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Growing need for caregivers could collide with immigration crackdown – Jobsmaa.com

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President Trump's plans to overhaul immigration could reduce the ranks of workers who care for the elderly and disabled at home and in long-term care facilities, leaving California and the nation reeling from the needs of an aging population, health experts and immigrant advocates say.

Trump has promised the largest deportation effort in US history. On his first day in office, he signed executive orders to suspend refugee admissions for months, requiring asylum seekers to stay in Mexico while their cases were adjudicated, and Roll back humanitarian projects It granted temporary legal status and work authorization to more than 1.5 million people.

This could have consequences for tens of thousands of older Americans who need long-term care. California Assessments By 2030, a quarter of the state's population will be at least 60 years old. Across the United States, demand for home health aides, nursing assistants, and personal care aides in long-term care is projected to rise 35% to 41% from 2022 to 2037. National Center for Health Workforce Analysis.

Harvard Medical School professor of health care policy David C. “Long-term care providers and nursing homes have struggled for decades, decades,” Grabowski said. “The jobs are challenging. They generally don't pay well.”

The problem was only magnified by the strain of the epidemic, he said. Now, “at a time when it seems fewer and fewer of us want to work in long-term care, the need has never been greater.”

Immigrants make up 28% of the direct care workforce for people in nursing homes and other long-term care, according to National analysis Independent research group KFF. In California nursing homes, more than half of the certified nursing assistants — direct care workers who feed, bathe and dress residents — were born in other countries, a Study Published last year in Health Affairs.

A small percentage are believed to be in the country without legal authorization: The American Immigration Council, a left-leaning nonprofit that advocates for immigrants, estimates that 4.2% of nursing assistants and 6.4% of home health aides nationally are undocumented, according to an analysis of Census Bureau data.

Those numbers may seem modest, but given the demand for such workers, “when you eliminate that percentage of the workforce, it becomes a huge problem,” said Steven Hubbard, senior data scientist at the American Immigration Council.

While Americans are more broadly in favor of deporting people convicted of violent crimes, a significant share of adults surveyed — 43% — support deporting all immigrants living in the U.S. illegally. A recent poll Associated Press-NORC Center for Public Affairs Research.

California Assemblyman Carl DeMaio (R-San Diego) dismissed the idea that changes to immigration policy expected under the Trump administration would harm the care sector, saying “a secure border does not equate to a vibrant workforce.”

“People who want an open border are trying to demonize or distort the public policy debate here by picking one element and not looking at the full spectrum of savings that we can achieve,” DiMaio said.

Groups that want to reduce immigration have argued that restricting the flow of migrants will put upward pressure on them WagesIt benefits American workers who can then take maintenance jobs.

Others questioned that idea: Despite a shortage of caregivers, wages for such care remain low, exacerbated by an exodus of staff amid the Covid-19 emergency, said Priya Chidambaram, senior policy manager for the Medicaid and Uninsured KFF program. If wages haven't increased yet, “it's hard to imagine why that would be true if we continue to reduce the available long-term care workforce.”

Caregivers could be affected by future changes to Temporary Protected Status or Deferred Action for Childhood Arrivals, both of which protect some immigrants from deportation, experts said.

“Even legal immigrants may actually suffer only from slowdowns in procedural processing that allow them to continue to function in our legal marketplace,” said Cecilia Esterline, senior immigration policy analyst at the Niskanen Center in Washington, D.C.

In Los Angeles, an immigrant woman attends to her elderly client's needs every day — bathing her, changing her diapers, and brushing her teeth. She prepares meals, cleans the bathroom and kitchen and changes bed sheets. She goes outside and helps with walking and helps with daily exercises.

“These people need love, understanding, someone to take care of them,” the Honduran immigrant said in Spanish. The 67-year-old worker asked not to be named because of concerns about his immigration status, fearing that with Trump in the White House, he could be at risk of losing his protection from deportation.

The woman said she entered the United States without authorization decades ago after escaping an abusive spouse. And then she got it Temporary protected statusThis allows them to legally work in the country. The program, which must be renewed regularly, expires within months for Hondurans like him. Under Trump, the caregiver fears she and other immigrants could lose their jobs Government scheme For housekeeping.

“The customers are on their own,” he said, “and no one is taking care of them.”

Advocates have made a point Analysis Published in The Oxford Bulletin of Economics and Statistics, this is a Immigration Enforcement Program If undertaken between 2008 and 2014, it led to a reduction in direct care for nursing home residents.

A crackdown on immigration could reverberate in indirect ways, such as driving away migrant workers who share homes with family members at risk of deportation, experts said.

“We don't know that any policies that come into effect are going to slow the flow of legal immigration,” by making it harder to immigrate to the U.S. or preventing people from coming, said Joan Spetz, director of the U.C. Long-Term Care of the Health Workforce Research Center of San Francisco.

If immigration enforcement slows the flow of workers, “not only is it going to worsen the caregiver shortage we have across America, but it could make caregiving services more expensive and further restrict public assistance programs,” said Megan Ross, a consultant for California representing non-profit providers of senior living and care. Chief Government Affairs Officer.

Industry groups have called for an easier path for migrant carers. “Streamlining legal pathways for interested people to come to our country and serve our seniors is an important part of how our sector will respond to the growing need for long-term care,” said Cliff Porter, president and CEO of the American Health Care ASSN. and the National Center for Assisted Living, which refers to long-term care facilities.

With the Trump presidency, “the biggest threat to this industry is not enforcement,” says George W. said Laura Collins, director of the Bush Institute-SMU Economic Development Initiative. “He's more concerned about the lack of a plan to bring in workers,” he said.

When an area had an influx of migrant workers in nursing homes, Grabowski's research found “negligible impacts on wages.” A Working paper Published by the National Bureau of Economic Research, Grabowski and other researchers found that when immigration rose, the number of care for nursing home residents and other indicators of care improved.

Beyond nursing homes and other residential facilities, “the home care sector is very dependent on immigrants,” said Diana Silver, a professor of public health policy at New York University. “These are all relatively low-skill minimum-wage jobs, but they provide an incredibly necessary skill set.”

One Analysis Phi, a national organization that works to improve jobs for such workers, found that in home care, one-third of caregivers are immigrants. Its president and chief executive, Jodi Sturgeon, said there is no “grey market” in which workers are hired and paid directly by families, which are vulnerable workers who are at risk of deportation.

If they are fired, “people like you and I will have to make decisions about leaving the workforce or reducing our hours to care for our family members,” Sturgeon said.

CU 2015 President Arnalbo de la Cruz, whose union represents California workers in home care, skilled nursing facilities and assisted living, said California and the nation are in the midst of “a care crisis,” and seniors and the disabled want home care more than existing workers can attend.

In recent years, millions of hours authorized under the California program for home care have gone unfilled each month, the union said, underscoring a shortage of needed providers.

Around the U.S., “there are people who can't get support or get dressed or get out of bed — or even sleep in their wheelchairs because there's no one to hire them and support them,” said Stacey Kono of Hand In, a national network of employers of domestic workers, including domestic helpers. Managing Director of Kai. “It's really life and death consequences.”

Times staff writers Andrea Castillo and Karen Kaplan contributed to this report.

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