Book with title Immigration reform on a table.
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Federal-level policy interventions, such as providing work authorizations and pathways to citizenship, are needed to better support immigrant direct care workers and address workforce shortages, according to a new report from the advocacy group PHI.

“This publication emphasizes how important immigrants are to a sector harmed by staffing shortages rooted in poor job quality, low wages and a general lack of advancement opportunities,” PHI President and CEO Jodi M. Sturgeon said in a press release. “Direct care workers are lifelines for older adults and people with disabilities, and we should be designing policy interventions that improve these jobs while supporting segments of the workforce, such as immigrants.”

Overall, the residential care aide workforce will have almost 1.2 million job openings from 2021 to 2031 — 88,400 new jobs created by growth, plus 538,100 job openings from workers transferring to other occupations, plus 561,100 workers leaving the workforce altogether, according to a previous report from PHI, which also contained forecasts for nursing home aide and home health aide needs. 

“In the past 10 years, immigrants grew substantially in their share of the direct care workforce. The proportion of direct care workers who are immigrants grew from about 21% in 2011 to 27% in 2021,” Robert Espinoza, executive vice president of policy at PHI, wrote in the current report.

PHI encourages Congress to enact the Citizenship for Essential Workers Act, which was introduced in the Senate in July after also being introduced in Congress in May 2021. The legislation, which is backed by long-term care advocates, would make undocumented people working as essential workers during the COVID-19 pandemic eligible for a path to citizenship.

Additionally, according to PHI, the State Department has the authority to “create a special ‘caregiver visa’ for direct care workers that would build the pipeline into this workforce and provide immigrants who obtain this visa with an opportunity to live permanently in this country.”

According to industry experts, immigrants could provide support to the direct care workforce, particularly as nursing homes express concerns over the Centers for Medicare & Medicaid Services proposed minimum staffing rule, which would mandate for nursing homes at least 3.0 hours per patient day of direct care – 0.55 hours provided by a registered nurse and 2.45 hours by a nurse aide. As currently written, the rule would allow non-rural nursing homes three years to comply with some elements of the rule, with rural facilities given five years to get up to speed on the overall hourly rate.

“Federal leaders have an opportunity to ensure immigrants play an even bigger role in addressing the workforce shortage in direct care and this report provides a roadmap for government leaders to invest in humane and effective solutions,” Espinoza said.

Read additional immigration-related news here.