The Global Aging Network, which is staffed and run by LeadingAge, in partnership with the Labor Mobility Partnerships (LaMP) has launched an anonymous Foreign-Born Workers Survey to gather information about the experience of foreign-born workers in aging services. The survey is available in all world languages and focuses on the immigrant workers’ experience at three stages: pre-arrival, hiring processes, and experience in the new country. Aging services providers are asked to distribute the brief anonymous survey among current foreign-born employees who do not hold citizenship of the country where they currently reside. Responses must be submitted by October 11, 2024. Learn more here.

The White House announced new protections on June 18 for 500,000 undocumented immigrants married to U.S. citizens that would provide work authorization and a legal pathway to permanent residency. The program applies to spouses who have lived in the U.S. for at least 10 years, are married to an American citizen as of June 17, 2024, and can pass a criminal background check.

Eligible spouses will be approved through a case-by-case assessment by the Department of Homeland Security. If approved, they will be afforded a three-year period to apply for permanent residency while they remain in the U.S. and are eligible for work authorization. The new program also applies to noncitizen children under the age of 21 whose parent is married to a U.S. citizen. The Executive Action does not take effect immediately but is expected to start by the end of Summer 2024.

The U.S.  Department of State’s July Visa Bulletin announced a retrogression in “Final Action Dates” for several high-demand countries. This retrogression will produce significant backlogs, causing extended waiting periods for nurses seeking to obtain their visas and work in the U.S. Visa retrogression occurs when more people apply for a visa in a particular category or country than there are visas available for that month. The statement suggests that the continued high demand for employment-based immigration post-pandemic has nearly exhausted the supply of EB-3 visas, which nurses vie for among a large pool of other occupations.

To combat this, LeadingAge members should urge their Congressional leaders to pass the bipartisan Healthcare Workforce Resilience Act (H.R. 6205/S. 3211). This bipartisan legislation would recapture 25,000 unused immigrant visas for nurses and 15,000 unused immigrant visas for physicians that Congress has previously authorized, as well as visas for immediate family members. It would also require employers to attest that international workers from overseas who receive these visas will not displace any American workers and require eligible international medical professionals to meet licensing requirements, pay filing fees, and clear rigorous national security and criminal background checks before they can receive recaptured green cards.

Foreign-born workers, who account for 27% of our country’s direct care workforce, play a critical role in delivering care to America’s older adults. However, many states maintain strict English-only testing and training requirements that can be a deterrent to prospective non-English speaking caregiver job seekers. Advocacy and research organization PHI analyzed five state initiatives that are working to address these restrictive language-based training and testing requirements with the goal of expanding opportunities for workers who do not speak English as their primary language.

The U.S. Department of State issues a monthly Visa Bulletin that shows which immigrant visa applications can move forward to completion, including employment-based immigrant visas. The tables in the bulletin identify which applications (based on an originating priority date) have moved to the front of the line; the information changes monthly—sometimes retrogressing, sometimes staying static and sometimes moving forward. When the Bulletin shows a change from an earlier date to a later date, it indicates progress is being made toward completing more visa applications.

The Visa Bulletin for April 2024 reflected limited, but positive, movement from the prior month with respect to the EB-3 visa category (Employment-Based Immigration: Third Preference), which allows skilled and professional workers, including in healthcare, to immigrate to the U.S. Specifically, the April Bulletin reflects a gain of 1.5 months for applicants from India and of 2.5 months for applicants from Mexico and the Philippines (these three nations are subject to a country-specific cap, as is China, for which no gain is reflected this month), as well 2.5 months for applicants from all other countries.

LeadingAge continues to advocate for streamlined asylum and immigration policies to support the critical staffing needs in aging services and is closely monitoring the released legislative text from Senate negotiators on February 4. The bill would provide aid to Ukraine, enhance immigration enforcement at the United States-Mexico border, and expedite work authorization for some asylum seekers.

• If enacted, the bill would make significant changes to the asylum claims process, including raising the bar for migrants claiming they fear persecution if returned to their country of origin:
• Migrants may be granted asylum immediately or will proceed to the merit protection interview process.
• Migrants are eligible for work authorization only after they clear the initial Protection Determination Interview at the new higher standard, occurring at the border or within 90 days of entering the country for those in non-custodial supervision.
• Migrants who fail their initial interview are removed from the country.
• Asylum seekers are supervised as they complete the second half of the asylum process and undergo their final Protection Merits Interview within an additional 90 days. During this second window of up to 90 days, migrants are authorized to work.

In addition to expediting the immigration process for asylum seekers, the bill created 250,000 visas for family and employment-based visas to be distributed over five years.  Importantly, it ensures that the children of H-1B immigrants will not be deemed ineligible for green cards when they become adults.

The January 2024 issue of Health Affairs, released January 8, includes an article titled “Nursing Home Staffing: Share of Immigrant Certified Nursing Assistants Grew as US-Born Staff Numbers Fell, 2010-2021.” The authors, Hankyung Jun and David Grabowski, used three nationally representative data sources and found that the percentage of U.S.-born direct care staff in nursing homes decreased, while the percentage of foreign-born workers increased.

In absolute numbers, the number of U.S.-born workers declined while the number of foreign-born workers remained flat. The authors also found that U.S.-born workers were more likely to leave their CNA positions during the pandemic, while foreign-born workers stayed on the job. Using pre-pandemic data, the authors found that nursing homes in regions with a higher share of immigrant CNAs were associated with more direct care staff hours per resident day and better nursing home quality performance.

There are currently no visa options for individuals to come to the U.S. from other countries to work in direct care positions. Foreign-born certified nursing assistants are most likely to have entered the U.S. with a family member who has a green card (“chain migration”). This study provides evidence to support LeadingAge’s position that new international pipelines must be created, and that the country requires immigration reform as a major part of addressing staffing shortages in aging services.

The Department of Homeland Security (DHS) published a Federal Register notice on December 13 reiterating the extensions of the periods to re-register for Temporary Protected Status (TPS) under the existing designations of El Salvador, Haiti, Honduras, Nepal, Nicaragua, and Sudan. Previously, on June 20, the Department posted notices extending the TPS designations of El Salvador, Honduras, Nepal, and Nicaragua for 18 months, but at that time announced that existing TPS beneficiaries who wished to extend their status would be required to re-register during a 60-day period specific to their country’s designation. However, as noted in this news release, the re-registration period for each country is changing from 60 days to the full length of each country’s current TPS designation extension.

Representative Chellie Pingree (D-ME) and Senator Susan Collins (R-ME) are working to reduce the amount of time asylum seekers are required to wait before legally seeking employment. Pingree is attempting to gut “H.R. 5283: Protecting our Communities from Failure to Secure the Border Act of 2023,” a Republican proposal that would block funding to house migrants on federal land, and replace it with her proposal to shorten the period asylum seekers must wait before they can work. 

Pingree’s proposal is one of 23 amendments to be filed by last week’s deadline. Democrats filed 13 amendments, including several attempts to protect the rights of asylum seekers, and creating new pathways for citizenship. Collins is trying to get a similar proposal to shorten the waiting period work permit attached to a border security bill. Shortening the waiting period for work permits from six months to 30 days has been supported by immigration advocates, state and local officials, and business organizations, and was recently endorsed by the U.S. Chamber of Commerce for the first time as a way to ease a nationwide workforce shortage.

Pingree’s pending legislation faces an especially fraught path as many Republicans are seeking to reduce the flow of asylum seekers at the southern border. In a statement, Pingree said, “Congress has been gridlocked over immigration reform for decades, but there is widespread, bipartisan support for my bill to get asylum seekers into the workforce faster.” Pingree’s office is expecting the house will likely vote on the bill this week.

Maine’s congressional delegation has long advocated for shortened waiting periods for asylum seekers to work including a bill championed by Sen. Angus King (I-ME) in 2015.

Rep. Nydia Velázquez (D-NY) also proposes shortening the waiting period to work, though her amendment doesn’t gut the original bill, as Pingree’s does.

Marking the release of a new report on the importance of community consultation as part of refugee resettlement, the Migration Policy Institute (MPI) invites interested individuals to attend a webinar on Thursday, November 30 at 10 a.m. ET. Speakers will include AnnaMarie Bena, U.S. Committee for Refugees and Immigrants; Lillie Hinkle, National Center on Immigration Integration Policy, MPI; and Bojana Zoric Martinez, Bureau of Refugee Programs, Wisconsin State Refugee Coordinator.

More than 200,000 refugees have arrived in the U.S. since 2021 when the country committed to rebuilding the refugee resettlement program after several years of dismantling and record-low admissions. The arrival of so many individuals has consequences for local programs and capacities, requiring consultation and collaboration with communities.

LeadingAge submitted comments to the Department of Homeland Security (DHS) Office of Policy and Strategy U.S. Citizenship and Immigration Services on November 20 in regards to the Modernizing H-2 Program Requirements, Oversight, and Worker Protections. Our comments focus on  specific provisions of the Proposed Rule and share our broader observations about the need to advance and reform our immigration system to provide greater opportunities for aging services providers to benefit from the talents and services workers who are currently outside the United States, and provide opportunities to these workers in return.

The Department of Homeland Security (DHS) and the Department of Labor (DOL) jointly published a temporary final rule increasing the numerical limit (or cap) on H-2B nonimmigrant visas by up to 64,716 additional visas for all of fiscal year (FY) 2024. The H-2B program allows U.S. employers to bring foreign nationals to the United States to fill temporary nonagricultural jobs. Congress has established a statutory cap on the total number of noncitizens who may be issued an H-2B visa or otherwise granted H-2B status during a fiscal year, which is currently 66,000 individuals. However, in late 2023 Congress granted DHS the authority to make available additional H-2B visas for FY 2024.

While the number of aging services providers that seek to hire temporary employees through this program is limited, the increase to the caps will be welcome news for those that do use the program.  Additional information, and a link to the temporary final rule, are available through this announcement from the U.S. Citizenship and Immigration Services (USCIS) website. Among other details, the USCIS notes that the supplemental visas will be distributed in several allocations, including two separate allocations for the second half of FY 2024.

Of the 64,716 additional visas, 44,716 are available only for returning workers (workers who received an H-2B visa or were otherwise granted H-2B status in one of the last three fiscal years). The remaining 20,000 visas are set aside for nationals of El Salvador, Guatemala, Honduras, Haiti, Colombia, Ecuador, and Costa Rica (country-specific allocation) who are exempt from the returning worker requirement.

LeadingAge joined thirteen long-term care organizations on October 17, 2023, in a letter to Secretary of State Antony Blinken asking him to address the critical shortage of health care workers by ending the freeze on green cards and EB-3 visas impacting international nurses. These policies have created backlogs, hindering the recruitment of much-needed workers further exacerbating the staff shortages. The letter asks Secretary Blinken to prioritize nurse cases at embassies and consulates outside the U.S. for those nurses who have current priority dates; and to consider making the dates current effective for the December visa bulletin for at least the EB3 category, to allow nurses outside the U.S. to proceed with immigrant visa interviews.

The following organizations also signed the letter: Advancing Excellence in Long-Term Care Collaborative, ADVION (formerly National Association for the Support of Long Term Care), AMDA – The Society for Post-Acute and Long-Term Care Medicine, American Assisted Living Nurses Association (AALNA), American Association of Post-Acute Care Nursing (AAPACN), American Health Care Association (AHCA), American Seniors Housing Association (ASHA), Argentum, Association of Jewish Aging Services (AJAS), LeadingAge, Lutheran Services in America, National Association of State Veterans Homes (NASVH), National Center for Assisted Living (NCAL), National Rural Health Association (NRHA), and the Pediatric Complex Care Association.

LeadingAge members who hire staff—particularly nurses—from overseas may wonder how a government shutdown could slow down the already slow processes around immigration. In short, the U.S. Citizenship and Immigration Service (USCIS) is primarily funded through application fees, so it will remain open if there is a shutdown. USCIS will continue to accept and adjudicate applications but certain types of applications will not be processed, including religious visas and non-minister religious worker visas. On the other hand, the Department of Labor will cease operations—meaning it will not process any petition types, including Permanent Labor Certifications (PERM). The Department of State is primarily fee-funded and will continue to process and issue visas and passports, but specific embassies and consulates may have to scale back because they do not generate enough revenue on their own.

The Biden Administration announced its September 20 decision to make 500,000 migrants from Venezuela eligible to apply for work permits, with Department of Homeland Security Secretary Alejandro Mayorkas extending their Temporary Protection Status (TPS) for eighteen months. This designation covers immigrants who entered the country prior to July 31, 2023. TPS is reserved for individuals who cannot return safely to their home country for due to armed conflict, natural disasters, or other “extraordinary conditions.”

Senate Majority Leader Chuck Schummer (D-NY) and House Minority Leader Hakeem Jeffries (D-NY), whose communities have been significantly impacted by the rise in immigration, released a joint statement upon the Administration’s announcement. “As a result of this decision, immigrants will be temporarily allowed to work, fill needed jobs and support their families while awaiting an asylum determination,” they said. While the Administration could extend TPS unilaterally, a senior administration official emphasized Congress needs to act to ease the immigration crisis.

An updated version of the Dignity Act (H.R. 3359), a large package of immigration reforms introduced in the House by Representatives Maria Salazar (R-FL) and Veronica Escobar (D-TX) May 23, includes language focused on fixing the current immigration system that aligns with LeadingAge’s current policy priorities. It also includes creating a new visa program with a legal way for most workers to come to the U.S. through established channels.

The legislation, whose other original cosponsors include Representatives Jenniffer González-Colon (R-PR), Hillary Scholten (D-MI), Lori Michelle Chavez-DeRemer (R-OR), Kathy Manning (D-NC), and Mike Lawler (R-NY), covers policies in the following areas: 1) Securing the Border and Restoring Law and Order; 2) Fixing Our Asylum System; 3) Giving Dignity and Redemption to Undocumented Immigrants; 4) Dignity for American Workers; 5) American Agricultural Dominance; and  6) Unleashing American Prosperity and Competitiveness. This last area is of particular interest to LeadingAge as it proposes to make fixes to the current system aligned with our current policy priorities including:

• Cutting the legal immigration backlog at ten years, ensuring anyone that has been waiting for a legal visa (either family-based or employment-based) for ten years or more (calculated by priority date) will be provided with that visa.
• Raising the per-country cap set in the Immigration Act of 1990 from 7% to 15%.
• Increasing high-skilled employment visas opportunities by only counting the principal applicant and excluding derivatives (children and spouses) from counting towards the annual Employment-Based visa caps. It does not raise the caps.
• Creating an Immigration Agency Coordinator position to oversee and streamline immigration functions at USCIS, the State Department, and the Department of Labor; and
• Surging resources to USCIS operations, the Bureau of Consular Affairs and Visa Service at the State Department, and the Office of Foreign Labor Certification at DOL to reduce delays and improve visa processing.

Read “Congress Should Pass Bipartisan Immigration Reform Bill,” written by Laura Reiff, who chairs the Essential Workers Immigration Council. The article describes the provisions of the Dignity Act and makes a strong case for Congress to pass it.

Despite sharp cuts to fiscal year 2024 (FY24) funding for the Department of State, the FY24 House State, Foreign Operations, and Related Programs appropriations bill, released June 22, does include some new bill language directing the Department of State to use funds “to lower wait times for visa services.” If passed, the language, which was not in the fiscal year 2023 (FY23) version of this spending bill, could advance LeadingAge advocacy efforts. The House Committee on Appropriations is expected to vote on the bill on June 23.

LeadingAge and our members have urged Congress to increase funding for the Department of State’s visa processing funding. Thank you to all who responded to our action alert. Your voice makes a difference. Thousands of desperately needed foreign-born health care workers are poised to come to the United States, but cannot due to the federal government’s backlogged and overburdened visa processing operations. With more funds, the Department of State’s National Visa Center could hire additional staff to accelerate the processing of new employment-based visas for foreign-born health care workers.

The Department of Homeland Security (DHS) on June 20 posted Federal Register notices extending the Temporary Protected Status (TPS) designations of El Salvador, Honduras, Nepal, and Nicaragua for 18 months. These notices follow the decision of the Secretary of Homeland Security to rescind the 2017 and 2018 terminations of these designations and extend the reinstated designations for 18 months. This action is effective as of June 9, 2023. Individuals who arrived in the United States after applicable continuous residence dates for these designations are not eligible for TPS.  Existing TPS beneficiaries who wish to extend their status must re-register during a 60-day re-registration period for their country’s designation. For additional information, see the specific TPS country pages on the U.S. Citizenship and Immigration Services website.

The House Foreign Affairs Subcommittee on Oversight and Accountability held a hearing June 7 to examine the workload and budget of the U.S. Department of State’s Bureau of Consular Affairs. Among other issues within the Bureau’s scope of work is the processing visa applications by U.S. embassies and consular offices to qualified visitors, workers, and immigrants from other countries.

Visa application processing is critical given that large numbers of foreign-born health care workers are poised to come to the U.S., but are not able to given the federal government’s backlogged and overburdened visa processing operations. While the questions from subcommittee members focused on issues other than visas for foreign workers, the Bureau’s deputy secretary, Rena Bitter, acknowledged the pent-up demand for business-related visas in her remarks.

Bitter asked the members to support the Consular and Border Security Programs Fiscal Year 2024 budget request, which includes significant funding to add new staff positions and fill existing vacancies within the Bureau. She also urged the subcommittee to make permanent certain spending flexibilities that allow the Bureau to direct resources where they need to go to respond to emerging challenges and unexpected fluctuations in demand and surging workloads.

LeadingAge members can support our advocacy efforts for Congress to increase funding for the Department of State’s National Visa Center through this Action Alert.

The U. S. Citizenship and Immigration Services (USCIS) is updating the review process for authorized migration to the U.S. In January, the Department of Homeland Security (DHS) announced an expansion of its new migration process for Venezuelan nationals, which allowed up to 30,000 per month cap on the number of nationals from Cuba, Haiti, and Nicaragua and their immediate family members, from all four countries. They were to request advance authorization for travel and temporary parole for up to two years in the United States, including work authorization. Due to high interest in these slots, USCIS needed to make process updates effective May 17.

The government is granting advance travel authorization for up to 30,000 non-citizens each month to seek parole on a case-by-case basis under the processes for Cubans, Haitians, Nicaraguans, and Venezuelans. USCIS is updating the review process because the number of supporters who have submitted Form I-134A, Online Request to be a Supporter and Declaration of Financial Support, is significantly higher than the 30,000 monthly travel authorizations available. It is intended to maintain a meaningful and equitable opportunity for all beneficiaries to move forward through the process and seek advance travel authorization. Under the new review process, USCIS will randomly select about half of the monthly total, regardless of filing date, from the entire pending workload of Form I-134A to determine whether the case can be confirmed. They will review the other half of the monthly total of Forms I-134A based on when the case was submitted under the first-in, first-out method, which prioritizes the oldest Forms I-134A for review. Under this updated review process, processing times will vary.

Potential supporters may monitor the status of a Form I-134A they filed in their USCIS online account or check the most recent status in Case Status Online.

The Essential Workers Immigration Coalition (EWIC), of which LeadingAge is a member, posted a statement on May 4 urging Congress to address legal immigration reforms. The Coalition’s statement acknowledges that more effective border security and enforcement are vital to addressing the issues contained in the Secure the Border Act (H.R. 2) and stresses that reform of the legal immigration system is equally important to enable the country to deal with its economic needs. The Coalition requests policies that enable year round temporary visas for all portions of the economy and a commonsense visa program that helps both US workers and the economy.

On May 1, LeadingAge and 430+ business groups joined the U.S. Chamber of Commerce in launching the “Legal Immigration and Border Enforcement Reform This Year (LIBERTY)” Campaign. The Coalition kicked off the Campaign by sending a letter to members of  Congress to “fix our broken legal immigration system, and to strengthen border security policies.”

The Coalition also wants Congress to act on bipartisan compromises that would break the current immigration reform gridlock, which includes expanding the scope of essential worker programs and specifically allowing employers to meet temporary labor needs in non-seasonal jobs. Additionally, the LIBERTY Campaign asks Congress to create new visa options for other high-demand workers to help American employers meet their critical workforce needs.

For more on the LIBERTY Campaign letter and full list of campaign members, click here.

Recent news of the cap on employment-based (E-B) 3 visa petition filings underscores the need for broad-based, government-wide action that taps every potential source of solutions to address critical workforce challenges.  

Take immigration policy. Foreign-born workers, particularly nurses and personal care assistants, are vital contributors to aging services, and make up a significant percentage of America’s long-term care workforce. 

Over the years, LeadingAge members have devised innovative solutions to bring more staff from outside the U.S. to their communities; some of these initiatives depend on employment-based (EB) 3 petition filings to do so.

Creating new pathways to bring refugees and other foreign-born workers here is a policy priority LeadingAge has been advancing throughout the past year to build a pipeline of new workers. As one LeadingAge member said in response to our March 2023 Informal Workforce Snap Poll,  “immigration is key to addressing workforce needs.”

Equally urgent is the reform of existing policy, such as the EB-3 caps. These are examples of our outdated immigration programs and laws that, says Ruth Katz, senior vice president, policy, LeadingAge, that “do not address the workforce needs of today’s America.”

This current freeze, say LeadingAge members, could “potentially cost lives.”

About 150 nurses now in the visa process to come to the U.S. from the Philippines will be delayed, says Bill Lowe, president and CEO of Chicago Methodist Senior Services, who launched United Methodist Healthcare Recruitment in 2005 to bring nurses from the Philippines to work in long-term care. For over 15 years, UMHR has established a worker pipeline of over 300 nurses ready to come to the U.S. 

“These nurses are ready to come over. The Filipino government is ready. The U.S. (government) is not, because of this retrogression,” says Lowe. “Providers are struggling to make it as is. This is a travesty and a tragedy. It’s a really gut punch to say the least.”

Roseville, MN – based Presbyterian Homes and Services since 2002 has used the EB-3 visa to bring nurses over from the Philippines to work in their communities throughout Minnesota, Wisconsin and Iowa through their International Nurse Recruitment (INR) program. Today, over 25% of PHS’s nurses are Filipino.

Rob Lahammer, Vice President of Engagement and Advocacy for PHS, says freezing this visa could “absolutely hurt our organization as we have at least nine nurses from the Philippines who could arrive sooner.”

Lahammer continues, “This announcement will certainly delay the process of getting much needed nurses (and other workers) to our organization in the future. Our international nurses have been such a benefit to PHS as they not only provide outstanding care but work very hard and stay with us for years.”

Adds Katz, speaking to a reporter at The Hill: “To freeze the ability for foreign-born nurses to immigrate to the US using the EB-3 visa eliminates a valuable option for bringing more qualified workers into the aging services sector.” 

“The government is not in sync with the situation,” adds Lowe, speaking to trade outlet ModernHealthcare. “This is affecting everyone from hospitals down through skilled nursing, any healthcare provider that needs nurses to provide services. We’re desperate for nurses.” 

Who loses most? “Ultimately, this harms older adults and families who cannot access needed care and services,” said Katz. 

The U.S. Department of State’s Bureau of Consular Affairs May bulletin, released on April 14, imposes a cap on new employment-based (EB) visa petition filings. The State Department notice is required by the 1990 law that both sets the caps and sets the processes the Executive Branch must follow as the number of visa applications approaches the caps.

The May bulletin notice impacts international registered nurses and employers working to hire them and hoping to apply for a green card to work in the U.S. The May 2023 Visa Bulletin, establishes a worldwide final action cut-off date of June 1, 2022, for the third EB preference category, significantly delaying the issuance of immigrant visas to foreign nationals that are otherwise eligible. LeadingAge encourages Congress to update this immigration policy to reflect the workforce needs of our country today.

As Ruth Katz, SVP Policy, LeadingAge, told The Hill, “To freeze the ability for foreign-born nurses to immigrate to the U.S. using the EB-3 visa eliminates a valuable option for bringing more qualified workers into the aging services sector. This visa retrogression shuts off one meaningful workforce solution, and, ultimately, harms older adults and families who cannot access needed care and services. Without staff, there is no care.” (Full story: “Health Groups Sound the Alarm Over Foreign Nurse Visa Freeze,” Apr. 25, 2023)

On April 19, the House Committee on the Judiciary marked up the Border Security and Enforcement Act of 2023 (H.R. 2640).” Representatives Tom McClintock (R-CA) and Andy Biggs (R-AZ) released the immigration bill on April 17 that would provide border protection, reform the asylum system, crack down on the employment of undocumented workers, and expand migrant family detention. The bill is the House Republican response to high levels of migration on the U.S.-Mexico border. House Republicans have made border security a focal point of their new majority and addressing it is seen as a stepping stone to immigration reforms to help address the aging services workforce shortage.

Read the full bulletin for more details.

On April 11, LeadingAge met with the Migration Policy Institute (MPI) to discuss a wide range of potential immigration reforms that could help address the aging services workforce shortage. MPI’s April 2023 policy brief What Role Can Immigration Play in Addressing Current and Future Labor Shortages? examines how immigration can help address labor shortages, the trade-offs that governments must navigate, and current and potential approaches to factoring labor shortages into economic immigration policies. LeadingAge looks forward to working with MPI as we advocate solutions to the long-term care workforce shortage.

On March 31, the U.S. Citizenship and Immigration Services (USCIS) announced it had received enough petitions to reach the cap for the additional 16,500 H-2B visas made available for returning workers for the early second half of FY23 with start dates from April 1, 2023 to May 14, 2023, under the FY 2023 H-2B supplemental visa temporary final rule.

Read the full bulletin.

McKnight’s Senior Living Business Daily News reports the U.S. Citizenship and Immigration Services has received enough petitions to reach the congressionally mandated cap for the additional 16,500 H-2B visas made available for returning workers for the early second half of fiscal year 2023 for foreign workers starting April 1 to May 14, the agency announced Friday.

Read the full article.

LeadingAge members participated in a Workforce Snap Poll in March 2023 that showed a sizeable interest in how to tap into immigrants and refugees as aging services caregivers. As LeadingAge senior vice president of government policy Ruth Katz shared in her recent blog, “members of Congress on both sides of the aisle can come together and do something meaningful to help trained, qualified people from other countries to legally enter the United States and work in aging services. It will take courage and political will to frame and fund these solutions, but it must be done.”

Katz emphasizes the Administration can create pathways for refugees that can benefit from working in aging services. On the workforce snap poll, one LeadingAge member shared that “there seems to be no urgency among government agencies involved in [helping foreign workers come to the U.S.]” and another stated that they “have 100 caregivers petitioned and have been spending years to get them over.”

The budget requests $7.3 billion for the Office of Refugee Resettlement (ORR) to help rebuild the Nation’s refugee resettlement infrastructure and support the resettling of up to 125,000 refugees in 2024. Further, it includes a request for $865 million for United States Citizenship and Immigration Services to process an increasing asylum caseload, reduce the historically high immigration benefit request backlog, support the Citizenship and Integration Grant Program, and improve refugee processing to advance the Administration’s goal of admitting 125,000 refugees.

See the full budget proposal and LeadingAge’s response. 

LeadingAge joined other health and long-term care services and support organizations to send a March 6 letter to the Department of Homeland Security on its proposed increases to immigration and naturalization benefit request fees charged by the U.S. Citizenship and Immigration Services (USCIS). Twenty national organizations signed the letter. With 1 in 4 direct care workers born outside of the U.S., the letter reiterates LeadingAge’s strong support of our nation’s immigrants who make up a large portion of the long-term care workforce. The “increased fees could take a toll on long-term care communities that rely heavily on immigrants to care for their residents,” the letter says. The letter asks USCIS to consider implementing operational changes to save costs and offers ideas for consideration. Additionally, the letter urges USCIS to focus on ways to expediate immigrant visa processing to bring much-needed health care workers to the U.S. and requests USCIS continue its work to address delays in the “file transfer” associated with premium processing of I-140 Immigrant Petitions for Registered Nurses. The letter can be accessed here.

In this 21-minute Learning Hub QuickCast, Natasha Bryant shares key findings from a research project on hiring and integrating foreign-born workers in our field. LeadingAge members can access “Filling the Care Gap” QuickCast free, which summarizes LTSS Center research and offers: 

• An overview of the presence and impact of foreign-born workers in the long-term care sector.
• Tips on how to integrate foreign-born workers into workplace.
• Insights based on research and feedback from nine human resource directors from the U.S., U.K., Australia and Canada on: 
  • Issues that may arise and how to address and resolve them 
  • Recommendations on how managers can support and integrate foreign born workers into their team

On January 19, the Department of State, in collaboration with the Department of Health and Human Services, announced the creation of the “Welcome Corps” a new private sponsorship program that allows American citizens to support the resettlement and integration of refugees. The program allows groups of five or more Americans to assist refugees with everything from finances to finding a place to live. The program will roll out in two phases, with a goal of matching 10,000 U.S. citizens with 5,000 refugees in the first year, according to a DOS Fact Sheet. During the first phase, volunteers will be matched with refugees already approved under the U.S. Refugee Admissions Program. In the second phase, which will begin mid-2023 according to the State Department, sponsors will be able to identify refugees and refer them to the admissions program.

President Biden unveiled a new policy on January 5 that the Administration says will increase security at the Southwest border and expand legal pathways for safe, orderly and humane migration. The announcement included expansion of the “Venezuela Parole” program to Cuba, Haiti, and Nicaragua as part of the Administration’s New Border Enforcement Actions. On January 10, the Essential Worker Immigration Coalition (EWIC), of which LeadingAge is a member, issued a statement in support of the expansion, in the absence of action by Congress. EWIC members continue to believe that a key component to successful reform of our nation’s immigration system is the creation of a visa program that provides a legal way for U.S. employers to access workers to supplement their workforce when the economy needs them. The statement also reiterates that EWIC looks forward to working with the 118th Congress to address our flawed and outdated immigration laws “both at the border and through legal immigration reform.” 

On October 12 the Department of Homeland Security (DHS) announced actions to reduce the number of people arriving at the U.S. Southwest border, and create a more orderly and safe process for people fleeing the humanitarian and economic crisis in Venezuela. Individual businesses, including LeadingAge members, could ultimately provide support for Venezuelans arriving through this process, and provide employment opportunities.

Read the full article.

As the topic of expanding the recruitment pipeline for aging services to immigration and refugee opportunities picks up in the United States, LeadingAge highlights a couple of success stories in senior communities:

• Tampa Bay Times, July 29, 2022: How Afghan Refugees Found Stability in Tampa Bay Senior Communities.
• Washington Post, Sept. 20, 2021: Immigrants are there for these retirees. So the retirees decided to be there for them.

Read the full member story.

The acute shortage of frontline workers plagues long-term services and supports (LTSS) providers—and is now receiving much-needed media attention—but the struggle doesn’t end there. Providers face daunting challenges filling other positions as well, especially in licensed nursing. One solution to the nursing shortage is the recruitment of immigrant nurses, and LeadingAge member Chicago Methodist Senior Services (CMSS) has created its own solution.

CMSS created United Methodist Healthcare Recruitment (UMHR) in 2005 to facilitate the recruitment of nurses from the Philippines; today, more than 15 years later, the program is going strong despite disruptions caused by the pandemic.

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This week LeadingAge publicly released the IMAGINE initiative – a bold set of proposals to increase the number of foreign-born aging services workers available in the United States. The paper accompanying the announcement describes the challenge and offers ideas for solutions in the form of a series of proposed changes to the country’s immigration laws.

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Current immigration policy has potentially dire consequences for the aging population, particularly regarding the availability of direct care workers, who provide most formal long-term services and supports (LTSS) to older adults. This article summarizes the prevalence and characteristics of the immigrant direct care workforce, including how workers come to the United States, the importance of immigrants to LTSS service delivery, and implications of today’s immigration policy for the current and future immigrant direct care workforce. It also provides an alternative vision for immigration reform that supports workforce development.

Read the full journal article by Robyn I. Stone and Natasha Bryant.

Foreign-born nurses and personal care assistants make up an increasingly significant percentage of workers in the field of long-term services and supports (LTSS) around the world, according to new research from the Global Ageing Network and the LeadingAge LTSS Center @UMass Boston.

These immigrant/migrant workers, who come primarily from developing countries, bring myriad benefits to the LTSS organizations that employ them and the care recipients they serve, according to findings from a 2018 study by the LTSS Center.

Click here to access three new reports that explore those benefits, in addition to identifying challenges associated with hiring foreign-born LTSS workers, exploring strategies to address those challenges, and providing an overview of global migration patterns and policies.

The LeadingAge Center for Applied Research (CFAR) is working with the Global Ageing Network to explore the role that migrant/immigrant workers can play in delivering long-term services and supports (LTSS) to the world’s growing older population.

CFAR researchers will examine the complex issues facing nations that are experiencing a decline in the availability of native-born workers and caregivers even as the demand for qualified LTSS workers increases dramatically. “The use of a migrant and immigrant workforce has broad implications for the recruitment, retention, and working conditions of these workers,” says Bryant. “It also affects the recipients of care, the quality of care they receive, and the workplace environment at provider organizations.”

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