Heritier Nosso

Over the last year, as COVID ravaged nursing homes across the country, another kind of residential healthcare facility received far less attention: group homes for adults with intellectual disabilities.

These homes comprised nearly a third of Maine’s outbreak sites, according to the Maine Center for Disease Control and Prevention. But attempts to battle the COVID outbreak were made worse by a second troubling situation: staff shortages. 

Maine’s minimum safety requirements for group homes demand 24-hour on-call services and at least three direct support professionals on site. These employees help residents with everything from personal hygiene, to mealtime assistance to administering medications. They are literally keeping clients alive.

And yet many of our state’s 157 homes barely had enough workers to function during the pandemic. As a health promotion coordinator in Lewiston, I spent months sourcing healthcare staff and continuously came up short. As a result, agencies were forced to rotate nursing staff between facilities to fill shortages, and non-nursing staff were permitted to provide resident care. In extreme cases, the CDC even said COVID-positive staff could continue working under certain conditions.

This is unacceptable, but there is a solution: immigrants, including asylum seekers and refugees. These new arrivals have much to offer. So many of them are willing to roll up their sleeves and work labor-intensive jobs in exchange for the chance to build new lives in our state. President Biden acknowledged the contributions these newcomers can make, with two recent policy changes: resettling 62,500 refugees this year up from the previous cap of 15,000, and no longer requiring that non-Mexican asylum-seekers wait in Mexico for their U.S. court hearings. 

Immigrants are already filling our nation’s healthcare worker shortages. According to New American Economy, they are more than a quarter of all personal care aids and are twice as likely to fill home health aide positions than U.S.-born citizens. This is especially true of refugees. Nearly 16% of the nation’s refugee population work as personal care aides, nurses, nursing assistants and home health aides. In Maine, 6.2% of those working as health aides are foreign-born. And yet the demand for these jobs far exceeds the available workforce. Our most vulnerable Mainers deserve care. We need refugees to provide it. 

The economic contributions refugees and other immigrants make far outmatch any assistance they receive. Seventy percent of refugees are essential workers. In fact, 69% of immigrants are essential workers compared with 65% of native-born Americans.

Here in Maine, immigrant households make $1.6 billion in annual income and pay $464.4 million in taxes, according to New American Economy. And $151.9 million of that goes directly to state and local taxes, which help fund entitlement programs on which our aging and low-income populations depend. That’s why Maine’s public health community was excited when President Biden initially pledged to restore refugee admissions; the move would help native-born Mainers too.

Of course, resettlement is also a moral imperative. Since 1980, America has saved 3.1 million people from war, famine and civil unrest and granted many more asylum from political oppression. I came to the U.S. from my native Democratic Republic of the Congo and, like most refugees and asylees, I was determined to repay America’s generosity and become self-sufficient in my new home.

While waiting on my work permit to come through, I volunteered at Lewiston Public Works. Once I was eligible for employment, I became a nursing assistant. Today, I’ve devoted my career to keeping Mainers healthy; in addition to my public health position, I work part time caring for people with disabilities and am a teaching assistant at Bates College. I’m not alone; nearly 30% of sub-Saharan immigrants — many of them refugees — are employed in the healthcare industry. Only 13% of the U.S.-born working population fills similar roles. 

But there aren’t enough of us. A 2016 Maine Department of Labor report estimated that nursing and residential care facilities need at least 1,900 additional workers through 2024. Over the last four years, refugee resettlements in Maine fell from 650 in 2016 to 38 in 2020. As a result, the most vulnerable Mainers were at risk when they most needed protection. That’s unconscionable.

I’m glad the Biden administration delivered on its promise to reopen our doors to new refugees. Now that they are here, I hope we can welcome them into our communities. The more they integrate, the more they can contribute to our economic, civic and population growth. The future of our state depends on it.

Héritier Nosso is a health promotion coordinator and community organizer in Lewiston.