ICI Film Documents Crisis in Direct Support Workforce

Publication date: 
July 14, 2019

“Where it all comes together for people with disabilities is with their Direct Support Professional [DSP],” says Ronnie Polaneczky. “DSPs are doing some of the hardest work ever and they’re being paid terribly. How could we make the linchpin for all that so unstable? That’s insanity.”

Polaneczky is a reporter with the Philadelphia Daily News speaking in Invaluable: The Unrecognized Profession of Direct Support, a 44-minute film by ICI’s Research and Training Center on Community Living. Written by producer/director Jerry Smith and ICI director Amy Hewitt, the film documents the chronically low pay, high turnover, long hours, disrespect, and high expectations for Direct Support Professionals, the largely invisible staff who assist people with intellectual and developmental disabilities in living full, productive lives. In addition to providing physical assistance with daily living routines and ensuring the health and safety of individuals, many of whom have complex medical issues, DSPs connect people socially and ensure they are valued members of their communities.

Forty years ago, many people with developmental disabilities were confined to overcrowded and often squalid institutions before organized advocacy efforts led to community-based services and supports. People with disabilities and their families praise DSPs for making community living viable, but this civil right success story came at the expense of the DSPs themselves who are paid about 25 percent less than institutional staff and nursing home workers. “We willingly planned and implemented community support with staff who were being paid less, who had access to less stability and fewer benefits,” Hewitt says in the film. “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 workers and we’ve never caught up.”

Low wages, lack of benefits, highly demanding work, and little opportunity for advancement have led to a national turnover rate of about 45 percent and chronic staff shortages. And the problem is compounded by an increased demand for services. “Over the last two decades, just for people with intellectual and developmental disabilities, the service sector has grown by 290% already,” Hewitt notes. “So we've just gotten to this place where demand is far greater than our ability to meet it.” One million new DSPs are needed over the next 10 years.

The film explores a number of strategies addressing the workforce crisis, including professional development, credentialing opportunities, and the use of technology supports as an alternative to having the constant physical presence of staff in someone’s home. These approaches are necessary but not sufficient for bringing stability to the direct support workforce and continuity to the lives of the people receiving supports. Even as organizations across the country employing direct support staff have lobbied legislators for pay increases, DSPs have seen their wages, adjusted for inflation, decrease over the past 10 years.

Mary Ann Allen, director of a disability services provider agency in New York, said the direct support system is collapsing. “People with disabilities are already ending up in homeless shelters, hospitals, and institutions. We don’t have much time before the tipping point is crossed.”

Advocate Margaret Puddington, whose son Mark is featured in the film, believes the workforce crisis is in part one of perception. “I feel that if people understood what the work of direct support is, there would be no problem. They would be forced, ethically, morally, to give staff a decent wage, well above the minimum wage.”

Through public screenings and discussions across the country, Invaluable is being used to provide this understanding and raise the profile of an unrecognized labor force.

Invaluable is available for rental or purchase.