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- Wisconsin home health agencies and nursing homes have abandoned plans to hire overseas workers after federal authorities suspended nearly all refugee programs and terminated Temporary Protected Status for people from 13 countries.
- Immigrants make up 30% of direct care workers nationwide, including nursing assistants, personal care aides and home health aides, according to KFF.
- In-home and assisted living agencies, including one in the Fox Cities, had to stop plans years in the making to hire international workers. Some also lost staff who had Temporary Protected Status.
- Organizations that don’t have enough caregivers have to turn people away, which means more people aren’t able to live in their homes or find care in their communities, industry leaders say.
- A bipartisan group of Wisconsin lawmakers passed legislation in April to make it easier for immigrants, specifically DACA recipients, to work in long-term care or health care.
Americans are getting older. In 2025, nearly 19% of the U.S. population was over 65, and the majority of them will need long-term care.
Some home health agencies and nursing homes in Wisconsin have had to give up on plans started years ago to hire overseas workers after President Donald Trump’s administration suspended nearly all refugee programs. The administration also terminated Temporary Protected Status for people from 13 countries, which industry leaders say is weakening an already struggling workforce that helps care for the nation’s older adults and disabled population.
“We have basically cut off or severely limited every pipeline that we have for bringing in, for welcoming foreign-born workers, many of whom end up working in our sector in aging services. … We don’t have a sort of ready supply of U.S.-born individuals who are clamoring to work in aging services, and that’s not a new issue,” said LeadingAge CEO Katie Smith Sloan.
The workforce issue affects member agencies of LeadingAge, a national network of nonprofit nursing homes, home health and other organizations that serve older adults. Sloan said when long-term care facilities have to turn people away, that puts extra burdens on hospitals and family members to fill care gaps.
“We’re seeing home health agencies just not able to take new clients. We’ve seen nursing homes that have closed beds and closed wings,” Sloan said.
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According to KFF, a nonprofit health policy research organization, 30% of all direct care workers nationwide are immigrants. These workers include nursing assistants, personal care aides and home health aides who provide people with disabilities and older adults assistance with daily living or medical care.
Long-term care is important for people like Myranda Gereau, who lives in Sheboygan. She is quadriplegic, has a tracheostomy and needs 24/7 care. At 30 years old, she’s struggled for years to find nurses to provide in-home care, constantly worrying about her nurses’ schedule and whether she will be able to continue living independently.
“This is literally my life we’re talking about,” Gereau said. “This isn’t ‘Oh, I’m sorry. I can’t come in. I have to take off.’ That’s not how health care works. There are people’s lives that are needing care, and then when you take that caregiver out of the equation, those people suffer.”
Robin Wolzenburg is the current director of operations at Koru Health, which operates multiple senior living communities across Wisconsin. In her previous role at LeadingAge Wisconsin, she worked with resettlement agencies to place refugees in nursing home positions.
Wolzenburg’s efforts stopped in January 2025 when the Trump administration suspended refugee programs. Officials implemented the policy change because the U.S. was not able to support new refugees without “compromis(ing) the availability of resources for Americans,” according to a White House statement.
“We saw just a marked halt in refugees coming in. It didn’t seem like it was a trickle – it just seemed like it stopped,” Wolzenburg said.
Staffing issues for long-term care are so severe that lawmakers on both sides of the aisle want to make it easier for immigrants to get long-term care jobs. State Sen. Jesse James, R-Thorp; Rep. Joel Kitchens, R-Sturgeon Bay; and Rep. Sylvia Ortiz-Velez, D-Milwaukee, co-authored legislation that passed in April allowing DACA recipients to obtain professional licenses in nursing and other fields.
The U.S. Bureau of Labor Statistics expects home health aide jobs to grow by 847,000 over the next 10 years — the most of any job sector in the country. However, the median salary for home health and personal care aides was $35,800 in 2025, making it hard to attract workers.
“We don’t have domestic workers. I mean, we just don’t,” Wolzenburg said. “The market is so tight, and the competition is so tight, and caregiving is a tough job, it really is. You’re caring for the most vulnerable people in our population.”
For organizations that provide long-term care, not having enough workers means more people aren’t able to continue living at home or have to find care in a community even farther away. Wolzenburg said many assisted living facilities have had to limit admissions.
“You have a resident or an elderly person who is looking to come and reside in their own community, where they’ve maybe been in for the last 50, 60 years of their life, maybe longer,” Wolzenburg said. “That assisted living or nursing home in that community may or may not be able to meet their needs because they don’t have enough staff.”
Recruiting overseas workers is simply a smart business strategy, Wolzenburg said, and a necessary one.
“Obviously we want to support newcomers no matter what, but we also don’t have the domestic staff and the luxury of not engaging this population,” Wolzenburg said.
Multi-year hiring strategies overturned
Kate Battiato, vice president of media and community impact for LeadingAge Wisconsin, helps serve nonprofit long-term care providers across the state. Some members invested significantly in recruiting international staff, she said. One CEO of a nursing home in Sparta invested over $100,000 into building five apartments for new overseas workers. When immigration policy changed and visas became difficult to procure, he had to pivot. Instead, he used the housing for current workers.
“International recruitment is a multi-year strategy, and it doesn’t happen overnight,” Battiato said. “One election can change the strategy that has been built over years. … It makes their already difficult challenges recruiting and retaining workers more difficult.”
Still, leaders are able to use innovative strategies to retain current workers and attract more domestic employees. Battiato said her members are used to thinking on their feet and quickly developing new strategies to address staffing gaps.
“They’ve actually seen a lot of success in recruiting and retaining workers from their local community using that same workforce strategy of worker housing that was originally developed for international workers,” Battiato said.
Valley VNA Senior Care in Neenah, a nonprofit that provides both in-home and assisted living services, has not only lost out on international workers it planned to hire, but also staff who were under Temporary Protected Status. HR Coordinator Cheryl Ehlers said losing those employees fed into the turnover the organization was already experiencing.
“We did have some staff that unfortunately had to go back,” Ehlers said. “We lost them as staff members because they lost their protected status, and they are always welcome to come back to us if they’re able to return to the United States.”
Temporary Protected Status applies to immigrants from specifically designated countries that have been deemed unsafe due to a crisis, such as war or natural disaster. TPS allows them to live and work in the U.S. temporarily.
The Trump administration has terminated 14 TPS programs, affecting people from 13 countries. Nearly 350,000 Haitian immigrants lost TPS on Aug. 4. An estimated 53,000 TPS holders worked in health care in 2024, according to data from KFF.
In a press release, the Trump administration reaffirmed that the Temporary Protected Status program was always meant to be temporary and that Haitians could pursue legal status through other means. The Supreme Court backed the terminations of TPS for Haitians and Syrians in a June ruling.
Ehlers, who has worked at Valley VNA for over two decades, said the organization had also been trying to hire 15-20 workers from overseas for at least the last five years, but ultimately stopped hearing from the partner agency it was working with.
Haitian caregivers in Wisconsin lose immigration status
Marc Christopher, an immigration attorney who represents some of the hundreds of Haitian immigrants in central Wisconsin, said many of them work in home health care and nursing. Haitians in Wisconsin are losing their work permits and immigration status and are facing deportation.
“It’s a lose-lose-lose for our community,” Christopher said. “Number one, the employers that are employing people to provide the care, they’re losing valuable labor, people who are helping. For the people that they’re taking care of … they’re getting good quality care. And then obviously, it’s a lose for my clients, who are in a desperate situation because they’re now being told that they have to go back.”
The country is still considered unsafe due to gang violence and humanitarian crises. The U.S. Department of State issued a Level 4 “Do Not Travel” advisory in July. According to a 2025 press release, former Homeland Security Secretary Kristi Noem determined conditions had improved enough for Haitians to return.
Christopher is in the process of helping clients apply for asylum, which takes years. He stressed that most Haitians came to the U.S. legally under Temporary Protected Status. For the time being, many Haitians are weighing their options.
“So now they have to make that decision,” Christopher said. “Do they file for asylum, or do they simply go back, or do they live in this perilous state where they don’t have any status? … And that’s what affects our community. … Their kids go to school with my kids. They are working in our community.”
Zabi Sahibzada is the refugee resettlement director for Jewish Social Services of Madison. With no one new coming in, he’s trying to focus on supporting the refugees and immigrants who are already here. Three full-time and one part-time caseworker manage more than 500 individuals in addition to those who knock on their doors every day.
Out of his clients who are in the workforce, Sahibzada estimates 30% lost their jobs in the medical sector. They now need help with food, rental assistance, medical services and legal services, and JSS has limited funding.
“Some of our clients who used to work in those health care providers and the places like health care facilities, and some even providing transportation to the health care facilities, they have been losing their jobs,” Sahibzada said. “They have lost their driving licenses. They have lost their eligibility status.”
When a direct care worker loses their job, it can also mean a deeply personal relationship is “shattered,” Sloan of LeadingAge said.
“You’ve been there for four years and have had the same caregiver who knows everything about you, knows your birthday, knows what you like to eat for breakfast, knows what time you like to go to bed, knows what movies you watch … suddenly, that person is ripped away from you, which is what has happened recently with TPS,” Sloan said. “You’ve really lost an important part of your life.”
This story was produced as part of the NEW (Northeast Wisconsin) News Lab, a consortium of five news outlets.
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