Updated: Pathways for Foreign-Born Workers
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As workforce shortages persist across aging services, providers are looking to foreign-born workers as one potential source for filling open positions. Immigrants already are significant contributors to the long-term care workforce: over 30% of all home care aides, over 20% of all nursing assistants, 20% of RNs in nursing homes and over 15% of licensed practical nurses (LPNs) in nursing homes are foreign born. LeadingAge is supporting policies, programs, and innovations that expand pathways for foreign-born workers to enter the U.S. to join the aging services sector.
Follow this series of posts for updates and ideas.
June 08, 2023
Hearing to Examine Bureau of Consular Affairs
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.
May 24, 2023
Updated Immigration Reform-Focused Dignity Act Introduced in House
An updated version of the Dignity Act, a large package of immigration reforms introduced in the House by Reps. Salazar (R-FL) and Escobar (D-TX) on Tues. May 23, includes language focused on fixing the current immigration system that aligns with LeadingAge’s current policy priorities.
The legislation, whose other original co-sponsors include Reps Gonzalez-Colon (R-PR), Scholten (D-MI), Chavez-DeRemer (R-OR), Manning (D-NC), and 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.
May 22, 2023
USCIS Updates Review Process for the Processes for Cubans, Haitians, Nicaraguans, and Venezuelans
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.
May 05, 2023
Coalition Urges Legal Immigration Reforms, Commonsense Visa Policies
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.
May 02, 2023
Break Immigration Reform Gridlock, LeadingAge and U.S. Chamber Say
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.
April 28, 2023
A “Gut Punch”: Members Share Impact of EB-3 Visa Freeze
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.
April 25, 2023
Cap Issued on New EB-3 Visa Petition Filings
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)
April 24, 2023
Border Security Bill Passes Committee
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.
April 13, 2023
Exploring Immigration Solutions for Workforce Shortage
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.
April 07, 2023
Early FY23 H-2B Visa Cap Reached
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.
April 04, 2023
McKnight's: Reaches Limit for Additional Returning Worker H-2B Visas
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.
March 14, 2023
Members Report Interest in Foreign-Born Workers
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.”
March 09, 2023
Immigration Support in President's FY 2024 Budget Proposal
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.
March 07, 2023
LeadingAge Co-signs Letter Opposing Proposed Immigration Services Fee Schedule Changes
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.
March 01, 2023
QuickCast: Filling the Care Gap
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
January 19, 2023
New “Welcome Corps” Refugee Resettlement Program Launched
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.
January 10, 2023
Administration Expands Legal Pathways to the U.S.
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.”
October 28, 2022
Venezuelan Migration Process Expands Legal Pathways to Citizenship and Employment
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.
July 29, 2022
Stories of Immigration and Refugee Success in Senior Communities
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.
June 09, 2022
An International Workforce Program as a Source of Well-Trained Staff
Nonprofit aging services providers are using creative strategies to cope with workforce shortages. Western Home Communities, a full-continuum nonprofit provider in Cedar Falls, IA, is responding to chronic workforce shortages by welcoming its first group of hospitality interns from Jamaica this summer. A group of 34 interns will arrive in late June with J-1 visas obtained through the U.S. State Department’s Exchange Visitor Program.
Read the full member story.
October 12, 2021
Helping Immigrant Nurses Help U.S. Long-Term Care
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.
Read the full member story.
December 09, 2019
Workforce Shortages: Bold Solutions from LeadingAge
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.
Read the full article.
January 01, 2019
Journal of the American Society on Aging: The Politics of Immigration
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.
August 21, 2018
New Reports Explore Global Expansion of Foreign-Born LTSS Workforce
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.
February 23, 2017
Research Explores the LTSS Migrant/Immigrant Workforce
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.”
Read the full article.