Michigan's Long-Term Care Workforce: Needs, Strengths, and Challenges

What is the state of the long-term care workforce in Michigan? It's an important question as the stability and success of our LTC system is closely tied to this essential workforce. Their value and vulnerability have come into sharp relief during the Covid-19 pandemic. Yet before the pandemic arrived, many factors were contributing to the precarious state of this workforce—particularly for direct care workers, such as personal care aides and home health aides—from persistently low wages to the prevalence of part-time scheduling and lack of formal training and credentialing.

Our report presents a profile of the direct care and licensed long-term care workforce in Michigan, describes current and future needs for this workforce, explores the workforce training landscape, and summarizes findings from phone interviews with long-term care provider organizations and listening sessions with consumers, family caregivers, and direct care workers across the state. Highlights include:

• While demand is high for direct care workers in Michigan, their compensation is low. Median wages for these workers are $12.49 per hour and median annual earnings are $16,600. Consequently, 22 percent live in poverty, 52 percent live in low-income households (below 200 percent of the federal poverty line), and 48 percent rely on public benefits to support themselves and their families.
• There will be 238,200 total job openings in direct care from 2016 to 2026—the third highest number of job openings for any occupation in Michigan. Data from in-depth interviews conducted for this study show, further, that employers are already experiencing immense difficulty recruiting and retaining direct care workers, and that these shortages are leaving some Michiganders without needed services.
• Training requlations are highly fragmented and generally inadequate. Training quality varies considerably from employer to employer, training credentials are rarely transferable across settings or among employers, and workers are unprepared for their challenging roles in the field—undermining care quality as well as workforce mobility and stability.

The report concludes with seven recommendations for strengthening the long-term care workforce in Michigan: 

1. Improve compensation for the direct care workforce;
2. Invest in direct care workforce recruitment and retention;
3. Enhance training for direct care workers across long-term care settings and programs;
4. Strengthen long-term care workforce data collection and reporting;
5. Improve navigation assistance for family caregivers;
6. Create new funding and benefit structures to support family caregivers; and
7. Devise additional supports for family caregivers to improve their physical and mental/emotional health.

These recommendations could be implemented within the current long-term care system in Michigan or as part of a new financing approach. Taken together, they are designed to improve access to high-quality long-term care for consumers by ensuring a stable, sustainable supply of direct care workers and licensed professionals to provide these critical services and supports.

Download the report: Michigan's Long-Term Care Workforce: Needs, Strengths, and Challenges