DSPs describe upper level management as managers who work primarily offsite from the locations where DSPs support individuals with I/DD. It includes management and administration up to the level of the CEO. Upper management excludes frontline supervisors and program coordinators or house managers.

Great question! The people who DSPs identify as “the uppers” likely include some members of middle management. However, upper-level management constructs the ethos of an agency - it provides the foundations for organizational support - while middle management conveys that ethos. These workshops are designed to change minds by introducing new ways of thinking about the workforce and the individuals in it. Upper-level management has the influence to change thinking and practice all the way through an agency by modeling supportive behavior.

Support is not defined in the survey. Extensive responses to open-ended survey questions from DSPs and FLSs offer insight into what constitutes supportive practices and policies and how feeling unsupported drives workers out of the human services sector. Support can be organizational and/or interpersonal. 

Organizational support is experienced as the ways in which an organization demonstrates that it values workers’ contributions and cares about their well-being (Eisenberger et al., 1986; Eisenberger et al., 2002). Value can be expressed through appreciation but perhaps the most critical expression of value is respect. Recognizing DSPs as whole people, as human beings with valued, complex lives that include - but are in no way limited to - their role as a DSP.

Interpersonal support from management includes behaviors like showing personal concern, giving attention to subordinates, and regularly offering assistance. Staff and direct care workers describe supportive working conditions as a choice of schedule, good communication, and leaders who are willing to step in (Karmacharya et al., 2023). Empathetic, diverse leaders who can relate to the lived experiences of employees are more likely to provide interpersonal support and may take those experiences into consideration in developing organizational policies.

A sustainable entity - a household, agency, or sector - has the resources and capacity to maintain its existence. In a sustainable household, household members do not experience food or housing insecurity. A sustainable agency relies on DSPs who have sustainable households. These agencies have adequate staffing to meet the needs of those it serves and adequate revenue to pay those who deliver care, maintain operations and infrastructure, and satisfy reporting/administrative obligations. A sustainable sector depends on having sustainable agencies. As a whole, the I/DD sector requires a stable, skilled workforce and state infrastructure that supports the workforce and agency operations; one that processes claims quickly and implements regulations that are clear and purposeful.

The workshops take inspiration from the Moving Mountains awards that reward non-instrumental efforts to make working conditions better for DSPs. DSPs have intrinsic value as human beings. Employers should focus on the well-being of DSPs not merely because it is fundamental to their business model and is in their interest but because all people deserve to be recognized as human beings with complex, valuable lives outside of paid work. 

To do otherwise is dehumanizing. A DSP captures this sentiment clearly, saying that DSPs want to feel “…as if we were somebody and not just a body…” (Johnson et al., 2021). Many people in this sector have fought against the dehumanization of people with I/DD; the dehumanization of the workers, mostly women of color, who support people with I/DD cannot be the cost of community integration.

Probably—but not on their own! Internalizing the information shared in the workshops is likely to change behavior and practices. Over(?) 85% of the DSPs who responded to the survey were “very satisfied” or “satisfied” with the work they do, but even those who love the work may leave an employer if working conditions are poor. Working conditions include pay, support, and other factors. If the pay is low enough that DSPs and their families experience food or housing insecurity, it would be difficult to begrudge a DSP for moving on—in fact, it is very likely that DSPs who are satisfied with the work but can’t get by feel like they are being pushed out of a job they largely enjoy. Employers have complete control over the support they offer and some of the most valuable—respect and better, more thoughtful communication—are free.

Some research with direct care workers suggests that turnover and retention have different drivers (Vittal, Rosen, & Leana 2009): 

Factors associated with turnover:

• lack of respect

• inadequate management

• work or family conflicts

• difficulty of the work

• job openings.

Factors associated with retention:

• being “called” to service (internal satisfaction), patient advocacy (provide effective support)

• personal relationships with residents

• religion or spirituality

• haven from home problems

• flexibility (autonomy)

Because so many DSPs are satisfied with the work—85%!—we know that employers have the workforce they want—so reducing turnover and improving retention are both key. Factors contributing to turnover that we will address include respect and support from management. We will also discuss factors contributing to retention: enhancing internal satisfaction and efficacy, fostering relationships, work as a haven from ‘home problems,’ and flexibility.