LEPINE: Michigan made a promise to direct care workers. It’s time to keep it.
Everyday, thousands of Michiganders go to work before sunrise, often in someone else’s home, to help a person with a disability get out of bed, get dressed, take their medication, and live their life. These are Michigan’s direct care workers and without them, the disability services system does not function. Without them, my clients do not have a life in the community. Without them, families break under the weight of caregiving alone.
Michigan has acknowledged this reality. Over the past several years, the state has made meaningful commitments to raise wages for direct care workers, layering increases on top of the base minimum wage in recognition of the essential and skilled nature of this work. Those commitments matter. They represent a policy consensus that this workforce deserves more than what the market, left to its own devices, has historically provided. And they have begun to make a difference in recruitment and retention for providers who were — and in many cases still are — turning away people who need services because they simply cannot find or keep staff.
But right now, those commitments are in serious jeopardy. And the people who will pay the price are not bureaucrats or budget writers. They are people with intellectual and developmental disabilities in Macomb County and across Michigan who depend on direct care workers to live with dignity.
Here is the problem in plain terms. Michigan has mandated that direct care workers be paid $17.13 per hour as of Jan. 1, 2026, a $13.73 base minimum wage plus a $3.40 passthrough increase. That $1.25 per hour increase alone requires $179.4 million in gross Medicaid funding for behavioral health and aging services to cover statewide. But MDHHS has mandated the wage requirement while failing to ensure the funding actually reaches the providers and families responsible for paying it. As a result, many Community Mental Health service programs have not provided additional funding to their provider networks in the current fiscal year. Providers are absorbing a state-mandated wage increase with no state funding to cover it. This is an unfunded mandate.
Read that again: The state told providers they must pay their workers more but then did not send the money to make that possible. Providers are left to absorb the difference out of already razor-thin operating margins. And the proposed FY 2027 budget, as currently written, repeats the same structural problem. Effective Jan. 1, 2027, direct care workers are expected to receive a required wage of $18.40 per hour, a $1.27 increase over the current year, yet the Governor’s FY 2027 executive recommendation of $69.5 million does not adequately account for this cost on top of the existing gap. The full ongoing cost of cumulative wage commitments is $563.4 million gross. The budget as proposed covers only $258.4 million of that, leaving a gap of $305 million gross that must still be addressed.
This is not a theoretical problem. It is already happening. Providers across Michigan are telling us they cannot sustain services at current funding levels. Some are already reducing hours, cutting programs, or closing their doors to new clients. In Macomb County, we see the consequences firsthand, including waiting lists that grow longer, families who call us desperate for support we cannot provide, and dedicated workers who love this work but cannot afford to stay in it when a retail job or a warehouse position pays more with fewer demands.
The workforce shortage predates these funding gaps, but those make it worse. The reasons people are leaving direct care are well understood. While wages have increased in recent years, direct care work still does not pay particularly well; the median wage for the highest-paid class of direct care workers nationally is $18.16 per hour. Michigan direct care workers earn less than the national average even as the state has taken concrete steps to close the gap. The solution is not complicated: when the state mandates a wage, it must fund it. Fully. On time. Without asking providers to quietly absorb the shortfall through cuts to the very services the wage increase was meant to sustain.
The federal picture compounds the urgency considerably. Under H.R. 1, Michigan must now implement new federal Medicaid requirements including work requirements of 80 hours per month for most recipients and semi-annual re-enrollment instead of annual. MDHHS Director Elizabeth Hertel has estimated hundreds of thousands of Michiganders could lose Medicaid coverage over the next several years as a result. People with disabilities who rely on Medicaid-funded direct care services are not exempt from these pressures. The combination of a state funding gap and a federal policy environment hostile to Medicaid spending is a threat multiplier for the people The Arc of Macomb County serves.
The Michigan Legislature is currently finalizing the FY 2027 budget with a July 1 deadline. The DCW Wage Coalition, a statewide coalition that includes Arc Michigan and dozens of disability rights organizations and service providers, has called on lawmakers to take four specific actions: fully fund the $3.40 per hour wage passthrough; address the FY 2026 shortfall that has already left providers holding the bag; fund the FY 2027 increase of $1.27 per hour without repeating the structural gap; and ensure that funding flows to providers in a way that actually reaches workers.
These are not radical asks. They are the logical completion of commitments the state has already made. Michigan made a promise to the workers who get up every morning and show up for our most vulnerable neighbors. The FY 2027 budget is the opportunity to honor it.
The people with disabilities I work with every day in Macomb County did not choose to need support. But they did choose Michigan. They want to live here, to be part of their communities, to build their lives. They deserve a state that chooses them back. That starts with making sure the people who care for them can afford to stay.
Lisa P. Lepine, B.A., J.D., is Executive Director of The Arc of Macomb County, which supports people with intellectual and developmental disabilities and their families throughout Macomb County.
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