As long-term care staffing crisis worsens, immigrants can close the gap

When Margarette Nerette arrived in the United States from Haiti, she sought safety and a fresh start.

The former human rights activist feared for his life amid the political turmoil following the military coup that toppled President Jean-Bertrand Aristide in 1991. Leaving behind two young children and sister in Port-au -Prince, Nerette, then 29 years old, went to Miami a few years later on a three-month visa and never returned. In time, she was granted political asylum.

She eventually studied to become a nursing assistant, passed her certification exam, and got a job in a nursing home. The work is hard and doesn’t pay much, she said, but “as an immigrant, those are the jobs for you.”

A few years later, her family also joined her, but her children did not want to follow her career path. As a teenager, Nerette’s daughter, now 25, would ask, “Mom, why are you doing this?” Nerette said. Her daughter considers the work underpaid and too hard.

After many years, Nerette, now 57 years old, left the nursing home to work for the local Florida labor union SEIU1199, representing more than 25,000 healthcare workers. As local vice president of long-term care, she is acutely aware of the staffing challenges that have plagued the industry for decades and are only going to get worse as those in The older baby boomer generation exceeds the limits of long-term care services.

The United States is facing a growing crisis of unfilled job opportunities and high employee turnover rates that put the safety of frail, elderly residents at risk. In a tight labor market where job options are plentiful, low-paying and physically demanding long-term care jobs are a tough sell. Experts say paving the way for immigration care workers will help, but policymakers have yet to move.

In the decade before 2031, employment in healthcare support jobs is expected to increase further 1.3 million won, a growth rate of nearly 18 percent outperformed every other major occupational group, according to the federal Bureau of Labor Statistics. This direct care worker include different types of nurses, home health aides, physical therapy assistants, and occupational therapists, among others.

Certified nursing assistants, who help people with everyday tasks such as bathing, dressing, and eating, make up the largest percentage of staff at nursing homes. In the decade before 2029, nearly 562,000 nursing assistant jobs will need to be filled in the United States, according to an extensive report on nursing home quality issued by the National Academy of Sciences, Engineering, and Medicine. announced last year.

But as the US population ages, there will be fewer workers to fill vacancies in nursing homes, assisted living facilities, and private homes. While the number of adults aged 65 and over will nearly double to 94.7 million between 2016 and 2060, the number of working-age adults will increase by only 15%, according to an analysis of regulatory data. Census of PHI, a research and advocacy organization for the elderly and children. People with disabilities conduct workforce research.

Experts say immigrants can play an important role in filling those gaps. Currently, 1 in 4 direct care workers is foreign-born, according to a report. PHI analysis in 2018.

“We think immigrants are very important to this workforce and the future of long-term care,” said Robert Espinoza, PHI executive vice president of policy. “We think the industry would probably collapse without them.”

Nursing homes and other long-term care facilities have long struggled to maintain enough staff. The problem is exacerbated during a pandemic, when those facilities become hotspots for COVID-19 infections and deaths. More than 200,000 Residents and staff died in the first two years of the pandemic, accounting for about a quarter of all covid deaths during that time.

Since March 2020, the long-term care industry has lost more than 300,000 jobsbringing employment to a 13-year low of just over 3 million, according to an analysis of BLS payroll data by the American Health Care Association and the National Center for Life Support.

Immigration policies aimed at identifying potential workers from abroad to fill long-term care work positions can help relieve stress. But unlike other countries facing similar long-term care challenges, the United States has generally not made it a priority to attract direct care workers from abroad.

“Immigration policy is long-term care policy,” said David Grabowski, a professor of health care policy at Harvard Medical School whose research has focused on the economics of aging and long-term care. term. “If we really want to encourage a strong workforce, we need to make immigration more accessible to individuals.”

Mostly roughly 1 million immigrants come to the United States every year as family members of citizens, although some come on work visas, usually for highly skilled jobs.

On his first day in office, President Joe Biden proposed comprehensive immigration reform to create a pathway to citizenship for undocumented workers and revised visa rules based on immigration. do, and other things, but get nowhere.

“There is not a lot of interest or political will behind opening up more immigration opportunities for mid- to lower-level care aides such as home health aides, health care aides, etc. personal health and certified nursing assistant,” said deputy Kristie De Peña. President of Policy and Director of Immigration Policy at The Niskanen Centera think tank.

The Biden administration did not respond to requests for comment.

A number of local and regional organizations are working to connect immigrants with healthcare jobs.

Ascentria Care Alliance provides social services, refugee resettlement and long-term care services in five New England states. With public and private charitable funding, the organization is beginning to help refugees from Ukraine, Haiti, Venezuela and Afghanistan get the support services they need – language, housing, care childcare – so they can get permanent healthcare jobs in Ascentria. care facilities and of healthcare partners.

Angela Bovill, president and chief executive officer of Ascentria, which is based in Worcester, Massachusetts, said the group has long helped refugees resettle and find work in traditional settings like warehouses or warehouses. Retail store. “We are now looking at what it takes to move them into healthcare jobs,” she said.

The union is applying to the Department of Labor for a grant to scale up the program. “If we do it right, we will build a pathway and a system to move from immigrant to health care worker at the fastest pace,” said Bavill.

Some long-term care experts say the United States can’t wait to come up with policies to attract immigrants.

“We are competing with the rest of the world, other countries want these workers too,” said Howard Gleckman, a senior fellow at the Urban Institute.

For example, Canada will all in about immigration. In 2022, it was more welcoming 430,000 new permanent residents, the most in its history. The government says immigration accounts for nearly 100% of Canada’s workforce growth, and that by 2036, immigrants are expected to make up 30% of the population.

In the US, immigrants make up about a quarter of 14% of the populationaccording to an analysis of census data by the Migration Policy Institute.

Canada Piloting economic transition routes aims to identify and recruit refugees with the skills Canadian employers need. In January, after visiting a refugee camp in Kenya, recruiters offered jobs in Nova Scotia for 65 continuity of care assistants.

In a December survey of 500 nursing homes in the United States, more than half said staff shortages had forced them to turn away new residents.

Industry representatives said these staffing challenges are likely to become an even heavier problem, with more facilities, units or wings closing, after the Biden administration announced it in last year that they were going to establish Minimum nursing home staffing requirements.

A single government mandate will not solve long-standing problems of inadequate training, pay, benefits or career advancement, experts say.

“Young people are not going to clean for 10 to 15 patients for $15 an hour,” says Nerette. “They’re going to McDonald’s. We need to face that reality and come up with a plan.”


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