Supporting our members’ workforce and ensuring access to skilled employees is a longstanding LeadingAge priority: it is a pillar of our strategic plan and the focus of so much of our association’s endeavors—in education, in live programming, in research, and, of course, in policy. The reason is simple: without staff, there is no care and there are no services. To sustain and grow our sector’s workforce, action is needed on multiple fronts. And advocacy is crucial to that success.

Improving America’s outdated and inefficient approach to immigration is a core component of our workforce policy goals. Our 2019 IMAGINE initiative offered a set of proposals to increase the number of foreign-born aging services workers in the U.S. As workforce challenges mounted, via virtual congressional briefings in 2022 and in 2023 LeadingAge and members raised awareness of systemic shortcomings and needed fixes. And, in 2024, at the introduction of our Immigration Imperative white paper, president and CEO Katie Smith Sloan said, “We’ve got to think boldly; systemic changes are needed to address the shortage of professional caregivers for the long term,” and laid out recommendations to restructure the immigration system.

Over the past 18 months, with urgency for action growing as the current administration’s immigration policy changes directly diminish the ability of hundreds of foreign-born staff to continue working legally at many LeadingAge members nationwide, we’ve stepped up. Now, I’m pleased to share proof of impact resulting from Hill-focused meetings, communications, and collaborations, coupled with a steady drumbeat of stories in national media, all of which raise awareness of the need for change. LeadingAge is the recipient of a new grant from the Open Society Foundations to accelerate our work on immigration policy.

Overview of Efforts

From terminations of categorical parole and temporary protected status (TPS) for people from certain countries to actions that shorten or complicate work authorization renewals, increase scrutiny of existing approvals, and expand enforcement activity, the Department of Homeland Security (DHS) has since early 2025 created uncertainty and concern for employers, lawfully employed workers and residents–with real-world consequences.

In response, LeadingAge has sent letters to federal agency chiefs at the DHS, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS); supported members of Congress in coordinated efforts to oppose TPS cancellations; joined with farmers, hospitality organizations and others in meetings with elected officials in DC; with state partners we’ve spoken at press events in Boston and in Washington DC urging change and responded to a congressional oversight inquiry seeking insight on the impact of TPS cancellations and other policy changes on the aging services workforce. In collaboration with multiple partners led by the American Business Immigration Coalition (ABIC), we’ve helped to push through Representative Ayanna Pressley’s discharge petition that will force a House vote  in the coming weeks to extend Haiti TPS.

Members and residents have been tireless in raising their voices. They’ve joined our president and CEO Katie Smith Sloan in speaking to reporters, resulting in a wealth of national and regional coverage.

Rachel Blumberg, the chief executive of Toby and Leon Cooperman Sinai Residences, a life plan community and LeadingAge member in Boca Raton, FL, told the New York Times of having to notify 38 workers from Cuba, Haiti, and Venezuela in mid-June that they would have to go because the Trump administration ended their country’s temporary legal status. At the time, those staff represented 9% of her work force. “It was like this funeral that would never end,” she said, of those conversations. “They’re my best employees.”

Speaking of his community’s caregivers, the Rev. Donald Goodness, 92, a resident of Goodwin House in Alexandria, VA, last summer said to NPR: “We are full of people who come from other countries.” Without them, the retired Episcopal priest said, “I would be, and my building would be, desolate.”

Explaining the aging-services impact of the late 2025 tightening of work permits for immigrants who have applied for asylum or a range of other humanitarian programs, Rob Liebreich, CEO and president of Goodwin Living, said that asylum seekers could be deterred from coming to the U.S., which could, in turn, potentially worsen labor shortages for senior care. “There’s a huge reality that we need more hands, more trained hands,” he shared with the Wall Street Journal. An even smaller pool of potential workers could raise prices for care, especially as the older adult population in the U.S. grows, he said.

At a January 2026 press conference to highlight the impact of Haiti TPS terminations, Boston, MA’s Laurel Ridge Rehabilitation and Skilled Care Center executive director Colin O’Leary said his community would lose 40% of its dietary aides, as well as 15% of certified nursing assistants–a group that he called “backbone of our industry.” The jobs that they do “are not …easily … filled. … [they] require a personal relationship between the staff and the residents that are forged over months and years together.”

As the February 3 Haiti TPS termination date loomed, Jennifer Stevens, vice president of healthcare at John Knox Villages in Florida–a state that is home to nearly half of all Haitian TPS recipients in the U.S.–shared with the Miami Herald both the negative consequences on her community–and also on the local economy. She said the loss of 10 certified nurse aides would be “huge … there’s no price you could put on the knowledge of really knowing the residents and being able to meet their needs seamlessly.” Nursing homes, hospitals and other care centers, she explained, will have to compete for a smaller pool of qualified workers. They’ll have to pay higher wages to attract applicants, ultimately driving up costs for patients and residents.

What’s Ahead

Our work to understand the demographics of aging in the U.S., and the scale of the aging services’ workforce gap, brought us to immigration policy change as the source of solutions–both for foreign-born workers who are already in the country and authorized for employment, and for the legions of those who we hope to bring into our communities. And, though the issues of aging services are in many ways unique from other economic sectors, we know, through our Hill, media engagement, and coalition work, that we’re onto something very important. Immigration reforms are truly imperative to meet America’s workforce needs, for aging services, and for all of us.

Speaking up matters–let’s keep it up!