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In this photo from November 27, 2013, the caregiver Warren Manchess, right, crosses the living room with Paul Gregoline, 92, in Noblesville, Ind. (AP Photo / Darron Cummings)
What would you do if you do not find home health help to take care of your aging mother? It could happen sooner than you think. Strict new rules, proposed by the Trump administration, would effectively prevent immigrants from coming to the United States to work as home health aides or as employees of retirement homes or assisted living centers.
With at least one million helpers (one in four) being an immigrant, Trump's complex rules over the weekend are drying up a major source of personal care for the elderly or the disabled. At a time when the number of caregivers available is dropping dramatically, the long-term outcome could be a health care disaster.
Trump's proposal exposes the existential paradox of our system of care. We pay so little for people who care for our aging parents and other disabled family members that they have to rely on public supports such as food stamps and Medicaid to survive. Yet the cost of long-term care is so high that most Americans can not afford it.
Slam the door
In this environment, Trump would have slammed the door on a significant source of direct care workers. The inevitable result: a shortage of workers even more serious than the one we may already be facing. But where will the money come from to pay these workers?
Trump wants to ban resident status (green card) and limit access to other types of visas for those who receive – or are likely to receive – most forms of state aid. You can read the rules proposed here. For a good explanation in English, here is a good article from Vox reporter Dara Lind.
That's the problem: the wages of homeworkers and most of the staff in nursing homes and assisted living are so low that many have to rely on public supports such as food stamps, food and beverage services. low income housing assistance or Medicaid.
According to Robert Espinoza, of the Institute of Paraprofessional Health Care (ISP), 42% of direct care workers for immigrants have access to public benefits. Two-thirds are Medicaid beneficiaries and more than half receive food and nutrition assistance. About 4% receive cash assistance (aka well-being).
Live with $ 11 at the hour
Their median salary is about 11 dollars at the hour. But because many caregivers work part-time, their median annual income is $ 15,100. Keep in mind that these salaries only apply to assistants on the book. There are hundreds of thousands of people on the gray market of which we know very little.
Wages are slightly higher for nursing assistants in nursing homes: they earn an average of $ 21,200 a year.
But even this salary is far below the income criterion included in the proposed rules. One interpretation is that those earning less than $ 62,750 in 2018 may be excluded from residency in the United States. And those who earn less than $ 31,375 would be penalized, according to the new formula proposed for determining residence.
Keep in mind that Medicaid itself, which effectively sets these very low wages, is one of the main reasons why aids are poorly paid. Given the state of the labor market, the much more sensible policy would be to increase Medicaid's salary and not reduce the supply of workers.
Replenishment of the pool of workers
The proposed rules do not seem to apply to current green card holders, but would affect immigrants who are currently in the United States while awaiting permanent resident status or those who come to the United States. United States in the future. In addition, because the turnover of helpers is very high and many helpers reach an age when they can no longer perform this physically demanding job, the pool of these workers must constantly be replenished.
Without new immigrants, there will be far too few workers to provide personal care. This at a time when the American population is aging rapidly and the demand for aid is increasing. According to CareerCast, by 2025, Americans will need half a million caregivers and 750,000 additional caregivers.
The new proposal is just the last salvo of Trump's long-standing war against immigration and the direct workers of immigrants. Not only did he act aggressively to ban undocumented immigrants, but he also took steps to limit legal immigration and deport hundreds of thousands of "dreamers", those children of parents who arrived illegally United States. He has also vowed to deport residents of countries like Haiti, El Salvador and Honduras, who are legally in the United States under a program called Temporary Protection Status (TPS). PHI estimates that they include about 35,000 direct care workers.
But these new rules are particularly draconian. The Department of Homeland Security estimates that each year, 382,600 green card applications and 517,500 requests for other types of visas could be submitted to the new public test.
Many of these candidates would be essential direct care workers, whether at home or in institutions. The question is: what will frail elderly people do without them?
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In this photo from November 27, 2013, the caregiver Warren Manchess, right, crosses the living room with Paul Gregoline, 92, in Noblesville, Ind. (AP Photo / Darron Cummings)
What would you do if you do not find home health help to take care of your aging mother? It could happen sooner than you think. Strict new rules, proposed by the Trump administration, would effectively prevent immigrants from coming to the United States to work as home health aides or as employees of retirement homes or assisted living centers.
With at least one million helpers (one in four) being an immigrant, Trump's complex rules over the weekend are drying up a major source of personal care for the elderly or the disabled. At a time when the number of caregivers available is dropping dramatically, the long-term outcome could be a health care disaster.
Trump's proposal exposes the existential paradox of our system of care. We pay so little for people who care for our aging parents and other disabled family members that they have to rely on public supports such as food stamps and Medicaid to survive. Yet the cost of long-term care is so high that most Americans can not afford it.
Slam the door
In this environment, Trump would have slammed the door on a significant source of direct care workers. The inevitable result: a shortage of workers even more serious than the one we may already be facing. But where will the money come from to pay these workers?
Trump wants to ban resident status (green card) and limit access to other types of visas for those who receive – or are likely to receive – most forms of state aid. You can read the rules proposed here. For a good explanation in English, here is a good article from Vox reporter Dara Lind.
That's the problem: the wages of homeworkers and most of the staff in nursing homes and assisted living are so low that many have to rely on public supports such as food stamps, food and beverage services. low income housing assistance or Medicaid.
According to Robert Espinoza, of the Institute of Paraprofessional Health Care (ISP), 42% of direct care workers for immigrants have access to public benefits. Two-thirds are Medicaid beneficiaries and more than half receive food and nutrition assistance. About 4% receive cash assistance (aka well-being).
Live with $ 11 at the hour
Their median salary is about 11 dollars at the hour. But because many caregivers work part-time, their median annual income is $ 15,100. Keep in mind that these salaries only apply to assistants on the book. There are hundreds of thousands of people on the gray market of which we know very little.
Wages are slightly higher for nursing assistants in nursing homes: they earn an average of $ 21,200 a year.
But even this salary is far below the income criterion included in the proposed rules. One interpretation is that those earning less than $ 62,750 in 2018 may be excluded from residency in the United States. And those who earn less than $ 31,375 would be penalized, according to the new formula proposed for determining residence.
Keep in mind that Medicaid itself, which effectively sets these very low wages, is one of the main reasons why aids are poorly paid. Given the state of the labor market, the much more sensible policy would be to increase Medicaid's salary and not reduce the supply of workers.
Replenishment of the pool of workers
The proposed rules do not seem to apply to current green card holders, but would affect immigrants who are currently in the United States while awaiting permanent resident status or those who come to the United States. United States in the future. In addition, because the turnover of helpers is very high and many helpers reach an age when they can no longer perform this physically demanding job, the pool of these workers must constantly be replenished.
Without new immigrants, there will be far too few workers to provide personal care. This at a time when the American population is aging rapidly and the demand for aid is increasing. According to CareerCast, by 2025, Americans will need half a million caregivers and 750,000 additional caregivers.
The new proposal is just the last salvo of Trump's long-standing war against immigration and the direct workers of immigrants. Not only did he act aggressively to ban undocumented immigrants, but he also took steps to limit legal immigration and deport hundreds of thousands of "dreamers", those children of parents who arrived illegally United States. He has also vowed to deport residents of countries like Haiti, El Salvador and Honduras, who are legally in the United States under a program called Temporary Protection Status (TPS). PHI estimates that they include about 35,000 direct care workers.
But these new rules are particularly draconian. The Department of Homeland Security estimates that each year, 382,600 green card applications and 517,500 requests for other types of visas could be submitted to the new public test.
Many of these candidates would be essential direct care workers, whether at home or in institutions. The question is: what will frail elderly people do without them?
