Why the IDD Workforce Crisis Isn’t Just About Pay

The workforce crisis in intellectual and developmental disability (IDD) services is often framed as a compensation problem. And it’s true: wages matter. For years, underfunding and stagnant reimbursement rates have left providers struggling to compete for talent in a tight labor market.

But recent evidence suggests something important and often overlooked. Pay alone does not retain Direct Support Professionals (DSPs).

Across the country, providers continue to face high turnover, persistent vacancies, and growing strain on remaining staff. Yet states and organizations experimenting with deeper workforce investments are seeing a different outcome: retention improves most when staff feel prepared, supported, and confident in their work, not just better paid.

The Limits of Wage-Only Solutions

There is no question that wage increases are necessary. However, many providers have learned the hard way that raises alone do not solve burnout. DSPs leave not only because of pay, but because the job can feel overwhelming, isolating, and unclear, especially for new staff.

When expectations are ambiguous, training is front-loaded and quickly forgotten, and support is reactive rather than proactive, even well-intentioned employees struggle. The result is a revolving door: hire, train, lose, repeat.

This cycle is costly, disruptive to care, and emotionally draining for teams and the people they support.

What the Data Is Showing

Recent workforce initiatives point to a more durable solution. In New York, the Office for People With Developmental Disabilities invested heavily in credentialing programs, structured training pathways, and professional development for DSPs. Independent evaluation showed higher job satisfaction, improved confidence, and increased retention among participating workers.

The takeaway wasn’t subtle: DSPs are more likely to stay when they understand their role, feel capable of doing it well, and see a future for themselves in the field.

This aligns with broader workforce research across “adult and disability” OR “Home and Community Based  Services (HCBS)”. Employees in demanding care roles remain longer when they receive:

• Clear expectations
  
• Ongoing skill reinforcement (Cite an example of this)
  
• Accessible guidance during real situations (what does this mean?)
  
• Recognition of professional growth
  
  

Training, in other words, is not a one-time event. It’s an ongoing condition.

Training Gaps Create Burnout

One of the most common stressors DSPs report is feeling unprepared in the moment. Situations change quickly. Individuals have unique needs. Policies exist, but aren’t always top of mind when something unexpected happens.

When staff are unsure how to respond or worry about “getting it wrong,” anxiety builds. Over time, that stress compounds into disengagement or exit.

(Many) traditional training models don’t help much here because…. Classroom sessions, manuals, and onboarding checklists fade quickly once staff are in the field. Without reinforcement, knowledge decays and confidence goes with it.

Shifting From Training Events to Training Systems

The providers seeing better workforce outcomes are reframing training altogether. Instead of treating it as something that happens before the job, they are building systems that support learning during the job.

This includes:

• Reinforcing expectations through daily workflows
  
• Making guidance easy to access at the moment it’s needed
  
• Connecting policies to real-world scenarios
  
• Reducing reliance on memory and guesswork
  
  

In practice, this means moving toward embedded training workflows that support staff continuously, not just at onboarding.

When learning is integrated into daily work, DSPs don’t feel abandoned once training ends. Service becomes muscle memory. Support skills become embedded — which directly affects retention. 

Confidence Is a Retention Strategy

Confidence is rarely discussed as a workforce metric, but it should be. 

Confident staff are more resilient, more engaged, and more likely to stay. 

Confidence comes from clarity, repetition, and support — not just experience.

For IDD providers, investing in confidence means investing in systems that help staff succeed in real time. When DSPs know where to turn for guidance, expectations are reinforced consistently, and feedback loops are clear, the work becomes more manageable.

This is especially critical as providers welcome new staff into increasingly complex care environments.

Workforce Stability Is a Care Issue

Turnover doesn’t just affect operations, it takes away from great care delivery. Frequent staff changes disrupt relationships, undermine trust, and make person-centered support harder to deliver. Stability matters to the people receiving services just as much as it matters to organizations.

That’s why workforce strategy and care quality are inseparable. Supporting staff is not separate from supporting individuals, it’s foundational to it.

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