A high-quality direct support professional workforce that earns a living wage is essential to providing the necessary support and services to our constituents where they live and work. Medicaid is the primary source of funding for the programs employing these workers. The current Medicaid reimbursement system, cost-cutting actions by state legislatures and Medicaid officials, and recent strides to raise the minimum wage in several cities and states have exacerbated the workforce crisis already hampered by low wages, a lack of affordable health insurance, high turnover, and a shortage of staff. Demand for these workers from private industry and other human services sectors is also high, leading to competition among industries for workers. These problems have been compounded over three decades, leading to a crisis that presents a grave threat to the lives of our constituents and their families.

​​​Millions of people received help from family and unpaid caregivers for health and functioning reasons. These supports are critical and yet we do not have sufficient data for strategic future planning conversations and exploration of community-supported living options and employment goals when family caregivers can no longer provide adequate care.

Direct Support Professionals Priorities for the 118th Congress
  • Ensure adequate funding so that direct support professionals are paid a living wage, or as much as other jobs in the area that require the same skills (market wage), whichever is greater, including appropriate benefits;
  • Require that the Centers for Medicare and Medicaid Services (CMS) incentivize states to develop and implement a plan to address all relevant components that drive the crisis, including low wages and reimbursement rates, high turnover, and inadequate training;
  • ​​Require state reimbursement rates for services to incorporate any local, state, and federal minimum wage increases or changes in employment standards;​​​
  • ​​​​​Ensure that the Bureau of Labor Statistics and other federal agencies appropriately track data about direct support professionals by establishing a separate category for direct support professionals within the Standard Occupational Classification (SOC) Code system and in other appropriate ways; ​​     ​​  ​​     ​​
  • Ensure adequate reimbursement rates to cover services including appropriate staffing levels to ensure the provision of person-centered services;
  • Ensure financial support, including payment of wages, to provide pre-service and in-service training and other relevant educational opportunities for direct support professionals to meet the diverse needs of individuals with disabilities;
  • Implement programs aimed at the direct support labor market to increase the pool of available workers, including individuals with disabilities, and improve recruitment, retention, training, and supervision of direct care professionals to better serve individuals with disabilities, and through use of appropriate waivers or statutory changes to allow immigration of qualified workers; and
  • Ensure inexpensive and timely access by families, providers, and states to federal criminal background checks for anyone employed in the disability service system.