Some lessons are better left in the classroom: Michigan’s direct care worker crisis


Economics is a beautiful discipline. In essence, it’s the study of balance — all markets naturally seek it, the point where supply equals demand and a stable equilibrium has been reached. On paper, it’s all very elegant.

In practice, however, that’s not always the case. Unemployment, homelessness, hunger — these are all examples of market imbalance, of supply and demand failing to sync and the very real human casualties that come along with it.

Unfortunately, without action, Michigan is about to experience one of those painful lessons and the victims will be some of our state’s most vulnerable — those in need of the care and support Michigan’s direct care workers provide.

It’s a substantial population. An estimated 100,000 Michigan residents with mental illness and developmental disabilities receive critical personal care, training and emotional support from direct care workers, and the reach of those positively impacted by these indispensable workers goes well beyond that. All told, nearly a million Michigan residents rely on the value direct care workers provide. 

It’s noble, highly in-demand, important work that can at times be mentally challenging, emotionally taxing, and physically straining, and all of that has only been amplified by the COVID-19 pandemic, which has further eroded mental health and increased the prevalence of substance-use disorders. In any free-functioning market, a job matching that description would be a highly compensated one.

Unfortunately, market forces don’t dictate the wages of Michigan’s direct care workers. Their salaries are instead directly tied to state Medicaid funding and have always been artificially lower than they should be. As a result, the starting wage for Michigan’s direct care workers is less than what they would earn had they instead decided to take your order at Starbucks.

The problem should be clear by now: due to low pay, inadequate (and oftentimes non-existent) benefits and limited professional growth opportunities, Michigan is struggling to find and retain the direct care workers we so desperately need.

To stem the tide, Michigan’s lawmakers acted to provided direct care workers with a temporary $2-per-hour increase through a supplemental appropriations measure that passed last June. Without additional action, that temporary pay increase is set to expire on Feb. 28.

Should that happen, it isn’t hard to predict what will transpire next. Anyone with a basic grasp of the laws of supply and demand could arrive at the obvious conclusion: direct care workers will leave the profession in droves, making an already bad situation even worse.

It’s an economics lesson we’d all prefer to avoid experiencing, but the only way that happens is if our state’s lawmakers act immediately to — at the very least — sustain the wage increase Michigan’s direct care workers have been receiving.

The appetite for action is there. State Senate leaders have introduced a measure to make the $2/hour increase permanent, and even to increase it by 25 cents. Gov. Gretchen Whitmer unveiled a similar concept in her recent State of the State message. However, we simply cannot afford to wait until next year’s budget has been enacted for a solution to this looming crisis. March 1st isn’t months away; in fact, it’s just days away. The time to act is now.

It’s time to demonstrate that we greatly value our state’s most vulnerable residents and the workers who do so much to protect and serve them.

Tracey Hamlet is executive director of MOKA and Robert Stein is general counsel for the Michigan Assisted Living Association.

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