Workforce Shortage Continues to Hurt People with Intellectual and Developmental Disabilities

Direct Support Professionals (DSPs) are critical to the individuals and families who count on them. Many people with intellectual and developmental disabilities (IDD) require daily physical supports in order to access their homes and their communities.

Without DSPs, people with IDD are isolated, prone to abuse or exploitation, and report higher rates of poor health outcomes. Providers continue to see alarming turnover rates, some experiencing up to 40-70%.

The Arc of North Carolina continues to work closely with state legislators, North Carolina Department of Health and Human Services, and community organizations to advocate for changes in workforce development. The shortage of DSPs is detrimental to people with IDD who need assistance with activities of daily living. 

Right now, a DSP does not have a career path and many DSPs still earn under $15 an hour. Providers and care management agencies are competing with businesses such as Starbucks or Target who are willing to pay the same or more per hour, offer benefits, and management opportunities. The need for direct care workers to provide Home and Community Based Services (HCBS), which is the largest funder of services for people with IDD, is expected to increase dramatically over the next decade, with more than an additional 20,000 DSP positions needed by 2028.

As Medicaid Transformation continues and Tailored Plans launch on December 1st, this will further exacerbate an already fragile workforce, and it will create additional DSP shortages across our state. Over fifteen thousand people with IDD are on a waiting list for services. They will become eligible to receive care management services on December 1st but will not have access to them due to the workforce shortages in our state.

            The Arc of North Carolina proposes the following suggestions to assist in alleviating this crisis:

• Increase Medicaid reimbursement rates to service providers so they can pay DSPs a living wage that is competitive with retail industries and state-employed DSPs working in our institutions to stabilize this workforce. 
• Create a rate structure that allows for a cost-of-living increase (COLA) annually for all levels of the service system that is critical if providers are to attract and retain employees. 
• Allocate scholarship funding to service providers to invest in the DSP workforce that will create a career ladder and a pipeline for this fragile workforce. 
• Change the minimum age from 18 years of age to 17 years of age for DSPs to work in the service delivery system. This will help to build the DSP pipeline.

We implore state legislators and state leadership to recognize DSPs and the organizations that employ and support them as vital resources and make immediate and significant investment in this critical workforce.