[Federal Register Volume 67, Number 198 (Friday, October 11, 2002)]
[Proposed Rules]
[Pages 63313-63327]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 02-25974]
========================================================================
Proposed Rules
Federal Register
________________________________________________________________________
This section of the FEDERAL REGISTER contains notices to the public of
the proposed issuance of rules and regulations. The purpose of these
notices is to give interested persons an opportunity to participate in
the rule making prior to the adoption of the final rules.
========================================================================
Federal Register / Vol. 67, No. 198 / Friday, October 11, 2002 /
Proposed Rules
[[Page 63313]]
DEPARTMENT OF JUSTICE
Immigration and Naturalization Service
8 CFR Parts 103, 212, 214, 245, 248 and 299
[INS 2080-00]
RIN 1115-AE73
Certificates for Certain Health Care Workers
AGENCY: Immigration and Naturalization Service, Justice.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: This rule specifies the organizations already authorized to
issue health care workers certificates, and sets up procedures for
authorizing additional organizations, including an appeals process in
the event that requests for authorization are denied. In addition, this
rule proposes to add the requirement that all nonimmigrants coming to
the United States for the primary purpose of labor as health care
workers, including those seeking a change of status, be required to
submit a health care worker certification. Previously, the Service had
implemented health care worker certification requirements through three
interim regulations. This proposed rule expands on those three interim
rules and allows for a comment period. Finally, the Immigration and
Naturalization Service (Service) proposes amendments to a previously
created form that will allow organizations to formally seek
authorization to issue certificates to health care workers in a uniform
manner. Publication of this proposed rule will ensure more uniformity
in the adjudication of petitions and admissibility determinations for
aliens seeking to enter the United States to engage in labor as health
care workers.
DATES: Written comments must be submitted on or before December 10,
2002.
ADDRESSES: Please submit written comments to the Director, Regulations
and Forms Services Division, Immigration and Naturalization Service,
425 I Street, NW., Room 4034, Washington, DC 20536. To ensure proper
handling, please reference INS No. 2080-00 on your correspondence.
Comments may also be submitted electronically to the Service at
insregs@usdoj.gov. When submitting comments electronically, please
include INS No. 2080-00 in the subject box. Comments are available for
public inspection at the above address by calling (202) 514-3048 to
arrange for an appointment.
FOR FURTHER INFORMATION CONTACT: Mari F. Johnson, Adjudications
Officer, Office of Adjudications, Immigration and Naturalization
Service, 425 I Street, NW., Room 3214, Washington, DC 20536, telephone
(202) 353-8177.
SUPPLEMENTARY INFORMATION:
What Are the Provisions of Sections 212(a)(5)(C) and (r) of the
Immigration and Nationality Act (Act)?
Section 343 of the Illegal Immigration Reform and Immigrant
Responsibility Act (IIRIRA), Public Law 104-208, 110 Stat. 3009, 636-37
(1996), created a new ground of inadmissibility now codified at section
212(a)(5)(C) of the Act, 8 U.S.C. 1182(a)(5)(C). It provides that,
subject to section 212(r) of the Act, an alien who seeks to enter the
United States for the purpose of performing labor as a health care
worker, other than a physician, is inadmissible unless the alien
presents a certificate from the Commission on Graduates of Foreign
Nursing Schools (CGFNS) or an equivalent independent credentialing
organization approved by the Attorney General in consultation with the
Secretary of the Department of Health and Human Services (HHS)
verifying that:
(1) The alien's education, training, license, and experience meet
all applicable statutory and regulatory requirements for admission into
the United States under the classification specified in the
application; are comparable with that required for an American health
care worker of the same type; are authentic; and, in the case of a
license, unencumbered;
(2) The alien has the level of competence in oral and written
English considered by the Secretary of HHS, in consultation with the
Secretary of Education, to be appropriate for health care work of the
kind in which the alien will be engaged, as shown by an appropriate
score on one or more nationally recognized, commercially available,
standardized assessments of the applicant's ability to speak and write
English; and
(3) If a majority of States licensing the profession in which the
alien intends to work recognize a test predicting an applicant's
success on the profession's licensing or certification examination, the
alien has passed such a test, or has passed such an examination.
Section 4(a) of the Nursing Relief for Disadvantaged Areas Act of
1999 (NRDAA), Public Law 106-95, now codified at section 212(r) of the
Act, 8 U.S.C. 1182(r), created an alternative certification process for
aliens who seek to enter the United States for the purpose of
performing labor as a nurse. In lieu of a certification under the
standards of section 212(a)(5)(C) of the Act, an alien nurse can
present to the consular officer (or in the case of an adjustment of
status, the Attorney General) a certified statement from CGFNS (or an
equivalent independent credentialing organization approved for the
certification of nurses) that:
(1) The alien has a valid and unrestricted license as a nurse in a
State where the alien intends to be employed and that such State
verifies that the foreign licenses of alien nurses are authentic and
unencumbered;
(2) The alien has passed the National Council Licensure Examination
(NCLEX); and
(3) The alien is a graduate of a nursing program that meets the
following requirements:
(i) The language of instruction was English; and
(ii) The nursing program was located in a country which:
(A) was designated by CGFNS no later than 30 days after the
enactment of the NRDAA, based on CGFNS'' assessment that designation of
such country is justified by the quality of nursing education in that
country, and the English language proficiency of those who complete
such programs in that country; or
(B) was designated on the basis of such an assessment by unanimous
agreement of CGFNS and any equivalent credentialing organizations which
the Attorney General has approved for the certification of nurses; and
[[Page 63314]]
(iii) The nursing program:
(A) was in operation on or before November 12, 1999; or
(B) has been approved by unanimous agreement of CGFNS and any
equivalent credentialing organizations which the Attorney General has
approved for the certification of nurses.
CGFNS designated the following countries for purposes of this
alternate certification: Australia, Canada, Ireland, New Zealand, South
Africa, the United Kingdom, and the United States.
How Has the Service Implemented These Requirements?
Section 212(a)(5)(C) of the Act became effective upon enactment on
September 30, 1996. Shortly thereafter, the Service met and conferred
with HHS, the Department of Labor (DOL), the Department of Education
(DoED), the Department of Commerce (DOC), the Office of the United
States Trade Representative (USTR), and DOS to reach consensus on the
best approach for implementation of the new provision. In addition, the
Service met with interested private organizations including CGFNS, the
American Occupational Therapists Association, the National Board for
Certification in Occupational Therapy (NBCOT), the Federated State
Board of Physical Therapy, and the American Physical Therapy
Association.
The Service has implemented section 343 of IIRIRA and NRDAA, via
three interim rules published in the Federal Register as follows:
(1) Interim Procedures for Certain Health Care Workers, 63 FR 55007
(Oct. 14, 1998) (codified at 8 CFR 212.15 and 245.14)(the first Interim
Rule);
(2) Additional Authorization to Issue Certificates for Foreign
Health Care Workers, 64 FR 23174 (April 30, 1999) (amending Sec.
212.15)(the second Interim Rule); and
(3) Additional Authorization to Issue Certificates for Foreign
Health Care Workers; Speech Language Pathologists and Audiologists,
Medical Technologists and Technicians, and Physician Assistants, 66 FR
3440 (Jan. 16, 2001) (amending Sec. 212.15)(the third Interim Rule).
These current regulatory provisions shall remain in effect until
this proposed rule is adopted as a final rule.
What Were the Provisions of the First Interim Rule?
The Service in consultation with HHS initially identified, on the
basis of the legislative history, seven categories of health care
workers subject to the provisions of section 212(a)(5)(C) of the Act.
See H.R. CONF. REP. NO. 104-828 at 227 (1996). The seven categories are
nurses, physical therapists, occupational therapists, speech-language
pathologists, medical technologists (also known as clinical laboratory
scientists), medical technicians (also known as clinical laboratory
technicians) and physician assistants. See 63 FR at 55008.
In the first Interim Rule, the Service authorized CGFNS and the
NBCOT to issue certificates to immigrant nurses and occupational
therapists respectively, established the appropriate English language
competency levels for foreign nurses and occupational therapists, and
specified exemptions from English language proficiency testing. The
first Interim Rule was adopted without the notice and comment period
ordinarily required by 5 U.S.C. 553, the Administrative Procedure Act,
because the Service found that delay in the establishment of a
certification process could adversely affect the provision of health
care, particularly in medically underserved areas for nursing and
occupational therapy. The Service identified two criteria to support
the temporary authorization of CGFNS and the NBCOT to issue
certificates to immigrant nurses and occupational therapists: (1) The
existence of a sustained level of demand for foreign workers for the
particular occupation exists; and (2) the fact that these are both
organizations with an established track record in providing
credentialing services.
The first Interim rule applied only to immigrants. The Service and
DOS exercised their discretion under section 212(d)(3) of the Act, 8
U.S.C. 1182(d)(3), to waive the foreign health care worker
certification requirement for nonimmigrant health care workers until
promulgation of final implementing regulations. The Service and DOS
exercised their waiver discretion after carefully considering the
complexity of the implementation issues, including how the health care
certificate requirements affect United States obligations under
international agreements, and the need for health care facilities
across the country to remain fully staffed and provide a high quality
of service to the public. The waiver of inadmissibility applies to
nonimmigrant health care workers already in possession of nonimmigrant
visas and visa exempt aliens, including Canadians applying for
classification under section 214(e) of the Act, 8 U.S.C. 1184(e)(TN
classification). Under current procedures, a formal application or fee
is not required for a nonimmigrant health care worker to obtain the
waiver. Nonimmigrant health care workers are admitted on a multiple
entry Form I-94, Arrival--Departure Record, for one year. In addition,
otherwise admissible dependents are also authorized admission into the
United States for the specific dates of stay authorized for the
principal alien. A new waiver is not required if the nonimmigrant
health care worker makes an application for admission to the United
States during the validity period of the previously issued Form I-94.
Nonimmigrants applying for TN classification are not required to pay
the admission fee described at 8 CFR 214.6(f) when applying for
admission during the validity period of the previously issued Form I-
94. Finally, nonimmigrant health care workers are eligible for
extensions of the waiver and corresponding extensions of stay in
increments of one year.
What Were the Provisions of the Second Interim Rule?
In the second Interim Rule, the Service temporarily authorized
CGFNS to issue certificates to immigrant occupational therapists and
physical therapists, temporarily authorized the Foreign Credentialing
Commission on Physical Therapy (FCCPT) to issue certificates to
immigrant physical therapists, and established the appropriate English
language competency levels for physical therapists.
The Service, in consultation with HHS, evaluated CGFNS' and FCCPT's
applications for authorization to issue certificates under the criteria
in the first Interim Rule. The Service found that both CGFNS and FCCPT
met the ``established track record'' criterion, and concluded that
there was a sustained level of demand for occupational therapists and
for physical therapists.
What Were the Provisions of the Third Interim Rule?
In the third Interim Rule, the Service temporarily authorized CGFNS
to issue certificates to immigrant speech-language pathologists and
audiologists, medical technologists (also known as clinical laboratory
scientists), physician assistants, and medical technicians (also known
as clinical laboratory technicians), listed the passing scores for the
English language tests for those health care occupations, and amended
the regulations concerning which organizations may administer the
English language tests. The Service also modified the criteria it had
used in the first and second Interim Rules to temporarily authorize
organizations to issue certificates to immigrant health care workers.
[[Page 63315]]
By the time the third Interim Rule was adopted, the Service had
experienced tremendous administrative difficulty in promulgating
permanent regulations implementing 8 U.S.C. 1182(a)(5)(C) due to the
complexity of the issues to be addressed, particularly the issues
concerning the impact on United States obligations under various
international agreements. While the Service and DOS had exercised their
discretion under section 212(d)(3) of the Act to temporarily waive the
inadmissibility of nonimmigrant health care workers, thereby permitting
nonimmigrant health care workers to be admitted to the United States
without a certification, they lacked the statutory authority to waive
the inadmissibility of immigrant health care workers. Accordingly, the
Service and DOS were unable to adjudicate the petitions of those
immigrant health care workers not covered by the first or second
Interim Rules. The immigrant petitions and adjustment applications for
speech-language pathologists and audiologists, medical technologists/
clinical laboratory scientists, physician assistants, and medical
technicians/clinical laboratory technicians had been held in abeyance
for several years. Recognizing that it was unable to execute its
adjudicative functions with respect to this growing backlog, the
Service did not rely on the criterion of a ``sustained level of
demand'' for the immigrant workers in question. The Service found that
CGFNS had an established track record in issuing certificates for the
additional occupations.
What Were the Provisions of the H-1C Rule?
The Service also published a related rule in response to the
passage of the NRDAA, Petitioning Requirements for the H-1C
Nonimmigrant Classification under Public Law 106-95, 66 FR 31107 (June
11, 2001) (amending 8 CFR 214.2(h)). Among other things, the NRDAA
created an alternative certification process for foreign nurses only,
as provided in section 212(r) of the Act. In the H-1C rule, the Service
announced that it would continue to waive the certification
requirements for nonimmigrant nurses, pending the promulgation of new
regulations implementing both certification processes. That is the
purpose of this proposed rule.
It should be noted that in the H-1C Rule, the Service incorrectly
stated that two interim rules had been promulgated, which authorized
credentialing organizations to issue certifications to immigrant health
care workers in three occupations. In fact, as previously described,
with the publication of the third Interim Rule, the Service had
authorized credentialing organizations to issue certifications in all
seven of the health care occupations initially identified as subject to
the certification requirements.
What Does This Rule Propose?
This rule proposes to implement a comprehensive process for the
certification of foreign health care workers under sections
212(a)(5)(C) and (r) of the Act. It addresses foreign health care
workers coming to the United States on a temporary basis (nonimmigrant
aliens) as well as on a permanent basis (immigrants).
This rule proposes to amend 8 CFR 212.15 by:
(1) Specifying which organizations are authorized to issue
certificates (Sec. 212.15(e));
(2) Describing the required content of the certificate itself
(Sec. 212.15(f));
(3) Specifying the English language requirements for certification
(Sec. 212.15(g));
(4) Implementing the alternative certification process for foreign
nurses and the required content of the certified statement (Sec.
212.15(h));
(5) Describing the procedure to qualify as a certifying
organization (Sec. 212.15(j));
(6) Listing the standards that an organization must meet in order
to obtain and retain authorization to issue foreign health care worker
certifications (Sec. 212.15(k)); and
(7) Providing for periodic review of the performance of certifying
organizations (Sec. 212.15(l)) and the termination of their authority
(Sec. 212.15(m)).
This rule proposes to amend 8 CFR 103.1 by specifying at new
paragraphs (f)(3)(iii)(QQ) and (RR) that the Associate Commissioner for
Examinations exercises appellate jurisdiction over applications for
authorization to issue foreign health care worker certifications, and
the termination of authorization to issue foreign health care worker
certifications.
This rule proposes to amend 8 CFR 103.7(b)(1) by adding a fee for
filing Form I-905, Application for Authorization to Issue Certification
for Health Care Workers. This form was previously approved for use in
order to ensure that organizations formally seeking authorization to
issue health care worker certificates or certified statements will be
able to submit complete and uniform applications. This form has not yet
been implemented by the Service.
This rule proposes to amend 8 CFR 214.1(h) by adding a requirement
that an alien who seeks to enter the United States for the purpose of
performing labor in a health care occupation must present a foreign
health care worker certification to the Service in accordance with 8
CFR 212.15(d).
This rule proposes to remove text at 8 CFR 245.14 relating to the
adjustment of status of certain health care workers. This provision is
duplicated by the provisions of 8 CFR 212.15(d).
This rule proposes to amend 8 CFR 248.3 by adding paragraph (i) to
mandate that a nonimmigrant seeking a change of status to perform labor
in a health care occupation must submit a foreign health care worker
certification.
Who Is Subject to the Health Care Certification Requirements?
After the Service's consideration of the relevant statutory
provisions, legislative history, judicial precedent, international
agreements, and other proposed rulemakings, and after extensive
consultations that the Service has had with other agencies, this
proposed rule takes the position that the requirements of section
212(a)(5)(C) apply to both immigrants and nonimmigrants who seek to
enter the United States for the purpose of performing labor as a health
care worker. Physicians, however, are explicitly exempted from the
certification requirement by the statute and, therefore, are not
covered by this rule.
With respect to immigrants, the certification requirement applies
to both aliens overseas who are seeking an immigrant visa before
traveling to the United States, and aliens in the United States who are
applying for adjustment of status to that of a permanent resident. The
Service interprets the statutory language, ``any alien who seeks to
enter the United States for the purpose of performing labor as a health
care worker * * *'' with respect to immigrants, to limit the scope of
this provision to aliens with an approved employment-based (EB)
preference petition under section 203(b) of the Act, 8 U.S.C. 1153(b),
to perform labor in a covered health care occupation. Therefore, an
alien who has applied for an immigrant visa or adjustment of status,
pursuant to a family sponsored petition under section 203(a) of the
Act, 8 U.S.C. 1153(a), or pursuant to an EB preference petition for a
non-health care occupation, or pursuant to section 209 of the Act, 8
U.S.C. 1159 (adjustment of status of refugees), or pursuant to section
210 of the Act, 8 U.S.C. 1160 (special agricultural workers), or
[[Page 63316]]
pursuant to section 240A of the Act, 8 U.S.C. 1229(b) (cancellation of
removal), or pursuant to section 249 of the Act, 8 U.S.C. 1259 (record
of admission for permanent residence), or pursuant to any other
statutory provision relating to admission as an immigrant, is not
subject to the requirements of section 212(a)(5)(C) of the Act.
With respect to nonimmigrants, the proposed rule applies the
certification requirement to all aliens who have obtained nonimmigrant
status for the purpose of performing labor as a health care worker,
including, but not limited to, those aliens described in sections
101(a)(15)(H), (J), and (O) of the Act, 8 U.S.C. 1101(a)(15), and
aliens entering pursuant to section 214(e) of the Act, 8 U.S.C.
1184(e), as TN professionals.
The Service is proposing that a nonimmigrant entering the United
States to receive training in an occupation listed at 8 CFR 212.15(c)
will not be required to obtain a health care certification. This
includes F-1 nonimmigrants receiving practical training and J-1
nonimmigrants coming to the United States to undertake a training
program in a medical field. In the Service's view, nonimmigrants
entering the United States to receive training in a health care
occupation fall outside the ambit of section 212(a)(5)(C) of the Act
because they are not independently performing the full range of duties
of their occupation, and therefore are not entering for the purpose of
performing labor as a health care worker.
Finally, the Service has concluded that the health care
certification requirement should not be applied to the spouse and
dependent children of an immigrant or nonimmigrant alien. Dependent
aliens enter the United States for the primary purpose of accompanying
the principal alien, not to perform labor as a health care worker, or
in any other field. A dependent alien derives his or her nonimmigrant
status from his or her familial relationship with the principal alien.
Therefore, while he or she may be permitted to work in some
circumstances, he or she is not required to work in a particular
occupational field or for a specific employer to maintain his or her
status. Accordingly, regardless of whether or not a dependent alien may
intend to work in a health care occupation listed at 8 CFR 212.15(c),
while accompanying the principal alien to the United States, he or she
would not be subject to the health care worker certification
requirement.
The Service is very interested in and invites public comment on the
appropriate scope of the certification requirement.
Are Foreign Health Care Workers Who Have Been Trained in the United
States, or Who Are In Possession of a Valid State License, Subject to
the Health Care Certification Requirement?
After passage of IIRIRA, the Service received a number of inquiries
and comments regarding whether a foreign health care worker in
possession of a full and unrestricted license issued by the State of
intended employment would be required to obtain a certificate under
section 212(a)(5)(C) of the Act. After carefully considering the plain
language of the statute, and upon consultation with HHS, the Service
has concluded that possession of a State license does not exempt a
foreign health care worker from compliance with the certification
requirement. First, section 212(a)(5)(C) of the Act applies to all
aliens coming to perform labor as health care workers, except for
physicians and for registered nurses who can meet the alternative
requirements in section 212(r) of the Act. Nothing in the text of
section 212(a)(5)(C) of the Act relieves alien health care workers of
this requirement, on the ground that they were trained in the United
States or are already licensed here. Moreover, one aspect of the
required certification is the certification that any State license the
alien may already have is unencumbered. Indeed, had Congress intended
to exempt such aliens from the certification requirement, it would not
have explicitly provided that the certification must document the fact
of an alien's successful passage of any test or examination that is
accepted as evidence of an applicant's likely success on a State
licensing examination, if a majority of States recognize such a pre-
licensing test or examination. In addition, in NRDAA, Congress
explicitly addressed whether a foreign nurse, in possession of a full
and unrestricted license issued by the State of intended employment,
should be subject to the certification requirement. NRDAA created a
less onerous, alternative method of certification for foreign nurses
who have unrestricted State licenses and meet certain other conditions,
as provided in section 212(r) of the Act. The fact that Congress has
chosen not to provide a less rigorous alternative certification option
to State-licensed foreign health care workers other than nurses
supports the inference that Congress intended State-licensed foreign
health care workers to comply with the certification process.
In addition to the statutory scheme, there are policy
considerations that mitigate in favor of applying the certification
requirement to State-licensed foreign health care workers. The State
screening process alone would not demonstrate that the other two prongs
of the certification requirement, English language competency, and
comparable training and unencumbered licensing, had been met. First,
the State screening process does not always measure English
proficiency. Secondly, HHS has advised the Service that the State
screening process may not always discover encumbrances and restrictions
on a license.
The statute and legislative history are silent with respect to
whether foreign health care workers, who received their training in the
United States, are subject to the certification process. While such
aliens would satisfy the comparable training certification
requirements, their licensure would not be verified, as required by the
statute. Given the lack of evidence of congressional intent that such
aliens be exempt from the reach of section 212(a)(5)(C) of the Act, the
Service has concluded that foreign health care workers who received
their training in the United States must comply with the certification
requirement.
The Service, however, would not be opposed to permitting
credentialing organizations to develop a modified or streamlined
certification process for foreign health care workers who hold an
unrestricted State license, or who have been trained in the United
States. The Service invites comments regarding the feasibility of
having a more streamlined certification process for those who train in
the United States or who are already licensed here, and regarding
specific proposals on how to adopt such a policy. The critical issue
would be whether, as a matter of its own professional judgment, the
appropriating credentialing organization considers its appropriate to
certify an alien's satisfaction of the substantive requirements of
section 212(a)(5)(C) of the Act on the basis of the alien's having been
trained or licensed in the United States.
Which Health Care Occupations Are Subject to 8 U.S.C. 1182(a)(5)(C)?
As previously noted, after passage of IIRIRA the Service
identified, on the basis of the legislative history, seven categories
of health care workers subject to the health care certification
requirements. See H.R. CONF. REP. NO. 104-828 at 227 (1996). The seven
categories are nurses, physical therapists, occupational therapists,
speech-language pathologists, medical
[[Page 63317]]
technologists (also known as clinical laboratory scientists), medical
technicians (also known as clinical laboratory technicians) and
physician assistants. See the first Interim Rule. The conference report
also provided that the Service could designate additional health care
occupations subject to certification by regulation. Since the Service
has limited agency expertise with health care occupations and issues,
it has consulted extensively with HHS, the agency generally responsible
for overseeing health care occupations and other related health care
issues in the United States, with respect to the question of whether
aliens in additional health care occupations should be required to
comply with 8 U.S.C. 1182(a)(5)(C).
The Service and HHS have identified two factors relevant to the
consideration of which health care occupations fall under the ambit of
section 212(a)(5)(C) of the Act. The first factor is whether the health
care occupation generally requires a license in a majority of the
States. This factor reflects the States' historical and practical
experience in distinguishing between those health care occupations
requiring extensive regulation and those occupations that do not. The
second factor is whether the health care worker has a direct effect on
patient care, or in other words whether a health care worker in that
occupation could reasonably pose a risk to patient health.
Under this rule, health care workers such as, but not limited to,
medical teachers, medical researchers, managers of health care
facilities, and medical consultants to the insurance industry would not
be required to comply with the certification requirement. In contrast,
health care workers, such as supervisory physical therapists, who may
not typically be involved in hands-on patient care but do have a direct
effect on patient care, would be subject to the certification
requirements. The Service invites comments on whether the list of
health care occupations should be expanded, addressing its use of these
two factors to determine which health care workers are subject to
certification, and whether particular occupations should be added to
the list.
The Service acknowledges that the job description of certain
occupations that could be added to the list, such as a ``clinical
social worker,'' may differ in other countries from the U.S. definition
of a ``clinical social worker.'' These differences may create confusion
about who exactly is subject to certification. A solution may lie in
explicitly defining each health care occupation, subject to
certification, in the final rule. Accordingly, the Service invites
comments regarding the need to define a health care occupation that is
subject to certification.
How Will an Alien Submit the Foreign Health Care Worker Certification
to the Service?
The statutory language at section 212(a)(5)(C) of the Act requires
certain aliens seeking to enter the United States for the purpose of
performing labor as a health-care worker to present a certificate from
CGFNS or an equivalent credentialing organization to the consular
officer or, in the case of an adjustment of status, the Attorney
General. Accordingly, the requirement that the certificate be presented
to a consular officer at the time of visa issuance and to the Service
at the time of admission or adjustment of status will continue.
When an alien seeking entry to the United States to perform labor
in a particular health care occupation has already presented the
certification and been admitted as a nonimmigrant, an immigrant, or has
adjusted to permanent resident status, he or she will not be required
to present the certificate again when he or she makes future
applications for admission to the United States to perform labor in
that particular health care occupation. The presentation of a Form I-94
issued to the alien at the initial admission to the United States, or a
fee receipt showing that the alien was processed for admission under
the North American Free Trade Agreement after this rule is adopted in
final form, can be used, if required, as evidence that the alien has
previously presented a foreign health care worker certificate for a
particular health care occupation. Similarly, such an alien will not be
required to again present the foreign health care worker certificate to
the Service, with an application for extension of status to perform
labor in that particular health care occupation. It should be noted
that these proposed regulations do not affect or diminish the authority
of State regulatory bodies with respect to whether an alien is
permitted to continue employment as a health care worker in that
particular State.
This rule proposes to add a new Sec. 248.3(i) to outline the
procedure for submitting the certificate to the Service when an
application is made to change nonimmigrant status within the United
States.
Upon the effective date when this rule is published as a final
rule, nonimmigrants who have already entered the United States under a
waiver of inadmissibility under section 212(d)(3) of the Act and are
working as health care workers will be required to present a
certificate to the Service only if, at any point in the future, they
file an application for an extension of stay, or apply for admission to
the United States, whichever event occurs first.
The Service welcomes comments and suggestions on how this procedure
can be modified or altered to better accommodate the aliens affected by
this provision.
How Will an Organization Obtain Authorization To Issue Health Care
Certificates?
The statute provides that a foreign health care worker must present
a certificate from CGFNS or an equivalent credentialing organization
or, in the case of certain foreign nurses, a certified statement from
CGFNS or an equivalent credentialing organization. In the legislative
history to IIRIRA, the conferees identified seven health care
occupations (which are currently reflected in Sec. 212.15(c)). It is
reasonable to infer from the statutory designation of CGFNS as a
credentialing organization that Congress considered CGFNS to possess
the resources and expertise to issue certificates in at least those
seven designated health care occupations. Accordingly, the Service will
not require CGFNS to apply for credentialing status with respect to
those seven health care occupations. However, CGFNS will be required to
submit information regarding its certification processes via filing of
Form I-905, Application for Authorization to Issue Certification for
Health Care Workers, without fee with the Director, Nebraska Service
Center, in order to enable the Service to review the content of
certificates for the seven health care occupations, and content of
certified statements for nurses, and ensure compliance with the
universal standards set forth in this rule. Like other credentialing
organizations, CGFNS will also be subject to ongoing review by the
Service, and termination of credentialing status for noncompliance with
this rule.
It is less clear, however, that Congress considered whether CGFNS
possessed the expertise to issue certificates for health care
occupations other than the seven identified in the legislative history.
Therefore, although CGFNS' statutory designation creates a strong
presumption of expertise with respect to all health care occupations,
the Service will require CGFNS to file an application on Form I-905
with fee under the procedures outlined at proposed Sec. 212.15(j), for
credentialing status with respect to any health care
[[Page 63318]]
occupation other than the seven identified in the legislative history.
Organizations, other than CGFNS, may be approved to issue
certificates or certified statements by submission of Form I-905 to the
Director, Nebraska Service Center, with fee. The fee for Form I-905
will be $230. The Service will submit Form I-905 to the Office of
Management and Budget for approval pursuant to the Paperwork Reduction
Act of 1995.
For purposes of administrative ease and efficiency, the Service
will centralize all requests for designation as a credentialing
organization at the Nebraska Service Center, regardless of the
geographical location of the requesting organization. Centralization of
these requests will enable personnel at the Nebraska Service Center to
establish and maintain the appropriate contacts with HHS and DoED to
assist in the adjudication of applications for credentialing status.
The Service will accord significant weight to the opinion of HHS in the
adjudication of applications for credentialing status because of that
agency's expertise with credentialing requirements for health care
occupations and health care issues. It should be noted, however, that
the Service may deny a request for authorization on grounds unrelated
to credentialing requirements for health care occupations or health
care issues, despite a favorable HHS opinion.
The Form I-905 will require the organization seeking credentialing
status to:
(1) Provide a point of contact and a written, detailed description
of the organization and how the organization meets the standards
described in 8 CFR 212.15(k);
(2) List the health care occupations for which the organization is
seeking approval to issue certificates, and describe the organization's
expertise in each health care occupation for which approval to issue
certificates is sought;
(3) Describe how it will process applications and issue
certificates on a timely basis; and
(4) Describe the procedure it has designed in order for the Service
to verify the validity of a certificate.
The Service will provide the organization with a written decision
on its application. An organization granted authorization to issue
certificates must agree to provide the Service with all requested
documentation and to allow the Service access to its records relating
to the certification process. If the application is denied, the Service
will explain the reason(s) for the denial. Applications that are denied
by the Service may be appealed to the Administrative Appeals Office
pursuant to 8 CFR 103.3.
The Service is planning to add new organizations that are approved
to issue certificates and certified statements to Sec. 212.15(e) via
publication of an interim rule in the Federal Register. In the
alternative, the Service is considering designating, by a separate and
comprehensive public notice in the Federal Register, the list of
organizations approved to issue certification. The Service would also
maintain this list on its website at http://www.ins.usdoj.gov. This
method would allow the Service to update the list of authorized
organizations more quickly than through publication of interim rules.
The Service seeks comment on whether this alternative method of
maintaining a list of authorized organizations would better serve the
public.
More than one organization may be approved by the Service to issue
certificates for the same health care occupation. An alien may obtain a
certificate from any organization authorized to issue certificates for
that occupation. This rule also provides that the Service's approval
will be for a 5-year period of time subject to the review process
described in 8 CFR 215.15(l).
The Service proposes to extend the temporary authorization of
CGFNS, NBCOT, and FCCPT to issue health care certificates and/or
certified statements until adjudication of their credentialing status
under this final rule.
How Did the Service Decide That the Form I-905 Application Fee Should
Be $230?
The Service believes that it is reasonable to identify a current
application whose process is similar to the requirements outlined under
Sec. 212.15(k) in order to select an appropriate fee to charge
organizations who wish to be authorized to issue health care worker
certifications. Organizations filing health care worker certification
applications are requesting that the Service review their resources,
including staffing and financial and material resources, their ability
to evaluate foreign credentials, and their ability to conduct
examinations outside the United States. The current Service petition
whose process is most similar to the application process for
authorization to issue health care worker certification is the Form I-
17, Petition for Approval of School for Attendance by Nonimmigrant
Student, which is currently used by other organizations that seek
approval to admit nonimmigrant students. In developing fees, the
Service must comply with guidance provided in the Office of Management
and Budget (OMB) Circular A-25. This guidance directs Federal agencies
to charge the ``full cost'' of providing benefits when calculating fees
that provide a special benefit to recipients. Section 6(d) of OMB
Circular A-25 defined ``full cost'' as including ``all direct and
indirect costs to any part of the Federal Government of providing a
good, resource, or service.'' In its most recent review of immigration
and naturalization benefits, the Service identified the current full
cost of the Form I-17 to be $230. The Service determined that a $230
fee for the Form I-17 would underwrite the Service's processing and
administrative costs incurred in the Form I-17 adjudication process,
such as staffing, training of Service personnel, and adjudication of
the petitions. The Service will thus use $230 for the fee for the Form
I-905 until the next biennial fee review, as required by the Chief
Financial Officers Act of 1990, Public Law 101-576, 104 Stat. 2838.
What Are the Standards an Organization Must Meet in Order To Obtain
Authorization To Issue Certificates?
This proposed rule lists the standards an organization must
substantially meet in order to be authorized to issue certificates at
Sec. 212.15(k). An organization seeking approval to issue certificates
or certified statements should submit evidence addressing each of the
standards. These standards were developed by HHS in order to ensure
that an organization meets the requirements contemplated by Congress.
In drafting these standards, HHS drew upon the legislative history to
IIRIRA, and drew extensively from the standards of the National
Commission for Certifying Agencies, a nationally recognized body that
accredits certifying organizations. There are four guiding principles
to the standards:
(1) The Attorney General should not approve a credentialing
organization, unless the organization is independent and free of
material conflicts of interest regarding whether an alien receives a
visa;
(2) The organization should demonstrate an ability to evaluate both
the foreign credentials appropriate for the profession, and the results
of examinations for proficiency in the English language appropriate for
the health care field in which the alien will be engaged;
(3) The organization should also maintain comprehensive and current
information on foreign educational
[[Page 63319]]
institutions, ministries of health, and foreign health care licensing
jurisdictions; and
(4) If the health care field is one for which a majority of the
States require a predictor examination (currently, this is done only
for nursing), the organization should demonstrate an ability to conduct
the examination outside the United States.
Since the statute and the report language intend to ensure that
aliens entering the United States for purposes of performing labor as a
health care worker are of the same quality as United States trained
workers, the HHS has determined that this can be assured by requiring
that organizations issuing certificates be held to a select group of
standards. The Service is concerned that in the absence of strict
standards, unqualified organizations may obtain authorization from the
Service to issue certificates that could ultimately have adverse
consequences for health care in the United States. Since the provisions
of section 212(r) of the Act appear to share with section 212(a)(5)(C)
the goal of ensuring a high quality of health care service in the
United States, the Service will use the same standards to adjudicate
applications from credentialing organizations under either provision.
The Service welcomes comments from the public and from interested
organizations regarding the proposed standards. Specifically, the
Service is concerned that an organization seeking authorization to
issue certificates may meet most, but not all of the proposed
standards. The Service seeks comment on the question of whether a
prospective credentialing organization's inability to meet all of the
proposed standards should preclude the Service from authorizing the
organization to issue certificates. Also, the Service seeks public
comment on the question of whether the proposed standards should be
considered as guidelines, or as strict criteria that would preclude an
organization from qualifying. Finally, the Service invites public
comment on the question of how a prospective credentialing organization
can meet the requirement that it demonstrate that it is independent and
free of material conflicts of interest regarding whether an alien
receives a visa.
How Will the Service Monitor Organizations Authorized To Issue
Certificates or Certified Statements?
The Service intends to develop a regulatory process to monitor
credentialing organizations, including CGFNS. This process will ensure
that a credentialing organization continues to follow the standards
described in this rule. The Service proposes to review and reauthorize
the credentialing organizations every 5 years. This rule proposes that
the Service will notify the credentialing organization in writing of
the results of the review and reauthorization. If the Service develops
adverse information with respect to the performance of the
organization, the Service may institute termination proceedings.
Comments from the public regarding the frequency of review, e.g.,
review as part of the 5-year reauthorization, or an annual or biannual
review, the nature of the review, and whether reviews, if conducted
separately from reauthorization, should be targeted versus random,
would be of great assistance in the development of a review process.
In particular, as part of the review process, the Service proposes
to assess whether an authorized credentialing organization has issued
certificates in a timely manner so as to minimize any delays that may
affect an alien's ability to proceed with his or her application for an
immigration benefit, and to assess whether the fee charged for a
certificate unduly impairs an alien's ability to seek an immigration
benefit. Accordingly, the Service seeks comments on what might
constitute a reasonable period of time within which a credentialing
organization would be required to issue certificates, and regarding
what methodology the Service should use in assessing whether a fee
constitutes an obstacle to obtaining an immigration benefit.
How will the Service terminate an Organization's Authorization?
Upon notification that an authorized credentialing organization has
been convicted, or the directors or officers of an authorized
credentialing organization have individually been convicted of a
violation of state or federal laws, such that the fitness of the
organization to continue to issue certificates is called into question,
the Service shall automatically terminate authorization to issue
certificates via notice to the credentialing organization.
Upon receipt of information that the credentialing organization is
no longer complying with the standards contained in Sec. 212.15(k), or
upon receipt of information that termination of the organization's
approval is otherwise warranted, the Service will issue a Notice of
Intent to Terminate Authorization to Issue Certificates to Foreign
Health Care Workers to the credentialing organization. The
credentialing organization will be given 30 days from the date of the
Notice of Intent to Terminate Authorization to Issue Certificates to
Foreign Health Care Workers to rebut or cure the allegations made in
the Service's notice.
Thirty days after the date of the Notice of Intent to Terminate,
the Service will request an opinion from HHS regarding whether the
organization's authorization should be terminated. The Service shall
accord HHS' opinion great weight in determining whether the
authorization should be terminated. After consideration of the
organization's response, if any, to the Notice of Intent to Terminate,
and of HHS' opinion, the Service will provide the organization with a
written decision.
The Service's decision terminating an organization's authorization
may be appealed to the Administrative Appeals Office pursuant to 8 CFR
103.3. Termination of credentialing status will occur on the date of
the decision and remain in effect until and unless the terminated
organization reapplies, with fee, for credentialing status and is
approved, or its appeal of the termination decision is sustained by the
Administrative Appeals Office. There is no waiting period for an
organization to re-apply for credentialing status.
What Actions Will the Service Take When It Finds That an Alien
Certificate Holder Was Not Eligible To Receive the Certificate at the
Time That It Was Issued?
A credentialing organization must develop policies and procedures
for revocation of certificates at any time if it finds that the
certificate holder was not eligible to receive the certificate at the
time it was issued. These policies and procedures include notification
to the Service that a certificate has been revoked. The Service may
then take any appropriate action, including revocation of the petition,
and initiation of removal proceedings against the individual alien
under section 240 of the Act.
What Will the Foreign Health Care Worker Certificate or Foreign Nurses
Certified Statement Look Like?
The proposed regulation at Sec. 212.15(f) describes the content of
the certificate. The proposed regulation at Sec. 212.15(h) describes
the content of the certified statement. They will generally contain the
following information:
(1) the name, designated point of contact to verify the validity of
the certificate, address, and telephone number of the certifying
organization;
(2) the date the certificate was issued;
(3) the health care occupation for which the certificate was
issued; and
[[Page 63320]]
(4) the alien's name, and date and place of birth.
It should be noted that the certificate or certified statement does
not constitute professional authorization to practice in that health
care occupation.
What Are the Requisite English Language Scores for Certification?
HHS, in consultation with DoED, is required to establish a level of
competence in oral and written English appropriate for the health care
field in which the alien will be engaged, as shown by an appropriate
score on one or more nationally recognized, commercially available,
standardized assessments of the applicant's ability to speak and write.
The statute vests the Secretary of HHS with the ``sole discretion'' to
determine the standardized tests and appropriate minimum scores. In
developing the English language test scores, HHS consulted with DoED
and appropriate health care professional organizations. HHS also
examined a study sponsored in part by NBCOT entitled ``Standards for
Examinations Assessing English as a Second Language.'' The scores
reflect the current industry requirements for particular health care
occupations.
HHS has identified four testing services which conduct a nationally
recognized, commercially available, standardized assessment as
contemplated in the statute. The four testing services are the
Educational Testing Service (ETS), the Michigan English Language
Assessment Battery (MELAB), the Test of English in International
Communication (TOEIC) Service International, and the International
English Language Testing System (IELTS). The proposed regulation at
Sec. 212.15(g) lists the tests and appropriate scores as determined by
HHS for each occupation.
As an alternative to listing the tests and appropriate scores by
regulation or interim rule, the Service is considering designating, by
a separate and comprehensive public notice in the Federal Register, the
list of tests and appropriate scores. The Service would also maintain
this list on its website at http://www.ins.gov. This method would allow
the Service to update the list of tests and scores more quickly than
through publication of interim rules. The Service seeks comment on
whether this alternative method of providing the public with the lists
of tests and appropriate scores would better serve the public.
Other testing services are encouraged to submit information
concerning their testing services to the Service, for HHS and DoED
review, and credentialing organizations are encouraged to develop a
test specifically designed to measure English language skills and to
seek HHS approval of the test. This rule provides that the Service will
notify the public of new approved testing services in the future by
publishing an interim rule in the Federal Register.
HHS has advised the Service that graduates of health profession
programs in Australia, Canada (except Quebec), Ireland, New Zealand,
the United Kingdom, and the United States are deemed to have met the
English language requirements. HHS has determined that aliens who have
graduated from these programs have the requisite competency in oral and
written English. The level of English that the graduates of these
health profession programs would need to graduate is deemed equivalent
to the level that would be demonstrated by achieving the minimum
passing score on the tests previously described. Nurses who are
eligible to present an alternate certified statement under section
212(r) of the Act also by definition have satisfied the English
language requirements.
Finally, HHS has advised the Service that the MELAB will no longer
offer the English-speaking portion of its test outside the United
States and Canada. As a result, individuals who seek to meet the
English language requirements will be required to do one of the
following:
(1) Take the three tests offered by ETS; or
(2) Take the TOEIC offered by TOEIC Service International, in
addition to the test of spoken English and the test of written English
offered by ETS; or
(3) Take Parts 1, 2, and 3 of MELAB overseas and then take the test
of spoken English offered by ETS; or
(4) Take Parts 1, 2, and 3 of MELAB overseas and then take the test
of spoken English in the United States or Canada; or
(5) Take the IELTS examination.
Regulatory Flexibility Act
The Commissioner of the Immigration and Naturalization Service, in
accordance with the Regulatory Flexibility Act (5 U.S.C. 605(b)), has
reviewed this regulation and, by approving it, certifies that this rule
will not have a significant economic impact on a substantial number of
small entities. It is projected that there will be, at most, 21 small
businesses that apply to the Service to issue certificates for health
care workers. Although these small entities are required to pay a fee
when submitting their applications, these small entities may recoup
this expense if they charge aliens who must obtain a foreign health
care worker certificate. The Service invites comment on whether and how
this rule may have a significant impact on small entities.
Unfunded Mandates Reform Act of 1995
This rule will not result in the expenditure by State, local and
tribal governments, in the aggregate, or by the private sector, of $100
million or more in any one year, and it will not significantly or
uniquely affect small governments. Therefore, no actions were deemed
necessary under the provisions of the Unfunded Mandates Reform Act of
1995.
Small Business Regulatory Enforcement Fairness Act of 1996
This rule is not a major rule as defined by section 804 of the
Small Business Regulatory Enforcement Act of 1996. This rule will not
result in an annual effect on the economy of $100 million or more; a
major increase in costs or prices; or significant adverse effects on
competition, employment, investment, productivity, innovation, or on
the ability of United States-based companies to compete with foreign-
based companies in domestic and export markets.
Executive Order 12866
This rule is considered by the Department of Justice, Immigration
and Naturalization Service, to be a ``significant regulatory action''
under Executive Order 12866, section 3(f), Regulatory Planning and
Review. Accordingly, this regulation has been submitted to the Office
of Management and Budget (OMB) for review.
Executive Order 13132
The rule will not have substantial direct effects on the States, on
the relationship between the National Government and the States, or on
the distribution of power and responsibilities among the various levels
of government. Therefore, in accordance with section 6 of Executive
Order 13132, it is determined that this rule does not have sufficient
federalism implications to warrant the preparation of a federalism
summary impact statement.
Executive Order 12988 Civil Justice Reform
This rule meets the applicable standards set forth in sections 3(a)
and 3(b)(2) of Executive Order 12988.
[[Page 63321]]
Paperwork Reduction Act of 1995
The information collection requirements contained in this rule
(Form I-905 (OMB Control Number 1115-0238) and the information required
on the health care certificate or certified statement (OMB Control
Number 1115-0226)) are being revised. Accordingly, these revisions will
be submitted to the Office of Management and Budget for review in
accordance with the Paperwork Reduction Act.
List of Subjects
8 CFR Part 103
Administrative practice and procedure, Authority delegations
(Government Agencies), Freedom of information, Privacy, Reporting and
recordkeeping requirements, Surety bonds.
8 CFR Part 212
Administrative practice and procedures, Aliens, Immigration,
Passports and visas, Reporting and recordkeeping requirements.
8 CFR Part 214
Administrative practice and procedures, Aliens, Employment, Foreign
officials, Health professions, Reporting and recordkeeping
requirements, Students.
8 CFR Part 245
Aliens, Immigration, Reporting and recordkeeping requirements.
8 CFR Part 248
Aliens, Reporting and recordkeeping requirements.
8 CFR Part 299
Immigration, Reporting and recordkeeping requirements. ]
Accordingly, chapter I of title 8 of the Code of Federal
Regulations is proposed to be amended as follows:
PART 103--POWERS AND DUTIES OF SERVICE OFFICER; AVAILABILITY OF
SERVICE RECORDS
1. The authority citation for part 103 continues to read as
follows:
Authority: 5 U.S.C. 552, 522a; 8 U.S.C. 1101, 1103, 1304, 1356;
31 U.S.C. 9701; E.O. 12356, 47 FR 14874, 15557, 3 CFR, 1982 Comp.,
p.166; 8 CFR part 2.
2. Section 103.1 is amended by:
a. Removing the word ``and'' at the end of paragraph
(f)(3)(iii)(NN);
b. Removing the period at the end of paragraph (b)(3)(iii)(oo) and
adding a semicolon and the word ``and'' in it's place, and adding and
reserving paragraph (f)(3)(iii)(PP); and by
c. Adding paragraphs (f)(3)(iii)(QQ) and (RR).
The additions read as follows:
Sec. 103.1 Delegations of authority.
* * * * *
(f) * * *
(3) * * *
(iii) * * *
(PP) Reserved.
(QQ) Application for authorization to issue certificates to foreign
health care workers under 8 CFR part 215; and
(RR) Termination of authorization to issue certificates to foreign
health care workers under 8 CFR part 215.
* * * * *
3. Section 103.7(b)(1) is amended by adding a new entry for the
``Form I-905'' to the list in alpha/numeric sequence, to read as
follows:
Sec. 103.7 Fees.
* * * * *
(b) * * *
(1) * * *
* * * * *
Form I-905, Application for Authorization to Issue Certification
for Health Care Workers--$230.00.
* * * * *
PART 212--DOCUMENTARY REQUIREMENTS: NONIMMIGRANTS; WAIVERS;
ADMISSION OF CERTAIN INADMISSIBLE ALIENS; PAROLE
4. The authority citation for part 212 continues to read as
follows:
Authority: 8 U.S.C. 1101, 1102, 1103, 1182, 1184, 1187, 1225,
1226, 1227; 8 CFR part 2.
5. Section 212.15 is revised to read as follows:
Sec. 212.15 Certificates for foreign health care workers.
(a) General.
(1) Any alien who seeks to enter the United States for the primary
purpose of performing labor in a health care occupation listed in
paragraph (c) of this section is inadmissible unless the alien presents
a certificate from a credentialing organization, listed in paragraph
(e) of this section.
(2) In the alternative, an eligible alien who seeks to enter the
United States for the primary purpose of performing labor as a nurse
may present a certified statement as provided in paragraph (h) of this
section.
(3) A certificate or certified statement described in this section
does not constitute professional authorization to practice in that
health care occupation.
(b) Inapplicability of the ground of inadmissibility. This section
does not apply to:
(1) Physicians;
(2) Aliens seeking admission to the United States to perform
services in a non-clinical health care occupation. A non-clinical care
occupation is one in which the alien is not required to perform direct
or indirect patient care. Occupations which are considered to be non-
clinical include, but are not limited to, medical teachers, medical
researchers, and managers of health care facilities;
(3) The spouse and dependent children of any immigrant or
nonimmigrant alien;
(4) Any alien applying for adjustment of status to that of a
permanent resident under any provision of law other than under section
245 of the Act, or any alien who is seeking adjustment of status under
section 245 of the Act on the basis of a relative visa petition
approved under section 203(a) of the Act, or any alien seeking
adjustment of status under section 245 of the Act on the basis of an
employment-based petition approved pursuant to section 203(b) of the
Act for employment that does not fall under one of the covered health
care occupations listed in paragraph (c) of this section.
(c) Covered health care occupations. With the exception of the
aliens described in paragraph (b) of this section, this section applies
to any alien seeking admission to the United States to perform labor in
one of the following health care occupations, regardless of where he or
she received his or her education or training:
(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.
(7) Medical Technicians (Clinical Laboratory Technicians)
(d) Presentation of certificate or certified statements.--(1)
Aliens requiring a nonimmigrant visa. An alien described in paragraph
(a) of this section who is applying for admission as a nonimmigrant
seeking to perform labor in a health care occupation as described in
this section must present a certificate or certified statement to a
consular officer at the time of visa issuance and to the Service at the
time of admission. The certificate or certified statement must be valid
at the time of visa issuance and admission at a port-of-entry. An alien
who has previously presented a foreign health care worker certification
or certified statement for a particular health care occupation will
[[Page 63322]]
not be required to present it again at the time of visa issuance or
admission to the United States.
(2) Aliens not requiring a nonimmigrant visa. An alien described in
paragraph (a) of this section who, pursuant to Sec. 212.1, is not
required to obtain a nonimmigrant visa to apply for admission to the
United States must present a certificate or certified statement as
provided in this section to an immigration officer at the time of
initial application for admission to the United States to perform labor
in a particular health care occupation. An alien who has previously
presented a foreign health care worker certification or certified
statement for a particular health care occupation will not be required
to present it again at the time of a subsequent application for
admission.
(3) Immigrant aliens. An alien described in paragraph (a) of this
section, who is coming to the United States as an immigrant or is
applying for adjustment of status pursuant to 8 U.S.C. 1255, section
245 of the Act, to perform labor in a health care occupation described
in paragraph (c) of this section, must submit the certificate or
certified statement as provided in this section to the Service at the
time of adjustment of status. An alien who has previously presented a
foreign health care worker certification or certified statement for a
particular health care occupation will not be required to present it
again at the time of an adjustment of status.
(4) Expiration of certificate or certified statement. The
individual's certification or certified statement must be used for an
initial admission into the United States, change of status within the
United States, or adjustment of status within 5 years of the date that
it is issued.
(5) Revocation of certificate or certified statement. When a
credentialing organization notifies the Service that an individual's
certification or certified statement has been revoked, the Service will
take appropriate action, including revocation of approval of any
related petitions, consistent with the Act and Service regulations at 8
CFR 205.2, 8 CFR 214.2(h)(11)(iii), and 8 CFR 214.6(d)(5)(iii).
(e) Approved credentialing organizations for health care workers.
An alien may present a certificate from any credentialing organization
listed in this paragraph (e) with respect to a particular health care
field.
(1) The Commission on Graduates of Foreign Nursing Schools (CGFNS)
is authorized to issue certificates under section 212(a)(5)(C) of the
Act for nurses, physical therapists, occupational therapists, speech-
language pathologists and audiologists, medical technologists (also
known as clinical laboratory scientists), medical technicians (also
known as clinical laboratory technicians), and physician assistants.
(2) The National Board for Certification in Occupational Therapy
(NBCOT) is authorized to issue certificates in the field of
occupational therapy pending final adjudication of its credentialing
status under this part.
(3) The Foreign Credentialing Commission on Physical Therapy
(FCCPT) is authorized to issue certificates in the field of physical
therapy pending final adjudication of its credentialing status under
this part.
(4) The Service will notify the public of additional credentialing
organizations through interim rules published in the Federal Register.
(f) Contents of the health care certificate. A certificate issued
under section 212(a)(5)(C) of the Act must contain the following:
(1) The name, address, and telephone number of the credentialing
organization, and a point of contact to verify the validity of the
certificate;
(2) The date the certificate was issued;
(3) The health care occupation for which the certificate was
issued; and
(4) The alien's name, and date and place of birth.
(g) English language requirements. (1) With the exception of those
aliens described in paragraph (g)(2) of this section, every alien must
meet certain English language requirements in order to obtain a
certificate. The Secretary of HHS has determined that an alien must
have a passing score on one of five combinations of the four tests
listed in paragraph (j)(3) of this section before he or she can be
granted a certificate.
(2) The following aliens are exempt from the English language
requirements:
(i) Alien nurses who are presenting a certified statement under
section 212(r) of the Act.
(ii) Aliens who have graduated from a college, university, or
professional training school located in Australia, Canada (except
Quebec), Ireland, New Zealand, the United Kingdom, and the United
States.
(3) The following English testing services have been approved by
the Secretary of HHS:
(i) Michigan English Language Assessment Battery (MELAB).
(ii) Educational Testing Service (ETS).
(iii) Test of English in International Communication (TOEIC)
Service International.
(iv) International English Language Testing System (IELTS).
(4) Passing English test scores for various occupations.
(i) Occupational and physical therapists. An alien seeking to
perform labor in the United States as an occupational or physical
therapist must obtain the following scores on the English tests
administered by ETS: Test Of English as a Foreign Language (TOEFL):
Paper-Based 560, Computer-Based 220; Test of Written English (TWE):
4.5; Test of Spoken English (TSE): 50. The certifying organizations
shall not accept the results of the MELAB, the TOEIC, or the IELTS for
the occupation of occupational therapy or physical therapy.
(ii) Registered nurses and other health care workers requiring the
attainment of a baccalaureate degree. An alien coming to the United
States to perform labor as a registered nurse (other than a nurse
presenting a certified statement under section 212(r) of the Act) or to
perform labor in another health care occupation requiring a
baccalaureate degree (other than occupational or physical therapy) must
obtain one of the following five combinations of scores to obtain a
certificate:
(A) ETS: TOEFL: Paper-Based 540, Computer-Based 207; TWE: 4.0; TSE:
50;
(B) MELAB: Final Score 79; Oral Interview: 3+;
(C) MELAB: Final Score 79; plus TSE: 50;
(D) TOEIC Service International: TOEIC: 725; plus TWE: 4.0 and TSE:
50; or
(E) IELTS: 6.5 overall with a spoken band score of 7.0.
(iii) Occupations requiring less than a baccalaureate degree. An
alien coming to the United States to perform labor in a health care
occupation that does not require a baccalaureate degree must obtain one
of the following five combinations of scores to obtain a certificate:
(A) ETS: TOEFL: Paper-Based 530, Computer-Based 197; TWE: 4.0; TSE:
50;
(B) MELAB: Final Score 77; Oral Interview: 3+;
(C) MELAB: Final Score 77; plus TSE: 50;
(D) TOEIC Service International: TOEIC: 700; plus TWE 4.0 and TSE:
50; or
(E) IELTS: 6.0 overall with a spoken band score of 7.0.
(h) Alternative certified statement for certain nurses.--(1) CGFNS
is authorized to issue certified statements under section 212(r) of the
Act for aliens seeking to enter the United States to perform labor as
nurses. The Service will notify the public of new
[[Page 63323]]
organizations that are approved to issue certified statements through
interim rules published in the Federal Register.
(2) An approved credentialing organization may issue a certified
statement to an alien if:
(i) The alien 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;
(ii) The alien has passed the National Council Licensure
Examination (NCLEX);
(iii) The alien is a graduate of a nursing program in which the
language of instruction was English;
(iv) The nursing program was located in:
(A) Australia, Canada (except Quebec), Ireland, New Zealand, South
Africa, the United Kingdom, or the United States; or
(B) Another country designated by unanimous agreement of CGFNS and
any equivalent credentialing organizations which have been approved for
the certification of nurses and which are listed at paragraph (e) of
this section; and
(v) 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 that have been approved for the
certification of nurses.
(3) An individual who obtains a certified statement need not comply
with the certificate requirements of paragraph (f) or the English
language requirements of paragraph (g) of this section.
(4) A certified statement issued to a nurse under section 212(r) of
the Act must contain the following information:
(i) The name, address, and telephone number of the credentialing
organization, and a point of contact to verify the validity of the
certified statement;
(ii) The date the certified statement was issued; and
(iii) The alien's name, and date and place of birth.
(i) [Reserved]
(j) Application process for credentialing organizations.--(1)
Organizations other than CGFNS. An organization, other than CGFNS,
seeking to obtain approval to issue certificates to health care
workers, or certified statements to nurses shall submit Form I-905,
Application for Authorization to Issue Certification for Health Care
Workers, and all accompanying required evidence, to the Director,
Nebraska Service Center, in duplicate with the appropriate fee
contained in 8 CFR 103.7(b)(1). An organization seeking authorization
to issue certificates or certified statements must agree to submit all
evidence required by the Service and, upon request, allow the Service
to review the organization's records related to the certification
process. As required on Form I-905, the application must:
(i) Clearly describe and identify the organization seeking
authorization to issue certificates;
(ii) List the occupations for which the organization desires to
provide certificates;
(iii) Describe how the organization substantially meets the
standards described at 8 CFR 212.15(k);
(iv) Describe the organization's expertise, knowledge, and
experience in the health care occupation(s) for which it desires to
issue certificates;
(v) Provide a point of contact;
(vi) Describe the verification procedure the organization has
designed in order for the Service to verify the validity of a
certificate; and
(vii) Describe how the organization will process and issue in a
timely manner the certificates.
(2) Applications filed by CGFNS. (i) Prior to issuing certificates
to nurses, physical therapists, occupational therapists, speech-
language pathologists, medical technologists (also known as clinical
laboratory scientists), medical technicians (also known as clinical
laboratory technicians), and physician assistants under section
212(a)(5)(C) of the Act, or issuing certified statements to nurses
under section 212(r) of the Act, CGFNS shall submit Form I-905 to the
Director, Nebraska Service Center, to ensure that it will be in
compliance with the regulations governing the issuance and content of
certificates and certified statements.
(ii) Prior to issuing certificates for any other health care
occupation listed in paragraph (c) of this section, CGFNS shall submit
Form I-905, Application for Authorization to Issue Certification for
Health Care Workers, to the Director, Nebraska Service Center with the
appropriate fee contained in 8 CFR 103.7(b)(1) for authorization to
issue such certificates. The Service will evaluate CGFNS' expertise
with respect to the particular health care occupation for which
authorization to issue certificates is sought, in light of CGFNS'
statutory designation as a credentialing organization.
(3) Procedure for review of applications by credentialing
organizations. (i) After receipt of Form I-905, the Director, Nebraska
Service Center shall, in all cases, forward a copy of the application
and supporting documents to the Secretary of HHS in order to obtain an
opinion on the merits of the application. The Service will not render a
decision on the request until the Secretary of HHS provides an opinion.
The Service shall accord the Secretary of HHS' opinion great weight in
reaching its decision. The Service may deny the organization's request
notwithstanding the favorable recommendation from the Secretary of HHS,
on grounds unrelated to the credentialing of health care occupations or
health care services.
(ii) The Service will notify the organization of the decision on
its application in writing and, if the request is denied, of the
reasons for the denial. Approval of authorization to issue certificates
to foreign health care workers or certified statements to nurses will
be made in 5 year increments, subject to the review process described
at paragraph (l) of this section.
(iii) If the application is denied, the decision may be appealed
pursuant to 8 CFR 103.3 to the Associate Commissioner for Examinations.
(k) Standards for credentialing organizations. The Service will
evaluate organizations, including CGFNS, seeking to obtain approval
from the Service to issue certificates for health care workers, or
certified statements for nurses, under the following standards.
(1) Structure of the organization. (i) The organization shall be
incorporated as a legal entity.
(ii) (A) The organization shall be independent of any organization
that functions as a representative of the occupation or profession in
question or serves as or is related to a recruitment/placement
organization.
(B) The Service shall not approve an organization that is unable to
render impartial advice regarding an individual's qualifications
regarding training, experience, and licensure.
(C) The organization must also be independent in all decision
making matters pertaining to evaluations and/or examinations that it
develops including, but not limited to: policies and procedures;
eligibility requirements and application processing; standards for
granting certificates and their renewal; examination content,
development, and administration; examination cut-off scores, excluding
those pertaining to English language requirements; grievance and
disciplinary processes; governing body and committee meeting rules;
publications about qualifying for a certificate and its renewal;
setting fees for application and all other services provided as part of
the screening
[[Page 63324]]
process; funding, spending, and budget authority related to the
operation of the certification organization; ability to enter into
contracts and grant arrangements; ability to demonstrate adequate
staffing and management resources to conduct the program(s) including
the authority to approve selection of, evaluate, and initiate dismissal
of the chief staff member.
(D) An organization whose fees are based on whether an applicant
receives a visa may not be approved.
(iii) The organization shall include the following representation
in the portion of its organization responsible for overseeing
certification and, where applicable, examinations:
(A) Individuals from the same health care discipline as the alien
health care worker being evaluated who are eligible to practice in the
United States; and
(B) At least one voting public member to represent the interests of
consumers and protect the interests of the public at large. The public
member shall not be a member of the discipline or derive significant
income from the discipline, its related organizations, or the
organization issuing the certificate.
(iv) The organization must have a balanced representation such that
the individuals from the same health care discipline, the voting public
members, and any other appointed individuals have an equal say in
matters relating to credentialing and/or examinations.
(v) The organization must select representatives of the discipline
using one of the following recommended methods, or demonstrate that it
has a selection process that meets the intent of these methods:
(A) Be selected directly by members of the discipline eligible to
practice in the United States;
(B) Be selected by members of a membership organization
representing the discipline or by duly elected representatives of a
membership organization; or
(C) Be selected by a membership organization representing the
discipline from a list of acceptable candidates supplied by the
credentialing body.
(vi) The organization shall use formal procedures for the selection
of members of the governing body which prohibit the governing body from
selecting a majority of its successors.
(vii) The organization shall be separate from the accreditation and
educational functions of the discipline, except for those entities
recognized by the Department of Education as having satisfied the
requirement of independence.
(viii) The organization shall publish and make available a document
which clearly defines the responsibilities of the organization and
outlines any other activities, arrangements, or agreements of the
organization that are not directly related to the certification of
health care workers.
(2) Resources of the organization. (i) The organization shall
demonstrate that its staff possess the knowledge and skills necessary
to accurately assess the education, work experience, licensure of
health care workers, and the equivalence of foreign educational
institutions, comparable to those of United States-trained health care
workers and institutions.
(ii) The organization shall demonstrate the availability of
financial and material resources to effectively and thoroughly conduct
regular and ongoing evaluations on an international basis.
(iii) If the health care field is one for which a majority of the
States require a predictor test, the organization shall demonstrate the
ability to conduct examinations in those countries with educational and
evaluation systems comparable to the majority of States.
(iv) The organization shall have the resources to publish and make
available general descriptive materials on the procedures used to
evaluate and validate credentials, including eligibility requirements,
determination procedures, examination schedules, locations, fees,
reporting of results, and disciplinary and grievance procedures.
(3) Candidate evaluation and testing mechanisms. (i) The
organization shall publish and make available a comprehensive outline
of the information, knowledge, or functions covered by the evaluation/
examination process, including information regarding testing for
English language competency.
(ii) The organization shall use reliable evaluation/examination
mechanisms to evaluate individual credentials and competence that is
objective, fair to all candidates, job related, and based on knowledge
and skills needed in the discipline.
(iii) The organization shall conduct ongoing studies to
substantiate the reliability and validity of the evaluation/examination
mechanisms.
(iv) The organization shall implement a formal policy of periodic
review of the evaluation/examination mechanism to ensure ongoing
relevance of the mechanism with respect to knowledge and skills needed
in the discipline.
(v) The organization shall use policies and procedures to ensure
that all aspects of the evaluation/examination procedures, as well as
the development and administration of any tests, are secure.
(vi) The organization shall institute procedures to protect against
falsification of documents and misrepresentation.
(vii) The organization shall establish policies and procedures that
govern the length of time the applicant's records must be kept in their
original format.
(viii) The organization shall publish and make available, at least
annually, a summary of all screening activities for each discipline
including, at least, the number of applications received, the number of
applicants evaluated, the number receiving certificates, the number who
failed, and the number receiving renewals.
(4) Responsibilities to applicants applying for an initial
certificate or renewal. (i) The organization shall not discriminate
among applicants as to age, sex, race, religion, national origin,
disability, or marital status and shall include a statement of
nondiscrimination in announcements of the evaluation/examination
procedures and renewal certification process.
(ii) The organization shall provide all applicants with copies of
formalized application procedures for evaluation/examination and shall
uniformly follow and enforce such procedures for all applicants.
Instructions shall include standards regarding English language
requirements.
(iii) The organization shall implement a formal policy for the
periodic review of eligibility criteria and application procedures to
ensure that they are fair and equitable.
(iv) Where examinations are used, the organization shall provide
competently proctored examination sites at least once annually.
(v) The organization shall report examination results to applicants
in a uniform and timely fashion.
(vi) The organization shall provide applicants who failed either
the evaluation or examination with information on general areas of
deficiency.
(vii) The organization shall implement policies and procedures to
ensure that each applicant's examination results are held confidential
and delineate the circumstances under which the applicant's
certification status may be made public.
(viii) The organization shall have a formal policy for renewing the
certification if an individual's original certification has expired
before the individual first seeks admission to the United States or
applies for adjustment of status. Such procedures shall be restricted
to updating information on licensure to determine the existence of
[[Page 63325]]
any adverse actions and the need to re-establish English competency.
(ix) The organization shall publish due process policies and
procedures for applicants to question eligibility determinations,
examination or evaluation results, and eligibility status.
(x) The organization shall provide all qualified applicants with a
certificate in a timely manner.
(5) Maintenance of comprehensive and current information. (i) The
organization shall maintain comprehensive and current information of
the type necessary to evaluate foreign educational institutions and
accrediting bodies for purposes of ensuring that the quality of foreign
educational programs is equivalent to those training the same
occupation in the United States. The organization shall examine,
evaluate, and validate the academic and clinical requirements applied
to each country's accrediting body or bodies, or in countries not
having such bodies, of the educational institution itself.
(ii) The organization shall also evaluate the licensing and
credentialing system(s) of each country or licensing jurisdiction to
determine which systems are equivalent to that of the majority of the
licensing jurisdictions in the United States.
(6) Ability to conduct examinations outside of the United States.
An organization undertaking the administration of a predictor
examination, or a licensing or certification examination shall
demonstrate the ability to conduct such examination fairly and
impartially.
(7) Criteria for awarding and governing certificate holders. (i)
The organization shall issue a certificate after the education,
experience, license, and English language competency have been
evaluated and determined to be equivalent to their United States
counterparts. In situations where a United States nationally recognized
licensure or certification exam is offered overseas, the applicant must
pass such an examination prior to receiving a certification. In
situations where both a licensure and certification examination are
offered overseas, the licensure examination, or its equivalent, shall
be the standard for receiving a certification, provided a license is
required in at least a majority of the licensing jurisdictions in the
United States. If a majority of the licensing jurisdictions do not
require licensure, then the certification examination shall be the
standard.
(ii) The organization shall have policies and procedures for the
revocation of certificates at any time if it is determined that the
certificate holder was not eligible to receive the certificate at the
time that it was issued. If the organization revokes an individual's
certificate, it must notify the Service and the appropriate State
regulatory authority with jurisdiction over the individual's health
care profession.
(8) Criteria for maintaining accreditation. (i) The organization
shall advise the Service of any changes in purpose, structure, or
activities of the organization or its program(s).
(ii) The organization shall advise the Service of any major changes
in the evaluation of credentials and examination techniques, if any, or
in the scope or objectives of such examinations.
(iii) The organization shall, upon the request of the Service,
submit to the Service, or any organization designated by the Service,
information requested of the organization and its programs for use in
investigating allegations of non-compliance with standards and for
general purposes of determining continued approval as an independent
credentialing organization.
(iv) The organization shall establish performance outcome measures
that track the ability of the certificate holders to pass United States
licensure or certification examinations. The purpose of the process is
to ensure that certificate holders pass United States licensure or
certification examinations at the same pass rate as graduates of United
States programs. Failure to establish such measures, or having a record
showing an inability of persons granted certificates to pass United
States licensure examinations at the same rate as graduates of United
States programs, may result in a ground for termination of approval.
Information regarding the passage rates of certificate holders shall be
maintained by the organization and provided to HHS on an annual basis,
to the Service as part of the 5 year reauthorization application, and
at any other time upon request by HHS or the Service.
(v) The organization shall be in ongoing compliance with other
policies specified by the Service.
(l) Service review of the performance of certifying organizations.
The Service will review credentialing organizations every 5 years to
ensure continued compliance with the standards described in this
section. Such review will occur concurrent with the adjudication of the
request for reauthorization to issue health care worker certificates.
The Service will notify the credentialing organization of the results
of the review and request for reauthorization in writing. If the
Service determines that an organization is not complying with the terms
of its authorization or if other adverse information is developed, the
Service may initiate termination proceedings.
(m) Termination of certifying organizations. (1) If the Service
determines that an organization has been convicted, or the directors or
officers of an authorized credentialing organization have individually
been convicted of the violation of state or federal laws, such that the
fitness of the organization to continue to issue certificates or
certified statements is called into question, the Service shall
automatically terminate authorization for that organization to issue
certificates or certified statements by issuing to the organization a
notice of termination of authorization to issue certificates to foreign
health care workers. The notice shall reference the specific conviction
that is the basis of the automatic termination.
(2) If the Service determines that an organization is not complying
with the terms of its authorization or other adverse information is
brought to the Service's attention, the Service will issue a notice of
intent to terminate authorization to issue certificates to the
credentialing organization. The Notice shall set forth reasons for the
proposed termination.
(i) The credentialing organization shall have 30 days from the date
of the Notice of Intent to Terminate Authorization to rebut the
allegations, or to cure the noncompliance identified in the Service's
notice of intent to terminate.
(ii) Thirty days after the date of the Notice of Intent to
Terminate, the Service shall request an opinion from HHS regarding
whether the organization's authorization should be terminated. The
Service shall accord HHS' opinion great weight in determining whether
the authorization should be terminated. After consideration of the
rebuttal evidence, if any, and consideration of HHS' opinion, the
Service will promptly provide the organization with a written decision.
If termination of credentialing status is made, the written decision
shall set forth the reasons for the termination.
(3) An adverse decision may be appealed pursuant to 8 CFR 103.3 to
the Associate Commissioner for Examinations. Termination of
credentialing status shall remain in effect until and unless the
terminated organization reapplies for credentialing status and is
approved, or its appeal of the termination decision is sustained by the
Administrative Appeals Office. There is no waiting period for an
[[Page 63326]]
organization to re-apply for credentialing status.
PART 214--NONIMMIGRANT CLASSES
6. The authority citation for part 214 continues to read as
follows:
Authority: 8 U.S.C. 1101, 1102, 1103, 1182, 1184, 1187, 1282;
sec. 643, Pub. L. 104-208, 110 Stat. 3009-708; Section 141 of the
Compacts of Free Association with the Federated States of Micronesia
and the Republic of the Marshall Islands, and with the Government of
Palau, 48 U.S.C. 1901, note, and 1931 note, respectively; 8 CFR part
2.
7. Section 214.1 is amended by adding a new paragraph (h) to read
as follows:
Sec. 214.1 Requirements for admission, extension, and maintenance of
status.
* * * * *
(h) Employment in a health care occupation. Any alien described in
8 CFR 212.15(a) who is coming to the United States to perform labor in
a heath care occupation described in 8 CFR 212.15(c) must obtain a
certificate from a credentialing organization described in 8 CFR
212.15(e). The certificate or certified statement must be presented to
the Service in accordance with 8 CFR 212.15(d). In the alternative, an
eligible alien seeking admission as a nurse may obtain a certified
statement as provided in 8 CFR 212.15(h).
PART 245--ADJUSTMENT OF STATUS TO THAT OF PERSON ADMITTED FOR
PERMANENT RESIDENCE
8. The authority citation for part 245 continues to read as
follows:
Authority: 8 U.S.C. 1101, 1103, 1182, 1255; sec. 202, Pub. L.
105-100, 111 Stat. 2160, 2193; sec. 902, Pub. L. 105-277, 112 Stat.
2681, 8 CFR part 2.
Sec. 245.14 [Removed and reserved]
9. Section 245.14 is removed and reserved.
PART 248--CHANGE OF NONIMMIGRANT CLASSIFICATION
10. The authority citation for part 248 continues to read as
follows:
Authority: 8 U.S.C. 1101, 1103, 1184, 1258; 8 CFR part 2.
11. Section 248.3 is amended by adding a new paragraph (i) to read
as follows:
Sec. 248.3 Application.
* * * * *
(i) Change of nonimmigrant status to perform labor in a health care
occupation. A request for a change of nonimmigrant status filed by, or
on behalf of, an alien seeking to perform labor in a health care
occupation as provided in 8 CFR 212.15(c), must be accompanied by a
certificate as described in 8 CFR 212.15(f), or if the alien is
eligible, a certified statement as described in 8 CFR 212.15(h).
PART 299--IMMIGRATION FORMS
12. The authority citation for part 299 continues to read as
follows:
Authority: 8 U.S.C. 1101, 1103; 8 CFR part 2.
13. Section 299.1 is amended in the table by adding ``Form I-905''
to the list of prescribed forms in proper alpha/numeric sequence, to
read as follows:
Sec. 299.1 Prescribed forms.
* * * * *
----------------------------------------------------------------------------------------------------------------
Form No. Edition date Title
----------------------------------------------------------------------------------------------------------------
* * * * * * *
I-905................ ....................... Application for Authorization to Issue
Certification for Health Care Workers.
* * * * * * *
----------------------------------------------------------------------------------------------------------------
14. Section 299.5 is amended in the table by:
a. Adding the Form ``I-905'' in proper alpha/numeric sequence; and
by
b. Adding the entry ``Certificates for Health Care Benefits'' at
the end of the table.
The additions read as follows:
Sec. 299.5 Display of control numbers.
* * * * *
----------------------------------------------------------------------------------------------------------------
Current assigned
INS Form No. INS form title OMB control no.
----------------------------------------------------------------------------------------------------------------
* * * * * * *
I-905................................... Application for Authorization to Issue 1115-0238
Certification for Health Care Workers.
* * * * * * *
Certificates for Health Care Benefits.............. 1115-0226
----------------------------------------------------------------------------------------------------------------
[[Page 63327]]
Dated: October 7, 2002.
James W. Ziglar,
Commissioner, Immigration and Naturalization Service.
[FR Doc. 02-25974 Filed 10-10-02; 8:45 am]
BILLING CODE 4410-10-P