Michigan's Hidden Crisis: The Urgent Need for Direct Care Workers

Imagine if you or a loved one, who is older or living with a disability, needed critical or long-term care, and there was no one to provide this type of support. This is happening right now in Michigan because we don’t have enough direct care workers (DCWs). These vital workers, who go by many titles, help with personal care, daily activities, rehabilitation, job assistance, and community living support. Yet, despite their crucial role, DCWs are underpaid, undervalued, and in short supply.

This shortage has serious consequences. Families are overwhelmed. It is causing some employers to close their doors, cut back services and turn people away, which is putting lives at risk. It affects non-health care businesses, the economy, all of us. A strong direct care workforce can help people stay at home where most people want to live. It reduces unnecessary hospital stays and nursing home placements.  Competent DCWs can keep emergency situations and dangerous conditions from happening.

Michigan currently has about 190,000 DCWs.  We need at least 36,000 more. Over the past four years, the Michigan Legislature has increased the hourly pay for some categories of DCWs. The Michigan Department of Health and Human Services (MDHHS) has created a DCW Advisory Committee to address the problem and provided funds to IMPART Alliance at Michigan State University to set up a DCW career center. Other initiatives by advocates across the state have led to positive progress. What is happening in Michigan is exciting and something to be proud of, but it is not enough. 

We need to act now to address the causes of the crisis. The main reasons for the shortage are low wages, lack of benefits, no guaranteed hours, poor training, few career paths, and a lack of respect for the profession. This leads to economic instability for DCWs and high turnover rates.

We urge Gov. Gretchen Whitmer and the Legislature to:

• Make solving the DCW crisis a top priority for the state.
• Increase wages and benefits for all DCWs. Current pay is between $12 and $16 per hour. To attract and keep good workers, we need to raise it to $20 per hour plus benefits.
• Adopt the shared definition of DCWs developed by the DCW Advisory Committee. This will help standardize recognition and support across the board.
• Focus on the comprehensive, statewide, coordinated strategies and solutions that the Committee has recommended. Ensure that all solutions apply to all categories of DCWs.
• Support IMPART Alliance initiatives. Help establish a DCW career center, provide competency-based training and certification, career paths and resources, and change the culture to place more value on this essential workforce.

IMPART Alliance and the Area Agencies on Aging Association of Michigan are calling on state leaders, stakeholders, and every citizen to recognize and support the direct care workforce. These workers make up a critical piece of our healthcare system.

We need to act now. Every moment we wait puts more lives at risk. Let’s invest in the people who care for us and make sure Michigan leads the way in valuing and supporting its direct care workers. Together, we can solve this crisis and create a better future for everyone.

Clare Luz, Ph.D., is an associate professor in the Department of Family and Community Medicine at Michigan State University. Founding director of IMPART Alliance, Luz is also a gerontologist whose research focuses on quality of life for vulnerable older adults, long-term care health services, particularly the eldercare workforce shortage, and the intersection of aging, health, and the arts. 

David A. LaLumia, M.S.W., is executive director of Area Agencies on Aging Association of Michigan, representing the 16 Area Agencies on Aging (AAAs) serving older adults and adults with disabilities in all 83 counties of the state. LaLumia has nearly three decades of experience in the field.