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Addressing the Low-Wage Worker Challenge

Michigan’s long term care workforce is composed of many different types of professionals, with different kinds of skill. High-wage, high-skilled individuals like doctors, nurses, physical and occupational therapists make up a small, but important part of this workforce.

As we outlined in March , most of the issues facing Michigan’s long-term care workforce will not be easily solved and Michigan’s health care leaders will need to develop innovative solutions to ensure all Michigan residents have access to high-quality health care.

However, the vast majority of workers in long-term care settings are primarily low-skill, low-wage workers. There are 158,000 of these direct care givers in Michigan, of which almost half rely on some type of public assistance program.

The turnover rate among these employees is extremely high – in some cases over 60 percent – and it’s easy to see why. Many other service sector jobs pay better, and most of those have much improved working conditions.

For many, jobs in telemarketing, hairdressers, retail sales, and even fast food are preferable to the demanding work of direct care positions.

This effect could have a troubling impact on the stability of the long-term care workforce. Numerous studies have shown increased turnover means worse health care outcomes for patients.

Moreover, new research from the National Opinion Research Center at the University of Chicago found that lower-wage workers broadly see few opportunities for advancement, have much higher degrees of pessimism about the future and are more dissatisfied with their jobs than workers as a whole.

These findings should be extremely troubling for the outlook for Michigan’s long term care workforce. With already-high levels of dissatisfaction, turnover, and workforce instability, providing more pathways to success and advancement should be a priority for health care policy makers.

Download the Michigan Health Council’s long-term care workforce fact sheet. For more information, contact the MHC here.

Unfortunately, health care careers are highly rigid, leaving little room for low-skilled workers to develop career skills that can be used to advance into better paying positions.

Looking at this information, the Health Professions Network convened a summit to look at how health care reform will impact health care workforce issues. One key finding was to create clearer pathways and stackable credentials to help develop the current workforce.

Developing skills across the long term care workforce is essential to expanding the capacity of Michigan’s health care workforce to care for all of Michigan’s aging population.

The Michigan Health Council’s programs are working to bolster Michigan’s health care workforce to address these looming challenges.



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