Standardized Tests and Minimum Passing Scores for Foreign Health Care Workers To Demonstrate English Language Proficiency

Federal RegisterNov 7, 2024

89 Fed. Reg. 88294 (Nov. 7, 2024)

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Department of Health and Human Services Health Resources and Services Administration

AGENCY:

Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS).

ACTION:

Request for comments.

SUMMARY:

HRSA proposes modifications to the list of standardized tests and minimum passing scores for foreign health care workers to demonstrate English language proficiency pursuant to section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA).

DATES:

Submit comments no later than December 9, 2024, 11:59 p.m. (ET).

ADDRESSES:

You may submit comments by any of the following methods:

Federal Web-Based Portal: https://www.regulations.gov/. This is the preferred method for the submission of comments. Follow instructions for submitting comments. Include Billing Code 4165-15 in your comments. All submitted comments will be posted without changes to https://www.regulations.gov/. Please do not include any personally identifiable or confidential business information you do not want publicly disclosed.
Email: HRSAComments@hrsa.gov and HRSA_ELP@hrsa.gov with the subject line: “Billing Code 4165-15 Comments on Standardized Tests and Minimum Passing Scores for Foreign Health Care Workers.” This is the alternative method for the submission of comments. Please do not include any personally identifiable or confidential business information you do not want publicly disclosed.

FOR FURTHER INFORMATION CONTACT:

Tanchica West, Office of Special Health Initiatives, Office of Global Health, HRSA, 5600 Fishers Lane, Rockville, Maryland 20857, 301-443-4412.

SUPPLEMENTARY INFORMATION:

I. Background

The purpose of this request is to solicit public comments regarding proposed modifications to the current list of tests and passing scores approved by HHS through HRSA pursuant to section 343 of the IIRIRA, Public Law 104-208 (8 U.S.C. 1182(a)(5)(C)) and implementing regulations promulgated by the Department of Homeland Security at 8 CFR 212.15(g), to demonstrate English language proficiency for noncitizen health care workers. Demonstration of English language proficiency is an element of the certification requirements for certain noncitizen health care workers seeking admission to the United States for the primary purpose of performing labor in a covered health care occupation. HRSA is seeking public comments regarding proposed modifications to the current list of approved standardized tests and minimum passing scores required for certification of foreign health care workers to enhance consistency across approved tests.

Public comments may include the submission of evaluation studies, concordance analysis and findings of concordance, or methodologies supporting the inclusion of a particular test or minimum passing score for demonstrating English language proficiency. In addition to evidence and justification, HRSA requests that comments include:

(1) A bulleted summary of no more than five (5) pages (12-point font single spaced) and

(2) The table (below) with responses for each applicable recommendation.

Comments may address any aspect of the proposed modifications, and all comments will be considered.

Summary of Recommendations on English Language Proficiency Tests and Scores

[12-point font single spaced]

Test name	Test section	Current score	Recommended score	Justification and impact	Evidence	Timeframe
[Insert Name of Test]	[Insert what section of the test the modification refers to, i.e., overall, listening, reading, writing, or speaking.]	[Insert current score for each test by health profession or occupation by level of degree.]	[Insert recommended score for each test by health profession or occupation by level of degree.]	[Provide a brief description of why the modification is necessary.] [Provide a brief description of potential impact of the modification if accepted.]	[Describe evidence to support this modification ( i.e., concordance analysis and findings, evaluation studies, and other supporting material to substantiate this recommendation).]	[Insert if this modification is time sensitive. If yes, describe why.]
Summary of Administrative Comments on English Language Proficiency Tests and Scores

Test name	Test section	Current language	Suggested language	Justification and impact	Evidence	Timeframe
[Insert Name of Test]	[Insert what section of the test the modification refers to, i.e., overall, listening, reading, writing, or speaking, if applicable.]	[Insert recommended modification by health profession or occupation by level of degree.]	[Insert recommended modification by health profession or occupation by level of degree.]	[Provide description of why the modification is necessary.] [Provide description of potential impact of the modification if accepted.]	[Describe evidence to support this modification ( i.e., concordance analysis and findings, evaluation studies, and other supporting material to substantiate this recommendation).]	[Insert if this modification is time sensitive. If yes, describe why.]
General
[Insert any other comments.]

English competency tests	Scores: occupational therapists/physical therapists	Scores: registered nurses and B.S. level health care workers	Scores: <B.S. level health care workers
Cambridge English B2 First, C1 Advanced, or C2 Proficiency	Cambridge English Scale 185 overall and 185 Speaking	Cambridge English Scale 176 overall and 185 Speaking	Cambridge English Scale 169 overall and 185 Speaking.
Educational Testing Service: TOEFL Internet-Based Test	Overall 89 with minimum of 63 on Reading, Listening and Writing and 26 on Speaking	Overall 83 with minimum of 57 on Reading, Listening and Writing and 26 on Speaking	Overall 77 with minimum of 53 on Reading, Listening, and Writing and 24 on Speaking.
Educational Testing Service: TOEIC (Listening and Reading)	Not applicable	725	725.
Educational Testing Service: TOEIC (Speaking/Writing)	Not applicable	160 Speaking/150 Writing	160 Speaking/150 Writing.
International English Language Testing System (IELTS)	Not applicable	6.5 academic with minimum of 7 on Speaking	6 academic or general with minimum of 7 on Speaking.
Michigan English Test (MET)	Not applicable	Overall 55; minimum Speaking section score of 55	Overall 55; minimum Speaking section score of 55.
Occupational English Test (OET)	Reading, Writing, Listening/300; Speaking 350	Reading, Writing, Listening/300; Speaking 350	Reading, Writing, Listening/250; Speaking 350.
Pearson PTE Academic	Not applicable	Overall 55; Reading, Writing, Listening, no section below 50 63 minimum for Speaking	Overall 55; Reading, Writing, Listening, no section below 50.