Senators asked to sign letter to Ridge
CGFNS doesn’t object to foreign nurse rule deadline
extension
Federal authorities disagree on Canadian nurse issue
Progress made on Canadian nurse issue
Snowe writes Ridge about Canadian nurses
Delegation works hard to allow Canadian nurses
MHA writes delegation regarding Canadian workers
Homeland Security requires new certification for overseas
health professionals
The Maine Board of Nursing has set up a web page dedicated to assisting
Canadian nurses who need to take the NCLEX exam at http://www.state.me.us/boardofnursing/NCLEX%20immigration_files/NCLEX%20Information%20for%20Immigration.htm.
Senators asked to sign letter to Ridge
MHA Friday Report, March 12, 2004
MHA asked Maine’s senators to sign a letter to Homeland Security
Secretary Tom Ridge asking for an 18-month delay in the final implementation
of visa screen.
A new Department of Homeland Security rule requires that foreign nurses
commuting to work in the United State be certified by Commission on
Graduates of Foreign Nursing Schools (CGFNS) or an equivalent credentialing
organization by July 25. Because Maine accepts Canadian nursing boards
as a licensing exam, the provision requiring the Canadian nurses to
take an American licensing exam causes an undue burden on the Canadian
nurses already licensed by the state to work in Maine hospitals.
The letter, circulated by Georgia Republican Sen. Saxby Chambliss,
chairman of the Immigration Subcommittee of the Senate Judiciary Committee,
and addressed to Ridge, urges him to delay implementation of the rule
until January 1, 2006. Sen. Olympia Snowe (R) has agreed to sign the
letter. Sen. Susan Collins was pleased to see that the issue is gaining
momentum among her colleagues and was giving positive consideration
to adding her signature as requested.
Collins, Snowe and Rep. Michael Michaud (D) already have been working
hard with Federal agencies to ask for a delay in implementing the rule
and a policy to “grandfather” nurses already working in the
United States.
MHA Contact: Sandra Parker
CGFNS doesn’t object to foreign nurse rule deadline
extension
MHA Friday Report, March 5, 2004
The Commission on Graduates of Foreign Nursing Schools(CGFNS) has
written Homeland Security Secretary Tom Ridge telling him that the credentialing
organization does not object to a request to allow foreign nurses working
in the United States another year to be certified by CGFNS.
However, the commission objected to a request to “grandfather”
nurses already licensed and working in the United States.
The new Department of Homeland Security rule requires that foreign
nurses commuting to work in the United State be certified by CGFNS or
an equivalent credentialing organization by July 25. Because Maine accepts
Canadian nursing boards as a licensing exam, the provision requiring
the Canadian nurses to take an American licensing exam causes an undue
burden on the Canadian nurses already licensed by the state to work
in Maine hospitals.
MHA and the American Hospital Association (AHA) have been pushing to
have the deadline extended and to exempt nurses already working in the
US from having to take the exam.
Sen. Susan Collins (R) recently wrote to the director of the
U.S. Citizenship and Immigration Services (CIS) requesting that nurses
with 10, 20 and 25 years of experience in a single discipline be exempt
from the examination, which tests general nursing knowledge. Her letter
pointed out that under CIS’s interpretation of the rules there
was a one year extension for nurses who worked in the U.S. and didn’t
leave the country, but that nurses who commuted from their homes in
Canada don’t get to take advantage of the waiver.
Under the Bureau of Customs and Border Protection (CBP) interpretation,
Canadian nurses who secure nursing licensure from the Maine State Board
of Nursing and present themselves at a CBP boarder entry point with
a letter of employment from a United States hospital may qualify for
a multiple entry visa, which is valid for one year. Under this visa,
the nurse may leave the U.S. for up to 30 days and still be allowed
admission into the United States for the purpose of working as a nurse.
Collins asked CIS to use the CBP’s interpretation of the rule.
In a related matter, Maine Bureau of Nursing Executive Director Myra
Broadway is clarifying statements made by national organizations
that half the nurses in Maine would be affected by this rule. In fact,
up to about 40 percent of the nurses working in the five hospitals nearest
to the Canadian border, along with other Canadian nurses working in
Maine, would be affected.
MHA Contact: Sandra Parker
Federal authorities disagree on Canadian nurse issue
MHA Friday Report, Feb. 20, 2004
Federal authorities have conflicting opinions on whether Canadian
nurses working in Maine must be recertified by July 2004.
At issue are new Homeland Security regulations that require non-immigrant
foreign health professionals who work in the U.S. to present a certificate
from the Commission on Graduate of Foreign Nursing Schools (CGFNS) or
an equivalent credentialing organization. Because Maine accepts Canadian
nursing boards as a licensing exam, the provision requiring the Canadian
nurses to take an American licensing exam causes an undue burden on
up to approximately half the nurses working in five Northern Maine hospitals.
The U.S. Citizenship and Immigration Services wrote last week saying
that nurses who commute from Canada will have to obtain certification
by July 25. However, the United States Customs and Border Protection
apparently has a different interpretation, one that would give Canadian
nurses another year to obtain certification. Sen. Susan Collins' (R)
office is working to resolve the conflicting interpretations.
Meanwhile, MHA has shared the impact of the new rule on Maine hospitals
with other state associations and the American Hospital Association
(AHA). AHA is being responsive to state concerns and is also working
to obtain relief. AHA wrote a letter to Secretary Tom Ridge, U.S. Department
of Homeland Security, urging that the rule's effective date be delayed
by at least one year, that the Secretary exempt those health care professionals
who already hold a valid license to practice in a U.S. state, and to
also exempt alien health care workers who received their training in
the U.S.
AHA and the American Society for Healthcare Human Resources Administration
also created an online survey assessing the impact of the Department
of Homeland Security (DHS) regulation. MHA urges hospitals to complete
the survey by Feb. 27 by going to http://www.surveymonkey.com/s.asp?u=11028357843.
For more information, and tools to help in completing the survey, visit
http://www.hospitalconnect.com/ashhra/advocacy/hrarticles.html
and click on "ASHHRA Legislative Alerts."
MHA Contact: Sandra Parker
Progress made on Canadian nurse issue
MHA Friday Report, Feb. 6, 2004
The state Board of Nursing has posted on its website information about
the nurses exam that will allow nurses from Canada to keep working in
Maine.
Meanwhile, Maine’s Congressional delegation is continuing to advocate
for an extension of the exam requirements and a policy that would grandfather
Canadian nurses currently working and licensed in Maine.
At issue are new Homeland Security regulations that require non-immigrant
foreign health professionals who work in the US to present a certificate
from the Commission on Graduate of Foreign Nursing Schools (CGFNS) or
an equivalent credentialing organization. Because Maine grants state
credentials to licensed Canadian nurses, this provision causes an undue
burden on up to approximately half the nurses working in five Northern
Maine hospitals.
Sen. Susan Collins (R), as Sen. Olympia Snowe (R) has
already done, will soon write Homeland Security chief Tom Ridge
asking that he postpone the effective date of this rule to July 2005,
and that health care professionals with current Maine licenses be allowed
to continue practicing and apply the regulations only to future applicants.
Collins initially worked with the regional US Citizenship and Immigration
Services offices, but those offices would only grant a one year extension
to nurses who didn’t leave the United States for that year, effectively
shutting out the scores of nurses who commute from Canada every day,
or even residents that visited their families in Canada at any time
during the extension period.
Rep. Michael Micaud’s (D) office is still pressing Ridge’s
office to reply to MHA’s letter on this matter.
The Maine Board of Nursing has set up a web page dedicated to assisting
Canadian nurses who need to take the NCLEX exam at http://www.state.me.us/boardofnursing/NCLEX%20immigration_files/NCLEX%20Information%20for%20Immigration.htm.
The Board of Nursing is responsible for forwarding an applicant’s
scores and proof of licensure to the CGFNS at the applicant’s request.
To avoid confusion, the board asks that applicant make those requests
together, after the nurse has taken the NCLEX exam, rather than having
the items forwarded seperately.
MHA Contact: Sandra Parker
Snowe writes Ridge about Canadian nurses
MHA Friday Report, Jan. 23, 2004
Sen. Olympia Snowe has written Homeland Security Chairman Tom Ridge,
urging him to delay regulation that requires Canadian health professionals
working in the United States to comply with new certification requirements,
and “grandfather” currently licensed nurses.
The new regulations require that non-immigrant foreign health professionals
who work in the US will be required to present a certificate from the
Commission on Graduate of Foreign Nursing Schools or an equivalent credentialing
organization. Because Maine grants state credentials to licensed Canadian
nurses, this provision causes an undue burden on up to approximately
half the nurses working in five northern Maine hospitals.
Snowe asked that Ridge postpone the effective date of this rule to
July 26, 2005. In addition, she asked that health care professionals
with current Maine licenses be allowed to continue practicing and apply
the regulations only to future applicants, effectively grandfathering
current staff.
MHA Contact: Sandra Parker
Delegation works hard to allow Canadian nurses
MHA Friday Report, Jan. 16, 2004
At MHA’s urging, Maine’s Congressional delegation is pushing
for, at a minimum, a one year delay in implementing Federal rules that
require nurses commuting from Canada to work in Maine to obtain a statement
of certification from the Commission on Graduates of Foreign Nursing
Schools.
Canadian nurses working in Maine have Maine licenses because the state
accepts their Canadian qualifications. The new Bureau of Citizenship
and Immigration Services rules would require that even nurses with valid
state licenses take either the Commission on Graduates of Foreign Nursing
Schools (CGFNS) certificate exam or the National Council Licensure Examination
(NCLEX).
Sen. Olympia Snowe’s staff is working on the issue from the Washington
perspective. Sen. Susan Collins' office is working on it from the perspective
of the regional U.S. Citizenship and Immigration Services offices. Rep.
Michael Michaud's staff is working on getting a federal response to
MHA’s letter pointing out the problem and requesting relief.
At first the Maine Board of Nursing said that because the Canadian
nurses were already licensed in Maine, they couldn’t take the NCLEX
because it is a licensing exam, creating an almost impossible burden
because the CGFNS exam is offered only twice—once in New York and
once in Toronto—before the new rules take effect.
After complaints from MHA, affected hospitals, and inquiries from the
Congressional delegation prompted by a letter from MHA, the board of
nursing reversed itself. Canadian nurses will be allowed to take the
NCLEX even if they are already licensed in Maine. The test is offered
daily in Portland and Bangor.
Myra Broadway, executive director of the Board of Nursing, sent a letter
to nurses describing the NCLEX examination process and related fees,
providing websites that offer on line applications and review course.
Applicants who do not pass the exam the first time may reapply for the
examination after 45 days.
Hospitals that would like a copy of the board of nursing letter to
applicants can call Broadway at the board of nursing at 287-1133 ext.
3.
MHA Contact: Sandra Parker
MHA writes delegation regarding Canadian workers
MHA Friday Report, Dec. 12, 2003
MHA is writing to Maine’s Congressional delegation asking them
to provide relief from the requirements in a new Department of Homeland
Security Rule.
The rule requires certain non-immigrant health care workers working
in the United States to obtain a Visa Screen Certificate or a statement
of certification from the Commission on Graduates of Foreign Nursing
Schools.
Maine’s five border hospitals employ many Canadian health care
workers affected by the new rule, including physical therapists, occupational
therapists, medical technologists and, most notably, 20-50 percent of
their nursing staff.
“The nursing issue is the most acute because the federal rule,
when considered with existing Maine law and with the limited infrastructure
in place to enable Canadian health care workers to meet the new requirements,
could force those hospitals to close beds as a result of decreased staffing
as of the rule’s July 26, 2003 compliance deadline,” MHA’s
letter stated.
The letter outlines the major concerns:
- The Canadian nurses working in Maine currently hold a valid state
license. To require these nurses to have their original education
re-validated and to take another general licensing exam is redundant
and totally unnecessary.
- The federal rule offers two possible exams for the Canadian nurses
commuting to work in Maine hospitals. The first possibility is to
take the National Council Licensure Examination. (NCLEX) The Maine
State Board of Nursing’s initial position was that currently
licensed nurses, Canadian or American, cannot take the NCLEX because
it is a licensure exam. The Board has said that Canadian nurses must
apply for licensure in another state in order to take the NCLEX. The
Board now states that they are working to make the necessary changes
that would allow Canadian nurses with Maine licenses to apply to take
the NCLEX without seeking licensure in another state. However, the
time delay awaiting those changes (or time taken to apply for licensure
in another state) usurps precious time that prolongs the certification
process, which must be completed by July 26, 2003.
- The second testing possibility is to take the Commission on Graduates
of Foreign Nursing Schools’ Qualifying Exam. This exam is offered
once between the effective date of the new rule and the July 26, 2003
certification deadline, with the application deadline of December
10, 2003. The closest examination sites are New York City and Toronto.
Even if all of the Canadian nurses working in Maine were willing and
able to drive to those cities and find accommodations to take the
day-long exam, the five most northern hospitals would have to close
approximately half of their facilities for the days that all of their
Canadian nurses were traveling to take the exam.
- The total fees associated with the various required applications,
credential submissions, testing and travel costs are collectively
substantial.
MHA asked the delegation for the following:
- A Congressional amendment of the underlying statute to exempt non-immigrant
alien workers. MHA believes that the new federal rule is in conflict
with NAFTA, as it erects new barriers to cross-border services, given
that the Canadian nurses have already met Maine state licensing standards.
- Asking the Department of Homeland Security to recognize and honor
the current state licensing practices in Maine.
- Alternatively, permit Canadian nurses with current Maine licenses
to continue practicing in Maine, and apply the new requirements to
future applicants.
- If additional testing of the Canadian nurses with Maine licensure
is required, MHA asked that the Department of Homeland Security recognize
nationally accepted specialty examinations, in lieu of the NCLEX or
the Commission on Graduates of Foreign Nursing Schools’ Qualifying
Exam.
- At a minimum, MHA has asked that Maine nurses be allowed additional
time to become compliant with the new federal standards.
MHA will continue conversations with the delegation to change this
rule.
MHA Contact: Sandra Parker
Homeland Security requires new certification for overseas health professionals
MHA Friday Report, Aug. 8, 2003
The Department of Homeland Security (DHS) has issued a final rule
requiring nurses and certain other health care workers from overseas
to obtain a certificate from an approved credentialing organization
verifying their education, training, licensure and experience before
they can enter the U.S.
The long anticipated rule, published in the July 25 Federal Register
and effective Sept. 23, pertains to foreign-born nurses, physical therapists,
occupational therapists, speech-language pathologists, medical technologists,
medical technicians and physician assistants, whether they trained in
the U.S. or overseas.
Immigration attorneys expect the requirement to increase the time it
takes to hire and employ such workers, for example delaying the process
by three to six months for foreign-born nurses. Nurses who already have
a temporary visa to work in the U.S. and are seeking admission, readmission,
or an extension or adjustment of their stay will not be subject to the
requirement if their applications are approved by July 26, 2004. After
that, a waiver of the requirement may be granted on a case-by-case basis.
MHA Contact: Sandra Parker
