Commentary: Fabric of behavioral health system is unraveling

Originally posted in Crain’s Grand Rapids

For over 45 years, MOKA has been working to help people with intellectual and developmental disabilities live rich, independent lives here in West Michigan. We aim to support these individuals as they build relationships, make life choices, develop competence, and contribute to the community.

In recent years, however, this work has become increasingly complex and difficult. The Direct Care Workers (DCWs) clients like ours rely on for essential support have continued to become less and less available. Despite their invaluable contributions, they are too often undervalued, underpaid, and overburdened 

Michigan's DCWs are facing a stark reality: their wages are tethered to Medicaid funding, which has failed to keep pace with the growing needs of our community. Consequently, many need to work 2 jobs or work significant overtime to support themselves and their families. This untenable situation has forced thousands of dedicated caregivers to make the agonizing choice to leave their profession in search of better opportunities.

The consequences of this exodus are dire. Tens of thousands of Michigan residents are left vulnerable, facing emergencies without access to care, enduring prolonged hospitalizations, and relinquishing their hard-won independence as they are forced to rely on aging parents for support. The fabric of our behavioral health system is unraveling before our eyes, plunging families into a state of perpetual crisis.

While we commend the Legislature for their efforts to increase DCW compensation in recent years, the truth remains: piecemeal solutions are no match for the magnitude of this crisis. We need bold, comprehensive strategies to uplift and empower our essential workforce.

Raising wages is crucial, but it's only one piece of the puzzle. The current average starting wage of $16 per hour isn't enough to retain talent in this field, evidenced by the staggering 38% turnover rate. We must take decisive action to stem this tide of attrition and safeguard the future of Michigan's behavioral health system.

That's why we call on the state to ensure a $20 per hour starting wage for all 50,000 DCWs in the behavioral health system in the Fiscal Year 2025 budget. This is not a luxury; it's a necessity. It's an investment in the well-being of our communities, a commitment to the dignity and worth of every individual, and a recognition of the invaluable contributions made by those who dedicate their lives to caring for others.

Unfortunately, the legislative budgets under discussion do not include any increases for Michigan DCWs. Instead, they keep wages low and put DCWs—and the people they serve—into terrible situations. DCWs must choose whether to keep doing work that is physically and emotionally taxing at an unsustainable rate of pay, and the outcome of that choice could force people with disabilities to give up their freedom and self-direction.

The urgency of this issue cannot be overstated. The time for action is now. Let us stand together in support of Michigan's Direct Care Workers, ensuring that they have the resources, respect, and recognition they deserve. Our collective future depends on it.

Tracey Hamlet is executive director of MOKA.