How will immigrant hiring affect the direct care workforce?
A recent Register editorial ("Trump should support chain migration," Aug. 15) gave important attention to one of the most significant workforce issues in Iowa — that current and future demand for paid direct care workers cannot be met by the supply of Iowans able and willing to do the work.
The editorial suggested the hiring of immigrants is one way in which the growing demand for workers can be addressed.
Hiring immigrants can help meet the demand for direct care workers, but it may only mask — and further delay dealing with — the real problem: that the people who do this work are neither respected nor rewarded.
Sadly, the long-term care industry (nursing homes, assisted living centers, home care agencies, organizations supporting people with disabilities) uses a business model built on a foundation of inadequate pay, benefits, and training for front line workers.
Those three factors — low pay, benefits and training — lead to high levels of turnover, and high levels of turnover — an estimated 50 percent annually — produce a lower quality of care.
This business model has worked for the owners and operators as they’ve made money, but it hasn’t worked for the people providing the services or those receiving them.
Direct care workers have been, in too many instances, exploited. They’ve been seen by too many as expendable commodities; with employers viewing the labor market from a “if someone leaves, we’ll find somebody else” mentality.
I’ve witnessed this “expendable” mindset at the Iowa Capitol over the years, with a facility owner once referring to their workers as “a dime a dozen” and a former Republican legislator equating the value of direct care workers to migrant “melon pickers.”
Similarly, direct care jobs have been consistently referred to by workforce and economic development officials as “low skill” and “entry-level” — damaging words that send the message that these are unimportant and not valuable enough to consider for a career.
These are the attitudes that have prevented direct care workers from being in jobs that Iowans should aspire to be in and stay in.
Iowans receiving services have been shortchanged. Poor jobs that create a revolving door of direct care workers have led to lower quality of care provided by workers with less knowledge and experience. Lower quality care has led to more service complaints and greater frustration among consumers and their families.
Iowans — the workers and those they serve, support and protect — deserve better.
So what will the impact be if the industry chooses to address their workforce challenges by recruiting and hiring more immigrants?
If immigrant hiring is used to transform the business model, to raise wages, improve benefits, expand training, give necessary attention to the challenges of different languages and cultures, then workers and those they serve will benefit.
However, if expanded immigrant hiring is used to maintain the status quo — keeping wages and benefits low with inadequate training — then the impact will simply make a bad situation worse. The all-too-common lack of respect for and the exploitation of direct care workers will continue, while language and cultural differences will add additional barriers to the provision of quality care.
Regretfully, my bet is the industry will work to maintain the status quo. The solution to the problem of direct care worker shortages has been known and ignored for a long time. It’s pretty simple — if you create better jobs, you’ll get better care.
The crisis in the direct care workforce and the growing conversation about the use of immigrant labor creates a need for leadership.
My request for whoever delivers the governor’s Condition of the State address in January is this: Tell legislators and the public that your administration cares about direct care workers and those they serve. Tell them that you will work with the industry, workers, consumers and advocates to make poor jobs much better jobs. Tell them you will make jobs that will be attractive to existing Iowans and future immigrants.
That commitment will make Iowa a much better place to live and work.