Florida’s nursing homes are bracing for life without Haitian TPS workers

This week, about 350,000 Haitians in the US will lose their legal status in light of a US Supreme Court decision on June 25 that allows the Trump administration to gut the Temporary Protected Status program.

For decades, immigrants from countries rocked by natural disasters or armed conflict have sought refuge in the US under the program, which grants them work permits and protection from deportation as long as they pass regular background screenings. But in the last year, as part of its anti-immigrant agenda, the Trump administration has aimed at decimating TPS protections for more than 1 million immigrants from countries such as Venezuela, Honduras, Nicaragua, Somalia and Burma. The latest US Supreme Court ruling explicitly targets TPS holders from Haiti and Syria. 

No other state will feel the repercussions of the loss of Haitian TPS recipients more than Florida, where about half of the 350,000 in the US now live. Among them is a woman I will call Nina, a certified nursing assistant. She spoke to me last week on the condition that she remain anonymous given her precarious legal status. Nina and her two children left Haiti soon after the earthquake in 2010, which prompted the US government to include Haitians in the TPS program.

Nina started working in retail and later obtained her CNA license, and currently works at two nursing homes. She’s one of about 35,000 Haitians in Florida under TPS who work within the health care industry as nurses, for instance, or home health aids. She provides care to residents, helping them with feeding, grooming, and bathing. “Sometimes you get people who don’t have family or friends,” she told me. “We are their family.” At the height of the Covid pandemic, when visits from family and friends were cancelled, she held the hands of patients on their deathbeds. 

Nina told me she will report to work until she can no longer do so legally. TPS protections, including work permits, are scheduled to expire on July 24. 

“I try to keep a smile on my face, but my world is upside down,” she told me. “I do love my country, but right now is not the right time (to return).” She described how her former neighborhood in Port-au-Prince has been overrun by the violent gangs that have infiltrated much of the island nation in recent years. The US Department of State has warned Americans to avoid travel to the country, citing armed conflict between these gangs, the risk of kidnappings and other violent crimes, and a ban on US commercial flights to the main airport in the capital of Port-au-Prince after several planes were struck by gunfire. “My country is still a war zone,” she said, her voice sounding tired. “Going back right now is a death sentence.” 

The multiple crises that TPS recipients are experiencing as a result of the Supreme Court decision and the subsequent actions of the Trump administration have reverberated throughout Florida. I spoke with leaders of health care trade associations, immigration attorneys, and health care workers to understand what this means for the medical field at a time of staffing shortages and increased demand. “Take a look at the economics about what the impact is going to be on healthcare, on hospitality, on our farm workers, every major sector across the US,” said Sui Chung, executive director of Americans for Immigrant Justice, a legal nonprofit in Miami. “In Florida, I think people have to really understand what the impact is going to be.” Haitian TPS holders contribute $2.6 billion to Florida’s economy each year, according to data released by the Haitian Bridge Alliance and other groups in January. And that does not begin to account for the human cost on people who receive necessary care from those workers.

The concerns prompted the Florida Health Care Association, which represents hundreds of assisted living facilities, nursing homes, and rehabilitation centers in the state, to write to the US Department of Homeland Security requesting an exemption for their workers, the Florida Phoenix reported. 

“Florida is home to one of the nation’s largest and fastest-growing older adult populations, and demand for long-term care services continues to increase each year,” the letter reads. It describes “an exceptionally competitive labor market,” meaning that finding qualified workers has been challenging. “Any significant reduction in the available workforce would make it more difficult to serve current and new residents, causing a ripple effect that could overwhelm our local hospitals and the entire healthcare system.”

In recent years, Florida has ranked last in the country in the availability of home health care workers, Kyle Simon, senior director of communications at the Home Care Association of Florida, which represents thousands of providers in the state, told me. The TPS issue is “something else that’s going to create more of a workforce challenge,” he added.

Denise Bellville, the association’s executive director, told me about a case in which one provider will have to dismiss six nurses who are providing at-home care to children. “You don’t want the kids to go to a higher level of care, but the care is not able to be provided by family members,” Bellville said. “So now, what happens?” Employers are faced with dismissing employees who are otherwise doing their jobs—or risk a visit from ICE, a growing concern for providers who employ immigrants. “I worry that the patients are going to end up in a higher level of care.”

Margarette Nerette, a vice president for the 1199SEIU Florida, the largest healthcare worker union in the state, has been deluged with calls from union members seeking advice. She estimates that in South Florida, more than 200 workers are here under TPS. At one nursing home, roughly 30 of its 100 employees are TPS holders. “I don’t know how we’re going to survive this,” said Nerette, who is Haitian and is a US citizen. She left her country more than 30 years ago. “The workers are suffering, but the patients are going to suffer more.” 

A further staffing shortage means that caregivers must attempt to figure out how much time they can dedicate to each patient. Nina, who is a member of 1199SEIU, told me it’s common for her to be assigned at least 10 residents during day shifts and up to 20 at night. “We’re running,” she said. “When you get home, you’re exhausted.”

In the end, the patients most likely to bear the brunt of the end of TPS are the elderly, Nerette told me. “One thing I would like to do is challenge all the elected officials,” she said, “come to the nursing home, walk one day in our shoes to feel like what the job is all about.”

Meanwhile, lawmakers in Congress have been considering a bill that would preserve legal protections for Haitians until 2029. It has drawn bipartisan support, including from Republicans from Florida such as US Reps. Carlos Gimenez, Maria Elvira Salazar, and Mario Díaz-Balart. “Haiti is a failed state, and I think that deporting Haitians who are under TPS right now, back to Haiti would be a huge mistake,” Gimenez told CBS News on July 5. The measure passed the House in April, and is now up for consideration in the Senate. 

On the ground in South Florida, where most of Florida’s TPS community lives, immigrant advocacy groups such as Americans for Immigrant Justice are mobilizing to help Haitians assess their options.

“TPS holders don’t know what’s next for them,” Chung, the legal nonprofit’s executive director, said. “It is such a sense of terror and disbelief that they could be returned to a country that is so completely in chaos and so very dangerous.” She’s particularly concerned about family separations as parents struggle with the “difficult choice” of whether to leave their US-born children behind. 

Employers are seeking legal guidance as well. Attorney Eddy Laguerre, who is Haitian and practices immigration law in Miami, said he has received calls from hospital executives and nursing home directors wondering about how to sponsor work visas for their employees—a process, he explains, that could take years. And if a TPS holder lived in the US at some point without documentation, that means they would need to apply while living in Haiti.  

In the last few weeks, he’s watched his community grapple with panic and confusion. Many of his clients work in the healthcare sector, including some who came to the US as minors. Some may apply for green cards if they’re married to a US citizen or have adult children who were born here. He’s seen comments on social media pointing out that TPS is, as its name suggests, a temporary protection. But he wants the public to understand that many here under TPS are unlikely to have other pathways to become documented. “I’m talking about people with clean records and good jobs in the healthcare industry or other industries,” he said. “If they have TPS for so many years, it’s only because the system is not offering anything else.”

Nina had no idea what will happen to her and her family after her TPS status expires. Her mother, who is quadriplegic, is in a nursing home. Her children have built lives here as TPS holders. At work, she finds solidarity among her colleagues facing the same situation. 

“We try to lift each other up. Whenever we hear some kind of information, we try to share it,” she said. “We try to support each other. That’s what we can do for now.”