The Direct Support Professional Crisis

Direct Support Professional

It’s estimated there are more than two million Americans working as Direct Support Professionals (DSPs). A DSP is someone who teaches life skills, supports empowerment, and provides physical assistance as needed while supporting the self-direction and choices of an individual with intellectual or developmental disabilities (IDD). 

DSPs are often referred to as the backbone or linchpin of the care/support system for people with IDDs. These dedicated professionals specialize in providing the services necessary for their clients to live, work, and thrive in the community with their peers and family instead of institutions. At the same time, DSPs are the expert relationship builders who connect adults with disabilities to the appropriate volunteering opportunities, jobs, religious groups, friends, and civic life. 

While DSPs are undoubtedly critical and wear a vast number of hats, they are — along with other Direct Care Workers — underpaid. The stress of the profession coupled with stagnant wages is causing many skilled DSPs to leave the workforce to find better paying jobs, which creates a vacuum and a care crisis. Let’s take a closer look at the DSP Crisis and how it mirrors the larger problem with Direct Care Workers. 

The Direct Support Professional Crisis  

The primary role of a DSP is to help their clients live safer, more productive and more comfortable lives. DSPs help their clients complete any number of tasks you would do on a daily basis, but most importantly, they help adults with IDDs learn to complete these tasks themselves. And while DSPs play a profoundly important role in the lives of those they serve, a low, stagnant wage leaves a lot to be desired. 

To put it in perspective, the annual Case for Inclusion by the American Network of Community Options and Resources (ANCOR) reports that retail stock clerks and sales people are most likely paid several dollars more than DSPs. Often earning close to minimum wage, the DSP salary has very little room for change because it primarily comes from Medicaid. According to the NJ Spotlight, DSPs often work multiple jobs and receive government benefits just to be able to provide for their own families.

In addition to low wages, the DSP role can be inconsistent and stressful, which explains why: 

  • The average turnover for DSPs is 46%
  • 88% of respondents leave their jobs due to inadequate pay
  • A mere 21% stay six to 12 months on the job 

The Impact of Low Wages & High Turnover

Across the nation, the low wages of the DSP profession makes it increasingly difficult to recruit qualified professionals. Barbara Merrill, CEO of ANCOR explains, We are seeing across the country that providers are not only not accepting new referrals, but starting to close down services because they can’t find the workforce.”  

At the same time, the low wages and constant turnover can be very disruptive to people with IDDs as well as their families. Consider the impact of losing the backbone of support — it can cause life to come to a standstill even for those with a very supportive community and family. 

On the other hand, if wages were to increase for DSPs, almost every aspect of an adult’s life with IDDs could change for the better. Even so, many legislators lack an understanding of the crucial role of DSPs in the caregiving system, which has been one of the primary drivers of the limited funding.

The Bigger Problem with Direct Care Workers

The problems with DSPs actually speak to a larger and growing situation with direct care workers. DSPs are only one type of direct care worker, and other types include personal care aides, nursing assistants, and home health aides. 

Acute shortages of nursing assistants and home health aides are emerging across the U.S., placing care for older adults and those with disabilities at risk. For instance, Wisconsin nursing homes have reportedly denied access to thousands of patients over the previous year because they simply didn’t have the staff. And right here in the state of New York, patients in rural areas have went without meals, soiled themselves, and have been injured because caregivers are not available, according to an article featured in the Washington Post

Similar to the DSP crisis, the larger crisis with direct care workers is being driven by extremely low wages of approximately $10 an hour according to PHI National. And experts predict the problem will worsen as America’s population of seniors balloons from 48 million today to 88 million people in 2050. 

A Push for Salary Increases for DSPs

The crisis surrounding DSPs and direct care workers is a call to arms for every state to push forward and demand increased support, mainly through Medicaid. The fastest and most immediate impact will have to be through seeking Medicaid reimbursement rate increases. Fortunately, we’re already seeing promising changes in the neighboring New Jersey. Last year, Governor Murphy and the New Jersey Legislature recently identified $32 million in extra federal and state funding to support higher wages for DSPs. 

Contact Community Mainstreaming to learn more about what you can do to impact DSP wages.