ST. PAUL-His words slurred but resolute, David Birkholz calls medical assistant Sevelle Kamara his "Liberian princess," and with good reason.

"You're always positive," said Birkholz, who uses a wheelchair as a result of an assault that left him severely disabled more than 20 years ago. "She's super cool to me."

When Kamara, 46, explains that thousands of Liberian immigrants may soon be forced to return to their home country as a result of expiring immigration status, Birkholz asks, "Did that happen to you?"

Kamara, who has permanent residency in the U.S., tries to respond reassuringly, but her voice breaks.

"No," she says quietly. "I'll still be here."

Nicole Mattson, an administrator at the skilled-care facility in Robbinsdale where Kamara works and Birkholz lives, wonders on a good day where her industry will find enough workers to care for seniors and stroke victims as the general population ages.

Mattson fears federal immigration changes on the horizon will make matters worse.

"All immigrants, and Liberians in particular, are critical to our workforce," said Mattson, an administrator with the Good Samaritan Society-Specialty Care Community. "Without them, we would not be able to fulfill our mission here. They have been influential in referring people to the health care field and new employees our way."

State home to large Liberian community

The Rev. James Nyebe ­Wilson II oversees a St. Paul church that will celebrate its 130th anniversary this October, but his mood these days is far from celebratory.

The priest in charge of the Holy Trinity Episcopal Church on Van Buren Avenue said these are tense times for him and other members of Minnesota's Liberian community, many of whom face removal to an impoverished West African nation they have not been to in decades.

Wilson is an American citizen, as are his wife and two adult daughters. But he believes up to 4,000 Liberians with a more temporary status could be forced to leave the U.S. by March 2019.

With an estimated 11,000 to 25,000 Liberians, Minnesota is thought to be home to one of the nation's largest Liberian communities.

President Donald Trump has declined to renew a long-standing immigration policy that has allowed thousands of Liberians to remain in the U.S. almost since the onset of Liberia's civil war more than 28 years ago. With their temporary protected status expiring within a year, entire families may be uprooted.

"Liberia is a poor country," Wilson said during a recent interview in his church basement. "It's still struggling to rebuild itself. The infrastructure is all damaged. This country still does not have good paved roads in the cities. People use a lot of generators. It's embarrassing to even talk about. What's the point of sending immigrants back who are working really hard in this country?"

Business groups engaged

Their clearest shot at remaining in the U.S.?

That may be support from Minnesota's business leaders, who are being asked to step up on behalf of employees.

Liberians make up a large percentage of allied health workers such as nursing home employees and home health aides. Census surveys show that 36 percent of Liberian workers are employed in health-related fields.

Kamara, who has worked for Good Samaritan Society for more than 20 years, said she's recruited many Liberians as co-workers, including friends with temporary status.

"Many days and nights, they can't sleep because they're worried what will happen," she said. "The parents can't sleep; the children can't sleep. What will happen to their dad, to their mom?"

Some business leaders are listening.

"Their presence here has been good for everybody. Why wouldn't we come up with a permanent solution?" said Bill Blazar, senior vice president of the Minnesota Chamber of Commerce. "Overall, Minnesota's labor market is tight. Losing a group that is a significant contributor to our health care system, that's something that all Minnesotans should be concerned about. Immigrants are key to the development of Minnesota's economy."

Labor organizers with SEIU Healthcare Minnesota say several nursing home management companies - which they have sometimes tangled with on labor issues - are considering working with them on a joint advocacy campaign.

"We're trying to make an economic case," said Wynfred Russell, a Liberian and co-founder of the Brooklyn Park-based networking and advocacy organization African Career, Education and Resources Inc., or ACER. "A number of the big nursing home companies, they've been working very closely with us. They rely heavily on Liberian workers."

Peaceful transition in an unstable country

On Dec. 29, Liberia ­welcomed a new president, former soccer star George Weah, who unseated the country's first female leader, Ellen Johnson Sirleaf. Sirleaf was a two-term incumbent who held office for 12 years.

The change in leadership was the first time in decades that power transitioned in Liberia from one democratically elected head-of-state to another without bloodshed.

For the Trump administration, the peaceful transfer also marked another milestone: The end of the "Deferred Enforced Departure" program, otherwise known as a "temporary protected status" for Liberians that began under President George H.W. Bush in 1991.

The DED/TPS program was extended by subsequent presidents - Bill Clinton, George W. Bush and Barack Obama. With the civil war over, Trump recently ordered the program to roll down by March 2019.

"By definition, TPS is temporary," said then-Homeland Security Secretary John Kelly, now White House chief of staff, announcing cuts to the program in June 2017. "It's meant to be temporary. It's not meant to be forever."

A memorandum issued by the Trump administration last month said conditions in Liberia have improved considerably since the war years.

Similar immigration protections are ending or have ended for Salvadorans, Haitians and Nicaraguans. Hondurans are the next group awaiting their fate.

Taken together, that could spell trouble for employers. Foreign-born workers make up 10 percent of the Minnesota labor pool and are its fastest-growing segment, according to the Minnesota Department of Employment and Economic Development.

"The health care industry is going to be impacted," said Alfreida Daniels, a Liberian-born community organizer with the Minneapolis Regional Labor Federation.

Industry advocates say the fate of immigrant workers could directly affect care for seniors of all ethnic backgrounds.

"Not only do we have an increasingly diverse workforce, we have an increasingly diverse senior population we're taking care of," said Patti Cullen, president of Care Providers of Minnesota, a trade association. "When we have really good workers who have come from Liberia, who have worked for us for years, it's like losing part of your family."

Wilson still sees plenty of instability in his homeland. He notes that Liberian families have set roots in the U.S. across more than a generation.

It's unclear how many Liberians in Minnesota will be forced to leave the country, but the federal government is asking workers to come forward.

"As of September 2018, you have to reapply for work authorization," Wilson said. "In other words, 'we want to know where you are so ICE (U.S. Immigration and Customs Enforcement) can pick you up.' "

Wilson believes there's at least one way to keep Liberian families intact. Through the H-1 visa process, their employers could help them apply for permanent resident status as essential employees.

"We're asking employers to help change the status of their employees who are on (the DED program), who have been working with them all these many years," Wilson said. "This is our appeal to all employers."

Bipartisan Advocacy

Gov. Mark Dayton and members of the state's congressional delegation, including Sen. Amy Klobuchar, D-Minn., have asked the Trump administration to reconsider the policies. Wilson hopes business leaders will strike the same note.

Rep. Erik Paulsen, a Republican who represents Brooklyn Park and other corners of the 3rd Congressional District with a significant Liberian population, recently joined others in Congress calling for the yearlong reprieve last month, rather than terminating DED immediately.

In a March 27 Facebook post, Paulsen said the year "gives me and my colleagues on both sides of the aisle more time to work toward a permanent solution, and it gives us more time to raise awareness and educate others about what our Liberian community means to Minnesota."

Wilson said many families fear coming forward with their stories because it could bring them unwanted attention, even deportation.

"Congressional leaders say, 'We want to hear the stories of those who are on DED.' But the families are so afraid to speak out," he said.

Liberia "is not ready economically. It's not ready health-wise. It's not ready infrastructure-wise. They're not ready employment-wise. The country is still unstable," Wilson said. "Why would President Trump be so inhumane? His own wife is an immigrant. He comes from a family of immigrants. It doesn't make sense to me."