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Trump administration shuts Haiti out of seasonal worker program

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Rule tightening follows end to humanitarian program that allowed tens of thousands of Haitians to live and work in U.S.

The Trump administration is further tightening immigration rules for Haitians, as it plans to remove the country from a program for temporary seasonal jobs, weeks after ending a humanitarian program that allowed tens of thousands of others to live and work in the U.S.

According to a notice that was set to be officially published in the Federal Register on Thursday, Haiti is being removed from a list of countries approved for the H-2A and H-2B visa programs as its participation “is no longer in the U.S. interest.” The programs permit certain foreigners to take temporary seasonal jobs in agriculture and other industries in the U.S., including tourism.

Haitians represent just a fraction of foreigners participating in temporary worker programs. During the 2016 budget year, 883 temporary workers and their relatives were admitted to the U.S., according to government data. During that same 12 months, more than 218,000 such visas were issued to people from around the world.

The visa change is the latest move by the Trump administration to curb Haitian immigration to the U.S. and comes days after President Donald Trump last week, during a bipartisan immigration meeting at the White House, questioned the need to extend legal immigrant status to Haitians.

Late last year, then-acting Homeland Security Secretary Elaine Duke announced the end of a humanitarian program that let roughly 50,000 Haitians live and work in the U.S. in the wake of the deadly 2010 earthquake that devastated parts of the country. They were given until July 2019 to either leave or apply for another immigration status.

 

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Trump Slams Protections For Immigrants From ‘Sh--hole’ Countries

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The president suggested the U.S. needs fewer immigrants from Haiti and Africa, and more from Norway.

President Donald Trump slammed the idea of restoring protections for immigrants from “sh--hole” countries in an Oval Office meeting on Thursday, sources told multiple news outlets

“Why are we having all these people from sh--hole countries come here?” the president reportedly asked lawmakers. He was referring to African nations and Haiti, according to The Washington Post, the first to report the story. It was later confirmed by NBC NewsBuzzFeed and CNN.

Trump then said the U.S. “should have more people from places like Norway,” sources told NBC News. 

White House principal deputy press secretary Raj Shah responded in a statement to CBS News on Thursday afternoon, saying, “Certain Washington politicians choose to fight for foreign countries, but President Trump will always fight for the American people.”

The president “will always reject temporary, weak and dangerous stopgap measures that threaten the lives of hardworking Americans, and undercut immigrants who seek a better life in the United States through a legal pathway,” Raj added.

The statement did not directly address the reported “shithole” remark.

Trump is currently negotiating with congressional lawmakers over how to help so-called Dreamers, young undocumented immigrants who came to the U.S. as children. The president put many of them at risk of losing their protection from deportation when he ended the Deferred Action for Childhood Arrivals program. In exchange for helping Dreamers now, Trump wants various border security measures ― including his wall ― and restrictions on legal immigration that would largely affect people of color.

 

During the negotiations, some lawmakers have proposed granting visas to individuals from Haiti, El Salvador and multiple African nations who are in the U.S. on temporary protected status. The Trump administration has already terminated that status for people from Haiti, El Salvador and Nicaragua, which means more than 200,000 people currently living in the U.S. have a matter of months to either leave or face deportation.

Trump reportedly scoffed at “sh--thole countries” in response to that proposal.

This wouldn’t be the president’s first racially charged remark. He spent years furthering the conspiracy theory that Barack Obama, the nation’s first black president, was not born in the U.S. He launched his presidential campaign with a speech that accused Mexico of sending rapists and criminals across the border and proposed banning all Muslims from entering the country before settling for barring individuals from certain Muslim-majority nations. He has repeatedly referred to Sen. Elizabeth Warren (D-Mass.) as “Pocahontas,” including at an event to honor Native Americans who served in World War II.

Trump previously said in private meetings that Haitians “all have AIDS” and that people from Africa would never “go back to their huts” once they had seen the U.S., The New York Times reported in December. The White House has denied that he made either of those comments.

The president is demanding an end to the diversity visa lottery, which grants up to 50,000 green cards to people from countries that send comparatively few immigrants to the U.S., many of them in Africa. Those individuals are chosen by the U.S. and then vetted, and there is no indication that they pose a greater threat than other immigrants or native-born citizens. But Trump has nonetheless made the baseless claim that through the visa lottery, foreign governments “give us their worst people … really the worst of the worst.”

The president also wants to limit what he and many proponents of slashing legal immigration call “chain migration,” the process by which Americans and legal permanent residents can sponsor certain family members for green cards. That, too, could largely affect people of color, because recent immigrants are more likely to come from Asian or Latino countries.

 

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Trump administration eases penalties against negligent nursing homes

Reversing guidelines put in place under former President Barack Obama, the Trump administration is scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury.

The shift in the Medicare program's penalty protocols was requested by the nursing home industry. The American Health Care Association, the industry's main trade group, has complained that under Obama inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve.

"It is critical that we have relief," Mark Parkinson, the group's president, wrote in a letter to then-President-elect Donald Trump in December 2016.

Since 2013, nearly 6,500 nursing homes — 4 out of every 10 — have been cited at least once for a serious violation, federal records show. Medicare has fined two-thirds of those homes. Common citations include failing to protect residents from avoidable accidents, neglect, mistreatment and bedsores.

The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident's death. The guidelines will also probably result in lower fines for many facilities.

The change in policy aligns with Trump's promise to reduce bureaucracy, regulation and government intervention in business.

Dr. Kate Goodrich, director of clinical standards and quality at the Centers for Medicare & Medicaid Services (CMS), said in a statement that unnecessary regulation was the main concern that health care providers raised with officials.

"Rather than spending quality time with their patients, the providers are spending time complying with regulations that get in the way of caring for their patients and doesn't increase the quality of care they provide," Goodrich said.

But advocates for nursing home residents say the revised penalties are weakening a valuable patient safety tool.

"They've pretty much emasculated enforcement, which was already weak," said Toby Edelman, a senior attorney at the Center for Medicare Advocacy.

Medicare has different ways of applying penalties. It can impose a specific fine for a particular violation. It can assess a fine for each day that a nursing home was in violation. Or it can deny payments for new admissions.

The average fine in recent years has been $33,453, but 531 nursing homes amassed combined federal fines above $100,000, records show. In 2016, Congress increased the fines to factor in several years of inflation that had not been accounted for previously.

The new rules have been instituted gradually throughout the year.

In October, CMS discouraged its regional offices from levying fines, even in the most serious health violations, if the error was a "one-time mistake." The centers said that intentional disregard for residents' health and safety or systemic errors should still merit fines.

A July memo from CMS discouraged the directors of state agencies that survey nursing homes from issuing daily fines for violations that began before an inspection, favoring one-time fines instead. Daily fines remain the recommended approach for major violations discovered during an inspection.

Dr. David Gifford, the American Health Care Association's senior vice president for quality, said daily fines were intended to prompt quick remedies but were pointless when applied to past errors that had already been fixed by the time inspectors discovered them.

"What was happening is you were seeing massive fines accumulating because they were applying them on a per-day basis retrospectively," Gifford said.

But the change means that some nursing homes could be sheltered from fines above the maximum per-instance fine of $20,965, even for egregious mistakes.

In September 2016, for instance, health inspectors faulted Lincoln Manor, a nursing home in Decatur, Illinois, for failing to monitor and treat the wound of a patient whose implanted pain-medication pump gradually slipped over eight days through a ruptured suture and protruded from her abdomen. The patient died.

CMS fined Lincoln Manor $282,954, including $10,091 a day for 28 days, from the time the nursing home noticed the problem with the wound until supervisors had retrained nurses to avoid similar errors. An administrative law judge called the penalties "quite modest" given the "appalling" care.

The fines were issued before the new guidelines took effect; if the agency had issued a one-time fine, the maximum would have been less than $21,000.

Lincoln Manor closed in September. Its owner could not be reached for comment, and his lawyer did not respond to an interview request.

Advocates for nursing home residents say that relaxing penalties threatens to undo progress at deterring wrongdoing. Janet Wells, a consultant for California Advocates for Nursing Home Reform, said the changes come as "some egregious violations and injuries to residents are being penalized — finally — at a level that gets the industry's attention and isn't just the cost of doing business."

In November, the Trump administration exempted nursing homes that violate eight new safety rules from penalties for 18 months. Homes must still follow the rules, which are intended, among other things, to reduce the overuse of psychotropic drugs and to ensure that every home has adequate resources to assist residents with major psychological problems.

Rodney Whitlock, a health policy consultant and former Republican Senate staffer, said health inspectors "are out there looking for opportunities to show that the nursing homes are not living up to some extremely tight standards." He said while the motivation for tough regulation was understandable, "the fines don't make it easier to hire people and doesn't make it easier to stay in business."

In June, CMS rescinded another Obama administration action that banned nursing homes from preemptively requiring residents to submit to arbitration to settle disputes rather than going to court.

"We publish nearly 11,000 pages of regulation every year," the agency's administrator, Seema Verma, said in a speech in October. That paperwork is "taking doctors away from what matters most: patients."

Janine Finck-Boyle, director of health regulations and policy at LeadingAge, a group of nonprofit nursing homes and other entities that care for older people, said the group's members had been struggling to cope with regulations.

"If you're a 50-bed rural facility out West or in the Dakotas," she said, "you don't have the resources to get everything done from A to Z."

 

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http://money.cnn.com/2018/01/03/news/nursing-homes-trump/index.html



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