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Better Support for Direct Support Professionals

At a Glance

Direct support professionals (DSPs) are essential to a lot of community and adult services - they help make things happen!

DSPs face a lot of challenges related to the job, pay, and support they receive.

In this post, we’ll cover a few ways that we can better support DSPs on the job and for their career.

At AGU we talk at length about all sorts of different forms of support in the community, and in this regard, some of the community’s most essential members are direct support professionals (DSPs). DSPs can cover a huge variety of tasks and services for autistic adults. In short, they get things done! Without DSPs, many autistic adults would face gaps in services essential to their well-being and quality of life.

Despite the importance of DSPs to the functioning of so many support services, they often face tremendous challenges on the job related to their pay and the tasks they are expected to complete relative to the support they receive. 

In their 2017 Report to the President on the DSP workforce crisis, the President’s Committee for People with Intellectual Disabilities (PCPID) reported the following challenges faced by DSPs as an occupation:

  • Average wages of $10.72 per hour.

  • Average wages below the federal poverty level.

  • Half of DSPs rely on government-funded and means-tested benefits.

  • Most DSPs work multiple jobs.

  • Noncompetitive benefits.

  • High stress work for extended hours.

  • Lack of training and preparation.

  • Lack of professional recognition for people who excel in these challenging conditions.

Beyond the obvious sentiment that we should be providing our DSPs the resources they need to do their job, these on-the-job challenges have had dire real-world consequences. 

The same PCPID report noted some of the effects of these shortcomings on the ability of service providers to fill DSP vacancies:

  • An average annual turnover rate of 45 percent.

  • Average vacancy rates topping 9 percent.

  • An inability to meet growing demand for these services.

  • An increased burden on existing DSPs who cannot meet the full demand on their own.

As demographic shifts continue to point to both a greater need for DSPs and lower rates of eligible workers entering the workforce, we need now more than ever to improve the resources and conditions provided to DSPs so that they can effectively do a job that is so vital to so many people.

What kind of support do DSPs need?

The question of how to manage the challenges facing DSPs is not a simple one. It is a reflection of the challenges facing Direct Care Workers(DCWs), the broader workforce to which DSPs belong, which as of 2019 comprised over 4.5 million people in the United States. 87% of direct care workers are women and 53% are women of color.  

DSPs are skilled professionals who support their clients’ participation in their community, from activities for daily living to assisting clients in performing their jobs. From medical support to emotional support.


There is no simple blanket solution that will address all of these gaps on a national level! But a great place to start is to take a closer look at what DSPs want. On top of some obvious gaps like wages, benefits, workplace protections, and autonomy, there is a clear impetus to “professionalize the DSP workforce” in a way that is reflective of the demands and skill the job entails.

A 2022 DSP Think Tank included the following recommendations specifically related to better supporting DSPs among others:

  • Restructuring Medicaid reimbursement rates for credential-based pay.

  • Supporting state investments in career pathways.

  • Standardizing occupational categories related to DSPs in particular.

  • Leveraging state regulatory authority and generally encouraging cooperation from states and corporations.

  • Support DSP unionization and provide guidance to states on accommodating unionization.

DSP Aleatha Simmons echoes some of these recommendations in her own advocacy blog post, on the topic, which calls not only for better pay and training but “elevating the field’s professional standing by tracking national trends.” 

As a disabled DSP, Simmons also notes there are gaps for disabled people wishing to join this workforce and advocates for more support or those who choose that path.

Simmons closes out her post by reiterating an important truth about helping DSPs: improving the wellbeing of this workforce translates directly to improved care for those who need direct support. Simmons describes it as a “positive chain reaction,” and we can’t agree more!

Advocating for Change

When advocating for change in a multifaceted issue such as this one, there are often organizations out there attempting to move regulations closer to meeting the broad goals of the movement. 

The Consortium for Constituents with Disabilities (CCD) has a Long Term Services and Supports Task Force that regularly issues calls to action on various initiatives related to their stated 2022 legislative and administrative priorities. 

It can sometimes feel frustratingly abstract contribute in this way, but on issues like this showing your support can make a real difference in moving the ball in the direction we want.

That should not stop you, however, from sharing your own stories about the importance of DSPs to you or the people in your lives. We ask DSPs to do so much with so little and it’s long past time we start offering a lot more!

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