GoodLife U Episode 1: The National DSP Crisis

by Staff at GoodLife Innovations, Inc.

We are kicking off the new year with a new GoodLife U video blog and podcast series with Dr. Mike Strouse and a discussion about the national workforce crisis. Realistically, this crisis isn’t new – we’ve watched it ebb and flow across the years. But this season feels a little different, and in many ways we are facing some unprecedented challenges.

In the past, when unemployment is high we’ve had a bigger pool of direct support professionals (DSPs) to hire. Currently, unemployment rates are high — nearing or exceeding 7% in some states — and yet our best efforts at recruiting DSPs continue to fall short.

There are a lot of factors at play including the economy, minimum wage expectations and especially COVID-19, which taught us the importance of focusing on reducing the number of different people involved in care in order to keep those we serve safe. In fact, almost overnight this became a new industry standard for measuring organizational stability, effectively replacing discussions about turnover. This response to COVID-19 led to a pivot that was necessary and important. However, there are still barriers to overcome.

Nationally, the turnover rate for DSPs is more than 40%, with some states seeing rates as high as 65% and, in addition to this, vacancy rates are at about 18%. This means that of the DSP positions available, 18% of them are vacant — but the most disturbing part of this is that 31% of the positions are part-time, which have disproportionately higher turnover and vacancy rates.

It’s hard to make a case for a national approach to care where only 69% of the workforce is full-time. Why? Because nothing increases the number of different people involved in care more than having a high percentage of part-time caregivers, especially when part-time turnover and vacancies are greater.

And there’s more. These rates are reflective of ALL services, including traditional day services, which are almost exclusively full-time, 9-5, M-F. Residential services disproportionately fill in the gaps in the mornings, evenings, and on the weekends. So it’s common for residential services to have as many as half of their positions be part-time. Due to COVID-19, most full-time, classical day services closed, and all of the factors that contribute to instability came into the spotlight.

However, focusing on turnover alone is a bad idea. GoodLife U is designed to help us explore all of the different issues that impact reducing the number of different people involved in care. This means that turnover, vacancies, call-offs, scheduling, training, replacement strategies, and more need to be considered.

There’s no single solution. Instead, think of the solution as a portfolio where each presents an opportunity to harvest some low-hanging fruit, and offers an opportunity to change. We are going to take a deeper dive into these (and other) factors across the GoodLife U Video Blog and Podcast series:

1. Considerations for Day Services. We discuss how we should approach and deliver truly inclusive, community-based care where individuals don’t have to divide their life between “day” and “residential” services. To offer meaningful, choice-driven, integrated lives for those served, it’s time to consider some alternatives.
2. Expansion of Shared-Living models. The number of different people involved in care is extremely low, which allows for lives to be joined within a home where care is organically delivered.
3. Neighborhood Support Models. This offers a necessary movement away from group homes. We want individualized services yes, but not fractionalized care due to schedule limitations within isolated settings. Instead, we will discuss live-near, live-by, live-with care strategies that allow needs within a neighborhood to be supported by full-time, professional caregivers.
4. Embracing technology. This will allow support to be delivered on-demand across the day, flowing in the way that life organically unfolds. With GoodLife U, we are going to work together to make a big dent in the instability of how services are delivered and you’re invited! We are eager to collaborate with you, share what we’ve learned, and discuss solutions that are proven to make a meaningful difference in the lives of those we serve–and also in the lives of the DSPs who deliver care.