Aging in America News

Pathway for Immigrant Workers helps employers sponsor their lower-wage workers for green cards. Earlier this month, the nonprofit issued a newsletter titled “Immigrant Workers Are Essential to the Future of Elder Care,” stating, “The elder care crisis isn’t just a policy issue—it’s a human issue.” Aging in America News spoke with founder Leslie Ditrani to learn more about what she’s seeing in Massachusetts. 

What kind of response did your newsletter get? 

We receive a lot of thank-yous—people saying, “Thank you for understanding” or “Thank you for standing with us.” Personally, I think the situation will have to become even more dire before real change happens. 

What is the latest setback? 

Temporary Protected Status (TPS) for Haitians was just shortened, now ending in August 2025.  TPS has been extended for Haitians since the earthquake in 2010, and now people are going to lose their ability to remain and work in the U.S.—in less than six months. Even if people had another avenue to remain in the U.S., there is not enough time to secure alternative work authorization. 

Are there many Haitian health care workers in the Boston area? 

Yes. We have the third-largest Haitian population in the country, but because our total population is smaller than Miami and New York, we are actually the most Haitian-dense area in the U.S. Many Haitian immigrants work in health care. 

How does the care economy affect you personally? 

I have a spouse and adult children, as well as a special needs adopted daughter and an 85-year-old mother with Alzheimer’s who lives with us. I can tell you firsthand—finding help, even if you can afford to pay for it, is next to impossible. And it’s only getting worse. 

How did you get involved in this work? 

I’m a business immigration attorney by trade. I spent over three decades working in private practice, helping employers sponsor engineers, scientists, and managers  and other professionals for immigrant visas. Occasionally, I’d assist a lower-wage worker, but because the employer has to cover the costs, it was often too expensive for the employer. At Pathway for Immigrant Workers, we provide these services for free to employers of lower-wage workers, so all workers have a path to lawful permanent residency.

Who are your clients? 

We work with nursing homes and adult daycare centers for people with disabilities as well as restaurants, construction businesses, and hotels. Our mission is to help immigrant workers have a pathway to a green card and then citizenship. 

How are health care executives responding to the situation? 

I get a lot of calls from employers asking, How do I do this? And there’s no good answer. If you follow the rules and do your I-9s correctly, when a worker’s authorization expires, they have to stop working. But how do you run a hospital if all your certified nursing assistants are suddenly benched? It feels like the system is designed to make it impossible for employers who want to comply with the law to stay in business. 

Who are the immigrant workers in health care settings? 

There are hundreds of thousands of people in the U.S. with work authorization—individuals with TPS, DACA [Deferred Action for Childhood Arrivals; aka Dreamers], parole, or pending asylum cases. They’re following the rules, working, and contributing. But the current administration’s priorities are clear, that these workers are no longer welcome here.

Have you heard about increased enforcement efforts or Immigration and Customs Enforcement (ICE) raids in Massachusetts? 

There hasn’t been a major raid like in New Bedford in 2007, but we hear frequent reports of targeted enforcement—ICE going in for one individual and picking up anyone else in the vicinity. 

For families in need of care services, what are the consequences of these policies? 

If employers can’t retain their workers, they won’t be able to keep their businesses running. Families won’t get the care they need. Massachusetts already faces a severe worker shortage according to the Chamber of Commerce. Our economy needs labor. The labor is here, it’s working—so why isn’t that a good thing?