A significant number of elderly and disabled Americans rely on caregivers who are immigrants from varying backgrounds who entered the U.S. under a range of circumstances. Now, tougher enforcement of immigration policies – including deportations of those who entered or stayed unlawfully and an end to programs like the Temporary Protected Status – have many fearing what this will mean for so many of the elderly who rely on these workers for their care.
Some caregivers are hired by temp agencies to provide in-home care and assistance. Others work in skilled care or assisted living facilities. They are especially prevalent in large cities like Miami, Orlando and others.
For instance, there are approximately 59,000 Haitians living in the U.S. under Temporary Protected Status (TPS) which was granted following a devastating earthquake in that country in 2010. Many of those workers are now employed in low-wage positions, many in health care and a significant portion as home health aides or nursing assistants. However, the Trump administration has announced it will end TPS for these workers by July of 2019. That means people in the program must either leave the country of their own accord or face deportation.
As Kaiser Health News reports, several health care associations are pleading with the government to reconsider. For instance, the Massachusetts Senior Care Association, which represents more than 400 elder care facilities, penned an editorial recently explaining the concern if the Haitian health care workers on which it relies (some 4,300 within its company alone) were suddenly forced to leave, it would have a profoundly negative effect on elder care in the state. Already as it stands, even with them here, 1 in 7 certified nursing assistant (CNA) jobs in that state are vacant, which amounts to a shortage of about 3,000 health workers.
Nationally, an estimated 1 million immigrants work in providing direct health care, per data from the Paraprofessional Healthcare Institute. Immigrants comprise one-fourth of these workers. Median wages are anywhere from $10 to $13 an hour. There is very high turnover among native U.S. workers, who can often find higher paying work at a fast-food restaurant or at a retail counter.
Meanwhile, 10,000 baby boomers are turning 65 daily. We’re looking at a national shortfall of more than 150,000 direct care workers by 2030. By 2040, we’re looking at a shortage of 355,000. Regardless of where you stand politically on the issue of immigration, there is little denying that pushing out a significant number of the workers in an already strapped industry is going to have an impact. Many facilities say they are already feeling it, as workers began to flee (many to Canada) after learning TPS would end and immigration enforcement has tightened.
Short staffing is a well-known causal factor in nursing home neglect cases. But a drop in care quality seems almost inevitable, facility managers say, if reliable workers are deported. The CEO of one 170-bed nursing home revealed that she has eight workers – both Haitian and Salvadoran – with TPS who work as CNAs. Most have been employed for the last five years, never call off and show up reliably every morning at 4:30, she said. Given that the facility already has six CNA vacancies it can’t fill, it can’t afford to lose anymore. As the CEO explained, “There aren’t people to replace them.”
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As Trump Targets Immigrants, Elderly Brace To Lose Caregivers, March 26, 2018, By Melissa Bailey, Kaiser Health News
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