Direct Care Workforce Crisis

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Michigan Direct Care Workers are suffering. They aren't paid enough to stay on the job, and many people and families are heading toward a state of emergency. Take two minutes to fill out this survey so we can help make a difference.

Bridge Michigan

Crucial but underpaid, Michigan home care staff face inflation now, too


Direct Care Workforce Crisis

Without Direct Care Workers, Michigan’s behavioral health framework quickly collapses.

In fact, it’s already beginning to do so.

Today, Michigan’s entire system of supports for people with mental health challenges and developmental disabilities is anchored in a single assumption: that Direct Care Workers will always be available to help provide services.
Unfortunately, that is no longer the case. And Michigan families are already facing a state of emergency.
From Monroe to Marquette, the situation is the same. Salaries are going up for everyone except DCWs.
  • Most DCWs in Michigan earn a starting wage of $14.35 per hour, according to recent survey findings. This includes the $2.35 per hour premium pay increase.


This level of compensation is just too low to keep DCWs on the job.

Today’s labor market, coupled with inflationary pressures and gas prices, is pushing many DCWs away from the system. Today, DCW employee turnover is nearly 45 percent.

And that system? It’s starting to resemble a house of cards.
  • People end up going without the much-needed personal care, training, emotional support and respite they urgently need.
  • Across Michigan, people are entering emergency rooms—often for extended periods—when no DCWs can be found.


Without DCWs, Michigan’s behavioral health framework quickly collapses. In fact, it’s already beginning to do so.
Legislative action is needed to increase the DCW starting wage rate to a minimum of $18.00 per hour.
It’s too late for the FY 2023 budget cycle, but we believe this is an essential budget item for FY 2024. Without action, our state faces almost-certain catastrophe.

Unfortunately, FY 2024 is simply too far away for most families. The DCW care crisis is happening here and now.


Michigan’s legislature must immediately appropriate emergency funds to keep DCWs in the behavioral health sector on the job.
  • Our coalition asks for $175 million in ARPA money to pay retention bonuses for more than 50,000 Michigan DCWs.


Urgent legislative action is essential to prevent the looming behavioral health crisis that awaits.

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Commentary: Why direct care workers deserve a $4-an-hour raise


Sherri Boyd, Executive Director and CEO of The Arc Michigan


Sherri Boyd, Executive Director and CEO of The Arc Michigan

“We’re stretched beyond the point of reason. I’m not sure how we’re going to make it. “
These words, spoken recently by the head of a Michigan behavioral health service agency, are haunting. They signal the rising level of fiscal hardship and regulatory fatigue that now plagues caregivers providing direct support to people with developmental disabilities and mental health issues.


Two years after the onset of COVID-19, Michigan’s direct care workforce has been hard hit by rising labor costs, burnout, and a shortage of skilled workers. To help combat these issues, advocates continue to press for increased state-level funding.
After all, the job market isn’t what it was pre-pandemic. Today’s fast-food workers are making at least $18 per hour, often with other benefits such as tuition reimbursement or paid time off.


In contrast, Michigan’s direct care workers earn an average starting wage of around $14 per hour in the state’s behavioral health system. This includes the state’s recent $2.35 per hour wage increase, which lawmakers intended to make permanent when preparing last year’s budget.


That’s the same rate of pay as many high school students can earn at a summer job. And it’s certainly not enough to support an individual or family- not by a long shot.
But here’s the problem: direct care workers receive their pay via state wage passthroughs, and these dollars are limited. It’s simply not possible for families and agencies who compensate direct care workers to simply “raise their rates” without legislative action.


This means that while other employers can raise their wages to keep pace with the current labor market, those who employ direct care workers are stuck with what they’ve got.
And what they’ve got isn’t enough.


The result of this shortfall is that many direct care workers are simply choosing to leave the profession. Individuals and families are losing the help they need. And many of our state’s most vulnerable residents are either being pushed back into residential settings or trying to go it alone.


No matter how you look at it, this is a problem that won’t be going away soon. That is why a strong coalition of behavioral health advocates has come together to propose a state General Fund appropriation of $127 million in fiscal year 2023 which would increase the average starting wage rate in the behavioral health system by $4 per hour to approximately $18 per hour. This calculation is based upon an estimated 50,000 direct support staff providing community living supports and other services funded through the behavioral health system.


The state of Michigan has the resources required to meet the needs of this important population.


And the economic benefits of action are clear.


According to an analysis prepared by Great Lakes Economic Consulting, a $5 per hour increase in direct support staff wages would provide economic benefits to the state of Michigan totaling $261 million. These benefits would include reduced turnover and increased economic activity and tax revenue.


Even better, many Michigan direct care workers would be able to end their reliance on public assistance.


It’s long past time the state of Michigan began to solve this challenge for the people of our state. We have the means and structure to do what’s best; all that’s needed now is the will to make it happen.

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Valuing Quality Care Information


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