Proposal Presented for the Master Plan for Aging (#35)
Disclaimer
Throughout the MPA process, more than 100 proposals were developed thanks in particular to thousands of hours of work by external stakeholders and members of the public. These proposals and the MPA Council commentary are being submitted to the Governor and shared with policymakers and the public to inform policymaking. These proposals represent a starting point for discussion. Further discussion is necessary between relevant state agencies and stakeholders to both refine these proposals and assess which may be appropriate to adopt and implement.
Summary
Expand the paid caregiver workforce through immigration reform by amending the Immigration and Nationality Act (INA) to recapture unused permanent employment-based visas to fill health care workforce shortages. Modifications include classifying direct care professions as Schedule A shortage occupations, creating a temporary work visa for low-skill workers, and establishing a legalization program for qualifying foreign-born workers.
Justification
With immigration reform, the direct care workforce shortage may be mitigated by permitting immigrants to the United States to assume available jobs. This proposal is for NYS to advocate for Congress to make changes to the visa program such as reserving permanent employment-based visas for direct care workers, creating temporary work visas for low-skill health workers, modifying the au pair program to include caregiving roles for older adults, and classifying direct care professions as Schedule A shortage occupations for at least five fiscal years.
Full Proposal
Expand the paid caregiver workforce through immigration reform. Congress should amend the INA to recapture permanent employment-based visas (i.e., green cards) previously unused for FY1992 through FY2021 to increase the number of employment-based visas, up to 65,000 visas, available for FY2024 or any subsequent fiscal year to fill health care workforce shortages.
- Congress should reserve 25,000 of these visas for direct care workers. Congress should not count visas for certain family members to accompany the principal beneficiary of these permanent employment-based visas against the 65,000 cap. New York State should work with our federal delegation to champion the following incremental immigration reform proposals from the Bipartisan Policy Center (BPC) and ensure that NYS is prepared to take advantage of the programs once implemented.
- Congress should direct the US Labor Department to classify direct care professions as Schedule A shortage occupations for at least five fiscal years, allowing streamlined and simplified visa processing. The State Department should modify the J-1 Visa Exchange Visitor Program's au pair category to increase cultural exchange opportunities while also allowing eligible migrants to legally work in caregiving roles for older adults. Furthermore, it is recommended that the State Department establish distinct training requirements for J-1 au pair recipients who are working with older adults.
- Congress should amend the INA to create a temporary work visa for low-skill healthcare workers. The new visa classification would be valid for four years and would be limited to 15,000 visas per fiscal year from FY2025 to FY2027. From FY2028 to FY2030, the cap on the number of visas should be reviewed based on the National Health Care Workforce Commission's evaluation of the direct care workforce.
- Congress should establish a legalization program for qualifying foreign-born workers who will help relieve the country’s direct care workforce shortage. This program should be available to eligible foreign-born workers who currently reside in the United States and should provide them with the proper authorization to legally remain in the country, work, and pay taxes. Congress should appropriate additional resources to the US Labor Department, United States Citizenship and Immigration Services (USCIS), and other agencies involved in immigration processing to implement the recommended policy reforms.
- The State will include NYS Department of State’s (DOS) Office for New Americans in implementing and communicating any such reforms.
MPA Council Commentary
This proposal is categorized as long-term. New York State looks forward to discussing changes to federal policy with our federal government representatives.