Immigration Issues and Challenges for Long Term Care Providers Presentation to the Virginia Commissi

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Immigration Issues and Challenges for Long Term
Care ProvidersPresentation to theVirginia
Commission on Immigration

• April 1, 2008
• Elissa Clark
• Inova Cameron Glen Care Center
• Reston, VA
• Daniel ODonnell
• Inova Continuum of Care Division
• Fairfax, VA
• Donna Shaw
• Woodbine Rehabilitation Healthcare Center
• Alexandria, VA

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Immigration Issuesfor Long Term Care Providers

• Language and Communication Obstacles
• Undocumented Immigrants as Residents
• Workforce Challenges

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Language andCommunication Obstacles

• Language barrier is not a new issue, but one that
  is becoming increasingly common.
• Residents increasingly Asian and Arabic
• Staff increasingly African and Spanish
• This poses an increased risk of errors between
  physicians and nurses in verbal and written
  communications.
• Many residents families work and are unable to
  act as translators bi-lingual staff
  capabilities are critical.
• Tolerance has increased as some physicians and
  residents begin to accept that their health care
  provider has English as a second language.

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Immigrants as Residentsin Virginia Nursing
Facilities

• Access to services can be complicated.
• Relationships and communications with family
  often difficult or impossible.
• Financial risks are associated with providing
  care to individuals with little or no means to
  pay.
• Undocumented immigrants frequently are high cost
  patients due to severe injury.
• Difficulty or inability to safely discharge.
• Long term care survey risk factors for nursing
  home.

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Workforce Challenges

• Majority of nurses and nurse aides are foreign
  legal residents in the Northern Virginia area and
  increasing in numbers in other Virginia towns and
  communities.
• Sponsored program for RN/LPNs to work in U.S.
  currently in place for limited time periods.
• Difficulties in obtaining foreign nurses (H-1C
  Visas)
• Keeping track of foreign employees federal
  employment requirements adds to administrative
  burden.