The Impact of Immigration Policy Changes on Canada’s Home and Community Care Sector

As associations representing those who deliver home and community services, we are united by a shared purpose: to support high-quality care for Canadians. That means supporting not only our members, but also the patients, families, caregivers, and frontline workers who rely on and sustain this system every day.

Right now, that system is under increasing strain—and so is the workforce that makes it possible.

A System Under Pressure

Demand for home and community care is rising rapidly. Canadians are living longer, more people want to age safely at home, and hospitals and long-term care systems are already stretched.

Home and community care is a cornerstone of the health system, helping to relieve system pressures by enabling people to stay in their homes, maintain their independence, and avoid unnecessary hospital stays or early placement in long-term care.

But delivering this care relies on a stable, supported workforce.

Over the next decade, the sector will require a significant increase in workers—particularly Personal Support Workers (PSWs) and Health Care Aides (HCAs). In Ontario alone, more than 50,000 additional PSWs will be needed by 2032. Nationally, occupational forecasts already indicate a likely risk of shortage through 2033.

At the same time, the workforce is becoming less stable.

The Role of Temporary Foreign Workers

Home and community care increasingly relies on internationally trained workers to meet growing demand. Temporary Foreign Workers (TFWs) help fill roles that are difficult to recruit for domestically.

PSWs and HCAs provide essential, front-line care—supporting individuals with daily activities such as bathing, mobility, meals, and medication. These are not optional services. They are fundamental to health, safety, and dignity.

However, domestic recruitment alone cannot meet current or future demand. The nature of this work—physically demanding, emotionally intensive, often performed independently, and undervalued despite its importance—means that multiple workforce pathways are necessary. Put simply, a robust or adequate or sufficient workforce strategy must include both domestic recruitment and attract international talent.

Policy Changes Are Creating Immediate Risk

Recent changes by Immigration, Refugees and Citizenship Canada (IRCC) will significantly reduce the number of temporary residents, including a planned 43% year-over-year reduction in new admissions in 2026.

At the same time, many workers currently delivering care are facing rejection of work permit extensions and permanent resident visas.

For our sector, this is not a future concern—it is already happening.

Workers who are actively providing care are forced to leave Canada on short timelines. This results in an immediate loss of workforce capacity and care hours, with no ability to quickly replace those workers through domestic recruitment.

The consequences are significant.

A survey of Ontario’s largest home care providers found that: more than 9,500 TFWs could be lost; up to 14 million home care visits are at risk; and, between 50,000 and 70,000 patients could be directly affected.

And this represents only part of the national picture.

What This Means for Canadians

When home care workforce capacity declines, the impacts are felt across the entire system.

Patients lose access to essential daily support, increasing risks of falls, malnutrition, infection, and isolation.

Families and caregivers are forced to step in, often having to reduce their work hours or leaving their jobs altogether, leading to financial strain and burnout.

Frontline workers face increased workloads, contributing to stress, fatigue, and turnover.

At a system level, the consequences are clear: Increased emergency department visits; more hospital admissions; delayed discharges; and, greater demand for long-term care.

Home care is one of the most cost-effective parts of the health system. When it is weakened, pressure shifts to higher-cost, higher-acuity settings—driving up overall system costs and reducing efficiency.

Our Commitment as Sector Leaders

We care deeply about the sustainability of this workforce and the stability of care delivery across Canada. Adequately supporting the home and community care workforce is essential—not only for this sector, but for the entire health system.

The Path Forward

We believe there are practical, immediate steps the federal government should take to stabilize the workforce and reduce risk to care delivery.

These include:

• Extending work permits for TFWs currently providing care in the home and community care sector
• Ensuring immigration pathways remain accessible for critical roles such as PSWs and HCAs
• Reintroducing dedicated permanent residency pathways for home and community care workers
• Amending NOC 44101 to reclassify PSW/HCA work – regardless of setting (home care, LTC, Hospital) – as TEER 3 (“skilled”)
• Prioritize home and community care workers for permanent residence under the new one-time measure granting 33,000 temporary foreign workers permanent residence in in-demand sectors.
• Explicitly designate home and community care as a protected sector within the Temporary Foreign Worker Program.

These actions would help ensure continuity of care while longer-term workforce strategies continue to evolve.

The Canadian Home Care Association has released a detailed policy brief that examines this issue thoroughly, including in-depth, practical solutions the federal government can take to mitigate workforce risks. These measures are designed to help the sector grow its capacity—rather than deplete it—so Canadians can access the care they need and workers can remain in the roles they have trained for and dedicated themselves to.

We have also launched a letter-writing campaign, providing our members, service providers, families, caregivers, and care providers with an easy-to-use, pre-filled template that is fully editable, so they can share it as is or add their own perspective before contacting MPs, ministers, and other stakeholders to advocate for action on this critical issue.

The Bottom Line

Without action, the consequences are clear: Fewer workers available to provide care; tens of thousands of Canadians at risk of losing support; increased strain on hospitals and long-term care; and, greater economic and social costs

As associations representing this sector, we will continue to work to ensure the continuity of care for Canadians and that the workforce is adequately supported—so patients and caregivers can access the care they need, where and when they need it, from the right provider, in the setting of their choice.