Workforce Crisis: Direct Support Workforce

There is a workforce shortage crisis in Massachusetts for Direct Support Workforce, including home care workers, personal care attendants (PCAs), and direct support professionals (DSPs), that support individuals with intellectual and developmental disabilities (IDD) and autism in the Commonwealth.

Solutions to the workforce crisis are critical to ensuring that people with IDD and autism can safely live, work, and contribute to their communities.

Frequently Asked Questions (FAQs)

What is the problem?

  • 72% of Massachusetts human service providers report that it has become increasingly more challenging to fill job openings over the past three years.
  • A National 2017 survey of family caregivers reported that 9 out of 10 (92%) caregivers indicated difficulty with finding DSPs.
  • There is an approximate 43% national turnover rate annually for DSPs, and the average national wage is less than $11/ hour, making it difficult to provide continuity in services, provide a family-sustaining wage, and threatening the quality of care for people with disabilities.

Why is this happening?

Challenges and other key factors negatively impacting the retention and recruitment of the direct support workforce are not limited to the following:

  • Mean wages of DSPs are below janitors
  • Poor benefits and limited training/education opportunities
  • COVID-19 pandemic impact
  • High student loans
  • High cost of living/low unemployment rates in Massachusetts
  • Increase in incidence rates of Autism Spectrum Disorder and people with IDD are living longer
  • Poor status/image (unlike teachers/police officers/nurses)

What is at stake?

The work that the direct support workforce does is invaluable to the IDD community, serving as the linchpin to successfully live the independent life they choose in their communities with the proper supports.

Each year, about 1,300 individuals with intellectual and developmental disabilities turn 22, aging out of the school system and into adult services in Massachusetts.

We can prevent people with disabilities from entering costly, restrictive, and often segregated institutional settings if support staff members are successfully recruited, professionally trained and retained.

What can we do to end the Workforce Crisis?

To recruit and retain a stronger, more qualified direct support workforce, we ask for a goal of achieving $24/hour for direct support staff by 2025. Increased salaries for front-line managers and other experienced or mid-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 direct support workforce shortage.

What does the Direct Support Worker 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 are not limited to) assisting people with IDD 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 safely and make use of resources such as transportation and medical services.

Important Workforce Documents

Most Recent Documents

American Rescue Plan Act

On July 20, 2021, The Arc provided testimony at the Joint Hearing on the American Rescue Plan Act (ARPA) Funding.

Better Care Better Jobs Act

On July 25, 2021, The Arc and undersigned organizations and individuals released a letter urging the Massachusetts Congressional Delegation to support the Better Care Better Jobs Act.

Home and Community-Based Services

On August 16, 2021, Ellen Taverna, The Arc’s Director of Public Policy,  testified at an EOHHS virtual hearing regarding workforce rates for certain Home and Community-Based Services (HCBS), related to Section 9817 of the American Rescue Plan Act.

The Arc’s September 2021 Statement

Here is The Arc’s September 2021 statement on the COVID-19 pandemic that puts forth recommendations regarding COVID-19 vaccinations, testing, and infection control efforts.


Workforce Initiative Contacts

Leo Sarkissian

Executive Director
(781) 891-6270 x106

Maura Sullivan

Senior Director of Government Affairs and Health Policy
(781) 891-6270 x113

Charlie Fiske

Government Relations Specialist
(781) 891-6270 x111

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