Community Housing Network Supports Placing Higher Value on Direct Care Workers

Ongoing support and quality care for older adults and people with disabilities is crucial in the fight against homelessness

Last month, the Michigan Legislature cleared an $83 billion state budget for the 2025 Fiscal Year, including a $28.7 million investment to increase the wages for direct care workers.

The executive director of the Michigan chapter of The Arc, Sherri Boyd, told the Michigan Advance that while this 20-cent hourly raise for direct care workers is “better than nothing…it doesn’t address the underlying problem.”

The Arc, a CHN partner, is a nonprofit that promotes the rights and opportunities of people with intellectual and developmental disabilities. They are one of several local organizations that have come together to try and prevent the continued collapse of the behavioral health system.

The Direct Care Worker Wage Coalition is urging the state of Michigan to elevate the direct care worker profession by investing in training, research and innovation, mentorship and leadership development, and ethical standards, among other things to boost opportunity and growth.

This comes at a time when salaries across Michigan are going up for everyone except the state’s 50,000 direct care workers in the behavioral health system who earn on average about the same as cafeteria attendants and retail sales workers – around $16 per hour (around $33,00 annually) with no medical or other benefits to work with individuals that are vulnerable and present with sometimes challenging intellectual and developmental disabilities.

As a result, thousands of direct care workers are making a natural decision to leave the profession for jobs that allow them to better support themselves and their families. The industry has dealt with labor shortages and high turnover for years, problems that were made more acute during the COVID-19 pandemic.

This leaves the more than 100,000 individuals and families in Michigan that rely on direct care workers with several concerns – emergency situations in which care is not available, chronic or extended hospitalizations, reliance on aging parents for ongoing care, and a loss of the independence they enjoy when direct care workers are available. This independence includes being able to stay housed in their own homes and communities.

A Direct Care Workers Role in Preventing Homelessness

While the long game is played to fix the systemic problems that cause homelessness (social inequities of income, wealth, and opportunity, and the failures of the social safety net), a more short-term solution includes investing in the people who make it possible for individuals with disabilities and older persons to live as independently as possible, and making sure housing is affordable for them.

Currently, it’s not. This year in Michigan, a person with a disability received Supplemental Security Income (SSI) benefits equal to $957 per month. Statewide, this income was equal to 18 percent of the area median income. A person with a disability receiving SSI would have to pay 92 percent of their monthly income to rent an efficiency unit and 101 percent of their monthly income for a one-bedroom unit.

Direct care workers shoulder responsibilities and risks to address the immediate needs of our loved ones – everything from providing transportation to assisting with daily living activities, managing medication regimens, and offering companionship. Otherwise, these vulnerable individuals – people with mental illness, chronic health conditions, histories of trauma, and other struggles – are at a much higher risk of being forced into costly and segregated nursing facilities or state hospitals, incarceration or homelessness.

On a single night in January 2023, 138,098 adults over the age of 55 were homeless. This number is expected to nearly triple in 2030, and the population of adults aged 65 and older experiencing homelessness is anticipated to grow from 40,000 to 106,000.

“Direct care workers are passionate individuals who aren’t doing this job for the money…a job that requires skills, patience, and the ability to connect with other people on a human level,” said Marc Craig, CEO at CHN, about the direct care workforce, which is nearly 90 percent women – three in five are people of color, and one in four are immigrants to the U.S.

“CHN is in the business of, among other things, supporting people to be as independent as they can be, specifically in housing, but many of those people need caregivers,” he said. “Who do you want to have do that? And how much should that person get paid? It should be enough so they can afford a place to live, care for their own families, and have reliable transportation to get themselves to and from their place of work. There is a great demand for these folks and placed on these folks. They need and deserve, both for their sake and the sake of the people they’re taking care of, to be compensated accordingly and treated like professionals.”

Around 39 percent of direct care workers live in or near poverty and 46 percent rely on public assistance programs to make ends meet, according to PHI (Paraprofessional Healthcare Institute), a national organization focused on improving the direct care workforce through research, policy analysis, and workforce innovations.

It is coming to this: as the U.S. population of adults aged 65 and older nearly doubles from 49.2 million to 94.7 million by 2060, more Americans will need long-term care, and they will rely on direct care workers. However, if this formal relationship is not valued, there will never be enough people to fill the ever-increasing demand for direct care services.

What Is Being Done to Help Strengthen the Direct Care Workforce?

Through various media campaigns, committee hearings, and individual legislative meetings, the DCW Wage Coalition has been working to educate and inform Michigan policy makers about the importance of increasing state funding to supplement the low Medicaid reimbursement rate, which is the source of direct care worker compensation within the public behavioral health care system. 

A study, “Valuing Quality Care,” was prepared by the DCW Wage Coalition in 2021 to analyze the potential economic cost/benefit of a permanent increase in wages for direct care workers in Michigan. The study also estimates savings associated with reduced spending on government safety-net and income-support programs for low-wage workers, as well as the potential impact of reduced employee turnover. In addition, the study shows that higher wages for direct care workers will stimulate the economy and increase state and local government tax collections.

The Biden Administration finalized a rule in April requiring 80 percent of Medicaid payments for homecare services be used to pay workers to strengthen the caregiving infrastructure and increase the availability of home and community-based services for older adults and people with disabilities.

Looking ahead, the coalition has requested that Michigan include a $20 per hour starting wage for direct care workers in the Fiscal Year 2025 state budget. In addition to boosting compensation and simplifying administration, partnerships with workforce agencies like Michigan Works! will build better routes to direct care worker jobs.

Michigan is one of 14 states that was selected by the Direct Care Workforce Strategies Center, led by the National Council on Aging (NCOA) on behalf of the Administration for Community Living (ACL), to participate in State Peer-Learning Collaboratives.

Through this six-month program, which began in April 2024, Michigan will participate in working groups to discuss innovative strategies for growing and enhancing the direct care workforce. The working groups will hold monthly meetings focused on group learning, information sharing, and developing best practices. With the help of a subject matter expert, each participating state also will accomplish one policy or program-related milestone.

These efforts are commendable, but the situation is dire and as Tracey Hamlet, Executive Director of the MOKA Foundation in Muskegon, wrote in a recent commentary, “piecemeal solutions are no match for the magnitude of the crisis…we need bold, comprehensive strategies to uplift and empower our essential workforce.”

CHN stands together in support with Michigan’s direct care workers and will do what the organization can to ensure they have the resources, respect, and recognition they deserve.

Want to get involved? Check out the Direct Care Worker Wage Coalition’s how to help page on their website for more information and advocacy guidance.