On March 14, 2013, a member of the American Health Care Association (AHCA) testified before the House Education and Workforce Committee’s subcommittee on Workforce Protections hearing on the critical shortages of mid-level caregivers in the nation’s skilled nursing centers and its impact on the economy.  The hearing was held to examine the role of lower-skilled guest worker programs in the economy.  Representatives of the Essential Worker Immigration Coalition, the hotel industry, and the Southern Poverty Law Center also testified before the Subcommittee.  Health care employers have identified immigration reform and access to foreign workers as a critical issue for the industry.

Fred Benjamin, Chairman of the Kansas Health Care Association and COO of Medicalodges, Inc., a Kansas nursing home operator, represented AHCA.  Benjamin identified labor shortage as AHCA’s most pressing operating problem.  He stated, “The labor shortage deprives us of the most valuable resource we have, our caregivers. If we are to meet the expectations set for us, policymakers must act now to expand access to new pools of staff and take steps to encourage employment in long term care.”  In a recent study on the vacancy rate for nursing staff, AHCA found that there were approximately 60,000 vacant direct care staff positions as of 2010 — shortages that could worsen as nurses who retire and leave the profession are not replaced.  Another study by the U.S. Department of Health & Human Services (HHS) and the Department of Labor (DOL) estimates between 5.7 million and 6.5 million nurses, nurse aides, home health, and personal care workers will be needed in the coming years to care for the 27 million Americans who will require long-term care by 2050.  Finally, the Health Resources and Services Administration (HRSA) projects that, absent aggressive intervention, the supply of nurses in America will fall 36 percent (more than 1 million nurses) below requirements by the year 2020.

Benjamin testified that among the solutions Congress should consider to address the shortage is to “…increase staff supply, and there are many talented immigrants who are anxious to enter the caregiving field, yet are faced with insurmountable roadblocks. These talented caregivers should be given the opportunity to make a living and make a difference in their own lives and the lives of others. To increase the supply of labor, please give special consideration to permitting new entry for immigrants with nursing skills as well as increasing the pool of unskilled labor. We need a new immigration system that serves the economic needs of the U.S. economy.”  Members of the House subcommittee expressed the need to protect jobs for U.S. workers when designing any new low-skilled foreign guest worker program as part of a comprehensive immigration reform bill.

AHCA had earlier outlined its core principles for immigration reform as follows:

  1. Letting business and industry play a leading role to help drive solutions with Congress.  Any visa program must give employers, not the government, primary say in which workers (and how many) they need to staff their businesses.
  2. Creating a viable guestworker program that accommodates the needs of U.S. healthcare providers.  Employers should be allowed access to previously unused H-1B temporary work visas for nurses and physical therapists.
  3. Waiving the cap on employment-based visas for nurses and physical therapists, speech therapists and those providing other therapies.