This article is part of the HHCN+ membership
The Trump administration pledged a massive deportation and implemented a proactive strategy to implement the plan. When home care providers are already struggling with staffing crisis, massive deportation can spell out the troubles of healthcare providers and create disability for seniors who need care services.
Already concerned about a labor shortage, home care executives are pushing for policies that make it easier to expand the limited pool of healthcare workers to support seniors in their homes, including an expanded visa program.
Home Assist Health CEO Sara Wilson said he believes creating meaningful and effective pathways to U.S. citizenship should be a priority for the home care industry as a way to attract qualified workers.
“Favour and emphasize the importance of positive, healthy and productive immigration reform is extremely important for all sectors, especially for home care,” she told HHCN. “We are proud to have an effort to do this. We know that HCAOA has raised the EB-3 visa home care visa program and reform proposals, which I think are examples that allow us to do more, discuss and refine.
Home Assist Health is a home-based care provider that offers a wide range of care services, including personal care, housekeeping, and respite care.
Radiation fallout from Trump immigration policy
President Donald Trump signing an executive order to “expand the use of rapid removal” is just one of the actions taken by the administration since it announced this course of action. Trump has also suspended refugee enrollment programs.
Most recently, the Supreme Court allowed Trump to end his temporary protected status. This allows citizens of a particular country to live and work in the United States.
In general, larger health workers rely on migrant workers. According to a research letter published by JAMA, more than 1 million immigrants work in U.S. health care, a third of them have not been documented.
Looking closer at home care, researchers found that undocumented immigrants account for at least 10% of these agencies' staff.
“(Immigrants) play a major role as doctors, nurses, but especially in long-term care, such as nursing home care and home care,” Dr. Steffie Woolhandler, a professor of public health at Hunter University and one of the authors of the study, told Home Health Care News. “If Trump follows a massive deportation plan, there will be a huge shortage of healthcare workers, which will undermine access to care and the quality of care for Americans.”
A total of nearly 5.5 million positions are open in the home care industry between now and 2031, according to PHI data.
With this in mind, Ulhandler explained that a 10% loss across home care companies is a major blow to the industry, with widespread results across the larger healthcare continuum.
“The lack of home care really echoes across the system as hospitals and emergency rooms often want to send frail patients home after hospitals and emergency rooms deal with acute issues,” she said. “If you can't send home because home care is not available, they will back up the emergency room. Or hospitals and other patients will not be accepted. If you lose 10% of your workforce in home care, you will create a bottleneck and cause problems throughout the healthcare system.”
Visa defense
Home-based care leaders and stakeholders have relied on political advocacy to urge lawmakers to create new pathways for immigrants to play a key home care role.
Peter Ross, CEO of Senior Helper, is an HCAOA member. The organization advocates visa programs for home care workers. Ross is also a member of the Healthcare Leadership Council, promoting reusing unused immigrant visas to promote healthcare professional entries to the United States.
He stressed that without these efforts, the industry would not be well positioned to meet the growing demand for older people who need care services.
“The country is not ready for this silver tsunami,” Ross told HHCN. “There are 80 million elderly people, baby boomers who are beginning to turn 80 next year. We have to be able to find ways to help people age. 60% of all seniors need to put incredible pressure on Medicare, Medicare, government, counties, states and communities on Medicare, Medicaid, government, counties, nations and communities. Care.”
Based in Maryland, Senior Helper is a home care company that operates more than 400 franchise locations in the US, Canada and Australia. Senior Helper is one of the largest franchise companies in the home care space. The company was acquired in 2024 by Waud Capital, a Chicago-based middle market private equity company.
The immigration route was also the best heart of home CEO Margaret Haynes.
“(We're focusing) how can caregivers be made easier to come to the country, so we're asking for care to be added to Schedule A, where nurses and other important occupations are listed.
Based in Omaha, Nebraska, the home provides domestic dating, personal care and support to seniors and adults with disabilities who are trying to live independently through more than 750 locations in the United States and five other countries.
Ross said leveraging visa sponsorships to recruit new employees is not an easy process. However, CEOs are investigating tactics using examples set by other healthcare industries.
“I know they did it in nursing, and they did it in some other parts of the facility,” Ross said. “We try to find a way to do it. It's a very challenging process, so we've never done it in a very serious way before…but we want to find a way to work with the government.
Going forward, Wilson said home care providers must continue to advocate for immigration reform.
“It's really about using your voice to talk to, defend and engage with the right people,” she said. “I really think no matter who you have in the administration, the community needs to hear from community members what they need.”
