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Providing solutions for the shortage of direct care workers is a work in process. But an exciting new option exists that leverages technology so that some Direct Care Worker /Direct Support Professional (DCW/DSP) tasks can be performed remotely, making it possible for the individuals they support to have increased access to services.

Lunden Home in Kentwood is Michigan’s first “smart home” designed to help people with intellectual and developmental disabilities (I/DD) live as independently as possible. MOKA Corp., an organization dedicated to greater physical and social inclusion for those with I/DD, operates the home, which is outfitted with a variety of sensors and devices to create an ecosystem that is customized to the needs, abilities, and goals of the residents.

“With remote staff that support a smart home, a person has access to support 24 hours a day, without having them present in the home at all times,” said Emily Betz, director of programs at MOKA. “The smart home model also allows people to increase their autonomy when they would otherwise depend on a DCW/DSP to complete tasks.”

As one of the few post-acute brain injury programs in West Michigan, Hope Network Neuro Rehabilitation has received referrals for cases it cannot currently support. However, with additional staff training and equipment, the program could expand its offerings. Hope Network Neuro Rehabilitation is a community-based brain injury rehabilitation provider serving the Kalamazoo, Grand Rapids, and East Lansing areas through 16 locations for more than 40 years. It is also one of 25 IMPART Alliance mini-grantees developing innovative projects to strengthen the direct care workforce across Michigan.

While Hope Network Neuro Rehabilitation has a long history of providing interdisciplinary neuro rehabilitation, there was an identified need to rebuild the workforce following the COVID-19 pandemic. Recognizing the need for additional competency-based skill practice in specialized rehabilitation areas, Hope Network’s mini-grant project focuses on increasing recruitment and retention of direct care workers in the field of brain injury rehabilitation. The project has identified steps to enhance the knowledge and skills of direct care workers through a variety of education and training opportunities, utilizing onsite resources as well as certificate-based educational training provided by the Brain Injury Association of Michigan (BIAMI) and the BIAA’s Academy of Brain Injury Specialists (ACBIS).

Thanks to the funding support received through the grant, Hope Network Neuro Rehabilitation was able to send 39 direct care workers to the Brain Injury Association of Michigan’s annual conference, held at the Lansing Center on September 13, 2024. Although Hope Network had sent professional team members to this conference in the past, funding limitations prevented it from sending direct care workers until this year. This specialized training enhances the professional development of Hope Network’s direct care workforce team and improves the quality of life for individuals with brain injuries.

Armed with a recent $25 million grant, Michigan State University is spearheading an ambitious initiative to address the severe shortage of direct care workers who provide health care support for some of the state’s most vulnerable residents.  

Four million dollars has been allocated to 26 agencies statewide to support innovative projects designed to strengthen the workforce. The remaining $21 million of the grant supports initiatives such as establishing a comprehensive training and credentialing center and implementing new strategies and career success models to improve recruitment and retention. 

The federal grant was awarded to MSU’s IMPART Alliance from the Michigan Department of Health and Human Services using American Rescue Plan Act/Home and Community Based Services Spending Plan project funds.  

Eric Paad, founder and president of the Caregiver Incentive Project based in Marquette, plans to use mini grant funding to create a success fund to help direct care workers overcome barriers to success. For example, the fund will assist a care worker with auto repairs or childcare so they can cover their shifts.

“Receiving this mini grant from IMPART Alliance will ensure we can continue our work toward our mission to end the shortage of in-home caregivers across the Upper Peninsula of Michigan,” Paad said. 

Direct Care Workers (DCWs) from across Michigan convened at East Lansing's Kellogg Hotel & Conference Center to spearhead the development of a new credentialing exam pivotal to their field. Hosted by IMPART Alliance in partnership with WorkCred, the gathering aimed to enhance training protocols and ensure DCWs possess indispensable skills for their roles.

Throughout the week, DCWs from Midland, southeast Michigan, and the greater Lansing area engaged in intensive writing sessions. Their mission: to formulate rigorous exam questions that will assess competencies in areas such as communication, infection control, safety, and person-centered practices. These exams not only would validate the expertise of DCWs, but also match them effectively with individuals requiring their compassionate support.

Bethany Duyser, assistant director at IMPART Alliance, highlighted the collaborative nature of the initiative. “This event is pivotal for developing evaluation items that truly reflect the demands of Direct Care Workers,” she explained. “By incorporating insights from experienced consultants and the firsthand experiences of DCWs, we are committed to establishing credentials that are both meaningful and equitable.”

Marcus Jefferson, a DCW from Grand Ledge, works in a group home that supports individuals living with Prader-Willi syndrome, a rare genetic disorder that is defined by a constant sense of hunger, leading to obesity and type-2 diabetes. Jefferson said one individual lost more than 200 pounds.

“This isn’t a job for a person who’s not invested here,” Jefferson said, pointing to his heart. “In our home, we can’t afford to have just a warm body. We need people that are not only engaged, but capable. And that’s what this training does.”

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.

Michigan State University has received a $25 million grant to address the state’s shortage of direct care workers from the Michigan Department of Health and Human Services. A research team housed in the College of Osteopathic Medicine will use part of the grant to establish a Direct Care Worker Career Center.

IMPART Alliance is an MSU-led research team and nonprofit organization dedicated to advancing the direct care workforce profession through training programs, advocacy, research and career development.

Michigan State University received much-needed funding to address the state’s critical shortage of direct care workers. Those are the people who provide long-term care and support to people with disabilities or older adults.

“You need to be compassionate, you need to be empathetic and you need to have a lot of patience,” said Kelli Ohnstad, a direct care worker.

Helping those in need maintain as much independence as possible. An important job that is lacking staff.

“We have approximately 175 to 190 thousand direct care workers in the state right now we need 36 thousand more,” said Clare Luz, Executive Director of the Impart Alliance. 

Michigan State University has received a $25 million grant that will address the state’s critical shortage of direct care workers, or DCWs, by establishing a Direct Care Career Center that aims to increase pathways into the field and transform the public view to one that recognizes the workforce as a respected profession.

DCWs provide long-term support to individuals with disabilities and older adults. They assist with hands-on care and tasks needed to maintain as much independence as possible. Paid direct care assistance beyond what families can provide is often a necessity, but there is a dire shortage of people trained to do this kind of work. Employers are facing serious challenges in hiring and retaining staff. About 190,000 DCWs are currently serving the state’s residents; at least 36,000 more are needed.

IMPART Alliance is tackling a problem faced by all of us, including our parents, our partners and, ultimately, ourselves,” said executive director and leading faculty researcher Clare Luz. “The U.S. and Michigan’s populations are rapidly aging, which is creating a greater demand for high-quality, lower cost supports and services at home, where most people prefer to live for as long as possible in their later years.”

This collaborative effort is a crucial step towards developing competency assessments, which will serve as the basis for granting competency-based credentials for Direct Care Workers.

"Clare Luz, gerontologist, and Kevin Foley, a geriatrician, in MSU’s Department of Family and Community Medicine in the College of Osteopathic Medicine, say meeting the demand requires recruiting more medical students into geriatric specialties, training more direct care workers and improving the culture that defines aging."

LANSING, Mich. – The Michigan Department of Health and Human Services (MDHHS) today announced a partnership with IMPART Alliance at Michigan State University’s College of Osteopathic Medicine to develop infection control training for direct care workers. MDHHS has provided IMPART Alliance $50,000 in COVID Relief Funding to develop the training and make it widely available for direct care workers (DCW) providing home and community-based services. IMPART Alliance will develop a comprehensive Infection Control curriculum for training all direct care workers and family caregivers. MDHHS, IMPART Alliance and others will widely distribute the training to increase access and skills for the caregivers. The training will be free of charge and available online in December 2020.

Grand Ledge High School students are learning key healthcare skills by participating in a free IMPART Alliance Personal Care Aide training course! The first training session, "Introduction to Aging", encouraged students to learn about how some older adults might experience physical challenges. The Grand Ledge School District has provided great support for this pilot program and students are excited to build their healthcare skills!

IMPART Alliance has 23 trainers across Michigan teaching DCWs person centered supports and services skills using the BTBQ(TM) curriculum. Our next targeted area for trainer development: the U.P. and Southeast Michigan!

The NewsHour explores the state of today's Direct Care Workforce in two segments that features Direct Care Workers, homecare agencies and advocates in Michigan.