Alliance for Ethical International

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Alliance for Ethical International Recruitment
Practices
www.fairinternationalrecruitment.org
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Facilitate the adoption and compliance with
voluntary standards that aim to ensure that
recruitment practices of foreign-educated nurses
to the United States are ethical, responsible,
and transparent.
Mission Statement
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The Voluntary Code of Ethical Conduct for the
Recruitment of Foreign-Educated Nurses to the
United States (the Code)

• Grew out of concerns that
• The recruitment of health professionals from less
  developed nations should not weaken the capacity
  of those countries to deliver critical health
  services.
• Health professionals recruited from abroad may be
  vulnerable to unfair labor practices due to
  limited information about their rights and
  difficulties in accessing affordable legal
  counsel.
• In order to provide high quality care, most
  foreign-educated health professionals need
  adequate clinical and cultural orientation
  programs.

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The Code

• It was based on
• 1. Research 2007 comprehensive study of U.S.
  recruitment of foreign-educated nurses (FENs)
  that described the size, scope, and practices of
  the emerging industry.
• 2. Negotiations Among U.S. stakeholders
• Domestic and foreign-educated nurse
  professional associations
• Employers
• Unions
• Recruiters
• Nurse certification and licensure bodies

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The Code

• Acknowledges the rights of individuals to
  migrate.
• Reflects the mutual recognition of legitimate
  interests and responsibilities of nurses, source
  countries, and employers of destination
  countries, and understands that these may be in
  conflict.
• Affirms that a careful balance of these
  individual and collective interests is needed to
  maximize benefits and reduce potential harm to
  all parties.

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The Code

• Minimum Standards
• Compliance with laws in any country in which they
  operate.
• Communicate and make representations in an
  honest, forthright and accurate manner.
• Adhere to general principals of fair contract,
  immigration and labor practices.
• Support FENs transition into the U.S. workforce.

• Best Practices
• Working jointly with local authorities in
  source countries to ameliorate negative
  impact on health services.
• Avoiding recruitment in countries or areas
  within countries experiencing severe health
  worker shortages.

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Early Endorsements

• AFT Healthcare
• American Association of Colleges of Nursing
  (AACN)
• American Association of International Healthcare
  Recruitment (AAIHR)
• American Federation of State, County and
  Municipal Employees (AFSCME)
• American Health Care Association (AHCA)
• American Healthcare Services
• American Hospital Association (AHA)
• American Nurses Association (ANA)
• American Organization of Nurse Executives (AONE)
• Assignment America Inc., an affiliate of Cross
  Country Healthcare, Inc.
• Avant Healthcare Professionals
• Cambridge Staffing Solutions, LLC
• Cambridge Healthcare, A Division of Cambridge
  Global Services
• Canadian Travel Nurses
• DB Healthcare, Inc.
• District of Columbia Board of Nursing
• Hammond Law Group, LLC
• HCCA International
• Health Carousel, LLC

• National Association of Health Care Recruiters
  
• National Association of Indian Nurses of
  America
• (NAINA)
• National Center for Assisted Living (NCAL)
• National Council for State Boards of Nursing
  (NCSBN)
• New York State Nurses Association (NYSNA)
• Nurse Alliance of SEIU Healthcare (SEIU)
• OGrady-Peyton, International, a division of
  AMN Healthcare
• Philippine Nurses Association of America
  (PNAA)
• PPR Healthcare Staffing
• Procare USA, LLC (Nursing USA, Inc)
• Realizing Rights
• Reliable Healthcare Services, Inc.
• RN India, Inc.
• Sigma Theta Tau International
• St. Johns Health Network
• TKI Healthcare Resources, LLC

• Letters of Support
• CAREX
• Commission on Filipinos Overseas
• Commission on Graduates of Foreign Nursing
  Schools (CGFNS)
• Philippine Nurses Association, Inc. (PNA)
• Philippine Overseas Employment Agency (POEA)

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Subscribers to the Code

• Any organization that engages in the recruitment
  of foreign-educated
• nurses (FENs), directly or indirectly, should
  consider becoming an
• Alliance Subscriber.
• This includes
• Recruiting firms who contract with FENs in a
  source country to facilitate migration to the
  United States and placement in healthcare
  employment.
• Staffing Agencies who recruit and employ FENs and
  lease them to healthcare organizations in the
  United States.
• Hospitals, health systems and long-term care
  organizations who employ FENS (some recruit
  directly and others use recruiters or agencies).
• Subscribers to the Code are expected to
• Voluntarily agree to comply with minimum
  standards
• Strive to achieve best practices and
• Fully cooperate with the monitoring and
  remediation process.

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Alliance Board Composition
Domestic and Foreign-educated Nurse
Professional Associations
Nurse Licensure and Certification Bodies

• National Council of State Boards of Nursing
• Commission of Graduates of Foreign Nursing
  Schools

• American Nurses Association
• Association of Nurse Executives
• National Association of Healthcare Recruitment
• National Association of Indian Nurses of America
• Philippine Nurses Association of America

Recruiters

• American Association of International
  Healthcare Recruitment
• GlobalCare, Inc.
• OGrady Peyton International

Employers

• American Hospital Association
• Federation of American Hospitals
• Johns Hopkins Health System

Unions

• AFT Healthcare
• National Federation of Nurses
• Nurse Alliance of SEIU Healthcare

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Subscription Process

• Free During Pilot (2010-2011)
• Interested recruiters and employers download
  Code and guidelines for developing
  administrative processes to ensure compliance.
• Application form and administrative plan for
  compliance completed and submitted to the
  Alliance. Provisional Subscriber status awarded.
• Within six months of application, Provisional
  Subscribers implement administrative plan for
  compliance.
• Provisional Subscribers interviewed by Alliance
  staff. If approved, Certified Subscriber status
  is awarded.
• Certified Subscribers initial and sign Code and
  sign an agreement consenting to be monitored,
  and if necessary, participate in a remediation
  process.
• Certified Subscribers gain access to the Seal
  which can be used on promotional materials and
  will be listed on Alliance Web site. In addition,
  nurses employed or recruited by subscribers can
  access the Nurse Survey Program.

Phase I Provisional Subscribers
Phase II Certified Subscribers
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Monitoring Compliance of Subscribers

• Anyone, including FENs, may use the OPEN REPORT
  function on the Web site to file comments on
  recruitment practices of Certified Subscribers.
• Upon signing a contract with a subscriber, FENs
  will receive a copy of the Code and the
  subscriber will ask the FENs permission to
  provide the Alliance with their email. The email
  will be used to register them in the Nurse Survey
  Program.
• If registered, nurses will be invited by the
  Alliance to fill out a series of three anonymous
  surveys
• at time of signing contract in home country
• two weeks after arriving in the U.S.
• one year after arriving in the U.S.
• In the event that a nurse reports a situation of
  non-compliance with the Code, the survey will
  request supporting documentation and will ask the
  nurse if they would like Alliance staff to
  investigate the case.
• FENs will be provided with an extensive list of
  resources and contacts that they may find helpful
  in resolving their own situation.
• If the FEN would like the Alliance to open an
  investigation, the subscriber will be contacted
  and asked to provide documentation.
• If the determination is made after reviewing
  materials provided by both sides that the
  subscriber is in non-compliance, Alliance staff
  will engage in a period of remediation (maximum
  90 days) to work with the subscriber to correct
  the problem.
• If the problem is not corrected, subscribers can
  be de-listed.

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Handling Reports of Non-Subscribers

• FENs recruited by companies that do not
  subscribe to the Code may report on recruitment
  practices they have experienced through the
  OPEN REPORT function of the Alliance Web Site.
• In addition, employers, unions, and other U.S.
  health professionals may also use the OPEN
  REPORT mechanism to report recruitment practices
  they have either experienced or observed.
• While the Alliance can not allocate resources to
  investigating and mediating problems with
  non-subscribers, if requested by the FEN the
  Alliance will
• Notify the company that the Alliance has received
  a report involving them and encourage them to
  read the Code and develop a plan to ensure
  compliance with its principals.
• Refer FENs to relevant organizations for guidance
  and assistance.

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What Are Stakeholders Saying?
Unions
Regardless of nationality, no nurse should be
exploited. It is imperative that the Alliance for
Ethical International Recruitment Practices
continue to be supported in its work to protect
international nurse recruitments.Norma
Amsterdam, Executive Vice President, SEIU United
Healthcare East
Recruiters
The Code clearly demonstrates our commitment to
ethical recruitment practices. It separates us
from non-subscriber organizations and helps
distinguish us in the eyes of our customers, the
healthcare professionals we recruit, and the
hospitals and healthcare facilities we serve.
Marcia Faller, Executive Vice President, OGrady
Peyton International/AMN
Regulators
State boards of nursing believe ethical
recruitment practices are important to ensure
compliance with state nurse licensing laws and to
help the newly licensed nurse understand his or
her legal responsibilities Kathy Apple, CEO,
National Council of State Boards of Nursing
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What Are Stakeholders Saying?
Foreign-Educated Nurses
Recruiters and employers who are Certified
Subscribers of the Alliance are required to meet
recruitment standards that are ethical and
transparent. These standards were developed to
protect foreign-educated nurses throughout the
recruitment process employment/placement,
migration, and acculturation. The seal of the
Alliance should give nurses the confidence and
assurance that they are dealing with a reputable
vendor or recruiter.Sara Gabriel, Immediate
Past President, National Association of Indian
Nurses of America
Hospital HR Leaders
The Code represents a Stamp of Approval to the
healthcare community as well as external and
internal stakeholders that your hospital is a
preeminent healthcare leader and subscribes to
transparent, ethical recruitment practices for
international professionals. The Code sets your
hospital apart from other organizations and
clearly raises the bar for recruitment excellence
as measured by objective evidence and established
best practices.Lydia Ostermeier, Vice
President, National Association for Healthcare
Recruitment