Challenges of Direct Support

The New York State Office for People With Developmental Disabilities (OPWDD) and the New York Alliance for Inclusion & Innovation, in partnership with the McSilver Institute for Poverty Policy and Research at New York University, initiated a Workforce Recruitment/Retention Technical Assistance project in collaboration with New York State providers to identify, share, and create resources and tools that can be used in recruitment and retention efforts. Data was collected from providers through an organizational self-assessment (OSA) and directly from direct support professionals through a DSP questionnaire. 

The OSA’s purpose is to support providers and help them understand areas of strength and opportunities across multiple domains related to workforce recruitment and retention. The responses from 125 organizations and 3,135 DSPs underscore organizations’ multifaceted challenges in human services, ranging from staffing shortages and regulatory constraints to the need for competitive wages and comprehensive retention strategies.

Worker Voice and Equity Graph

Highlights from the OSA Aggregate Report

  1. HCBS Waiver Settings Rule: The HCBS Waiver settings rule is seen as a significant challenge due to staffing crises, and organizations seek regulatory relief to address this issue.
  2. Applicant Pool Shortage: There is a notable shortage in the applicant pool for positions, making recruitment challenging.
  3. Service Expansion: Some organizations provide services under multiple departments (OPWDD, OMH, OASAS), indicating the complexity of their operations.
  4. Complex Needs of Individuals Served: The individuals being served have increasingly complex needs, adding to the challenges faced by service providers.
  5. Wage Issues: Inconsistent cost-of-living adjustments have been observed, and wage increases must be implemented flexibly to address recruitment and retention challenges.
  6. Historical Wage Disparities: There is a significant gap between minimum and actual wages in the field, emphasizing the need for increased compensation.
  7. Regulatory Constraints: Regulations, protective oversight, and staffing shortages limit providers’ ability to implement effective workforce retention strategies.
  8. Diversity and Inclusion Initiatives: Several organizations have committees focusing on diversity, equity, and inclusion, reflecting a commitment to creating an inclusive work environment.
  9. Retention Efforts: Organizations employ monthly all-staff calls, open office hours with the CEO, and recognition programs to improve retention.
  10. Training and Career Development: Efforts are made to enhance training and career development opportunities, focusing on attracting and retaining quality staff.
  11. Communication and Engagement: Organizations are actively working on improving communication with staff, implementing engagement initiatives, and addressing turnover issues.
  12. Challenges in Talent Acquisition: Recruiting DSPs remains a significant challenge, with factors like low pay rates and competition from other industries contributing to difficulties in finding and retaining qualified staff.
  13. Community Engagement: Some organizations actively engage with the community through events, flyers, and community involvement to recruit quality staff.
  14. Data Utilization: Some organizations use data to understand employee turnover and retention better.
  15. Pay Parity Challenges: Pay parity with state DSP workforces is a major challenge, especially given increased competition from other employers.
  16. Employee Recognition: Recognition programs, retention bonuses, and other incentives are employed to show appreciation for employees and improve retention.
  17. Adaptability and Innovation: Organizations highlight the importance of adapting practices, innovating recruitment and retention strategies, and focusing on employee feedback.
  18. Competing with State Wages: There is a need for proper reimbursement for wages to compete with state-operated sites and address turnover challenges.
  19. Professional Recognition: Direct support is a true profession that needs to be recognized and provided with funds and training opportunities.