The infrastructure to train and keep direct service providers for those with intellectual and developmental disabilities has been neglected, resulting in a crisis that must be addressed, writes Karen Lee. Photo by Getty Images.
The direct support professional (DSP) workforce crisis is not new. According to the staff survey in National Core Indicators, 24% of disability service providers in Maryland have turned away new intakes because of staffing. Almost 36% of DSPs have been in their jobs less than a year, with the full-time vacancy rate at almost 12%, and almost 20% for parttime positions.
For more than 30 years, demand for a high-quality workforce to support individuals with intellectual and developmental disabilities (I/DD) has been outpacing supply, spurring ongoing research and urgent discussion by federal and state governments. COVID-19 worsened this urgent situation, leaving families, providers and individuals scrambling for solutions.
Yet even as demand surged over the years, the infrastructure to train and keep DSPs was left underfunded, resulting in a crisis. Without robust career paths, professional development opportunities and competitive wages, vacancies and turnover rates soared, creating an unsustainable environment for both workers and those they supported.
Parents stepped in to fill the gaps, creating a shadow system of family-directed services. While self-directed services offer meaningful options for those who prefer or require flexibility, they were never intended to replace a well-supported and professional community provider system.
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Self-directed services can offer innovative opportunities—like enabling a person to hire a music teacher at a higher pay for the purpose of career exploration—yet they often lack the training and specialization resources that community providers bring, including highly trained staff in roles ranging from employment specialists to community engagement coaches, all supported by instruction specialists, health care professionals and supporting infrastructure such as information technology and human resources.
Community providers, the bedrock of support for individuals with I/DD, offer a critical solution. These organizations specialize in delivering high-quality services that promote choice, control and independence for people with disabilities.
From choosing meaningful employment opportunities to selecting their own living arrangements, people with disabilities are empowered by trained DSPs and community providers who provide staff to ensure people with I/DD live the lives they want to lead. At the same time, community providers, who collaborate closely with families to provide support, are stretched thin with growing waiting lists of people seeking their services. The system has not received the investments it was promised, leading to the current fractured landscape of care.
To address this crisis, which is a hot topic on the local, state, and national level, collaboration is essential. States like Maryland are making strides with efforts like the Maryland Direct Support Professional Training Consortium, a partnership that includes state partners including Maryland Developmental Disabilities Administration and Department of Labor, and MACS, the state provider association, along with local providers including SEEC — Seeking Employment, Equality and Community.
The consortium’s focus is the tiered DSP training model (DSP I, DSP II, DSPIII), which equips professionals with the skills and knowledge necessary to deliver high-quality care. These efforts have proven that proper training and support not only reduce turnover and vacancy rates but also transform lives.
Consider the story of SEEC’s Rodney Jackson, Maryland’s 2023 DSP of the Year, now a DSP II who worked with a man who was reluctant to leave his home. Through the onboarding process, Rodney knew the man loved coffee so, using the technology provided to him, showed him the drinks menu from Starbucks. Today, the person we support, who is nonlinguistic, places his own order using assistive technology. Just one example of the use of innovative communication strategies to help individuals engage with their communities, underscoring the transformative power of a well-trained DSP workforce.
But training alone is not enough. To truly resolve the DSP workforce crisis, we must:
- Increase wages and benefits: DSPs deserve a living wage and access to benefits that reflect the critical nature of their work.
- Expand career pathways: Building a clear, practical career trajectory will help attract and keep talent in the field.
- Support collaboration: Partnerships between providers, families and individuals are vital to ensuring care is tailored and effective.
By investing in community providers and addressing systemic shortcomings, we can ensure that every person with I/DD has access to the high-quality services they deserve. This is not about fixing a broken system—it is about honoring our shared commitment to equity, inclusion, and opportunity. The time to act is now.