Procare USA has been the healthcare staffing company of choice for Canadian Registered Nurses since 1990. We specialize in placing Canadian RNs on assignments at acute and sub-acute care facilities throughout the United States.

Nursing in the United States offers a variety of unique opportunities to live and work in new places, while expanding your professional experience. Whether taking a brief leave of absence from your current position, or if you plan to remain in the United States indefinitely, our knowledgeable and caring staff will make your move painless and stress-free, guiding you every step of the way. Procare USA's experienced licensing, immigration and housing specialists coordinate all pre-employment arrangements and advise you on all aspects of relocation to the United States.

Procare USA can also assist you in preparing for the NCLEX exam through our association with Kaplan Inc., a premier provider of educational services. After July 26, 2004 it will be advisable for all Canadian RN
to have passed the NCLEX exam since it is one of exams required by the CGFNS for its VisaScreen certification. Call us to find out how Procare USA can save you 15% on Kaplan's NCLEX preparation courses.

Canadian RNs admitted under the North American Free Trade Act (NAFTA) need a TN nonimmigrant (temporary) work authorization to work in the U.S. In order to qualify, the applicant must present a job offer from a U.S. employer, and a professional license for the state of intended employment to a U.S. immigration officer at a U.S. Port of Entry (border or international airport). Eligible dependents are granted TD status and may enter for the duration of authorized stay of the worker. TN work authorization is granted in maximum increments of one year and may be renewed by returning to a Port of Entry or by petitioning for an extension by mail at least a couple of months prior to the expiration date of the period of authorized stay.

BULLETIN
On July 25, 2003, the Department of Homeland Security (DHS - formerly INS) ruled that beginning July 2004, Health Care Worker Certification (commonly referred to as VisaScreen) will be required of seven healthcare occupations including nonimmigrant TN workers. Occupations covered by the rule are: (1) Registered Nurses; (2) Occupational Therapists; (3) Physical Therapists; (4) Speech Language Pathologists and Audiologists; (5) Medical Technologists/Clinical Laboratory Scientists; (6) Physician Assistants; and (7) Medical Technicians/Clinical Laboratory Technicians.

Certification was previously required for professionals in these occupations who applied for Green Cards through employment based petitions. Current Green Card holders, and some family based Green Card applicants will not be required to obtain certification.

The DHS has granted a one year waiver to July 26, 2004 to allow time to obtain certification. TN workers entering the U.S. (or if already in the U.S., changing or extending their status) on and after July 26, 2004 must present Health Care Worker Certification. Workers with TN expiration dates later than July 26, 2004 who leave the U.S. during the period of validity of their TN are subject to inspection on their return and if returning after July 26, 2004 may be required to present certification. Workers with TN expiration dates later than July 26, 2004 who do not leave the country after that date may consider their "deadline" to obtain certification to be deferred until the next time they apply for a new TN.

Current and future TN workers should take action quickly to secure certification and not wait to the last minute to apply. U.S. healthcare employers should address the issue with their TN workers immediately. We estimate it will take three to five months to complete the process. There will undoubtedly be processing and other unforeseen delays, and as a result, workers who defer action will wait longer to come here and workers already here will risk interruptions to their employment and status.

The DHS considered this country's obligations to Canada under NAFTA but determined that the certification requirement was intended to apply to all nonimmigrant (and immigrant) health care workers. Another unfortunate aspect of the rule is that citizens of foreign countries who received education and training in the U.S. are not exempt from the certification requirement. However, DHS has indicated that these applications will be streamlined, allowing exemptions for the English language proficiency and the education equivalence review. Foreign nationals who have valid state license in the U.S. must also obtain certification.

Health Care Worker Certification verifies that: (1) the worker's education, training, license and experience are comparable with that required for an American health care worker; (2) the worker is competent in oral and written English (Note that graduates of health profession programs in Canada (except Quebec), are deemed to have met the English language requirements.); (3) the worker's license is unencumbered; and (4) the worker has passed the state licensing examination (NCLEX) or a predictor examination (CGFNS - we do not recommend this for Canadian nurses).

The certificate will be valid for five years. If a nonimmigrant foreign national seeks to enter the U.S or change status more than five years after a certificate is issued, they will have to obtain a new certificate. The purpose of the five year expiration date is to ensure that when the certificate is submitted, the holder still has the appropriate language and technical skills to perform the duties of the occupation.

The final rule signals the beginning of the end of reliance on U.S. endorsement (no exam) licenses by Canadian RNs because certification (and therefore employment eligibility) requires completion of NCLEX. 80% of employment opportunities were never available to Canadian RNs who depended on endorsement states for employment options. In the future, Canadians with Health Care Worker Certification will be able to take full advantage of employment opportunities throughout the United States.

We reimburse up to $1,000.00 ($250.00 for each thirteen week assignment, prorated for shorter assignments with Procare USA) for costs associated with VisaScreen Certification. In order to qualify for reimbursement, you must be in possession of your VisaScreen Certificate prior to beginning an assignment. Reimbursable expenses include: VisaScreen application fees; NCLEX exam application fees; state license application fees; CGFNS application fees; English language proficiency tests; education transcript fees; license verification fees and fingerprinting. We do not pay or reimburse for postage, copying, translations, notarizing, photos, or other miscellaneous application related costs.