Gina Policard was in her 50s when she left southern Haiti for New York in June 2022. She obtained Temporary Protected Status (TPS), allowing her to work legally in the United States, and by December 2023, she had trained as a home health aide and had begun working in the East Flatbush neighborhood of Brooklyn.
“I had to do something, because I have bills to pay,” she said about her move to New York. “But I love the job because I love taking care of people the same way I do for my family.”
Now, her future — and the future of hundreds of thousands of immigrant aides like her — hang in the balance.
Since his return to power, President Donald Trump has rolled back multiple Biden-era immigration programs such as TPS for Haiti in July and the CHNV parole program in March, which granted temporary legal status to people from Cuba, Haiti, Nicaragua and Venezuela.
With CHNV no longer in effect and TPS only remaining until February 2026, thousands of immigrants will likely see their work permits expire. That means for home health aides like Policard, continuing to care for patients could become a crime. The threat comes as New York’s home care sector is booming.
Between 2023 and 2024, the state added 57,000 home health and personal care aide jobs, a 10% jump, bringing the workforce to roughly 623,000, according to the Empire Center, a nonpartisan think tank in Albany. That growth, fueled largely by the city’s aging population, accounted for 38% of all job gains statewide during the period.
Nationwide, New York has the highest concentration of home health aides per capita, with 171 aides for every 1,000 residents aged 65 or older, a rate that is 153% higher than the national average. This workforce is larger than any other single job category in the state, notes the Empire Center.
Meanwhile, New York City’s residents aged 65 and older grew by 53% between 2000 and 2023, even as the overall population slightly declined, according to the state comptroller’s office. Projections show the state’s senior population will climb another 25% by 2040.
But despite those demographic trends, President Trump’s new federal policies, which aim to end work permits for thousands of immigrant aides and cut Medicaid coverage for the patients who need their care, serve to ultimately reduce the home care workforce at a time when demand is surging.
The “One Big Beautiful Bill” also imposes new eligibility and verification requirements for Medicaid, which Gov. Kathy Hochul warns will strip health coverage from an estimated 1.3 million New Yorkers.
The home care industry not only serves a growing elderly population but also represents a major employment sector, especially for women and immigrants. State health department data show more than 500 approved personal care aide and home health aide training programs across New York, including more than 330 in New York City alone as of August 2025.
Yet the sector’s reliance on immigrant labor makes it particularly vulnerable to changes in immigration policy.
In August, after a New York judge’s ruling, the Department of Homeland Security temporarily restored work permits for Haitian CHNV parolees until February 2026, when the program was previously set to expire. But these workers could still be forced out of their jobs, leaving patients without care as the Trump administration, once again, appears unwilling to extend the program.
Medicaid restrictions could also trigger a staffing crisis just as demand peaks. If 1.3 million New Yorkers lose Medicaid, as Gov. Hochul projects, many will no longer qualify for home care coverage.
“We cannot keep them”
Martine Duroseau, who has run Citi Health Home Care Services in Brooklyn for two decades, said she has been forced to terminate the contracts of dozens Haitian workers hired under the CHNV parole program, which did not offer as long of a stay as the TPS program. Some Haitian CHNV parolees applied for TPS to remain in the country after their parole expired, but many did not.
“Unfortunately, they did not apply for TPS,” Duroseau said. “Now they are in limbo because many agencies sent them home. We cannot keep them, because we don’t have a choice. That’s regulation.”
As a result of losing trained aides, Duroseau says she has faced a sudden staff shortage. “It’s a lot of people we have to replace,” she said. “We have to recruit more. But I have to follow rules and regulations. They must have a work authorization.”
Also Read: End of Cuban/Haitian/Nicaraguan/Venezuelan (CHNV) Parole: What Migrants Need To Know
According to Duroseau, home care jobs are a first step into the U.S. workforce for many immigrants. Flexible scheduling allows workers to take English classes, pursue nursing degrees or study for licensing exams in other health professions.
“Especially when they come young, one may want to work at night or only on weekends to go to school,” Duroseau said. “That’s why most immigrants are very interested in that.”
For Sabine L., also 57, the work has been both a lifeline and a source of humiliation she says. She came to New York in 2013 through a family reunification visa with her four children, speaking no English. She enrolled in a 1-month aide training course and started work that November.
“It’s the first step for us immigrants who don’t speak English,” Sabine said, who preferred to share only her first name. “From the moment we arrive, that’s what’s on our minds. We do it while we look for something else.”
Language barriers also limited her job options. “At schools, we learned to follow the care plan. But sometimes, patient families expect everything from you, like you’re always available,” she said. “I’m still doing it, mostly because of my limited English proficiency.”
Economic and human stakes
For Policard, the uncertainty is exhausting. She dreams of becoming a certified nursing assistant and eventually a registered nurse, but that path depends on keeping her work permit.
你知道吗？非公民办理驾照时的这个错误可能会导致选民欺诈
“Since Trump came to power, my future is in jeopardy,” she said in Haitian Creole.
Duroseau says her agency is already preparing for more disruptions. She is expanding recruitment efforts but worries about losing experienced aides who have built trust with patients.
“Many immigrants start here and go on to become nurses, physical therapists, doctors,” she said. “It’s a loss for the patients and for the system. It affects all of us.”
