How U.S. Immigration Policy Could Affect the LTSS Workforce

CFAR | February 06, 2018

How will immigration policy affect the LTSS workforce? Robyn Stone, senior vice president of research at LeadingAge, and Mary DiGangi, human resources director at the Menorah Center for Rehabilitation and Nursing Care, shared their thoughts with The New York Times.

Mary DiGangi, human resources director at the Menorah Center for Rehabilitation and Nursing Care, recently asked local employment agencies to find 20 to 25 new nursing assistants and practical nurses who could fill vacancies at the Brooklyn-based LeadingAge member.

DiGangi expected to be flooded with applications the next day. Instead, Menorah received only 5 applications over the course of a month, according to a Feb. 2 article in The New York Times.

Menorah, part of MJHS Health System, isn’t the only LTSS provider experiencing a shortage of workers.

Robyn Stone, senior vice president of research at LeadingAge, told The Times that widespread worker shortages stem partly from a growing economy. When choosing between LTSS jobs and jobs in other sectors, workers “are likely to look down the street at a hospital that pays more, or another industry like fast food, and leave,” said Stone.

In addition, demographic pressures are creating workforce challenges in the LTSS field, according to Times columnist Paula Span. These include:

  • An older population that is growing rapidly as baby boomers age;
  • Increased longevity, which brings with it higher risks for developing chronic diseases and disabilities, and greater need for services and supports; and
  • Expanding career options for working-age women who have traditionally provided both paid and unpaid care.

Add the fact that LTSS jobs are physically demanding and pay poorly, and you have a situation in which caring for older people “has become the classic example of a job native-born Americans would rather not take,” writes Span.

Immigrants Filling the Gap – for Now

To fill the care gap, many LTSS providers like Menorah draw heavily on immigrants to fill worker vacancies.

The number of immigrants in direct care grew from 520,000 in 2005 to approximately one million in 2015, according to PHI, a New York-based research organization. Despite these increases, however, DiGangi told The Times she’s worried Menorah’s drop in applications is a troubling sign of things to come.

PHI calculations appear to support that concern:

  • Nearly 35,000 LTSS workers are immigrants from Haiti, El Salvador, Nicaragua, and Honduras, reports PHI. But those numbers are sure to decrease after a recent decision to terminate temporary protected status (TPS) for immigrants from the first 3 countries. Twenty-five Haitian-Americans working as nursing assistants and practical nurses at Menorah will have to leave the country by July 2019 unless their TPS is reinstated.
  • Nearly 11,000 direct care workers come from largely Muslim countries affected by the current travel ban. These workers might leave the country if their family members can never join them.
  • An unknown number of LTSS workers, who entered the county as minors, currently receive a renewable 2-year period of deferred action from deportation, and are eligible for a work permit, under the Deferred Action for Childhood Arrivals (DACA) program. With DACA’s fate in question, these workers might eventually be forced to leave the country.

Impact of Immigration Policy

If current trends continue, large numbers of immigrants may become unable to work in the LTSS sector. Even workers who do not face deportation may become fearful that applying for an LTSS job will bring them unwanted attention. Either way, “this is going to create tremendous strain (on the LTSS workforce),” Stone told The Times.

“Just the scrutiny is casting a pall,” said Stone. “If they’re afraid, if they won’t apply for jobs, we could see more shortages.”