Jesse Bethke Gomez: Crafting a Legacy of Dignity in Direct Care
Across the United States, a silent crisis is unfolding—one that doesn’t make daily headlines but is reshaping lives in irreversible ways. The shortage of direct care workers has reached catastrophic levels, forcing individuals who rely on them out of their homes and into institutions, unraveling the very fabric of independence and dignity. This isn’t just about numbers or statistics; it’s about real people—about a nation unprepared for the tidal wave of aging populations and the growing demand for home-based care.
While most see this crisis as insurmountable, Jesse Bethke Gomez sees it as a call to action. Where others offer temporary fixes, he envisions systemic change. His groundbreaking work as Executive Director of the Metropolitan Center for Independent Living (MCIL) is not just about closing the workforce gap—it’s about redefining the role of direct care in society, elevating it to the status it deserves, and ensuring that those who dedicate their lives to caregiving are recognized, respected, and rewarded.
Engineering a Future of Independence and Care
Jesse Bethke Gomez brings to his leadership role a Master of Management and Administration degree with an emphasis on strategic leadership. Jesse is a recipient of a national Presidential Scholarship award from Elizabeth M. Dole, CEO of the American Red Cross when he worked at American Red Cross. The presidential scholarship award allowed Jesse to become a graduate of the Minnesota Executive Program for Advanced Strategic Leadership from the Curtiss L. Carlson School of Management at the University of Minnesota. Jesse also is a national Kellogg Fellow that allowed him to attend the #1 public health school in the nation at the University of North Carolina Chapel Hill, along with the University’s business school that co-presented advanced public health leadership. As a CEO in his current leadership role with MCIL, this is his third successive corporation he has led to greater performance and results. He has raised over $60 million in his fundraising efforts thus far in his career.
Today as Executive Director of MCIL, Jesse leads a wide range of programs and services that focus upon assisting people with disabilities to overcome barriers toward greater independent living. Over the past two years, MCIL has directly reached more than 13,534 people while also engaging with an additional 54,894 unique clients resulting in a total of 171,826 contacts through Disability Hub MN™, a statewide call center in which MCIL along with Southeastern Center for Independent Living both serve for over 20 years thus far, as operations centers for the Hub in working with the Disability Services Division of the Minnesota Department of Human Services.
With over 650,000 people with disabilities in Minnesota—50% of whom reside in the seven-county St. Paul and Minneapolis region—MCIL is deeply committed to its mission statement—To advance the independent living of people with disabilities by Removing Barriers and Promoting Choices. As a Center for Independent Living, more than half of MCIL’s Board of Directors and 65% of its 77 staff members are individuals with disabilities, ensuring that the organization remains genuinely connected to the community it serves.
Since its establishment in 1981, MCIL has continuously gathered input from the disability community to shape its priorities. In 2015, when Jesse assumed leadership, prominent disability community leaders urged him to address Minnesota’s severe direct care workforce shortage crisis. In response, he joined a state direct care workforce committee alongside an MCIL representative and contributed as a technical writer for a high-level recommendations report approved by the Minnesota government. This report guided MCIL’s focus on developing formalized education for direct care workers and creating new pathways to attract job seekers to the field.
Strides to Strengthen Direct Care Workforce
Under Jesse’s leadership, MCIL has pioneered two groundbreaking solutions to address the direct care workforce crisis. The first initiative, the PCA College Service Corps, is a pilot program designed to attract college students to work as Personal Care Assistants (PCAs). Through this program, students commit to a 30-week service period, working an average of 10 hours per week to support individuals who rely on PCA assistance for daily living. While participants are employed by a PCA agency, MCIL provides mentoring and a financial incentive. The program also recruits individuals who are assessed at 10 or more hours of PCA assistance per day and who direct their own care and are authorized to receive Minnesota’s direct care services. This initiative has gained significant support from post-secondary institutions, recognizing higher education’s role in addressing the workforce shortage. The program is made possible through funding from the Margaret A. Cargill Foundation Fund of the St. Paul and Minnesota Foundation, the Minnesota Legislature, and the Disability Services Division of the Minnesota Department of Human Services.
The second major initiative, funded by The Bush Foundation, has focused on developing a curriculum leading to the credential of “Certified Direct Support Professional.” Unlike the medical sector, which has long recognized the role of a Certified Nursing Assistant, the home care sector has lacked a similar educational pathway toward a postsecondary credentialed role. Jesse and his team have collaborated with college faculty to create a curriculum that not only establishes this certification but also ties it to a competitive wage differential across direct care services. Additionally, MCIL is working closely with Minnesota’s postsecondary institutions and state agencies in planning to implement this educational opportunity, ensuring long-term workforce sustainability.
Through these initiatives, Jesse and MCIL are making significant strides in strengthening the direct care workforce, improving career pathways, and enhancing the quality of care for individuals with disabilities across Minnesota.
Dismantling Barriers to Independence and Empowerment
As the Executive Director, Jesse leads the organization in its mission to advance independent living for people with disabilities by removing barriers and promoting choices. Under his leadership, MCIL is now in its second year of its approved five-year strategic plan, titled To Advance the Independent Living of People with Disabilities by Removing Barriers and Promoting Choices. With a renewed focus on mission, meaning, and the power of independent living, the organization remains dedicated to ensuring that individuals with disabilities can fully embrace their inalienable rights, human dignity, and pursuit of happiness within vibrant communities.
The 2024 strategic plan reflects a deep commitment to civil rights, recognizing the historic role of the Civil Rights Act in establishing as law, protected classes of populations from discrimination, including individuals with disabilities, and the Americans with Disabilities Act The plan also underscores the responsibility of MCIL to further advance accessibility, person-centered responsiveness, belonging, and stabilizing people, and their families in community, thus building vibrant communities that in turn results in economic sustainability.
Jesse has ensured that MCIL remains strategic and intentional in utilizing its thought leadership to address critical issues, including the direct care workforce crisis, which poses a significant challenge to human dignity and independent living for individuals, families, and youth with disabilities. At its core, MCIL envisions a society that upholds its commitment to civil rights, accessibility, welcome, belonging, self-determination, human dignity and independent living for all. This vision is captured in the statement: We believe in a world of opportunities, choices, and the freedom to live those choices, with dignity. A rigorous strategic plan, coupled with comprehensive program evaluations, allows the organization to measure and report on its impact annually.
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A Guardian of Dignity
A key aspect of long-term sustainability at MCIL is the collaboration with its Board of Directors. Jesse works closely with board members who are deeply committed to civil rights, Americans with Disabilities Act, accessibility, and ensuring that people with disabilities have the necessary support to live independently. His extensive experience, having served on more than 42 boards and commissions throughout his career, and as a CEO over many corporations, informs his leadership in aligning MCIL’s strategic direction with its mission. The organization maintains a structured planning process that includes service development, human resources strategies, financial operating budgets, and board engagement, all of which ensure a steadfast focus on delivering mandated services while expanding initiatives that enhance independent living.
With a staff of 77 professionals, Jesse cultivates a culture of dedication and excellence by embedding MCIL’s core values into every aspect of its operations. These values include Human Dignity, affirming that all individuals, possess inherent worth. Mindfulness and Responsiveness guide the organization’s empathetic and attentive approach to assisting individuals in leading self-determined lives. The principles of Self-Empowerment and Self-Determination emphasize that people with disabilities are the best experts on their own needs, deserving equal opportunities to shape their own lives of independent living and communities.
MCIL’s commitment to fostering a welcoming, accessible and supportive workplace of belonging, is reflected in its strategic human resources plan, which includes an independent annual employee survey. Notably, 100% of employee respondents identify with MCIL’s mission, demonstrating the organization’s dedication to creating an environment where every team member feels valued and motivated to further the cause of independent living. Jesse credits his mentor whom he personally trained with early in his career, W. Edwards Deming, Ph.D. who created the quality improvement movement globally, on the value of “driving fear out of the workplace” where all are appreciated, valued and belong.
Through strategic planning, strong governance, and a deeply embedded values-driven culture, Jesse continues to guide MCIL toward meaningful change, ensuring that individuals with disabilities receive the support and resources necessary to live independently and with dignity.
The Architect of Independent Futures
Managing a $8.1 million budget across a broad scope of services requires a strategic approach to resource allocation. Jesse explained that the Metropolitan Center for Independent Living (MCIL) ensures efficiency by aligning services with the organization’s leadership structure and cost centers, optimizing impact while maintaining fiscal responsibility.
MCIL is committed to assisting people with disabilities in transitioning from long-term institutional settings to accessible settings in the community in advancing independent living. Jesse shared a success story from MCIL’s Transitional Services housing advocacy efforts, illustrating the organization's impact; “Moving to a new home can be an expensive and arduous process – application fees, deposits and moving services are incredibly expensive and often unattainable, many times leaving individuals feeling stuck in their current living situations. Recently, MCIL provided transitional housing services to someone who was able to not only receive assistance with their damage deposit and moving services but was also able to pick out a new couch of their choice after never having owned a new piece of furniture before!”
Over the past two years, MCIL’s Transitional Services Program has assisted 1,633 individuals from transitioning from institutional settings into the community. Jesse pointed out that the long-term care costs associated with these individuals represent an estimated annual savings of $104,839,000 to $250,945,000. This calculation is based on the annual cost of a nursing home stay in Minnesota, which averages $153,665, compared to $64,200 for an assisted living facility, according to Genworth CareScout 2023 data.
Advancing Human Dignity and Person-Centered Responsiveness
MCIL operates in collaboration with statewide entities such as the Minnesota Association of Centers for Independent Living. Jesse noted that MCIL is one of 408 Centers for Independent Living nationwide and operates under the Centers for Independent Living Rules and Regulations of the Workforce Innovation and Opportunity Act (45 CFR Part 1329, November 28, 2016) and Minnesota State Statute (268A.11 Subdivision 8). As one of eight Centers for Independent Living in Minnesota, MCIL works alongside its counterparts and with the Minnesota Statewide Independent Living Council (MNSILC) to advance independent living throughout the state. Jesse emphasized that these partnerships are essential for ensuring a coordinated approach to supporting individuals with disabilities.
MCIL is honored to serve as the home for ADA Minnesota Program. Jesse underscored MCIL’s commitment to advocating for policy changes that further the rights and independence of individuals with disabilities. He acknowledged the Civil Rights Act’s historic role in recognizing people with disabilities as a protected class, along with the American with Disabilities Act, emphasize that MCIL’s mission aligns with advancing human dignity, person-centered responsiveness, and the development of accessible, vibrant communities that contribute to regional economic sustainability.
Jesse detailed MCIL’s advocacy efforts, which focus on ensuring compliance with federal laws that protect the rights of individuals with disabilities. Key legislation includes the Americans with Disabilities Act (ADA), particularly Title II, which mandates accessibility in all healthcare and social service programs operated by public entities. Additionally, Section 504 of the Rehabilitation Act of 1973 requires non-discriminatory access to programs and services receiving federal financial assistance, while Section 508 ensures accessibility for electronic and information technology provided by the U.S. Department of Health and Human Services, and the Workforce Innovation and Opportunity Act, which as federal legislation, has the statutory language on the role of the Centers for Independent Living and Statewide Independent Living Councils.
Contributing to a Vibrant and Inclusive Community
Looking to the future, Jesse shared MCIL’s plans for a renovation and expansion of its headquarters in downtown St. Paul, Minnesota. The expansion aims to provide additional space for employees and services while inviting additional agencies who also assist people with disabilities and policy-focused institutions to co-locate within the facility. Jesse described the vision for the new space as a welcoming environment designed with universal accessibility in mind, where individuals with both apparent and non-apparent disabilities can access services, build social connections, and contribute to a vibrant community of belonging.
Pioneering a Compassionate Workforce and Societal Transformation
Jesse emphasized the severity of the direct care workforce shortage crisis across the United States, noting that individuals who rely on direct care workers for daily living are facing an escalating gap in available support. This shortage has led to dire consequences, including people being forced out of their homes and experiencing unaddressed health complications.
To address this growing crisis, Jesse advocates for a transformative macro strategy that introduces a new model and a credentialed role of a Certified Direct Support Professional. He asserts that this new role must be fully integrated into all aspects of society, including the federal government and all 50 states. Jesse stresses that Congress must recognize the critical importance of the direct care workforce and ensure that the homecare sector receives equal attention alongside the medical sector, as both are integral components of the nation’s healthcare system.
He highlights the demographic shift currently taking place, noting that today’s older adult population is larger than in the past three to four decades combined and is projected to peak around the 2050s. Jesse underscores the importance of recognizing today’s historic moments to solve the direct care crisis, and seizing opportunities to implement solutions that transform society in positively impact future generations.
Jesse calls upon leaders in healthcare, higher education, workforce development, elected officials, and governors across all 50 states to champion solutions to solve the direct care crisis including the Certified Direct Support Professional model and the PCA College Service Corps. He believes that establishing this credential role will not only contribute to resolving the workforce crisis but also enable individuals in long-term institutional care settings to return home. Additionally, he envisions that strengthening the direct care workforce will lead to more vibrant communities and contribute to regional and national economic sustainability.
To further his efforts, Jesse has initiated discussions with the Federal Reserve Bank regarding their ongoing assessments of the economic impact of the direct care workforce crisis. He has also engaged with global stakeholders who are interested in adopting this transformative framework to address similar challenges in their own countries. Recognizing the widespread nature of this crisis, Jesse expresses his intention to bring the issue before the United Nations to elevate the need for a worldwide solution, emphasizing that humanity has both the resolve and the power to act to transform our world.
Jesse remains hopeful that the direct care workforce shortage crisis can be solved through collective action. He asserts that one of civilization’s most noble values is to advance the ability of people to care for one another, and he believes that healthcare leaders can play a significant role in upholding this fundamental principle.
He urges society to reflect on the shared human experience, emphasizing that our human nature is the same for all, and we all undergo the universal journey of life. In envisioning a solution, Jesse imagines a future where over four million direct care workers in the United States pursue and attain the credential of a Certified Direct Support Professional, receiving competitive wages and contributing to a sustainable workforce. Imagine also post-secondary institutions throughout the United States of America inviting college students to participate in the PCA College Service Corps in advancing their career success, increasing their awareness about the support needed to assist people who rely upon direct care services for daily living and greater civic participation in addressing the direct care crisis. He envisions a society where people with disabilities and older adults have reliable access to direct care services, leading to stronger, more vibrant communities that lead to economic sustainability and greater care for one another.
Rather than questioning why such an initiative should be pursued, Jesse challenges others to ask: Why not?
