Incentives, Wages, and Retention Among Direct Support Professionals: National Core Indicators Staff Stability Survey.
Raising base pay, not adding perks, is the clearest way to keep DSPs in IDD services.
01Research in Context
What this study did
Pettingell et al. (2022) asked what keeps direct support professionals on the job. They looked at pay, bonuses, and gift cards across many US states.
The team used the National Core Indicators Staff Stability Survey. They compared who stayed and who left.
What they found
Higher base wages won. Fancy incentive packages did not cut turnover.
In plain words: skip the pizza parties and raise the hourly rate.
How this fits with other research
Friedman (2018) showed that keeping the same DSP lifts client quality of life. L et al. now show that higher wages keep DSPs around, linking money to continuity and then to better outcomes.
Austin et al. (2015) found DSP attitudes drive inclusion efforts. The new study adds wages as a second, separate lever. Use both: pay well and shape attitudes.
Bould et al. (2019) and McGonigle et al. (2014) praised practice leadership for better Active Support. Their advice still stands, but L et al. say wages come first. Fix pay, then build leadership.
Why it matters
If you run a program for adults with IDD, budget talks start with wages. A one-dollar raise beats a yearly bonus at keeping staff. Stable staff mean safer, happier clients and lower training costs. When you pitch funders or HR, lead with the wage number, not the perk list.
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02At a glance
03Original abstract
Direct support professionals (DSPs) provide a range of supports in a variety of settings to people with intellectual and developmental disabilities (IDD) who count on these supports to live, work, and contribute in their communities. Despite this, high annual DSP turnover rates are problematic. DSP turnover is disruptive to people who receive supports as the lack of stable, reliable supports can negatively impact their important day-to-day outcomes (e.g., safety, community participation, and choice). Turnover also comes at a cost to provider organization in the hiring and training of new employees. To retain DSPs, organizations offer incentives (e.g., bonuses, retirement plans, health insurance). This study utilized National Core Indicators® (NCI®) Staff Stability Survey 2018 data to examine the relationships between wages, different types of incentives, including benefits (e.g., paid time off, access to health insurance, disability insurance, wage bonuses, health incentives programs, etc.) to annual turnover in participating states in the United States. Results indicated that incentives were not positively associated with DSP retention. Staff wages were the most notable factor associated with differences in DSP retention rates, along with the state in which the organization was located as well as organization vacancy rates.
Intellectual and developmental disabilities, 2022 · doi:10.1093/geront/gnp027