Position Statement on Direct Support Professionals

Position

The direct service professional (DSP) crisis is the foremost challenge to the long-term services and supports (LTSS) system that serves individuals with intellectual/developmental disabilities (I/DD). Research demonstrating the impact of low wages, limited competency-based training opportunities and career pathways, ineffective supervision, and growth in the need for support across disability and aging sectors have predicted the crisis currently confronting New Jersey.

The New Jersey Council on Developmental Disabilities believes that evidence-based practices must be widely implemented to increase the ability of individuals, families, and employers to recruit, retain, and ensure the competence of DSPs to improve the quality of life and outcomes of supports provided to people with I/DD. A comprehensive approach must address the need to build capacity within the DSP workforce, and should include the following:

  • • Development and implementation of a statewide plan to address the causes that drive the DSP crisis, including low wages, ineffective hiring practices, limited competency-based training and career pathways, poor supervision, and lack of professional recognition.
  • • Allocation of sufficient funds to establish reimbursement rates that lead to living wages and the benefits necessary to attract and retain qualified DSPs in home and community-based services;
  • • Adjust rates paid for services to correspond with minimum wage increases and pay DSP’s at least 25% above the state’s minimum wage; • Adopt the national code of ethics and core competency areas for direct support professionals1 and frontline supervisors2 statewide and align professional development and performance appraisals accordingly.
  • • Provide credentialing opportunities, career pathways, and ongoing competency-based training and mentoring, embedded in system policies and sufficiently funded to create incentives for DSP participation,
  • • Develop and implement practices that support Direct Support Professionals to effectively assist people with I/DD to live active, engaged, and valued lives in their communities.
  • • Ensure careful oversight in self-directed services and ethical administration in provider agencies in order to adequately train, support, recruit, and retain DSP’s and to ensure opportunities for mentoring and professional development through worker recognition;
  • • Evaluate and implement the use of technology as an option for support while simultaneously providing relief to the increased demand for support and support workers.
  1. NADSP Code of Ethics – https://www.nadsp.org/code-of-ethics-text/
  2. NADSP Competencies – https://www.nadsp.org/competency-areas-text/
  3. Centers for Medicare and Medicaid Services DSW Competencies https://www.medicaid.gov/medicaid/long-term-services-supports/direct-care-workforce/dsw-core-competency-project/index.html 2
  4. National Frontline Supervisor Core Competencies – https://ici.umn.edu/products/553

Background Information

Direct Support Professionals (DSP) are indispensable to individuals with I/DD and their families. DSPs provide essential supports necessary for individuals with I/DD to successfully live in our communities. DSPs help individuals with I/DD understand and exercise their right to make choices about their lives. DSP responsibilities are extensive and include supporting medical and behavioral health needs, and teaching workplace, social, and activities of daily living skills. DSPs also provide assistance with personal care and assist with mobility related needs. DSPs are responsible for completing documentation and complying with oversight and training regulations.

A well-trained, fairly-compensated DSP workforce is crucial to providing the necessary supports and services to 30,000 individuals with I/DD where they live and work. Effective, ethical, person-centered supports are the foundation of inclusive community life. State investment together with federal Medicaid match is the primary source of funding for services for people with disabilities and the provider agencies that employ DSPs. New Jersey’s current Community Care and Supports Program’s Medicaid rate structure, and recently enacted New Jersey minimum wage increases, will exacerbate the workforce crisis created by low wages, lack of affordable health insurance, high turnover (44%), and a shortage of staff (20% vacancy rate).3 Demand for DSPs from private industry and other human services sectors is also high, leading to competition among industries for workers. From 2007 through 2017, the State of New Jersey did not increase the rates paid to licensed providers or individuals/families who self-direct services. These problems have been compounded over three decades, leading to a crisis that presents a grave threat to the lives of individuals with I/DD and their families.4 Approved May 23, 2019

  1. The Coalition for a DSP Living Wage, njdspcoalition.org website, April, 2019
  2. Public Policy Agenda for the 116th Congress, 2019-2020, Staff Draft, AAIDD, ANCOR, NACDD, The Arc, UCP, 2018