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New ‘Public Charge’ Rule Would Devastate the Caregiving Sector

September 23, 2018

NEW YORK —A new proposed federal rule that would prevent immigrants who access public benefits from becoming permanent residents would hit the direct care sector particularly hard, says PHI, a national research and consulting organization widely considered the leading expert on the direct care workforce.

Earlier this month, PHI released new data on immigrants in the direct care workforce, depicting a vital demographic of workers who struggle in low-paying jobs and are forced to turn to public benefits to survive.

The proposed new rule would deny “green cards” (lawful permanent residence) to many hard-working, low-wage immigrants who access public benefits such as food stamps, Section 8 housing vouchers, and low-cost prescription drugs under the Medicare Part D program, among others.

Advocates argue that this rule would force many immigrants, now and in the future, to forego necessary food, shelter, and medicine.

“This harsh and unnecessary rule will hurt many skilled and compassionate immigrant direct care workers across the country, as well as the millions of people who depend on these workers to support themselves and their families,” said Jodi M. Sturgeon, president of PHI.

Direct care workers assist older adults and people with disabilities with daily tasks, such as dressing, bathing, and eating—and comprise a workforce that is expected to grow from 4.4 million to 5.8 million workers between 2016 and 2026.

Key Facts on Immigrant Direct Care Workers Who Access Public Benefits

According to PHI, one in four direct care workers is an immigrant, totaling more than one million workers.

Among those immigrants who are non-citizens, 44 percent—or 189,000 workers—access public benefits, including Medicaid (67%), food and nutrition assistance (57%), and cash assistance (4%). Most non-citizen immigrants who work in direct care and access public benefits are women (86%), 40% are Latino, and 30% are high school graduates.

Direct care workers overall earn about $11 an hour, yet immigrants in this sector who access public benefits earn $15,000 a year—markedly lower than their U.S-born direct care counterparts, who earn $18,000 a year.

Notably, 43 percent of non-citizen immigrant direct care workers who access public benefits have been living in the U.S. for less than 10 years.

The poor quality of direct care jobs—inadequate compensation, training, and more—drive many workers away from this sector, leaving their employers unable to meet demand, and family caregivers with few options for support. Nationally, PHI estimates that the turnover rate in direct care is about 60 percent.

“An attack on this important segment of the direct care workforce will reverberate through the caregiving sector, viciously punishing hard-working immigrants, and making it even more challenging to provide quality care to millions of families who need it,” said Robert Espinoza, vice president of policy at PHI


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