One not-so-great thing about my flight to the LeadingAge Annual Meeting on Sunday was having to get up before sunrise and be at the airport before 5 a.m. But a great thing about getting to Nashville, TN, so early on Sunday is that I was able to see the showing of the short documentary called “The Test” in the morning and then a panel discussion about it.
The award-winning film tells the story of Eric, who legally came to the United States from Ghana and got a job at Goodwin Living’s Goodwin House Alexandria in Virginia — he currently works in maintenance — to better provide for his wife and children. As the movie begins, Eric and his family have been separated from one another for eight years, with Eric being afraid that if he returned home before becoming a US citizen, he might not be able to come back to the United States. The documentary centers on the assistance that Eric received from two Goodwin House residents, Jill and Carl, to prepare for the 100-plus question citizenship test. (You can watch a trailer here.)
Claudia Myers, who directed and produced the movie with fellow American University faculty member Laura Waters Hinson, told audience members that the film was inspired by a 2021 Washington Post article she read that mentioned a resident-initiated Goodwin program that covers the cost of the citizenship test and provides tutoring for workers, although the article did not mention the specific people featured in the documentary.
“Two aspects of this story really drew me in,” Myers said. “One is that I feel like older adults really aren’t sufficiently represented in mainstream media, or they’re stereotyped, and there was something about this program that was so dynamic and so exciting and so positive. And then similar to that, the complementary nature of the relationship.” Eric, Jill and Carl all seemed to both contribute to and get something from it, she said.
A tear-jerker — and a solution
Before the film screening began Sunday, Nicole Howell, director of workforce policy at LeadingAge, warned audience members that they might need tissues while watching the “really, truly emotional and beautiful story.” Indeed, its 15 minutes packed a punch. I was struck by the true affection that Jill, Carl and Eric had for one another. At one point, in fact, Eric called the Goodwin residents “part of my family now.”
Goodwin Living President and CEO Rob Liebreich said the citizenship program speaks to the mission of his organization, and it also offers a solution to the staffing challenges that face senior living and care providers.
For senior living communities that want to establish more open and inclusive workplaces for new Americans, Jenna Kellerman, former director of workforce strategy and development at LeadingAge and now senior director of workforce development at PHI, said that the effort needs to start at the top.
“Rob is, obviously, an example of that type of leadership,” Kellerman said. “I don’t think that we as Americans are always very inclusive and welcoming by nature, so it does take someone at the top who is setting the tone and setting up the system to allow that type of openness between people, between colleagues, allowing for personal friendships between resident and staff. There’s often a big wall there.”
A workplace philosophy that encourages friendships between residents and staff members can lead to rich lives for everyone involved, she said, adding that the ideal environment is one in which residents and staff members can feel comfortable being themselves with each other.
For such programs to be successful, however, providers “need to be intentional about celebrating diversity,” Liebreich said. Goodwin, he noted, has activities that have led to an increased sense of belonging and connectedness as well as a better understanding of various cultures.
The principles of person-centered care and trauma-informed care that providers use to serve residents can be applied to staff members as well to create a sense of belonging, Howell and Kellerman said.
Legislation could help
The film’s screening at the LeadingAge conference comes at a time when lawmakers may be preparing to take up the Healthcare Workforce Resilience Act (S 3211/HR 6205), according to Howell. The bill would recapture unused visas for professional nurses and doctors to “help alleviate a US healthcare sector facing nationwide workforce challenges after shepherding the country through the paradigm-shifting challenge of the COVID-19 pandemic,” according to a press release from US Rep. Brad Schneider (D-IL) from November 2023, when he and colleagues introduced the bipartisan bill in the House.
Specifically, the legislation would allow up to 25,000 foreign-born nurses and 15,000 foreign-born physicians who currently are unable to finalize their green card applications due to green card backlogs to live and work in the United States permanently. According to the press release from Schneider, applicants for the visas would be subject to the same standards as all applicants for work-related visas. Approved individuals would be required to meet licensing requirements, pay filing fees and undergo national security and criminal history background checks, and employers would need to confirm that no American worker was displaced by the hiring of a foreign national.
Both LeadingAge and the American Health Care Association have supported the legislation as members of the Healthcare Workforce Coalition. National Center for Assisted Living Executive Director LaShuan Bethea previously asked assisted living providers to encourage their members in Congress to advocate for workforce-related legislation, including the act. LeadingAge has a form on its website where members can do just that and urged its members to ask lawmakers to “support, cosponsor and pass” the bill by the end of the year.
“Turnover in assisted living settings currently clocks in at 34.72% for RNs, 38.6% for LPNs, and 41.88% for nursing assistants, while turnover rates in organizations providing home and community-based services (HCBS) are even more concerning: 64% in 2021,” LeadingAge said in a recent white paper, The Immigration Imperative, citing research from PHI.
“Our immigration system is broken,” Howell said. “We talk about people coming here legally. The problem is, that process takes so long. It is so painful, and we are losing amazing talent to other countries for folks who want to come here and work.”
After next week’s election, Howell noted, a lame duck session of Congress will begin. “This is a time when sometimes folks feel a little brave, and they might be willing to step out of what they have said … to do the greater good, to do the bigger thing,” she said. “And we’ve heard from congressional offices that the HWRA is in that mix of bills that are sort of almost at the finish line. The way we get it across the finish line is, we need more members of Congress to co-sponsor that bill.”
Screenings of “The Test” can be part of the effort to persuade lawmakers, the panelists said.
“One of the reasons that is driving us to get this film out as widely as possible is not just to reshape public perception of older adults and how much they have to offer and how dynamic they are but also to counter the cynicism and the negativity around immigration,” Myers said.
Liz Stiff, founder of marketing agency Little Lion Impact, said that the story told in the film “has the potential to really change hearts and minds when it comes to the foreign-born workforce.”
“We want providers to have access to the film so they can show it in their communities,” she added. “We’re also putting together screenings for congressional representatives. We’re putting together screenings for statehouses, for governors’ teams.”
LeadingAge members can arrange for a screening at no cost by completing an online form or emailing [email protected].
Lois A. Bowers is the editor of McKnight’s Senior Living. Read her other columns here. Follow her on X (formerly Twitter) at Lois_Bowers.
