Immigration reform may solve long-term care worker shortage

Immigration reform is once again being taken up in the country’s capital, and depending on the final shape it takes, it could be a boon for the long-term care industry.

The long-term care industry has struggled with labor shortages and faces caring for a projected 88 million people age 65 and older by 2050. “As a result,” wrote Walter Leutz in a report for the Immigration Policy Center on immigrants in long-term care, “immigrants will continue to play a significant role in the growth of the U.S. labor force in general and the direct-care workforce in particular.”

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The Bureau of Labor Statistics projects that the direct-care workforce will be one of the fastest growing, increasing to about 6 million by 2050. In 2005, Leutz noted in his report, there were 2.5 million direct-care workers age 18 and older in the U.S. labor force. One of five of those was born abroad.

In an analysis of U.S. Census Bureau data released in February, the Institute for Women’s Policy Research found that immigrants constitute about 28 percent of the in-home healthcare workforce overall. In each of the reports, the authors noted that most immigrant direct-care workers are women.

“By 2020, we need an additional 1.6 million direct-care workers. There are not sufficient numbers of women entering the workforce to fill these jobs,” said Karen Kahn. “Immigrants will help us meet this challenge.” Kahn is the director of communications at the Paraprofessional Health Institute (PHI), a nonprofit advocating for the direct-care workforce. PHI and IWPR are members of Caring Across Generations, a national campaign to improve elder care that also supports immigration reform.

“We’re going to have a healthcare worker shortage as people live longer. There’s no question about it,” said Harlan York, a New Jersey-based immigration attorney. “Immigration reform, I think, cures, no pun intended, that problem.”

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There are many non-native-born people in the process of trying to immigrate to the United States, York said, but because of the backlog in the country’s immigration system, some have waited decades to be admitted legally. The bipartisan reforms currently being discussed in the nation’s capital could change all that and allow those who have been waiting – not fully documented but not undocumented either – entry to the U.S. and the long-term care workforce.

“Speaking as an immigration lawyer, I will tell you without fail when you look at people in fields like home healthcare, certified nursing assistants, people who work in assisted living facilities and so forth, they often come from countries like Philippines and Ghana, just to name two of many,” he said. “If an immigration reform is passed, I certainly believe it would be beneficial to all – U.S. citizens and immigrants alike – because many of these (people’s immigration status) are in flux.”

For those undocumented people already living, going to school and working in the U.S., immigration reform could open up paths to employment in the long-term care industry that they were barred from before, said Julie Weise, PhD, an immigration policy expert and assistant professor in the international studies program at California State University, Long Beach.

Undocumented residents are often employed below their skill level in the U.S., she said, and undocumented students often opt not to go into healthcare fields because of licensure requirements.

“(Jobs in healthcare) are exactly the types of professions that a lot of first generation college students go into because they are practical and they lead directly to a job …,” she said.

With immigration reform, undocumented residents could fill the positions needed in the long-term care industry – and in other healthcare fields.

“There are all kinds of skills that are out there that are untapped because people are undocumented and cannot work in any job that is going to seriously look at their green cards or seriously examine their documents.”

If immigration reform is passed soon, long-term care employers should expect a large number of non-native-born people to be available for skilled care positions within five to 10 years, Weise said, after they’ve had time to train and become licensed in the U.S.