By Carli Friedman, CQL Director of Research
Direct support professionals (DSPs) provide individualized personal assistance to people with disabilities and older adults. They not only provide a wide range of services, but must often balance a complex set of competencies to do so.
Human service organizations often experience DSP turnover rates ranging from 30-70% annually. Not only does DSP turnover impact DSPs themselves, it also significantly impacts the services organizations provide to people with intellectual and developmental disabilities (IDD), and by extension, people with IDD’s quality of life. While DSPs help facilitate people with IDD’s quality of life, turnover can hinder people with IDD’s quality of life significantly.
The aim of this study conducted by CQL | The Council on Quality and Leadership was to explore how DSP turnover impacts the health and safety of people with IDD, particularly their emergency department utilization, incidents of abuse and neglect, and injuries. To do so, we analyzed Personal Outcome Measures® data regarding DSP turnover, and health and safety data from a random sample of 251 people with IDD.
The findings of our study revealed, regardless of people with IDD’s support needs, people with IDD who experienced turnover had more emergency department visits, instances of abuse and neglect, and injuries than people with IDD who did not experience turnover (see figure).
Relationships between DSP Turnover and Health and Safety
“As DSP turnover can hinder both the health and safety, and the quality of life of people with IDD, attention to issues that cause turnover is necessary… DSPs not only have low wages and a lack of benefits, they also have a taxing workload that requires them to master a complex set of skills. The systemic treatment of DSPs, such as the poor reimbursement rates set for their services, simply does not reflect the critically important services they provide. As indicated by our findings, extended tenure of DSPs can help promote the health and safety of people with IDD… Remedying the DSP turnover epidemic is necessary not only to improve the lives of people with IDD, but also the lives of DSPs” (Friedman, 2021, pp. 69-70).