Predictors of Annual and Early Separations Among Direct Support Professionals: National Core Indicators Staff Stability Survey.
Raise wages, add health insurance, and offer paid days off—those three moves cut DSP turnover best.
01Research in Context
What this study did
Anderson et al. (2020) looked at why direct support staff leave. They used the big national survey that asks agencies about wages, benefits, and open jobs.
The team studied DSPs who support people with intellectual or developmental disabilities. They asked which agency facts predict who quits each year.
What they found
Low pay, no health plan, and no paid days off all raised turnover. Agencies with more empty posts, more part-timers, and lower Medicaid dollars also lost staff faster.
In short, money and basic benefits matter most.
How this fits with other research
McQuaid et al. (2024) asked the same questions in New York four years later. They found the same pattern: pay, benefits, and good bosses keep DSPs longer.
Older studies saw the same roots but called it "burnout." Kozak et al. (2013) and Marchese et al. (2012) showed that role conflict, work-home trouble, and weak bosses wear staff down. James turns those burnout clues into clear HR targets: raise wages, add health insurance, give PTO.
Heald et al. (2020) add one twist. They show personal motives also matter: staff who work for family reasons feel less strain. So agencies should both fix pay and pick applicants with helping motives.
Why it matters
You can’t serve clients well if staff keep walking out. Use this paper in your next budget talk. Show that every extra dollar in wage, health premium, or PTO buys lower vacancy rates and better continuity for the people you serve.
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02At a glance
03Original abstract
Direct support professionals (DSPs) provide a broad range of supports in a variety of settings to people with intellectual and developmental disabilities (IDD) that enables people to live, work, and participate in their communities. Despite the crucial importance in ensuring supports for community participation of people with IDD, high rates of annual turnover among DSPs in organizations that employ them have been documented for decades. This study utilizes National Core Indicators Staff Stability data from 2016 to examine the impact of organizational- and state-level factors related to DSP turnover, including annual DSP turnover and the percentage of DSPs who left their positions after less than 6 months. At the organizational level, a higher turnover rate in the last 12 months was significantly related to lower DSP wages and to not offering health insurance. At the state level, a higher turnover rate in the last 12 months was significantly related to a lower percentage of people living in individualized settings and lower per capita Medicaid spending. For early turnover at the organizational level, a higher percent of leavers within 6 months of tenure was significantly related to not offering paid time off and health insurance, higher vacancy rates, higher proportion of part-time DSPs, and lower overall staff sizes.
Intellectual and developmental disabilities, 2020 · doi:10.1352/1934-9556-58.3.192