Finding The Right Solution

Hiring and Training Direct Support Professionals (DSPs)

Every year there is a growing demand for Direct Support Professionals (DSPs) within an industry plagued with high turnover rates. “In 2003, according to the US Department of Health & Human Services, there were 874,000 full-time DSPs assisting individuals with intellectual disabilities, autism, and/or behavioral health concerns in various settings.[1]” It is estimated that by 2020 the demand for DSPs will increase to 1.2 million, which is a 40 percent increase in little more than 17 years. We are in a DSP Crisis!




In addition to turnover, DSP demand hinges on the increased life expectancy of individuals who require services; aging baby boomers; increased prevalence of Intellectual and/or Developmental Disabilities; and the expansion of community support systems. As highlighted in the Report to the President 2017: American’s Direct Support Workforce Crisis[2], Jack Brandt, Chair for the President’s Committee for People with Intellectual Disabilities, the following factors have the greatest impact:


  1. Growth in the number of people with ID/DD who need and receive services,
  2. Major shifts in the types of services desired and delivered to people with ID/DD,
  3. Steadily increasing the longevity of people with ID/DD,
  4. Changing U.S. population demographics,
  5. Changes in the overall U.S. labor force and economy and, above all,
  6. The failure to create an occupation of direct support with sufficient pay, benefits, training, career trajectories and status to recruit and retain a stable, skilled workforce.


To support these needs a wide range of education, training, and professional collaboration will be necessary.


DSP Education and Training

Although the most common education for a DSP is a high school education, the primary requirement is that a person must be at least 18 years of age. The job itself doesn’t require any prior experience. However, a DSP requires hours of training and national certification for three different levels. Currently, certification and training are sponsored by an employer.


Employers provide extensive training beyond new hire orientation with CPR, occupational safety, behavioral management, and patient abuse, neglect, and exploitation. The proper training can be costly. Perhaps more importantly, adherence to government regulations requires adequate reporting, documentation, and training to avoid any injury to the individual being cared for and potential penalties or litigation.


What More is Needed to be a DSP

It goes beyond a genuine passion for helping others. The role of a DSP is to assist a person with autism spectrum disorder to live independently. They help individuals with tasks most other people take for granted. They teach individuals to complete tasks to do for themselves, while also minimizing the risk of injury and other hazards.


The most important trait of a DSP is patience. Also, DSPs need compassion, honesty, integrity, composure under pressure, dependability, punctuality and a strong sense of teamwork.


Despite the proper training and the right individual, turnover rates continue to persist within the industry. Wages remain the leading cause of turnover. In Pennsylvania, the annual mean salary is slightly more than the national average, at $22,160. Private care workers, those who are not employed by a government agency, are among the DSPs most impacted by low wages. State DSP workers make about $17.85 per hour, compared to the $10.65 per hour for private DSPs.


In fact, the DSP workforce shows a more significant disparity even by type of service.


DSP Field in Pennsylvania Hourly Wage
Mental Health $9.39
Intellectual Disabilities $10.04
Autism $11.47
Drug and Alcohol $10.35
Childcare $12.01

Source: Glassdoor


Impact on the Industry

Although the industry is aware of and recommending significant changes, the impact can affect:

  • Employers hiring practices – they may relax their standards and potentially hire individuals who do not represent their company culture.
  • Individuals receiving care from different DSPs and losing contact with the staff they’ve grown to trust and rely upon.
  • Higher costs for Providers – in addition to hiring, training, and turnover costs, increases in overtime pay are prevalent to cover staff shortages.
  • Improperly trained DSPs – potentially putting individuals at risk for injury


One Solution at the Forefront

More efforts are being made to dive deeper into the DSP crisis. In the Presidents Report, Brandt suggests that there are several practices that would address the workforce crisis. Among some of the more obvious solutions, he cites worker cooperative and independent provider models, competency-based training models that lead to credentialing or certification of staff, and the use of technology-enhanced supports. One such solution is the development of Optonome DSP123. Optonome takes the pressure off the pre- and post-training for providers and gives them the opportunity to spend more time integrating new DSPs into practice.


The DSP123 is a certification program, offered under Optonome. The program is free to anyone 18+ years of age and provides training in:


  • HIPPA Compliance
  • Medical Administration
  • Incident Management
  • Individual Support Plans
  • Fire Safety
  • Behavioral Monitoring
  • And, more


Optonome is now in the forefront of small-scale solutions, offering big impact. For more information about Optonome or to request a demo, visit



[1] Direct Support Compensation Practices. Implications on Service Quality; Tax Dollars and Quality of Life, August 2017, Nicholas D. Torres, M.Ed., Scott Spreat, Ed.D., Michael Clark, M.P.A.

[2] Report to the President 2017. America’s Direct Support Workforce Crisis: Effects on People with Intellectual Disabilities, Families, Communities and the U.S. Economy, President’s Committee for People with Intellectual Disabilities.