Dr.

Claire Luz is executive director of Impart Alliance and one of Michigan's leading voices working to strengthen the caregiving workforce.

Today, she leads statewide efforts to elevate caregivers, support families, and help build a stronger, more sustainable system for those who rely on care.

Claire, thank you so much for being with us.

>> Thanks for having me.

Well, no one becomes uh a leading voice or advocate uh overnight.

Tell us about your journey in this area and and what brought you here.

>> It's really always been in my nature to want to help people even as a little girl and especially people who are marginalized who uh really need other people to step up and advocate on their behalf.

When I was quite young, I got a job as a direct care worker in a nursing home while I was going through college and I fell in love with it.

So then I finished my um undergraduate degree, became a social worker, worked for almost 20 years as a geriatric social worker >> all in nursing homes and home care agencies as a clinician but also as a consultant.

And I loved every minute of it.

I went back to school with the hopes that I would one day be able to conduct policy relevant research that would have high impact, positive impact on nursing homes and home and community based services and that's what I've been doing ever since.

>> Your level of leadership and advocacy inspiring what brought you to that place?

talk about the caregiving experience and those things in particular that you saw happening that may even be happening today that are particular barriers and areas of concern that maybe we can improve through a collective effort.

Outcomes uh are always a result of hard work.

Um but recognizing the problem is generally the first step.

I recognized that really really early on and I was able to recognize it because of my hands-on personal experience being in the the field before going into academics.

And of course, it's all around things that are policy relevant like staffing ratios and training requirements and funding mechanisms and reimbursement mechanisms that can either support good care or be a barrier.

So that is what we're doing at Impart Alliance.

We're trying to our main goal really is to work with the state of Michigan to build, expand, support, stabilize the direct care workforce and be a support to family caregivers as well because as you know there's a huge shortage of direct care workers which is key and so this shortage is a core problem that we're trying to address.

Well, talk about addressing that problem, developing a workforce.

And I don't think it's a giant leap to say that the majority of caregivers are women and many women of color.

And when you think about that portion of our workforce, again, uh it's something over time and over history, that particular cohort generally under served, underpaid.

What steps can we take?

What are you working on to turn that around and improve that workforce here in Michigan?

>> We have a an approach that we've been using for quite some time, which I can tell you about.

And it's it's really not about just the direct care workers.

It's about the family caregivers.

I know there's probably a lot of listeners who are family >> caregivers.

And there's a shortage of family caregivers as well.

And I do want to make clear that the majority un you know it's uh different than what some people will tell you but the majority of care in this country is provided by family caregivers.

And because there's a shortage of family caregivers one of the things they're doing is trying to reach down into younger generations and have younger people in the family help with uh caregiving.

So this is something that really affects everybody.

But to your point, when families turn for outside help, up up to 80% of that help is that personal hands-on care.

It's it's the direct care workers who go by many many names.

So, I also want to say just real quick that it's caregiving can be a a challenge.

Everybody knows that.

But there's also so much joy >> in caregiving.

I was a family caregiver.

I uh lived with my father for a couple of years and I consider it a gift.

You know, it was one of the best decisions I ever made and I think most caregivers will tell you that including the paid direct care workers.

But let me just give you an idea of how big this shortage is.

It's happening all over the country.

But um here in Michigan, Michigan alone, we estimate that we need approximately 36,000 more direct care workers than we currently have.

>> How are we going to fill that gap?

And there are several things that we're doing that I can tell you about.

Um and they they cut across it's really everybody.

Rosyn Carter famously said that there are only four types of people in this world.

people who have been caregivers, people who are caregivers, people who are going to be caregivers, and people who need a caregiver.

So, it really cuts across everybody and and um affects us individually, collectively, and in so many ways.

But what we're trying to do here is it's an approach that we started developing a number of years ago and and really put in motion starting in in 2000.

In 2020, Michigan actually took some really bold steps and the Michigan Department of Health and Human Services, their aging services unit decided to start a statewide direct care workforce advisory committee.

They asked me to co-chair it.

We've approached this challenge uh with a conceptual framework that I call for short an integrated strategies model.

And essentially we understand that all of the typical strategies that are being used across the country are so intricately uh connected that you have to address all of them simultaneously and they would include things like higher wages and benefits which is everybody knows is a no-brainer but also professionalization and culture change.

And by professionalization I mean all of the hallmarks of any profession.

So it's not just about training, it's about establishing some competency guidelines and then you can wrap training around those competency guidelines.

Um credentiing, so making sure that people have the competencies that they need and that they align with state guidelines, which by the way we have been able to do over the last five years.

Michigan is one of the only states with statewide direct care worker competency guidelines.

So, it's also about establishing career paths and networking so that direct care workers can talk with each other.

Um, continuing education, all of those hallmarks of professionalization.

I don't think we're going to get anywhere without culture change.

We as a society have to be putting more value on caregiving, direct care workers, yes, but caregiving in general.

and um and for that matter the more value on the people for which they provide support.

So people who uh have disabilities or older adults, we don't put a lot of value on these marginalized populations either.

So the root causes, we have to get to the root causes which are things like, you know, sexism, racism, all of the isms and fair those out, raise everybody's understanding about the the value of caregiving and and really work together.

>> The workforce uh you mentioned in addition to developing a workforce, recruiting people to the profession, I have to imagine there's also many who um leave >> Yes.

the line of work.

And so that exodus plays against the building toward these 36,000 positions here in Michigan.

But I will say one thing as a lifelong Michigander, we are >> uh innovative, not just cars and not just pizza, but when we put our mind to something with our and with our great land grant universities, >> I'm looking for signs of hope.

What are some things you're you're doing and seeing um that should give us some optimism in ways that we can make a difference here and maybe u provide some lessons and and other ways to help the rest of the country.

>> There are really amazing things happening in Michigan and and other states are taking notice of what we're doing because it's making a difference.

we're seeing outcomes and a lot of it goes back to 2020 when we developed this statewide direct care workforce advisory committee because statewide leadership is key.

So we've been able to do a lot of things over the last five six years including raising wages for direct care workers that has been built right into the general fund.

So that was a huge goal to be met and we have to keep going with that.

It still needs to be higher.

but also things like establishing competency standards, establishing model training programs that cover the the basic standard competencies that all direct care workers should have.

One of the things we're trying to do is establish a whole direct care worker and caregiving center that can house all of this amazing work that's happening so that we can keep it going.

We need to be able to reach into rural areas.

So with some of the funding that we've received, we've uh developed two different um mobile training options, Edwan is a big 45 foot retrofitted RV where the inside has been designed to simulate a home environment where future direct care workers or current direct care work or family members can come in a few at a time and learn just basic skills like body mechanics so they don't hurt the person they're caring for or themselves, right?

It's amazing.

The second one that is part of this I, you know, increasing access um by getting into areas that don't have access to training now is what we call a training class or lab in a box.

And we worked with an engineering professor at MSU and some of his engineering students to create four boxes, huge boxes, everything you need for a pop-up training lab.

Inside we have a van.

You load those into the van.

You can take them up to, you know, Sue St.

Marie, pull up to a high school, unload them, take them into the high school gym, you have a pop-up lab, you train for a couple of days, load them back into the van, and bring them back to campus.

So there are advantages to that over the big the big mobile units.

So we have both now and we're just really anxious.

They're just getting done and we're anxious to get them on the road and we're looking for partners um people who can join us on this journey.

There are just it's exciting times really for caregivers in Michigan.

We are uh truly grateful that you are at work in your leadership position making a difference for folks for families here in our state even in the corridors of power.

But as a final note um what would you say to someone considering a career to recruit them to join in caregiving um as work or a lifelong career?

So, I invite people to invite to visit our website, impart allianc's website.

We also have a statewide coalition, if you will, that we call essential jobs essential care or EJC.

And if you're interested at all in being a direct care worker, a professional direct care worker, you know, contact us, check it out.

Please consider it as a career.

We're looking at anybody, you know, u non-traditional population.

So, people from tribal communities or veterans or people rejoining the workforce or uh retirees or high school students uh who maybe haven't thought about it, you know, I I hope you'll consider it.

>> The Care Mobile coming to a neighborhood near you.

Dr.

Claire Les, thank you so much for your time uh and your talents.

We are grateful.

>> Thank you so much for the opportunity.

>> We want to thank Impart Alliance at Michigan State University's College of Osteopathic Medicine.

This work is made possible by a grant from the Michigan Department of Health and Human Services as well as the supporters of our caregiving initiative, the Ralph C. Wilson Jr.

Foundation, the Michigan Health Endowment Fund, and AARP Michigan.

Thanks to all for helping make this important program possible.