WASHINGTON, D.C. (Jan. 22, 2020) – Lawmakers have the opportunity to improve labor conditions within the international nurse-staffing industry by adding employment rules to a bipartisan bill currently under debate in the Senate, concludes a commentary published today in the New England Journal of Medicine.
The Fairness for High-Skilled Immigrants Act, currently pending a vote in the U.S. Senate, would remove caps on employment-based visas from any single country and reserves 4,400 employment-based visas for immigrant nurses. If signed into law, the proposed legislation would be a win for the international nurse-staffing industry, but may also exacerbate current unfair labor practices, writes Patricia (Polly) Pittman, PhD, FAAN, the commentary’s author and a professor of health policy and management at the George Washington University Milken Institute School of Public Health (Milken Institute SPH).
International staffing agencies often recruit workers from low-income countries with limited employment options. The workers contractually agree to low-paying jobs that make it difficult for them to leave later on. Nurses who do try to leave are often sued by the agency, leading to garnished wages and seized bank accounts.
“There is a unique opportunity right now to address the unfair treatment and exploitation of many immigrant health care workers,” Pittman said. “Under the current standard industry practices, nurses are forcibly retained by staffing agencies for about three years by way of exorbitant contract breach fees that labor migration experts compare to debt servitude.”
In September 2019, a court decision shed light on the unfair practice when a federal judge ruled that a New York nurse-staffing agency unfairly treated more than 200 nurses recruited from the Philippines. The court ruled that the agency violated the Trafficking Victims Protection Act by including unlawful provisions in the nurses’ contracts.
In the commentary, Pittman and co-author Adam R. Pulver, JD, an attorney at Public Citizen Litigation Group who has represented immigrant nurses in staffing-related cases, write that the proposed legislation in Congress could address the unfair treatment if they consider “five key measures for any legislation authorizing additional visas for international nurses.”
“Our experience speaking with and working with nurses shows that agencies rely on foreign nurses’ unfamiliarity with the U.S. legal system to get them to agree to contracts that no American nurse would,” Pulver said. “These are commonsense measures that Congress should pass now.”
The five measures are 1) No recruitment or contract-breach fees are permitted, with U.S. government visa fees paid by employers; 2) Employment contracts should last no longer than one year; 3) Nurses should have a job at a specific organization and location identified by the agency before arriving in the United States; 4) The job should begin within one week of the nurse arriving in the United States; and 5) contracts should not prohibit nurses from taking legal action against the agency if needed.
“Recruitment and staffing agencies should compete in a fair and free labor market with competitive wages and safe working conditions,” Pittman said. “No health care worker should be subjected to such unconscionable practices.”
The commentary, “Unethical International Nurse-Staffing Agencies — The Need for Legislative Action,” was published Jan. 22 in the New England Journal of Medicine. The authors’ views expressed in the commentary are their own and do not represent their affiliated universities or institutions.
WASHINGTON, D.C. (Jan. 16, 2020) – The Fitzhugh Mullan Institute for Health Workforce Equity (Mullan Institute), based at the George Washington University Milken Institute School of Public Health (Milken Institute SPH), today announced the 2020 fellows of the Atlantic Fellows for Health Equity program. The year-long program honors health sector professionals with a commitment to health equity and demonstrated leadership potential. This year’s fellows, the fourth and largest class in the program, were selected from a competitive pool of global and national applicants.
“We are thrilled to announce this year's cohort of extraordinarily talented fellows from all over the U.S. and the world,” said Patricia (Polly) Pittman, PhD, director of the Mullan Institute. “They will be tackling enormously complex challenges to advance health equity in their communities, and we look forward to working with them as they develop their leadership skills over the next year.”
The Atlantic Fellows for Health Equity is part of a network of programs at the Mullan Institute that are funded by The Atlantic Philanthropies. The fellowship advances health equity by connecting and preparing health leaders and is part of a larger network of seven interconnected Atlantic Fellows programs that advance fairer, healthier and more inclusive societies. The international community of Atlantic Fellows will grow to thousands over the next two decades and beyond. In October, the Atlantic Fellows for Health Equity program received additional funding from the Atlantic Philanthropies that will extend its operation at least through 2027.
“This year’s cohort is an incredible group of leaders,” said Guenevere Burke, MD, director of the Atlantic Fellows for Health Equity program and an assistant professor of emergency medicine at GW’s School of Medicine & Health Sciences (SMHS). “The program provides a unique opportunity for these emerging leaders to learn with and from each other, other health experts, community leaders and health equity pioneers.”
In addition to fellows based in the United States, the cohort includes health professionals from Trinidad and Tobago, Nigeria, Pakistan, Liberia, Philippines, Kenya, Malaysia, Nepal, Uganda and India.
The cohort includes leaders with expertise in mental health, health financing, social work, sociology, media, public health, law, health policy, medicine, dentistry and nursing. The following 21 professionals are the 2020 Atlantic Fellows for Health Equity:
2020 Atlantic Fellows for Health Equity View bios here.
Fatima Memorial Hospital
New Orleans, LA
ABRAHAM L.B. FREEMAN
Environmental Officer for Liberia Electricity Cooperation
Environmental Rescue Initiative
PETER GAN KIM SOON
National Primary Health Care Development Agency
American Medical Association
College of Nursing at the University of South Carolina
University of Rochester Medical Center
Pennsylvania State University
Health Global Access Project
Office of the Prime Minister
Trinidad and Tobago
SYED MUSTAFA HASNAIN NADIR
ROSE MARY NAKAME
REMI East Africa
Women & Realities of Disability Society
Ryan White HIV/AIDS Program
University of North Carolina School of Medicine
Fort Dodge, Iowa
LINDSLEY JEREMIAH VILLARANTE
Department of Health’s Health Policy and Development and Planning Bureau, Manila
Brigham and Women’s Hospital