Opinion | Michigan’s direct care worker shortage is an emergency

For people with mental illness or developmental disabilities, daily life can be filled with unknowns. How will they live life fully, despite the obstacles they face? How will they achieve their dreams?

Today, however, there are more urgent questions. How will they remain safe? Where will they find the care they need, given the shortage of skilled workers available?

Here in Michigan, the direct care worker shortage has grown from a slow-burning crisis to an outright emergency. As director of an agency charged with providing behavioral health care to residents in the Midland area, I have never experienced a reality like this. Not only am I struggling to find and retain staff, but I am literally having to turn away individuals and families in need of care.

This is completely unacceptable for a 21st-Century society. And it’s a tragedy for Michigan’s most vulnerable residents. As a state, we can – indeed, we must – do better.

These issues have been caused by multiple complex factors. Over the years, individuals in need of care have increasingly relied on Medicaid-funded services and supports. Federal Medicaid dollars are allocated and distributed by the state through a system known as a pass through. The Michigan Legislature sets the amounts of the pass throughs, and the MDHHS makes them happen.

Through Medicaid-funded support, people can live independently, with the support of Direct Care Workers (DCWs). My agency employs those DCWs here in Bay, Saginaw and Midland counties. Unfortunately, the amount of money allocated for their salaries by the Michigan Legislature is not enough to keep them on the job in today’s labor market.

When fast-food and retail establishments are paying upwards of $18 per hour to high school and college students, it is unconscionable for skilled caregivers to be earning far less. Today’s starting wage for DCWs is around $14 per hour – an amount that is roughly equivalent to the amount young teens can earn at their first job in today’s market.

Worse still, this dollar amount doesn’t increase based on DCW skills or experience. Instead, amazing individuals are kept on a treadmill of incredibly difficult, arduous tasks and paid at the same level they would be if they were a 15-year-old whose only responsibility is scooping ice cream.

My agency is struggling, as are the individuals and families we serve. I can’t keep DCWs on the job because the pay is simply too good elsewhere. I am regularly forced to tell people in urgent need of support that we can’t give them the aid they require.

There’s little I can do to change this reality. Given that these workers are paid via Medicaid wage pass throughs, I can’t simply offer more money. What I can do – creating a supportive work environment, keeping people as happy as possible on the job – is not enough, not in a job market that’s as tight as this one is.

I honestly don’t know how my organization has lasted this long. We’re at the absolute limit of our financial capacity, and every day is a struggle.

I speak on behalf of the people my organization serves, the people who work for us, and the entire behavioral health care system. We are at our limit. We cannot keep going without additional resources to pay the people who work to keep our entire system operational.

Legislative action is necessary – in fact, it’s overdue.

For too long, people with disabilities have lived with too many questions. It’s time for the people of Michigan to give them the answers they need and deserve.