Wages, Hours and Training are Biggest Barriers to Recruiting Home Care Workers

Compensation, lack of full-time hours and training are the largest barriers to recruiting and training direct-care workers in home and community-based programs, according to the findings of a new set of surveys of Michigan Medicaid-funded home and community-based service providers. 

The surveys, funded by a grant from the Centers for Medicare and Medicaid Services provided to the Michigan Office of Services to the Aging, looked statewide into concerns of providers and challenges to retaining and recruiting their workforce. The surveys spanned the Medicaid MI Choice HCBS Waiver, Community Mental Health (CMH) Waiver and Home Help programs in 2012 to determine the size, stability, and compensation of the direct-care workforce. 

Paraprofessional Healthcare Institute (PHI) Michigan, which administered the surveys noted “low wages, part-time hours, and the need for enhanced training as significant challenges to attracting and retaining direct-care staff to these programs,” in its report of the findings. 


“This effort was critical to ensuring that Michigan can meet the increasing demand for long-term supports and services that older adults and people with disabilities depend on,” said Kari Sederburg, director of the Michigan Office of Services to the Aging. “This survey has given us a better understanding of the needs of the state’s direct-care workforce and the challenges they face on a daily basis.”

Specifically, the starting hourly wage in the CMH program was $8.73, and $9.09 for the Home Help and MI Choice programs. In its survey of hours worked per week, PHI found only 60% of direct-care staff are employed part-time, at less than 36 hours per week. Employee benefits were low with just a third of HCBS providers reimbursing their direct-care staff for mileage and or gas for travel between participants.

High turnover is problematic, PHI notes, with the average annual turnover rate at 34 percent for direct-care workers. 


“[This] has presented us with a great opportunity to create new and innovative ways to grow this much-needed profession and we’re excited to get to work,” Sederburg said.

Written by Elizabeth Ecker

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