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      • The Triple Knot of Long-Term Care in the United States: Long-Term Care Financing, Delivery and Workforce Policy

        Robyn Stone 세계섬학회 2016 World Environment and Island Studies Vol.6 No.2

        The U.S. is currently in the midst of a serious debate about the future of immigration policy in the U.S. Any change has the potential to profoundly shape the circumstances of direct care workers and the demand for Long-Term Care LTC. Yet prior immigration reform debates and proposals have not considered workforce planning needs or contemplated immigration as a primary tool for managing labor markets. Historically, the U.S. has elected not to import lesser skilled workers for the purpose of employment because these workers compete directly with other vulnerable low-wage workers. Prediction of strong job growth in this sector, however, suggests a clear need to consider options that may include an immigration visa pathway to admission. Policies that limit the entry of low skilled workers may diminish the future labor pool of direct care workers in LTC. Options under exploration include 1) increasing pathways to legal status for undocumented immigrants; 2) increasing pathways for legal temporary workers with the option to offer extensions of stay or transitions to permanency; 3) pursuing an aggressive immigration strategy to permit an influx of low-wage workers to fill vacancies for direct care jobs; and 4) creating a new visa program for less-skilled, non-seasonal, non-agricultural workers. This latter option was proposed in Congress in 2013, but movement on any reforms has stalled.

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