A MARTÍNEZ, HOST:
If people with temporary protected status lose their ability to work in the U.S., it would put more strain on the healthcare sector, which is already facing staffing shortages. Many TPS holders are working in the U.S. caregiving industry, making up 15% of all noncitizen healthcare workers. That's according to a 2025 study. Now, for more, we're joined by Katie Sloan. She's the CEO of Leading Age, an association of nonprofits and providers serving older adults. Leading Age has more than 5,000 members across the U.S.
Katie, Mike Lawler is a New York Republican congressman, and he says immediately shutting off TPS would create a crisis in hospitals, nursing homes and within disabilities community. Does that statement hold water to you?
KATIE SLOAN: Absolutely, it does. I mean, we are a sector that has long been dependent on foreign-born workers for - to provide the care and support that older adults need. So in a nursing home and home health, in hospice, in home care, it can be as much as 25 or 30% of our workforce are individuals who have come from other countries to the U.S. to provide this kind of care and support.
MARTÍNEZ: What would a crisis look like? What could it look like?
SLOAN: A crisis could look like nursing homes deciding - and we have members that have already done so - deciding to shutter some of their beds, close a wing, a home health agency that stops taking admissions, home care agencies that don't have available staff, creating truly a crisis in access to care and the kind of care and support that older adults need. And this comes at a time when the population of older adults is growing in our country and the needs are increasing.
MARTÍNEZ: Yeah. Ohio GOP Governor Mike DeWine says it's Haitians who many times are taking care of your mom or your dad who has Alzheimer's, taking care of family members who might be in a nursing home. So it sounds like this could be something that is not just devastating, but deadly too.
SLOAN: Well, and I think that the impact then falls on family members.
MARTÍNEZ: Yeah.
SLOAN: If you can't have - if you can't put in - your loved one in a nursing home when they need nursing home care, somebody else has to provide that care. And so the burden, the responsibility falling on family members comes at great expense to families, you know, financially, practically, emotionally, at a time when many families are already strained.
But the other ripple effect that I think is important to note is, is that there is an impact on hospitals. If an individual's in a hospital and ready to be discharged and there's no place to discharge them to - they can't go to a nursing home or to home health for necessary rehab services - then they end up staying in the hospital, which is at great expense to our healthcare system.
MARTÍNEZ: And I imagine among the TPS workforce that there are some highly skilled healthcare professionals. I mean, what might this mean for their careers?
SLOAN: Well, the TPS workers are - they're nurses. They're physical therapists. They're occupational therapists. They're nursing assistants. I mean, these are important paid professional jobs, and they've had great careers. Many have been in this country for years providing this kind of service.
And the other thing I would just note is that when somebody is in a nursing home, that's their home. They've lived there for a period of time. They've developed trusting and loving relationships with their caregivers. Often they call them family members. So unlike a hospital where somebody is there for one or two days, when one is in a nursing home, you develop these relationships. And when one of those caregivers suddenly has to leave the country because of a government-mandated decision, you're breaking not only a really trusted relationship, but you're breaking the continuity of care.
MARTÍNEZ: If there does wind up being a shortage of nurses, a shortage of licensed caregivers, what will providers have to do to make up for the workers they've lost?
SLOAN: Well, they're already being incredibly creative. They're going to community colleges. They're going to high schools. They're hosting job fairs. They're becoming training - certified training centers. There's no one solution to this. It's really a combination of things that providers are having to employ in order to try to fill those empty positions.
MARTÍNEZ: And quickly, for people that do leave this job, this line of work, how easy is it to get them back?
SLOAN: Well, these are people who love this work. People coming from other countries, coming from countries that revere their elders, view these jobs as a privilege and an honor. And so the opportunity to bring them back in, should that be available to them, I think this is right there for them.
MARTÍNEZ: Katie Sloan is the CEO of Leading Age, which represents more than 5,300 aging service providers nationwide. Katie, thanks.
SLOAN: Thank you. Transcript provided by NPR, Copyright NPR.
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