1. Copyright ©2007 CGFNS International VisaScreen ® 1 May 2009

2. Copyright ©2007 CGFNS International VisaScreen® 2008 Statistics VisaScreen® 2006 – 2008 Comparative Statistics VisaScreen® Demographics & Renewal Information May 2009 VISASCREEN® ANALYSIS

3. Copyright ©2007 CGFNS International VISASCREN® 2008 STATISTICS May 2009

4. Copyright ©2007 CGFNS International TOTAL 2008 APPLICATIONS RECEIVED 11,280 May 2009

5. Copyright ©2007 CGFNS International VisaScreen® 2008 Applications by Profession Registered Nurse (RN)10,415 92% Clinical Lab. Scientist (CLS) 644 6% Clinical Lab. Technician (CLT) 18.16% Physical Therapist (PT) 377 3% Occupational Therapist (OT) 17.15% Physician Assistant (PA) 15.13% Speech Language-Pathologist (SLP) 122 1% Audiologist (AUD) 8.07% Licensed Practical Nurse (LPN) 55.49% May 2009

6. Copyright ©2007 CGFNS International May 2009

7. Copyright ©2007 CGFNS International TOTAL 2008 VISASCREN® CETIFICATES ISSUED 9,172 May 2009

8. Copyright ©2007 CGFNS International VisaScreen® 2008 Certificates Issued by Profession Registered Nurse (RN)8,368 91% Clinical Lab. Scientist (CLS) 423 4.7% Clinical Lab. Technician (CLT) 3.03% Physical Therapist (PT) 195 2.1% Occupational Therapist (OT) 9.10% Physician Assistant (PA) 8.09% Speech Language-Pathologist (SLP) 91 1% Audiologist (AUD) 3.03% Licensed Practical Nurse (LPN) 32.35% May 2009

9. Copyright ©2007 CGFNS International May 2009

10. Copyright ©2007 CGFNS International VISASCREN® 2006 - 2008 COMPARATIVE STATISTICS May 2009

11. Copyright ©2007 CGFNS International VisaScreen® 2006-2008 Applications by Profession 200520062008 Registered Nurse (RN)14,46711,60510,415 Clinical Lab. Scientist (CLS)662594644 Clinical Lab. Technician (CLT)2118 Physical Therapist (PT)572413377 Occupational Therapist (OT)281917 Physician Assistant (PA)15 Speech Language-Pathologist (SLP)150145122 Audiologist (AUD)10 8 Licensed Practical Nurse (LPN)799155 May 2009

12. Copyright ©2007 CGFNS International May 2009

13. Copyright ©2007 CGFNS International VisaScreen® 2006 - 2008 Certificates Issued by Profession 2005 2006 2008 Registered Nurse (RN)15,84311,1868,368 Clinical Lab. Scientist (CLS) 777 695423 Clinical Lab. Technician (CLT) 13 11 3 Physical Therapist (PT) 560 361195 Occupational Therapist (OT) 39 21 9 Physician Assistant (PA) 14 15 8 Speech Language-Pathologist (SLP) 131 14691 Audiologist (AUD) 8 12 3 Licensed Practical Nurse (LPN) 72 7132 May 2009

14. Copyright ©2007 CGFNS International May 2009

15. Copyright ©2007 CGFNS International VISASCREEN® DEMOGRAPHICS AND RENEWAL INFORMATION May 2009

16. Copyright ©2007 CGFNS International VISASCREN® DEMOGRAPHICS May 2009

17. Copyright ©2007 CGFNS International VisaScreen® Demographics by Visa Category: Jan – Dec 2008 May 2009

18. Copyright ©2007 CGFNS International VISASCREN® RENEWAL INFORMATION May 2009

19. Copyright ©2007 CGFNS International VisaScreen® Renewal Pursuant to § 212.15 Certificates for foreign health care workers: Expiration of certificate or certified statement The individual's certification or certified statement must be used for any 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. May 2009

20. Copyright ©2007 CGFNS International VisaScreen® Renewal Policy With the passage of the Final Rules on September 23, 2003, VisaScreen® Certificates are valid for five years. Unless the applicant has obtained a permanent visa or has become a U.S. citizen, the VisaScreen® holder must re-apply to CGFNS and obtain a new certificate prior to the expiration date of the original one. May 2009

21. Copyright ©2007 CGFNS International VisaScreen® Renewal Procedures RENEWAL APPLICATION Application, fee and photo must be submitted before expiration of existing VisaScreen® or 212(r) certificate (6 months prior is encouraged). Effective July 1, 2008, the current fee is $250.00 for a renewal. LICENSE VALIDATION All licenses ever held or obtained within past 5 years must be validated. Lifetime licenses must be validated if it has been 3 years since last validation May 2009

22. Copyright ©2007 CGFNS International VisaScreen® Renewal Procedures ENGLISH PROFICIENCY Non-exempt applicants must submit valid and passing English proficiency scores EDUCATION Transcripts from the initial application are deemed sufficient ISSUANCE OF CERTIFICATE New VisaScreen® certificate with an expiration date computed from original issuance date will be issued upon approval of all documents and materials May 2009

23. Copyright ©2007 CGFNS International VisaScreen® Renewal Applications: Jan - Dec 2008 May 2009

24. Copyright ©2007 CGFNS International VisaScreen® Renewals The potential pool of TN status applicants that may need a renewal certification when the original 2005 and 2005 VisaScreen® expires: 2004 2005 (2009 Renewal) (2010 Renewal) Registered Nurses38542547 Physical Therapists 47 91 Occupational Therapists 10 9 Clinical Laboratory Scientists (Medical Technologists) 207 83 TOTAL41182730 May 2009

25. Copyright ©2007 CGFNS International VISASCREEN® RENEWALS AND ENGLISH PROFICIENCY May 2009

26. Copyright ©2007 CGFNS International VisaScreen® Renewals and English Proficiency English Proficiency test criteria will not apply to those who request a VisaScreen® renewal and who have been working in the U.S. for the immediate past 3 years. Employers of renewal applicants will be required to verify the 3 year working history. May 2009

27. Copyright ©2007 CGFNS International VisaScreen® Renewals and English Proficiency Facilitates renewals of TN’s and H1-B visa holders VisaScreen® Certificates. VisaScreen® certificate holders who remain in their country due to retrogression will be affected Those VisaScreen® holders who cannot document 3 years of the U.S. working experience will have to take the English proficiency exam. May 2009

28. Copyright ©2007 CGFNS International VISASCREEN® PROFESSIONS UPDATE MEDICAL TECHNOLOGIST PHYSICAL THERAPIST OCCUPATIONAL THERAPIST

29. Copyright ©2007 CGFNS International VisaScreen® and Medical Technologists CGFNS has taken the position that specialists in medical technology (e.g., cytotechnologists) are not subject to the VisaScreen® requirement. USCIS agrees that a VisaScreen® can not be issued in these instances, as specialists fall outside of the regulation, and will adhere to CGFNS’ decision on each individual case. As provided in 8 CFR 212.15 (c), only the health care occupations listed are subject to the healthcare certification requirement. May 2009

30. Copyright ©2007 CGFNS International VisaScreen® and Physical and Occupational Therapists USCIS is rejecting H1-B and permanent visa petitions filed by PT’s and OT’s nullifying their VisaScreen® certificates. Challenging educational comparability based on Department of Labor (DOL) designation of master’s degree as entry level May 2009

31. Copyright ©2007 CGFNS International VisaScreen® and Physical and Occupational Therapists CGFNS, FCCPT, NBCOT and AILA are contesting USCIS action: DOL erred in its analysis. CGFNS holds state licensure requirements rule over educational standards. Deterrent to foreign educated PT’s and OT’s seeking occupational visas. May 2009

32. Copyright ©2007 CGFNS International FOREIGN EDUCATED PRACTICAL NURSES

33. Copyright ©2007 CGFNS International Foreign Educated Practical Nurses Historically, practical nurse programs outside the U.S. are rare Majority of practical nurses who were educated outside the U.S. were first level nurses who did not qualify for CGFNS Qualifying Exam or NCLEX-RN Current proliferation of practical nurse programs, especially in Philippines, Haiti and Jamaica. May 2009

34. Copyright ©2007 CGFNS International Foreign Educated Practical Nurses Practical nurses not recognized or regulated in those countries. No standards of education or practice to ensure quality or consistency of programs Promotes documentation fraud, misrepresentation and exploitation of nurses May 2009

35. Copyright ©2007 CGFNS International Foreign Educated Practical Nurses CGFNS supports consistency in U.S. licensure of foreign educated practical nurses –Require initial licensure from country of education. –Clear educational standards. –Government recognition, accreditation or approval of nursing program. May 2009