Michigan is home to 41 federally qualified health centers (FQHCs), two Tribal Health Centers, and one Urban Indian Health Program. In 2023 alone, community health centers in MI provided care each year to over 668,000 patients at approximately 400 service sites. Over 6,000 CHC staff make this care possible, but strengthening this workforce is an ongoing challenge. Cross-sector competition in recruitment, the lingering impacts of the COVID-19 pandemic, and endemic stress and burnout all complicate Michigan’s healthcare workforce development efforts.
So, too, does the challenge of the large state’s geography. “The needs of each health center are different: what works in Detroit won’t work in the Upper Peninsula,” said Rachel Ruddock, MBA, CPRP, Director of Workforce and Health Professions Training at the Michigan Primary Care Association (MPCA). Joining MPCA in 2022, she was attracted to the field after seeing the incredible work of health centers herself as a board member of a local CHC and a manager with the Michigan Center for Rural Health.
The Need to “Grow Your Own” at Health Centers
MPCA supports its members with a variety of peer networks, advocacy initiatives, training and technical assistance opportunities, and more—including the workforce programs Ruddock oversees. In the aftermath of the pandemic, MPCA identified a vital need to recruit and retrain health center support professionals such as medical and dental assistants (MAs and DAs), community health workers (CHWs), billers, and coders.
“We listened to our members, and they were vocal in their need for these professionals,” Ruddock noted. The road to those pathways, MPCA realized, laid in not only connecting CHCs with these staff, but also helping prospective learners to overcome the often-insurmountable cost and accessibility barriers to gain their certifications.
The necessity for a training initiative to help CHCs “grow their own” workforce was clear. And when the Michigan legislature provided supplemental funding in 2022, so, too, was the means to make it a reality.
The Rise of the Health Centers Career Training Program
In 2022, MPCA launched its Health Center Careers Training Program (HCCTP) in earnest. An “earn and learn” initiative, the program provides funds to health centers to hire, train, and retain support staff in a variety of roles. Beyond financial support, MPCA actively supports participating CHCs with tools for recruitment and promotion, as well as orientation materials, peer-to-peer collaborative calls, and program management.
HCCTP’s first cohort began in June 2022 with six CHCs and 21 MA and DA trainees. The program has grown substantially since, combining on-the-job training and instructional learning for further positions, including CHWs, pharmacy technicians, doulas, billers/coders, front office staff, and others. The initiative has opened doors not only for CHCs to build their workforce, but also for participants to support themselves as CHC employees while completing their coursework.
“We know it’s removing barriers,” Ruddock said. “We have parents who are in the HCCTP program that had always wanted to go to school, but life happened. Opportunities like these make it possible for people who can’t pause life and study to pursue these careers.”
The results thus far have been exceptional. “[As of January 2025] we’ve enrolled 343 individuals from 28 health centers,” said Ruddock. Of those, over 90% have graduated or remain in training with the program. “We’ve had health centers share with us that after years and years, they were fully staffed with medical assistants, something that hadn’t been a reality since the pandemic.” Additionally, nearly half of these individuals were 35 years old or younger and half were from rural communities.
Looking Ahead
Building on these successes, MPCA is actively exploring further ways to expand the HCCTP initiative and to create further training programs for CHWs. They have also shared information about their initiative with other PCAs to help foster similar programs across the U.S. Ruddock credits the partnership between MPCA and its health centers for the success of the program.
“Always seek input from your CHCs—you must understand what works for them,” Ruddock said, noting that feedback led to the program’s gradual redesign, helping establish MPCA as a trusted partner. “What emerged was a stronger initiative . . . we wouldn’t have had this if we hadn’t prioritized strengthening these relationships.”
