DHS Decisions Threaten Caregiving Workforce, LeadingAge Says

WASHINGTON—In the wake of a series of Department of Homeland Security (DHS) actions with significant impact on foreign-born individuals living and working legally in the United States, the head of LeadingAge, which represents nonprofit and mission-driven organizations serving and caring for older adults and families across America, urged the Trump administration to reverse course. 

“Your agency’s decisions…have created immediate uncertainty and concern for employers and workers alike,” association president and CEO Katie Smith Sloan said to Secretary Kristi Noem in an April 30, 2025 letter. Referencing the agency’s termination of categorical parole programs for Cubans, Haitians, Nicaraguans and Venezuelans (CHNV), as well as its partial removal of the 2024 Haiti Temporary Protected Status (TPS) extension, and full termination of Venezuela’s 2023 TPS designation, she explained the dire workforce situation in aging services.

“…the stakes could not be higher,” Sloan said. “Across the country, foreign-born workers with legal status, including parolees and TPS holders from Haiti and Venezuela, play a meaningful role” in care settings including nursing homes, home health, homecare and hospice agencies, and a range of senior living communities, including affordable housing for low-income older adults. “Absent significant policy intervention,” she continued, “we can be certain today’s workforce shortage will intensify as the gap between need and capacity widens with each passing year.”  

Sloan added the impact of DHS’ actions is immediate. 

“Unlike other sectors that depend heavily on foreign-born workers, the aging services field requires continuity, consistency, and trust between direct care workers and those they serve,” Sloan said. “Longstanding relationships with staff contribute directly to residents’ emotional wellbeing and sense of security. Some of the affected employees have been in their roles for a decade or more…The sudden loss of these individuals risks unsettling care routines, diminishing quality of care and causing distress among residents who depend on familiar, stable support in their daily lives.

“This is not a future concern–this is an April 2025 concern,” she said. “These are hardworking, taxpaying individuals who have dutifully obtained the necessary documentation to serve in vital roles in the U.S. workforce, including difficult to fill positions in the strained aging services sector.”

LeadingAge’s asks of DHS: 

1. Allow individuals paroled under the CHNV program to remain in the United States for the duration of their authorized parole periods. 
2. Restore the previously established expiration dates for Haiti’s 2024 TPS extension and Venezuela’s 2023 TPS designation. 
3. Extend these designations beyond those dates in recognition of the vital role these individuals play in our economy, which is solidly in our national interest.  
4. Commit to exploring more permanent immigration pathways for these essential workers in partnership with stakeholders like LeadingAge and with members of Congress.

LeadingAge Member Examples

Rachel Blumberg, President and CEO, Toby & Leon Cooperman Sinai Residences, in Boca Raton, FL: 430 staff

“With the Aug. 4 termination of the Temporary Protected Status (TPS) program, [we are] at risk of losing 8% of our workforce—men and women who are vital not only to our operations but to the fabric of our community. … this loss reverberates across our entire campus—from Certified Nursing Assistants (CNAs) to housekeeping to groundskeeping, to facility maintenance and beyond. These aren’t just employees. They are employee of the month staff members, trusted companions to our residents, and beloved parts of our extended family. They are kind, compassionate, and deeply committed to providing quality care. They pay taxes—contributions from which they will never benefit. To us, they are Americans in every way that matters. 

“…I’ve spoken with the staff most at risk. They’ve shared with me, often tearfully, what awaits them next. This is not an isolated issue. The entire ecosystem of South Florida’s workforce is under threat. Miami-Dade, Broward and Palm Beach counties alone account for 295,000 of the 530,000 TPS recipients who face deportation. These are not just workers in senior living—they are stocking shelves at the grocery store, pumping gas, staffing hotels and cleaning country clubs. They hold the essential, often invisible jobs that keep our economy and communities running.”

Rob Liebreich, President & CEO, Goodwin Living, a faith-based, not-for-profit senior living and health care organization serving the National Capital Region: 40% of 1,450 team members are foreign-born, representing 73 countries of origin

“Sixty five [employees of our more than 1,000-person staff] who are here legally under Temporary Protected Status (TPS) or humanitarian parole face the real possibility of losing their ability to stay and work in this country. This is very personal to us and especially personal to the nearly 4,000 older adults we serve daily.

“These changes are not merely a theoretical risk of losing 65 members of our staff; they are risks that will touch every part of our ability to serve older Americans who rely on these team members for direct caregiving, therapy to help in recovery from illnesses and health setbacks and through hospice at the end of life.

“Four of our staff from Haiti are impacted by [the administration’s] changes to temporary protected status. One of our nurses, for instance, shared that her brother was recently kidnapped and is being held for ransom in Haiti. It is incredulous to us that law-abiding, tax-paying and contributing legal workers are being put at risk.

“America lacks the available workforce to honor these older Americans with dignified care, which means that we need to welcome the international pipeline of workers to avoid abandoning older Americans in their greatest time of need.

“This reality will only grow given the size of the baby boomer generation now in retirement age, the fact that America’s population is aging and our birth rates are dropping. The math tells a grim story: America does not have the replacement population we need to care for our country’s aging population today—or for the coming two decades.

“As the Administration seeks to protect our borders, we are hopeful that the Administration will also seek to protect America’s older adults by respecting the foreign-born workers who have come here through legal pathways, are law-abiding, have completed background checks and are on TPS, are contributing to our economy and society and are the individuals caring for and supporting hundreds of thousands of older Americans.”

Human Resources leader of an East Coast nonprofit and mission-driven LeadingAge member: over 400 employees on staff

“We are a nonprofit long-term and subacute care skilled nursing facility (more than 300 beds). The vast majority of our population is long-stay rather than short-term rehabilitation patients, so continuity and consistency of care and stability of our caregivers is particularly important to ensuring residents’ well-being.

“Challenges in recruiting and retaining staff exist throughout the long-term care sector. Even now—five years since the COVID pandemic, when training programs shut down, employees retired or left the field—we still feel its impact on our staff. Our workforce pipeline is still in recovery, though our census has increased. We recruit nonstop.

“Foreign-born workers are essential to our ability to serve residents. Overall, at least 75% of our workforce are foreign-born. They are established, part of our community, employed in housekeeping, in direct care, as nurses. They are legally employed.  

“The repeal of temporary protected status impacts three of our full-time certified nurse aides. Two of them have been here for over 10 years. They are exceptional employees.

“It would be totally deleterious to our community to lose them—particularly for our residents, who depend on them. They help to train new staff; they are reliable. Their performance is outstanding.” 

A nonprofit and mission-driven LeadingAge member located in New England: about 450 total staff members

“Many of our team members—deeply respected and dearly loved by residents and colleagues alike—are foreign-born professionals who have dedicated themselves to serving older adults in nursing homes and other care settings. Despite their contributions, the national nursing shortage continues to be a critical challenge.

“Recent actions by the DHS…have had a profound and painful impact. These changes directly threaten the ability of valued employees to remain in the U.S. and continue the essential work they do every day. They pay taxes and contribute to the economy.

“Without the recent temporary stay issued by U.S. District Court Judge Indira Talwani on April 14, we would have lost 28 highly trained and compassionate team members in a single day—a devastating loss for our organization and, most importantly, for the people we care for.

“Even with this temporary relief, the future remains uncertain. If these federal changes are not reversed or mitigated, we could lose up to 20% of our workforce in the coming months. These are not just numbers—they are people. Caregivers. Friends. Family. Our coworkers. They are indispensable to our mission and to the well-being of our residents.

“We are working tirelessly to recruit replacement staff if this policy continues. But long-standing challenges in the aging services sector—including a limited pool of qualified candidates, intense competition for talent and insufficient Medicaid reimbursement rates—make this an uphill battle.

“The emotional burden on our team is immense. Many of our foreign-born colleagues are facing terrifying uncertainty. One of our Haitian employees recently shared that their family’s home was set on fire. Another from Venezuela fears for her life if she is forced to return. These are not distant political debates. These are lived realities for the people we work alongside every day.

“We are committed to doing everything within our power to support our team. We’re offering immigration counseling and legal guidance, and we’re standing by our staff with empathy and resolve. But as a health care employer, we remain bound by the constraints of current immigration law.”