the TOEFL/TSE/TWE:
TOEFL/ETS Services
P.O. Box 6151
Princeton, NJ 08541-6151
609-771-7100 tel.
609-771-7500 fax
e-mail: toefl@ets.org
For the MELAB:
English Language Institute
Testing and Certification Division
3020 N. University Building
University of Michigan
Ann Arbor, MI 48109
734-764-2416 or
734-763-3452 tel.
734-763-0369 fax
e-mail: melabelium@umich.edu
For the Visa Screen Certificate:
International Commission on Healthcare Professions (ICHP)
3600 Market St., Suite 400
Philadelphia, PA 19104
215-349-6721 tel.
215-349-0026 fax
e-mail: admini@ichp.org
It is important for the nurse to work on their VSC requirements while
waiting for the I-140 to be adjudicated and prior to the Embassy interview
until such time as the VSC is issued. If adjusting in the United States,
the VSC will have to be submitted before the adjustment of status
application is approved, usually following a Request for Evidence, if the
document was not submitted with the original application for adjustment.
Important Websites:
www.toefl.org
(for info on TOEFL/TSE/TWE)
www.ncsbn.org
(for info on the NCLEX)
www.lsa.umich.edu
(for MELAB)
www.cgfns.org
(for the Visa Screen Certificate)
To each and every nurse seeking to immigrate to the United States, this is
my message:
Nursing continues to be a viable employment-based option. While the
examinations seem daunting at first glance, there are more than enough
"success stories" to provide encouragement. Hospitals and nursing homes in
the United States are offering to pay for most, if not all, of the
expenses involved in the recruitment process, along with other benefits
not available to other professions. You are in a very good position right
now, unlike many professions where industry indicators are not so positive
at this time.
Choose a hospital in the intended place of relocation,
offering the best possible benefits obtainable. Weigh carefully the offers
presented to you, and the financial obligations, if any, incurred in
accepting an offer.
Do your research! Take the time to inquire into the
reputation of any hospital representative seeking to recruit, whether a
direct employee of the hospital or a contract representative. Many
hospitals have websites now.
Look for their website and look at their
recruitment needs, policies, and offers. This is not only your next
employer, but a starting point from which your career, your future and
your family's future will be determined.
As you will see, there is enough
of a need at this time so you can reasonably immigrate to the U.S. without
incurring any financial costs at all, except maybe the additional costs of
bringing in family members with you.
On the same token, it is hoped that
you will, upon making a commitment to a petitioning hospital or nursing
home, make good on that commitment. Remember that when you agree to work
for a petitioner upon entry into the U.S., or until issuance of your work
permit, there is the reliance on the part of the petitioner that their
nursing needs will be met in part by your employment as soon as you are
able to do so.
Look at all your options, take the time to decide, and when
you have, accept an offer in good faith. It reflects on you, your
profession, and your country. Remember that not all hospitals at this
time, despite the critical need for nurses, are choosing to meet their
needs by recruiting from foreign countries. Some have chosen instead to
offer scholarship programs to local nursing schools. Those who choose to
recruit have done so in large part because of the good experiences they
have had with the Filipino nurses already in their employ.
Do not forget
this. And in the coming months, as you study for your examinations and may
from time to time experience some setbacks, just remember that this is all
a part of what life is about in America. Success does not come overnight,
but it comes. You will work hard. And you, and your children, will benefit
from your hard work.
Vanessa S. Barcelona is a licensed attorney, practicing
primarily in the area of U.S. immigration law. She is a graduate of the
University of Florida, where she obtained both her law and undergraduate
degrees. For questions or comments about this article, please write to her
at vsbarcelona@law.com.
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