Workforce Initiative

Workforce Crisis: Direct Support Professionals & Front-Line Managers

There is a workforce shortage crisis in Massachusetts for Direct Support Professionals (DSP) and frontline managers. This crisis affects in-home workers for families and individuals with intellectual and developmental disabilities (I/DD) along with the entire human services system of care in the Commonwealth. Solutions to the workforce crisis are critical to ensuring that people with I/DD can live, work, and contribute in their communities.

72% of Massachusetts human service providers report that it has become increasingly more challenging to fill job openings over the past three years.

National 2017 survey of family caregivers reported that 9 out of 10 (92%) caregivers indicated difficulty with finding DSPs.

What Can We Do to End the Workforce Crisis?

To recruit and retain a stronger, more qualified DSP and managerial workforce, we ask that a minimum $17/hour prevailing required wage should be implemented for entry level direct care or support staff.  This should be reviewed every two years for marketplace adjustments with a goal of achieving $24/hour for direct care/support staff by 2025. Increased salaries for front-line managers and other experienced or middle-level managing human services workers, not including executive level staff, should also be adjusted based on salary compression.

We also request the Executive Office of Health and Human Services implement a long-term plan to address the human services workforce shortage.

What DSPs and Frontline Managers Do

DSPs could have many different titles including direct support specialist, personal care assistant, habilitation specialist, job coach, residential counselor, family care provider, personal assistant, and others. Direct Support roles include (but not limited to) assisting people with I/DD with activities of daily living such as dressing, toileting, medication administration, or mobility and addressing medical emergencies or behavioral crises.  DSPs also serve as bridge builders to the community so that individuals can be employed, participate in community social activities and make use of resources such as transportation and medical services.

In agency programs (employment, residential, etc.), Frontline Managers oversee DSPs and ensure a coordinated approach to supporting individuals’ goals and activities.  In the case of assistance provided in an individual’s home (self-direction, family support, etc.), they may be responsible for the development of personalized plans and helping recruit DSPs through matching skills with needs or goals.

DSP Workforce Challenges and Other Key Factors

These Workforce challenges and other key factors negatively impact the retention and recruitment of DSPs and frontline managers.

  • Mean wages of DSPs are below Janitors

  • Poor benefits and limited training/education opportunities

  • High student loans

  • High cost of living/low unemployment rates in Massachusetts

  • Increase in incidence rates of Autism Spectrum Disorder and people with I/DD are living longer

  • Immigration (H1-B Program) concerns impact hiring

  • Poor status/image (unlike teachers/police officers/nurses)


Leo Sarkissian
Executive Director
(781) 891-6270 x106

Ellen Taverna
Policy Officer
(781) 891-6270 x112

Maura Sullivan
Director of Government Affairs
(781) 891-6270 x113

Charlie Fiske
Director of Public Policy
(781) 891-6270 x111


The Arc of Massachusetts Workforce Initiative Whitepaper

Appendix A: Addressing the Lack of Specialists and Clinical Teams

Appendix B: Investment and Innovation Dollars Impact

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