Haitian TPS phaseout leaves U.S. families and healthcare providers scrambling to fill care gaps
By Maria Tsvetkova
NEW CITY, N.Y. (Reuters) - Richie Rosen, 43, was born with Williams syndrome, a rare genetic condition that leaves his hands weak and unreliable. He craves human connection, but social situations make him anxious and easily upset. For the past four years, a Haitian caregiver named Tassy helped him navigate day-to-day life at a Rockland County group home for men with developmental disabilities – cooking for him, driving him around and making difficult chores more manageable.
On July 27, Jawonio, the nonprofit that runs the home, ended Tassy's contract after the Trump administration terminated Temporary Protected Status for Haitians and, with it, his legal work authorization. Rosen learned his aide was gone without a chance to say goodbye.
“I miss him a lot,” Rosen told Reuters last week in his room at the home, a short drive from New York City. “I miss him just saying hi to me all the time.”
The loss Tassy represents is playing out across the country. According to an analysis of U.S. census data by Philip Connor, a Princeton University research fellow, about 21,000 of the 330,000 Haitians in the United States under TPS worked as caregivers and nursing assistants as of last year, serving roughly 77,000 patients. Their sudden removal from the healthcare workforce has intensified staffing pressures in an industry already stretched by the needs of a rapidly aging population.
Sharan Rosen, Richie's 77-year-old mother, said Tassy had become “like family” to her son. “My heart is breaking for him and for my son,” she said.
Reuters was unable to reach Tassy, and is using only his first name because of his vulnerable legal status.
At Jawonio, the effect has been immediate. The organization was forced to lay off nearly two dozen Haitian employees last month, roughly 7% of its staff. Many of them had been providing round-the-clock care to disabled patients for about $20 an hour, only a few dollars above New York's minimum wage.
“These are among the most difficult positions to fill,” Jawonio's CEO, Randi Rios-Castro, said in emailed responses to Reuters. “This has never been just an immigration issue. It is a healthcare workforce issue for us and our country.”
Patient care suffers
The U.S. first extended humanitarian protection to Haitians after the country's devastating earthquake in 2010. The Trump administration said conditions in Haiti had improved enough to end the program, even though the country remains one of the most unstable in the Western Hemisphere. Haiti has not held elections since 2016, its last president was assassinated in 2021, and gang violence has forced about 1.4 million people from their homes, according to the United Nations. Roughly six in ten Haitians live in poverty.
Former TPS holders who can no longer work legally in the United States now face a stark choice: return to Haiti voluntarily or remain in the U.S. and risk arrest and deportation. The uncertainty has hit states with large Haitian communities especially hard. New York is second only to Florida in the number of Haitian TPS holders, and Florida has one of the country's largest and fastest-growing elderly populations.
Weeks before TPS was due to expire, Emmett Reed, CEO of the Florida Health Care Association, wrote to the Department of Homeland Security urging officials to exempt long-term caregivers from the phaseout. Without Haitian workers, Reed warned, the state's healthcare system could feel a “ripple effect” that overwhelms local hospitals and nursing homes.
Nancy Hagans, president of the New York State Nurses Association, understands those concerns from a personal vantage point. A Haitian native who moved to the U.S. as a child, Hagans now works at a Brooklyn hospital. At a vigil outside Maimonides Medical Center on Aug. 5 to protest staffing shortages, she compared the impact of ending TPS to the workforce deficits seen during the COVID-19 pandemic.
“When healthcare workers live in fear of going to work, patient care suffers,” Hagans told the crowd.
The Department of Homeland Security disputed that framing. Asked by Reuters about the impact on healthcare, the agency said it was “grossly false and lazy” to argue that the healthcare industry relied on immigrants, and that TPS “has been allowed to function as a de facto amnesty program.”
Jawonio has turned to Rep. Mike Lawler, a Republican whose district includes Rockland County and an estimated 11,000 Haitian residents. Lawler has supported Trump and his hard-line immigration agenda, but he has opposed stripping protections from Haitians and is expected to face a competitive House race. His office said it is working with Jawonio and local groups to identify alternative legal statuses for the affected workers.
“Losing these experienced workers creates real staffing challenges for providers who were already facing shortages and risks disrupting care for vulnerable residents,” Lawler's spokeswoman Caroline Hunt said in an emailed statement.
Family fills in
At the Rockland County group home, remaining staffers have had to pick up extra shifts after Tassy and another former Haitian caregiver, Marc, left. For the Rosens, the loss is deeply personal.
Sharan Rosen said she had told her son Tassy might have to leave because of the new immigration policies, but never expected it would happen so abruptly. Now she and her 81-year-old husband are helping fill the void, including driving Richie to his job at a nearby grocery store.
Asked how it felt to learn Tassy was gone, Rosen did not want to revisit the moment. “I hope one day I can see him again,” he said.
(Reporting by Maria Tsvetkova; Editing by Jesse Mesner-Hage and Aurora Ellis)