As most hospitals on the U.S.-Canada border know, the Department of Homeland Security issued regulations last summer requiring foreign born health care workers to present a visa screen certificate (also called a health care certificate) when seeking admission to the U.S. to work. Unless halted by Congress, this regulation takes effect July 26, 2004. Many Canadian health care workers (especially nurses) who commute to the U.S. to work are affected by this new rule. Although there has been some discussion of extending the effective date, the present position of U.S. Customs and Border Protection (CBP) is to require proof of the visa screen at each admission to the United States starting July 26, 2004.

Canadian health care workers who have U.S. permanent resident status are exempted from this requirement. Temporary visa holders in the TN and H categories must obtain the visa screen certificate in order to keep working after July 26, 2004.

The visa screen requirement applies to the following occupations:

Nurses (R.N.; L.P.N.)
Physical Therapists
Occupational Therapists
Speech Language Pathologists and Audiologists
Medical Technologists
Medical Technicians
Physician Assistants

All of the professions listed may apply to the International Commission of Healthcare Professions (ICHP), a division of Commission of Graduates of Foreign Nursing Schools (www.cgfns.org). Physical therapists can also request the visa screen certificate from the Foreign Credentialing Commission on Physical Therapy (www.fccpt.org); occupational therapists from the National Board for Certification in Occupational Therapy (www.nbcot.org).

The costs for the visa screen certificate ranges from $325 to $445 depending on the organization, and depending on the individual situation, there could be additional costs for additional examinations, documentation (e.g., transcripts, translation of documents) and licensure verification fees.

It could take at least six months or more for the issuance of the visa screen, so it is imperative that the individuals begin the process now. The process involves an evaluation of the individual’s education and licenses, English proficiency and proof of either state licensure (e.g., NCLEX for nurses) or a test given by the profession for licensing or certification. There are some alternate and streamlined procedures for registered nurses, but it is still uncertain how long these procedures will take.

Once the certificate is issued, it is valid for five years.

Many human resource departments are assisting their health care workers in obtaining the visa screen certificate, for instance, by holding informational meetings, direct mailing to the homes of Canadian employees, and assisting employees with preparing the application and handling the mailing and application fee costs.

If we can assist you in this process, either by providing additional information or developing information materials for your use, please let us know.

Helpful web sites:

Commission of Graduates of Foreign Nursing Schools (www.cgfns.org)
Foreign Credentialing Commission on Physical Therapy (www.fccpt.org)
National Board for Certification in Occupational Therapy, Inc. (www.nbcot.org)
U.S. Citizenship and Immigration Service instructions on applications for visa screen certificate (health care certificates) (http://uscis.gov/graphics/howdoi/health_cert.htm)
Miller Mayer , LLP: useful general information on temporary and permanent visa categories (www.millermayer.com)