President Trump's plans to revise immigration could reduce the ranks of employees, look after older and disabled people at home and in long -term care facilities, since California and the country deal with the needs of an aging population, say experts in health and immigrants .
Trump has undertaken to carry out the greatest deportation efforts in US history. On his first day of the office, he signed Executive Orders to suspend refugee recordings for months, to request the asylum seekers to remain in Mexico because their cases have been checked, and humanitarian programs to regain more than 1.5 million people a temporary status and the Had granted work permits.
This could have consequences for tens of millions of older Americans who may need long -term care. California Estimates A quarter of the state's population will be at least 60 years old by 2030. In the United States, the demand for domestic health workers, nursing assistants and helper for long -term care from 2022 to 2037 was expected to increase between 35% and 41%, according to the information of 35% and 41% National Center for Health Personnel Analysis.
“In particular, long -term care providers and nursing homes have really had problems recruiting employees for decades,” said David C. Grabowski, professor of health policy at the Harvard Medical School. “The jobs are a challenge. They are usually not well paid. ”
The problem was only enlarged by the tribe of pandemic, he said. Now “at a time when we want to work less and less in long -term care, the need has never been greater.”
Immigrants make up 28% of workers who take care of people in nursing homes and other forms of long -term care National analysis From the Independent Research Group Kff. In other countries, more than half of the certified nursing assistant – direct nursing workers who feed, bathing and attracted – were born in other countries in Californian nursing homes. study Published last year on health matters.
It is assumed to analyze the data to the census office.
These numbers may appear modest, but given the demand for such employees, “this becomes a major problem if they remove this percentage of the workforce,” said Steven Hubbard, senior data scientist at the American Immigration Council.
Although the Americans are supported more to deport the people convicted of violent crimes recent survey From the Associated Press-Norc Center for Public Affairs Research.
The Californian Assembly Carl Demaio (R-San Diego) rejected the idea that the changes to the immigration policy expected during the Trump administration would damage the nursing sector, and said that “a safe limit does not exclude each other with a lively workforce”.
“People who want an open border try to demonize or distort the discussion of public order here by sweeping an element and not seeing the full spectrum of savings that we would achieve,” said Demaio.
Groups who want to reduce immigration WagesUse American workers who could then accept nursing jobs.
Others questioned this idea: Despite the existing lack of caregivers who were worsened by an exodus of employees in the middle of the emergency of Covid-19, wages for such a supply have remained low, said Priya Chidambaram, a high-ranking political manager at KFFS program For Medicaid and the non -insured. If wages have not yet increased, “it is difficult to imagine why that would be true if we further reduce the available long -term care offers.”
Nurses could also be affected by rollbacks for the temporary protected status or future changes to the postponed campaign for the arrival program in childhood, which both protect both certain immigrants from deportation.
“Even legal immigrants could only be affected by slowing down the procedural processing that enable them to continue working in our legal market”
In Los Angeles, a migrant works the needs of her older clients every day – bathes them, changes their diapers and brushed her teeth. It prepares meals, cleans the bathroom and the kitchen and changes the sheets. She helps the woman go out and walk and help with daily exercises.
“These people need love, understanding, someone who takes care of them,” said the Honduran immigrant in Spanish. The 67-year-old worker asked not to be named due to concerns about her immigration status because she feared that she could be at risk with Trump in the White House to lose protection against deportation.
The woman said that she joined the United States after decades ago after she had escaped an abusive spouse. She received later Temporary protected statusWhat enables her to work legally in the country. The program, which has to be renewed regularly, runs for Hondurans like you in months. Under Trump, the caregiver fears that she and other immigrants could lose their work with A Government program for home care.
“And the customers will be for themselves,” she said, “without anyone who takes care of them.”
Proponents have pointed out one analysis Published in the Oxford Bulletin of Economics and Statistics, in which it was found that a program carried out between 2008 and 2014 led to the enforcement of immigration to a lower direct care of the residents of the nursing home.
Experts said that an action against immigration could also indirectly sail, e.g.
“We do not know to what extent one of the guidelines that enter into the Health Workforce Research Center for long -term care from UC San Francisco.
If the enforcement of immigration slows down the flow of work, “it will not only worsen the lack of caregivers in the United States, but it could possibly become more expensive and continue to burden public support,” said Meghan Rose, General, General Author and Chief Government Affairs Officer of California, which represents non -profit providers of senior living and care.
Industry groups have asked to facilitate the path for caregivers with a migration background. “The tightening of right -wing trains for passionate people who come to our country and serve our seniors is an important part of the way our sector will answer the growing demand for long -term care,” said Clif Porter, President and CEO of American Health Care Assn. And the National Center for Assisted Life, which represents long -term care facilities.
With a Trump presidency “the greater threat to this industry is not the enforcement mechanisms,” said Laura Collins, director of the economic growth of George W. Bush Institute SMU. She said that she was “much more concerned about the lack of a plan to bring in workers”.
Investigations by Grabowski showed “negligible effects on wages” when an influx of migration stages in nursing homes occurred in an area. In A Working paper Grabowski and other researchers published by the National Bureau of Economic Research found that when the immigration was increased, the number of hours of maintaining the residents of the nursing home and other indicators were also improved.
In addition to nursing homes and other residential facilities, “the home care industry is heavily dependent on immigrants,” said Diana Silver, professor who studies public health at New York University. “These are all minimum wages with relatively minimal skills, but they offer an incredibly necessary ability.”
One analysis From Phi, a national organization that works to improve jobs for such employees, found that around a third of the supervisors were immigrants in home care. The President and Managing Director, Jodi Sturgeon, said that this does not include the “gray market” in which the employees are hired and paid directly by families, a more difficult workforce that is more likely to risk deportation.
When they are driven away, “people like you and I have to make decisions about leaving the workforce or shortening our time to take care of our family members,” said Sturgeon.
Seu 2015 President Arnulfo de la Cruz, whose union California workers represented in domestic care, qualified care facilities and assisted living, said California and the country are visited as by existing employees.
In recent years, millions of hours that were approved as part of a California program for home care have not become filled every month, according to the union and underlines the lack of necessary providers.
In the United States, there are people who were unable to maintain or dress support or become out of bed – or even have to sleep in their wheelchairs because nobody is available to adjust and support them ”, said Stacy Kono. Executive Director by hand in hand, a national network of employers of domestic workers, including home companions. “It's really life and death.”
Times Staff Writers Andrea Castillo and Karen Kaplan contributed to this report.