The United States faces a growing need for direct-care workers as more older adults and people with disabilities require long-term support. A new H-1D visa proposal could create an additional pathway for direct-care workers, including home health aides, personal care aides, and nursing assistants, to support this demand. If approved and implemented, the H-1D visa could help expand the direct-care workforce and improve access to care for older and disabled adults across the country.

What Is the Proposed H-1D Visa?

The H-1D visa is a proposed temporary employment-based visa for direct-care workers. Tara Watson of the Brookings Institution proposed the H-1D as one possible way to increase the number of workers available to care for older adults and people with disabilities. The proposal is modeled in part on the H-1B visa’s administrative structure but focuses on direct-care work rather than specialty occupations requiring a bachelor’s degree or higher. The program could cover both eligible immigrants already living in the United States and workers entering from other countries. Its goal would be to supplement the domestic workforce and address the projected direct-care worker shortage while protecting against wage undercutting.

Why Does the US Need More Direct-Care Workers?

Demand for long-term care is increasing as the US population ages. More than 20 million adults in the United States need long-term care or support with daily activities because of disabilities or functional limitations associated with aging. At the same time, healthcare providers have struggled to recruit and retain enough workers.

Staffing challenges became particularly serious during and after the pandemic, when the direct-care sector experienced recruitment and retention difficulties. Brookings projects that the number of Americans aged 65 and older with disabilities could increase by more than 6 million over the next decade. Meeting the additional care needs could require about 1.28 million more direct-care workers, representing roughly a 35% increase over today’s direct-care workforce.

Which Workers Could Qualify for the H-1D Visa?

The proposed H-1D direct-care worker visa would focus on direct-care work supporting older adults and people with disabilities. Direct-care occupations include:

• Home health aides
• Personal care aides
• Nursing assistants

These employees work in different settings, including homes and institutional long-term care settings. Under the proposal, applicants would need at least two years of direct-care experience or equivalent verified coursework or training, basic English-language literacy, an age of 21 to 54, and no criminal history in the United States or elsewhere.

H-1D Visa Requirements

Under the proposed framework, workers would need to meet several eligibility conditions. These include:

• Be 21 to 54 years old
• At least two years of direct-care experience or equivalent verified coursework/training
• Basic English-language literacy
• No criminal history in the United States or elsewhere
• Work in the direct-care field with an employer sponsor
• Employer sponsorship and recruitment through an approved employer or intermediary, as applicable

The exact H-1D visa requirements could change if lawmakers eventually consider and modify the proposal.

How Long Would the H-1D Visa Last?

The proposed H-1D would initially allow workers to remain in the United States for three years, with an option to renew once for a total of six years. The proposal also includes a pathway that could allow eligible workers to seek permanent residency after completing six years of H-1D status. This would make the H-1D different from a purely short-term seasonal work program. A potential H-1D green card pathway could also provide greater stability for workers and employers facing long-term staffing needs, although the proposal notes that current employment-based green card limits could create backlogs.

How Many H-1D Visas Could Be Available?

The proposal recommends a three-year pilot program with 30,000 H-1D visas available annually. After three years, the annual cap would increase to 65,000. Brookings estimates that 65,000 visas per year could meet about 35% of the projected growth in the direct-care workforce over the coming decade. After the first five years, a bipartisan commission would be appointed to set the annual cap and other program parameters for the subsequent five-year period, considering domestic workforce growth, general immigration flows, and economic demand for direct care.

Employer Requirements Under the H-1D Proposal

Employers participating in the proposed program would need to follow several requirements designed to protect workers and prevent misuse of the visa. Employers could be required to:

• Provide adequate and affordable health insurance for the worker and dependents
• Commit to providing at least 25 hours of employment per week
• Meet required wage standards, including an initial wage at the 75th percentile of local occupational wages
• Pay the required employer fees and comply with applicable Social Security and Medicare tax requirements
• Document workers’ direct-care experience and English-language literacy
• Document required English-language literacy
• Maintain liability insurance
• Document a transportation plan to ensure the worker can safely access the worksite
• Follow applicable recruitment and sponsorship requirements

The proposal aims to ensure that employers use the program to address genuine worker shortages rather than simply reduce labor costs.

H-1D Visa Wage Requirements

Wages are an important part of the proposed worker-protection framework. Under the framework, employers would need to pay an initial wage at the 75th percentile of occupational wages in the worker’s location. Pay would also have to meet applicable federal, state, and local wage requirements.

The wage would be reassessed when the worker renews the visa or changes employers. These rules are intended to protect both foreign workers and domestic direct-care workers from downward pressure on wages.

Worker Protections Under the Proposed Visa

The proposed H-1D pathway includes several safeguards intended to reduce worker exploitation. H-1D workers would receive the same protections and legal rights as other workers. The proposal also calls for workers to receive information about their rights in a language they understand. Participating employers could face random audits.

Employers that violate program requirements could lose the ability to sponsor H-1D workers. The framework also aims to give workers greater flexibility to change employers while remaining in the direct-care field.

Recruitment Fees Would Be Restricted

Recruitment practices would also face regulation. Workers could not be charged recruitment or application fees by vetted recruitment firms. Instead, employers would be responsible for applicable costs during the initial US-based pilot recruitment process, while the proposal separately establishes employer and lottery fees. During the initial pilot period, workers already in the United States would need to be recruited directly by a US firm or through a US-based intermediary. These requirements are intended to reduce the risk of workers entering the program with large recruitment debts.

Could H-1D Help Workers Already in the US?

The proposed program could potentially apply to eligible immigrants already living in the United States as well as workers entering from abroad. This could help some workers already providing direct-care services obtain H-1D status and gain a more stable employment pathway if they meet the program requirements. The proposal therefore focuses on both recruiting additional workers and stabilizing direct-care workers already in the United States.

Is the H-1D Visa Available Now?

No. The H-1D visa is not currently an available US immigration visa. It is a policy proposal by Tara Watson of the Brookings Institution to address the country’s growing direct-care workforce shortage. Applicants should therefore be careful of websites or recruiters claiming they can currently obtain or provide an H-1D visa.

Could the H-1D Visa Help Close the US Care Worker Gap?

The United States faces growing demand for workers who provide direct care to older adults and people with disabilities. With an estimated 1.28 million additional direct-care workers potentially needed by 2036, policymakers are looking at different ways to expand the workforce. The proposed H-1D visa for direct-care workers could provide one additional immigration pathway while including wage standards, employer oversight, and worker protections.

For now, however, the H-1D remains a proposal rather than an available visa. Its future will depend on whether US policymakers decide to move the idea forward.

If the H-1D visa moves forward, it could create new opportunities for eligible direct-care workers while helping the US address growing long-term care needs. Those planning future travel for work or family can compare international flights and explore Indian Eagle deals for affordable travel options.

The post H-1D Visa Proposal: What It Could Mean for Direct-Care Workers in the US appeared first on Travel Blog | Travel Inspiration, Tips and News | Travel Diary.