Wages Adjusted for Inflation: Over the past decade, inflation-adjusted median hourly wages for Nursing Aides, Orderlies, and Attendants in Michigan increased by 10 percent, from $9.15 to $10.04. Real wages for Personal Care Aides increased slightly while those for Home Health Aides declined.
Employer-Sponsored Insurance: Compared to the national civilian workforce, fewer of Michigan’s direct-care workers have access to and use employer-sponsored insurance. Some work for employers that do not offer health insurance. Others work for employers that limit eligibility for health insurance to full-time employees. This creates a barrier for many direct-care workers, especially those in home and community-based settings, who often work only part-time due to the episodic nature of direct-care work. Even workers who do have access to insurance from their employer may find the co-pays and premiums unaffordable.
HB 6081: This bill provides that the Department of Community Health study the feasibility, impact, and cost of supporting a Medicaid rate enhancement to fund affordable, accessible, and adequate health insurance for direct-care workers in nursing homes, adult foster care homes, homes for the aged, and HCBS programs. (Engrossed Nov. 10, 2010, Appropriations Bill)
PHCAST Grants: Michigan is one of 6 states awarded a 3-year grant by the federal government to develop a training and credentialing program for personal care attendants (PCAs), as part of the Personal and Home Care Aide State Training Program, a provision of the Affordable Care Act of 2010.
Direct Service Workforce Resource Center – Intensive Technical Assistance: In 2008, Michigan’s Medicaid agency and the Office of Long-Term Care Supports and Services received CMS-funded technical assistance to provide peer consumers and waiver agency staff who could: 1) help consumers explore the consumer-direction model; 2) build skills to effectively recruit, screen, and employ their own personal assistants; and 3) build the state’s capacity to grow more peer consumers and waiver staff.
One Vision: Moving Forward: In 2010, the Michigan Department of Community Health was awarded a grant from the Civil Monetary Penalties fund to support an initiative to overcome obstacles to implementing person-centered practices and culture change initiatives in Michigan’s nursing homes, including those related to the regulatory responsibilities of the Department of Community Health.
Direct Care Worker Pathway: Uniquely modeled for a large rural region, the Northwest Michigan Council of Governments, in consultation with local employers, has established a Direct Care Worker Pathway that aims to develop a credentialed, sustainable, qualified workforce in long-term care. The pathway includes a Basic Health Care Bridge Program, a CNA Apprenticeship program, skills upgrade classes, coaching supervision training, and more.
Earn, Keep, Save MORE! Campaign: This program aims to educate direct-care workers in Michigan about the availability of federal and state tax credits that could be worth thousands of dollars and to encourage these workers to take advantage of free tax preparation services through VITA sites.
Michigan Quality Community Care Council: This council operates a “matching service registry” where Medicaid Home Help consumers can call and be given a list of eligible independent providers based on certain criteria. The council also provides voluntary training classes to providers.
Adult Abuse and Neglect Prevention Training Program: In 2004, the Centers for Medicare and Medicaid Services awarded a grant to Michigan for a 3-year project to develop and pilot curricula and trainings to help direct-care staff identify, report, and prevent adult abuse and neglect across a wide array of long-term care settings and programs. The program was developed by a state-academic-community partnership that included Michigan State University, the Michigan Office of Services to the Aging, and BEAM, a culture change organization.
Providence Life: Providence Life Services employs a Director of Certified Nursing Assistants (DCNA) in 4 of its skilled long-term nursing care facilities. The DCNA is tasked with supervising the facility’s CNA staff, coordinating their care efforts, and modeling good care practices and interpersonal skills.
Self-Determination and the MI Choice Medicaid Waiver program: This October 2011 PHI Michigan report presents the results of a survey of direct-care workers who serve people using MI Choice’s self-determination option.
Caregivers Without Health Care: Michigan Fact Sheet: This Michigan-based 2006 report by PHI argues that quality long-term care depends on healthy direct-care workers and points out that many of these workers lack health insurance.
Mental Health Provider 2001 Wage and Benefit Survey: This 2001 survey of residential and vocational mental health facilities in Michigan, done by the Michigan Assisted Living Association, reports facility size and budget, wages and benefits of managers and direct-care staff, and staff turnover rates.
Michigan Profile of Publicly Funded Long-Term Care Services: The Michigan Department of Community Healthy issued this 2009 report to present information on the size, compensation level, and stability of Michigan’s direct-care workforce.
PHI State Facts: Michigan’s Direct-Care Workforce: This fact sheet, issued by PHI in September 2011, gives an overview of Michigan’s direct-care workforce.