Taking On the DSP Workforce Dilemma with Dr. Amy Hewitt

Institute for Community Inclusion, University of Minnesota, Disabilities, Rhode Island, DSP, Turnover, Employment

Dr. Amy Hewitt of University of Minnesota Institute for Community Inclusion

For individuals we support at Perspectives, it's the faces they see every day--the Direct Support Professionals--that contribute to making some of the biggest impacts in their lives. However, the stability of these essential employees, namely the length of time they stay within any one agency, is critical for the success and happiness of individuals with disabilities. That's why agencies have marched for their DSPs, advocating for higher wages, better tools, increased training, and more. Still, one of the issues facing the industry remains the constant high turnover rates of DSPs--and so Perspectives is excited to work with University of Minnesota's Dr. Amy Hewitt to find out how to shrink the problem not only within our agency, but across Rhode Island.

Dr. Hewitt's Journey into I/DD Activism

For over thirty years, Dr. Amy Hewitt has been a clear voice in the I/DD world, always advocating for not only individuals with disabilities, but also the professionals that support them. In fact, her career path in human services started as a direct support professional: as an undergraduate student at Indiana University, double-majoring in psychology and political science, part of her financial aid included a work-study experience at Stone Belt Center, an employment and day support provider. So started a path towards the present day; with a PhD from the University of Minnesota and an impressive track record of research projects at the state and federal level, she now works at the University of Minnesota's Institute on Community Inclusion. There, she continues to develop programs and training centered around one of the biggest challenges the industry faces: recruitment and retention of Direct Support Professionals (DSPs) within agencies.

"I want to make sure that all DSPs are properly trained for the work they'll do and feel competent to do their jobs," Dr. Hewitt says. "It's easy to hire people; it's much harder to keep them, and especially hard to hire the right people that are committed to doing this kind of work."

"It's easy to hire people; it's much harder to keep them, and especially hard to hire the right people that are committed to doing this kind of work."

One important focus of Dr. Hewitt's work is improving the stability of the I/DD workforce. As such, she has engaged in several efforts to bring attention to these challenges, including the development of a national online training curriculum called DirectCourse, which is used by organizations, individuals, and families across the United States and in other countries to train DSPs. She's also been part of creating a National Training and Technical Assistance Center on DSP Workforce Improvement to assist states and providers to improve workforce retention, as well as worked on other projects and resources aimed at providing top resources for individuals and families to not only find, but keep, quality DSPs at their side.

The DSP Workforce Dilemma: Turnover Rates and Their Causes

Employee turnover is something that, if the rates are too high, can have a harsh impact on a business or agency's productivity and overall functioning. Accountants, for example, have an average turnover rate of 12.4% according to 2017 data from Retensa, and nurses can have a turnover rate between 8.8% to 37% according to Relias. The National Core Indicators (NCI) Staff Stability Surveyidentifies the average national turnover rate for Direct Support Professionals as 51.3%--a number that, compared to other professions, is alarmingly high, suggesting that DSPs are leaving agencies faster than they can be replaced. For this reason, Dr. Hewitt's work to identify key competencies and skills required of DSPs, as well as consulting for agencies to help them identify strategies to keep valuable team members aboard, is crucial.

"I think we can all agree that we want individuals with disabilities to have great lives," Dr. Hewitt says, "but that's not possible without a stable workforce. How can we have quality services with turnover rates that are over 50%? Yet, across the nation, we've accepted that rate as an industry standard."

However, that rate reflects much more than just the issue of funding and DSP wages. Some factors known to influence employee turnover in any agency, and specifically DSPs, includes:

a mismatch between skills of DSPs and supports individuals need in their day to day lives
the quality of the company culture and management that oversees DSPs
the temperament of the professional applying for the job
potential conflicts with coworkers
effectiveness of supervisors at supporting their team

With turnover so high nationwide, there's no one answer to the problem. That's why it's crucial to take a holistic view of agencies like Perspectives to identify the problems that they can solve without relying on increased funding and state government intervention. This is especially important with issues like the COVID-19 pandemic creating more challenges and barriers for individuals and businesses globally.

"[The workforce problem] is systemic," she says, "and we have to work with what's available to address these systemic issues, like the funding structure, while simultaneously doing what we can to keep DSPs stable and supported on the job with and wages DSPs get because of those funding structures. DSPs make up an extremely important and highly skilled workforce, and they need to not only be paid, but seen, talked about and treated as such."

How Perspectives is Moving Forward with Dr. Hewitt

In the meantime, as the world continues to weather the COVID-19 pandemic and the crisis it's caused, Perspectives is continuing to make headway with Dr. Hewitt's DSP retention programs, starting first with a comprehensive assessment process. She's looking at organizational data to improve her understanding of the issues faced by Perspectives and how turnover is impacting its' mission and services.

An additional part of the assessment process was conducting one-to-one interviews with management staff and conducting focus groups with staff in various positions (DSPs, supervisors, program managers, directors and support coorinators) within the organization. Dr. Hewitt's conversations focused on thoughts on where there's room for improvement within the agency. Based on this information, Dr. Hewitt will compose a summary assessment report and provide recommendations to help guide leadership forward. It's a new process for the agency, an exciting venture, and one that has the potential to extend beyond Perspectives and hopefully benefit agencies across Rhode Island.

"It's not uncommon for a progressive provider like Perspectives to take the first step and bring these kinds of programs to other agencies in their states," Dr. Hewitt says. "That's why I'm hopeful we can find some really effective strategies to maximize DSP retention; that's my ultimate goal for all providers."

And that's Perspectives' goal, as well--as the health and safety of individuals with disabilities, as well as a great quality of life, is a goal that unites all service providers. The perseverance of our professionals throughout 2020 and the COVID-19 pandemic has been amazing, and we're looking forward to all the great things we can accomplish together in 2021 and beyond. It's a challenge we're ready to take on, and with great leadership like Dr. Amy Hewitt and the Perspectives team, we're confident in our ability to create a brighter future for all, one day at a time.