Trump-Backed Immigration Plan Could Worsen Senior Housing Workforce Crisis

A new bill aims to dramatically cut immigration levels over the next decade, an action that would be detrimental to the future of the senior housing workforce, experts and industry insiders say.

The Reforming American Immigration for a Strong Economy (RAISE) Act, co-authored by Republican Sens. Tom Cotton of Arkansas and David Perdue of Louisiana and supported by President Trump, could result in a 50% reduction in legal immigration—cutting the number of new green card holders per year from 1 million to just 500,000, according to the Washington Post.

If passed, the new bill would initiate a skills-based points system that would prioritize immigrants that have higher levels of education, better English language abilities, and high-paying job offers.


This could put up a roadblock to increasing immigrant workers in senior housing, which some leaders—including former Holiday Retirement President and CEO Kai Hsiao—have floated as one way to stave off a looming labor crisis.

“Our caregivers of the future are going to come from outside of our borders,” said Hsaio said at the 2015 Senior Housing News Summit in Chicago. “They want to live here in the U.S. and they’re willing to work for it.”

The proposed law would be detrimental to the already strained senior housing workforce, according to executives of the Paraprofessional Healthcare Institute (PHI), a New York City-based nonprofit organization that works to improve long-term care services for seniors.


“Legislation that curbs the number of legal immigrants in this country will have a harmful effect on the long-term care system, where one in four paid caregivers is an immigrant,” PHI vice president of policy Robert Espinoza told Senior Housing News.

Roughly one in four direct care workers are immigrants, totaling approximately 1 million immigrants in the field, according to research PHI released in June.

“Attacking workers who already occupy low-paying jobs with minimal protections will make it more difficult to stabilize a workforce critical to the U.S. economy,” said PHI president Jodi M. Sturgeon in the June research press release.

Long-term care (LTC) operators will need 69% more maintenance workers, 68% more nursing assistants, and 67% more food preparation workers to accommodate demand by 2030, according to a recent study from provider association LeadingAge. By that same year, LeadingAge estimates that care providers will have to boost total staff by 2.5 million people.

In April 2013, as the COO of SNF operator Medicalodges, Fred Benjamin testified before a congressional subcommittee on behalf of the American Health Care Association (AHCA), expressing support for a proposed W visa program to admit low-skilled foreign workers.

These workers could fill many open positions in senior housing, such as certified nurses’ aides, licensed practical nurses, housekeepers, activity aides, and dietary and kitchen workers, Benjamin—now president of the skilled nursing and post-acute division of Lexington Health Network—told SHN. Based in Lombard, Illinois, Lexington Health is a provider of post-acute and long-term skilled care services.

“We simply cannot find enough American workers to fill these jobs, despite having good benefits and many different kinds of outreach programs,” Benjamin said. “We need more workers, and traditionally unskilled immigrant laborers are the people that end up filling many of these roles. Cutting the number of legal immigrants in half would make an already difficult situation much worse.”

Written by Elizabeth Jakaitis

Photo credit: “President of the United States Donald Trump speaking at the 2017 Conservative Political Action Conference (CPAC) in National Harbor, Maryland” by Gage SkidmoreCC BY-SA 2.0

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