Action is needed on pending direct care worker shortage

Despite a growing need, and greater demand, issue remains unaddressed


Published:

You know them as the young woman who found your daughter with severe disabilities a job and checks in on her each week, or the young man who stays home with your son with a brain injury when you go away for the weekend. Or it might be the couple with whom your brother with severe autism lives, or the roommate who shares an apartment with your daughter who cannot live independently.

They work for agencies like Easter Seals, LifeShare, Living Innovations, One Sky Futures and more than 40 others across New Hampshire. They provide the direct supports and services that help your family member with a developmental disability or acquired brain disorder live, work and take part in community. They are direct support professionals, or DSPs.

The care delivered by a DSP is second only to the involvement of the person’s family as the most important factor in the quality of life of that individual. Yet they typically toil at the lower end of the salary scale, often without health insurance or other needed benefits.

Although the recession has postponed the problem, a coming shortage of direct care workers is a demographic fact and will pose a severe challenge to the quality and availability of services in the coming two decades. Demand will increase significantly due to the aging of the population, increased life expectancies (particularly for individuals with developmental disabilities), and expansion of home and community-based services. At the same time, there will be relatively fewer people to provide these services. We are not really preparing for this.

What can be done to avert this approaching crisis? Here are three actions that are needed whether our system is operated by managed care companies or nonprofit agencies:

 • Establish a livable wage and benefit package

 • Invest seriously in training

 • Empower DSPs and home providers by valuing their judgment and including them in decision-making.

These were called for in legislation (Senate Bill 138) and have been included in preliminary budget requests from the Bureau of Developmental Services, only to be dropped when the state budget is finalized.

Under Governor Shaheen, there was a modest DSP wage increase, but that was years ago. One positive development has been the advent of online learning, and many DSPs are receiving training through the College of Direct Support or E-Learning. Participation by DSPs and home providers is a win-win proposition, but it is often challenging to adopt within existing organizational structures.

Much remains to be done. Let’s keep at it, even in this uncertain and demanding time.

Bob James is executive director of One Sky Community Services, one of New Hampshire’s 10 regional area agencies, which provide services to people with developmental disabilities and acquired brain disorders.


 

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