Our Position
Michigan’s behavioral health system is enormously underfunded.
With federal Medicaid cuts looming, the situation is likely to get much worse in the coming months. The consequences will be catastrophic unless state policy leaders make tough choices now .
From behavioral health service providers to individual Direct Care Workers (DCWs) and their families, the whole system is gasping for resources. We have been urgently flagging this issue for decades—to the point that people are tired of our message.
You know what? We don’t like having the same conversation over and over, either, but we have no other choice. Without immediate action, more vulnerable Michiganders will go without the care they need, more families will be pushed to the brink, and more caregivers will walk away—leaving behind a collapsing system that simply cannot meet the moment.
For years, families have pleaded with state policy leaders to act. The courts have sought to compel necessary changes. But very little has changed.
Because of this, communities are losing caregivers. Many DCWs are leaving their jobs for better-paying positions that offer more support for themselves and their families. Currently, there is a 39% turnover in the field, which puts additional pressure on those trying to live and work within a system that pays an average starting wage of just around $16 per hour.
In short, Michigan now faces a costly—and dangerous— provider network adequacy issue. This issue will worsen exponentially as the economic inequalities being faced by DCWs continue to deteriorate. The Legislature has increased DCW compensation during the past few years, and we are grateful for its efforts. But it’s not enough, and it won’t be until the following actions occur:
Infuse the state’s behavioral health system with much-needed funding to finally work as it should.
Bring DCW wages up to $20 per hour.
Require MDHHS to distribute all federal Medicaid funds as the Legislature directs—no exceptions.
Simplify administration to ensure more of each dollar can make it to the front lines of care—into the hands of DCWs.
Professionalize the DCW workforce through continued innovation and support.