November 2023
A man with a disability and his direct support professional (DSP) stand in front of a lake in sunshine. The DSP is wearing sunglasses and a surgical mask.

Drastic staffing challenges, inadequate wage increases, burnout, and depression formed COVID-19’s legacy among the professionals who support people with disabilities in their daily lives, a new report from the Institute on Community Integration shows.

Direct support professionals (DSPs) worked more overtime hours and took on new duties during the COVID-19 pandemic as many of their colleagues were unable to work. Their average hourly wages grew 13 percent, to $16.58, during the April 2020 to July 2022 period, but it wasn’t enough to adequately cover living costs, as 75 percent indicated they were the primary wage earner in their household. By 2022, about two-thirds were working additional weekly hours due to the pandemic.

“Asking these professionals to continually add work hours and new responsibilities exacerbates burnout and accelerates the retention challenges that service providers have been battling for many years,” said Sandra Pettingell, an ICI research associate and lead author of the November report, Direct Support Workforce and COVID-19: What Happened Over 24 Months?

The report, a final summary of four online national surveys ICI administered with several partners, also notes the challenges people with intellectual and/or developmental disabilities (IDD) have endured due to the pandemic, including increased anxiety and boredom resulting from not being able to go out in the community.

ICI’s partners in promoting the survey and distributing the survey link included the National Alliance for Direct Support Professionals, ANCOR, The Arc, and NASDDDS. Nearly 9,000 DSPs and frontline supervisors (FLS) completed the first survey, the largest survey to date of this workforce. In total, roughly 25,000 surveys were completed.

“In Covid’s early days, we knew that direct support professionals were, once again, about to be immersed in crisis. We also knew it was critical to understand how their work, their health, their mental health, and their home lives would be affected,” said Joseph Macbeth, chief executive officer and president of the National Alliance for Direct Support Professionals. “The NADSP team worked closely with ICI to get the word out to tens of thousands of DSPs through our robust social media forums and our connections within the provider community. It would have been a colossal failure for our field if we did not capture and publish the impact that the virus had on our workforce.”

Personal protective equipment, in short supply at the beginning of the pandemic, did become widely available, though up to 2 in 10 workers reported having to pay for it themselves. At the 24-month mark:

  • Nearly half (47%) of DSPs had not received COVID-19 augmentation pay or a bonus.
  • 52% had been diagnosed with COVID-19.
  • 16% of the DSP workforce had been vaccinated.

The report recommends service providers acknowledge the sleep issues, physical health complications, burnout, mental health and loss issues, and other ongoing effects of the pandemic on support professionals with counseling and other benefits.

Other recommendations for the future include ensuring DSPs and FLSs are identified as essential workers in federal and state emergency response plans, providing workers with childcare if schools close, raising wages to reflect risk exposure, and providing wellness and health programs. Developing better telehealth and online social opportunities for the people DSPs support are also recommended.

“This project provided an opportunity to hear the voices of DSPs during a critical time in our history,” Pettingell said. “We saw pieces of the DSP experience at each time point we surveyed, but this report provided an opportunity to look at the bigger story of their experience throughout the pandemic.”