Tag: DSP

Investing in Communities

September 6, 2019

Video: Invaluable: The Unrecognized Profession of Direct Support¹

“DSPs need a unique combination of skills to support people with disabilities. When they do their job well, they not only transform the lives of people with disabilities, but they also make a vital contribution to the whole community.”

This direct support workforce crisis has a multifaceted impact on the community. When there are not enough staff, and when those who are present are not well trained, the people they support use more of the community’s police, ambulance, firefighter, emergency department, acute care, and other resources. Availability of more experienced and better-trained DSPs could reduce this cost to communities and increase the health, safety, and quality of life for people with disabilities.²

Additionally, given that nearly half of all DSPs use some form of government-funded, means-tested public assistance, the current crisis’ foundation in low-wage, limited-advancement employment results in communities and taxpayers picking up the costs of income replacement supports for health care, housing, food, child care, and other necessities.²

There persists a belief that Medicaid is an entitlement for people with disabilities, a drain on public resources. “There’s no handout to [Medicaid],” says Mary Ann Allen, director of Wildwood Programs in New York. “That’s earned resources that are then reinvested in a community and in our loved ones. And they in turn are now being able to work if they have stable support, volunteer in ways that people in other organizations benefit from because they have the support of a direct support professional workforce.” Maintaining and strengthening this workforce is essential to the well being of people with disabilities and their families.

DSPs give back to the community. How can we give back to DSPs?

Invaluable: The Unrecognized Profession of Direct Support is a documentary film by he Institute on Community Integration, University of Minnesota exploring the underappreciated and underfunded work of direct support professionals (DSPs), the people who support individuals with intellectual and developmental disabilities in living full lives as members of their communities. Through stories and interviews with DSPs, family members, advocates, and people with disabilities from across the country, the film honors the complexity of the work and the immense value it provides to individuals receiving support. And it asks us to take action now in strengthening the DSP workforce before the system collapses. Read more about “Invaluable” here.

References:

Invaluable: The Unrecognized Profession of Direct Support. Directed by Jerry Smith. Institute on Community Integration, University of Minnesota, 2019. https://ici.umn.edu/product/invaluable/main
Hewitt, A., Lakin, C., Macbeth, J. Kramme, J., & Benway, C. (2018). President’s committee for people with intellectual disabilities report to the president 2017: America’s direct support workforce crisis — Effects on people with intellectual disabilities, families, communities and the U.S. economy. Washington D.C.: President’s Committee for People with Intellectual Disabilities.

More Like Teachers and Mentors

September 5, 2019

Video: Invaluable: The Unrecognized Profession of Direct Support¹

“Really, direct support staff are more like teachers, more like mentors. They are doing things with the person and not for the person necessarily. In my son’s case, he doesn’t speak, he uses sign language. So whoever works with him has to learn his signs. It’s not optional.” – Parent of a person with disabilities.

Like teachers, DSPs develop and implement effective strategies to teach people new skills. Like nurses, they dispense medications, administer treatments, document care, and communicate with medical professionals. Like various allied health professionals, they assess needs, implement specific treatment plans, and document progress. Like social workers, they get people connected to community resources and benefits. Like counselors, they listen, reflect, and offer suggestions. DSPs provide whatever support it takes so people can live and participate in their communities with greater independence and dignity.²

“It’s that hands-on person that really tries to balance that walk of providing support, but also helping people be as independent as possible.” – Joe Macbeth, Executive Director, NADSP.

“The feeling you get for making a difference in someone’s life, you get that every day. And that to me is priceless” – Hiram Williams, DSP, New Horizons Recourses, Inc.

DSPs make a difference EVERY DAY… How can we make a difference in DSPs lives today?

References:

Invaluable: The Unrecognized Profession of Direct Support. Directed by Jerry Smith. Institute on Community Integration, University of Minnesota, 2019. https://ici.umn.edu/product/invaluable/main
Hewitt, A., Lakin, C., Macbeth, J. Kramme, J., & Benway, C. (2018). President’s committee for people with intellectual disabilities report to the president 2017: America’s direct support workforce crisis — Effects on people with intellectual disabilities, families, communities and the U.S. economy. Washington D.C.: President’s Committee for People with Intellectual Disabilities.

The Most Alarming Consequences

September 5, 2019

Video: Invaluable: The Unrecognized Profession of Direct Support¹

“The most alarming consequence of high turnover, and the most highly publicized, is the abuse and neglect that results on relying on unqualified and poorly trained staff.”

Direct Support Professionals need better training. Most do not come to their jobs with the knowledge, skills, and attitudes required of their roles. Federal regulations are largely silent about the preservice and in-service training required for DSPs to provide quality community support to people with intellectual and developmental disabilities (IDD).²

At the state level, it is common for employers to provide a minimal number of preservice training hours (around 40) that focus on topics or basic skills that must be taught within a certain number of hours post-hire (e.g., CPR, first aid, documentation, blood-borne pathogens) and at regular intervals after hire. Rarely is engaging, interactive, competency-based training required or expected. Yet, we know far too well that research-based knowledge, sophisticated skills, and high ethical standards are required of DSPs to be effective in their jobs. Over the past several decades many sets of national and state DSP-specific competencies have been identified and refined.²

Viewing DSPs as replaceable low-wage workers makes them easier to dismiss. Greater awareness and understanding of the work of DSPs, and the value that people with disabilities bring to our communities, is desperately needed, in order to create a strong and professional and valued workforce.

DSPs make a DIFFERENCE every day. What can we do to make a difference to support their education and professional development?

References:

Invaluable: The Unrecognized Profession of Direct Support. Directed by Jerry Smith. Institute on Community Integration, University of Minnesota, 2019. https://ici.umn.edu/product/invaluable/main
Hewitt, Amy; Macbeth, Joe; and Kleist, Barbara. “The Direct Support Workforce Crisis: A Systematic Failure.” Impact, Volume 31, Number 1 https://ici.umn.edu/products/impact/311/Systemic-Failure/#Systemic-Failure. Accessed September 2, 2019.

On the Backs of Workers

September 5, 2019

Video: Invaluable: The Unrecognized Profession of Direct Support¹

“We were able to deinstitutionalize and provide opportunities for people with disabilities to live in the community on the backs of the workers. We willingly planned and implemented community supports with staff who were being paid less, who had access to less stability, fewer benefits. We did that because of a good thing. We wanted people with disabilities to live in the community, but the way we could afford it was on the backs of the worker and we’ve never caught up, we’ve never caught up.” – Amy Hewitt, Director, Institute on Community Integration University of Minnesota.

The direct support workforce is large and one of the highest-demanded and anticipated growth areas in the U.S. No matter how much DSPs might love their jobs, they need to be able to support themselves and their families. Low wages and lack of affordable benefits are universally identified by agencies, DSPs, and people who receive supports as the most significant issue.² The following data about the workforce represents 20 states that participated in the 2018 NCI Staff Stability survey:

In addition to low wages and lack of affordable benefits, career pathways rarely exist for DSPs. There are no required credentials that ensure DSPs have met the knowledge requirements and demonstrated proficiency in skills needed for the job, nor to certify a person’s commitment to the profession. With few opportunities for growth and development there’s little increased earning potential, and many DSPs leave the profession.²

What can we do to fix this crisis?

References:

Invaluable: The Unrecognized Profession of Direct Support. Directed by Jerry Smith. Institute on Community Integration, University of Minnesota, 2019. https://ici.umn.edu/product/invaluable/main
Hewitt, Amy; Macbeth, Joe; and Kleist, Barbara. “The Direct Support Workforce Crisis: A Systematic Failure.” Impact, Volume 31, Number 1, https://ici.umn.edu/products/impact/311/Systemic-Failure/#Systemic-Failure. Accessed September 1, 2019.

Wearing Many Hats

September 5, 2019

Video: Invaluable: The Unrecognized Profession of Direct Support¹

Direct Support Professionals are the paid staff who support individuals with intellectual and developmental disabilities (IDD) to live their lives and enjoy the same opportunities and experiences as people without disabilities. DSPs support people in whatever ways they need to enhance inclusion and independence. These workers are employed in many types of settings, including family/individual homes, intermediate care facilities, small community residential group homes, community job sites, vocational and day training programs, and others. The direct support workforce includes full-time (66%) and part-time (34%) employees (NCI, 2018). Most employers use the occupational title of Direct Support Professional, yet many DSPs may have different titles including direct support specialist, personal care assistant, habilitation specialist, job coach, residential counselor, family care provider, personal assistant, and others.²

So what exactly is a DSP? DSPs are interdisciplinary individuals who have to be able to provide whatever support is needed across a wide range of activities throughout the lifespan of people with IDD.

In 2016, there were roughly 4.5 million direct support workers (BLS, 2016). Nearly 90% of DSPs are women, one-fourth were born outside of the United States, and one out of five lives in poverty.² Half rely on public assistance just to support their own families. We will need nearly one million new DSPs to support people with intellectual and developmental disabilities in less than 10 years.³

The urgent question is, where are we going to find new DSPs and how are we going to keep them?

References:

Invaluable: The Unrecognized Profession of Direct Support. Directed by Jerry Smith. Institute on Community Integration, University of Minnesota, 2019. https://ici.umn.edu/product/invaluable/main
Hewitt, Amy; Macbeth, Joe; and Kleist, Barbara. “The Direct Support Workforce Crisis: A Systematic Failure.” Impact, Volume 31, Number 1 https://ici.umn.edu/products/impact/311/Systemic-Failure/#Systemic-Failure. Accessed September 1, 2019.
“Direct Care Worker Projected Job Openings, 2016 to 2026”.
Workforce Data Center, https://phinational.org/policy-research/workforce-data-center/#tab=National+Data