Visas: How About Adding an H-1D to the Mix?

A proposal urges the creation of a new class of work visa to entice direct care workers from overseas to work in the U.S. long-term care sector. Called the H-1D, the visa as proposed would help ease the labor crunch that will see about 1.28 million additional workers needed in the direct care sector by 2036, an increase of about 35 percent versus today.

The idea comes from Tara Watson, director of the Center for Economic Security and Opportunity at Brookings, who said “the solution to the emerging direct care workforce crisis should also include the targeted recruitment of immigrants to work in the U.S. in this industry. Immigrants are disproportionately represented in the direct care workforce, and the presence of immigrants has been shown to improve quality of care and reduce elderly mortality.”

Temporary Visa to Ease Shortages

She said the H-1D visa would be a temporary employment-based visa for immigrants who have at least two years of experience in direct care to work in the U.S. in the direct care field.

“The visa would be additive to existing legal pathways and would be available to immigrants already living in the United States as well as to new immigrants,” a summary of the proposal said. “Like the H-1B visa, the H-1D would be structured as a three-year initial visa with an option for renewal. It would be dual intent with the possibility of applying for legal permanent residence after six years and would include dependents.”

The program includes safeguards to reduce the risk of exploitation and includes support for training and professional development for direct care workers.

“Following an initial pilot, 65,000 visas would be made available each year, a level projected to meet about 35 percent of the needed growth in the direct care workforce over a decade. The program includes a commission to periodically review the numerical caps, allowing flexibility if the demographic or economic outlook changes,” the report said.

Coalition Urges H-1B Action

In a separate visa development, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), as part of a therapy coalition, commented in response to the U.S. Department of Homeland Security (DHS) proposal of a $103,265 fee for all H-1B petitions subject to the annual cap, including those for workers with advanced degrees from U.S. institutions.

In its blog post, AHCA/NCAL said the H-1B program allows U.S. employers to temporarily hire foreign workers in specialty occupations requiring a bachelor’s degree or higher. “In long-term care, physical, speech, and occupational therapists are examples of the professionals who may enter through the H-1B program,” the association said.

In the coalition comment letter, the group requested that the Dept. of Homeland Security withdraw the proposed rule. “If it proceeds, DHS should at minimum exempt physical therapists, occupational therapists, speech-language pathologists, and other licensed health care professionals,” AHCA/NCAL said.

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.