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This chapter considers questions of immigration institutional design in light of lessons learned from how Caribbean home-care aides currently work and travel. The growth in paid home care has been largely staffed by migrant labor – with some care workers operating outside of the scope of their visas. While these workers may technically be noncompliant, the author argues that most of these workers are in fact “good types,” who would have been favorably screened ex-ante for elder-care visas. The chapter proposes that we urgently devise a system that permits temporary entry of elder-care workers. If migrant care workers are permitted long-term temporary visas in which they can work in the US for a few months per year over several years, they have every incentive to comply.
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