Government Affairs

Workgroup Report on Direct Support Staff

Below are the final report and Executive Summary of the legislatively mandated Workgroup report on the direct support staff recruitment and retention challenges with the CMH funded system of supports and services.  Members included people with disabilities, PIHP, CMHs, employers, DHHS staff, and workforce representatives.


SECTION 1009 REPORT executive summary

FINAL report section 1009 on direct support workforce

You are encouraged to review the full report including its appendices. This report documents that in February 2016, Kent county (Network180) had a 20% job vacancy rate among its employers—both organizational and individual/participant employers.  Of the 100 direct support staff needed to serve participants using self-determination, only 80 position were filled.

The Partnership for Fair Caregivers Wages (PHI-Michigan, The ARC, UCP, and UPCAP are members) ask that your organization share this Report and Executive Summary with your leadership, Board, staff, advocacy volunteers and others you think are or should be interested in CMH funded supports and services.

There are placeholders in both the House and Senate DHHS FY 2017 appropriations bills for wage increases for this workforce.

The Workgroup’s unanimous recommendations are:

Immediate Actions Needed to Improve Wages and Benefits

The Michigan Legislature and Governor need to make additional investments into all the named Medicaid covered supports and services to assure that:

  • Direct support staff earn a starting wage of at least $2.00 per hour above the state’s minimum wage. These investments and the starting wage rate should increase as the state’s minimum wage increases and should include the mandatory employer costs (FICA, worker’s compensation, etc.) associated with employment.
    • Direct support staff earn paid leave time at the minimum rate of 1 hour for every 37 hours worked (i.e., 10 days a year for full-time employment).
  • The Michigan Department of Health and Human Services (MDHHS) should use its contractual authority to set Medicaid payment and reimbursement rates that provide sufficient funding to provide and maintain a starting wage rate of at least $2.00 per hour above the state’s minimum wage, associated employer costs, and paid time off to the direct support workforce.
  • The Michigan Department of Health and Human Services and each Prepaid Inpatient Health Plan (PIHP) shall collect and publish data on the size, compensation, and stability (turnover rates and job vacancies) of the direct support staff providing the identified supports and services at least annually. The collected data shall be used to assess the impact of the funded wage increases on the wages paid, direct support staff turnover rates, job vacancies, service delivery, and the adequacy of the direct support workforce.

Long Range Solutions to Improve Workforce Stability

  • Develop and fund a promotional campaign to build public awareness and appreciation of people with disabilities and those who chose a career to support them. The campaign should build off the system’s mission of inclusion and stigma elimination. MDHHS, the PIHPs, employers, direct support staff, and people with disabilities should participate in the creation and execution of the campaign.
  • Expand the existing MDHHS funded matching services registry for Home Help beneficiaries to include all Medicaid beneficiaries using the self-determination option to address the difficulties (conducting criminal background checks, advertising, recruiting, etc.) individuals using self-determination have in finding direct support staff.
  • Change Michigan’s current laws and policies on criminal background checks to include a “rehabilitation review” similar to those authorized in 17 other states in order to increase the potential pool of applicants for direct support careers. Implementing a review process of applicants for direct support careers.  Implementing a review process would allow people with a disqualifying criminal conviction to demonstrate that they no longer represent a threat to people needing supports and services or to their property.
  • Provide publicly financed tuition reimbursement or incentives to direct support workers who are actively studying to become psychologists, behavior specialists, nurses, therapists and other health care occupations that serve people with intellectual and developmental disabilities, mental illness, and substance use disorders in order to increase the number of people interested in doing direct support work. This effort will also improve the frontline skills and broaden the experiences of other health care occupations serving these populations.
  • Legislatively require the creation of a workgroup to identify the wide ranging initial competences, skills, and aptitudes needed by the direct support staff and to provide recommendations for a training and credentialing program to assure a competent direct support workforce.