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We are Not the 'Forgotten Front-line;' We're Overlooked

You may have heard the Direct Support Professional (DSP) workforce referred to as the “forgotten front-line” of the COVID-19 pandemic. A DSP is someone who works directly with people who have intellectual or developmental disabilities. To say they work directly with people with disabilities is to drastically under-state the scope of their profession. Their work helps individuals with disabilities remain safe, healthy and independent in their homes.

In short, DSPs aim to assist people in realizing their full potential. They help people become integrated and engaged in their community while developing the skills necessary to be as independent as possible when performing activities of daily living, such as showering, bathing, toileting or feeding, with lower-functioning individuals. With higher-functioning individuals, they might teach daily living skills, such as cooking, cleaning and shopping, or provide job readiness training. They deal with the behaviors, struggles and everyday challenges of those they serve. DSPs also care for the individuals like they are family, creating innovative solutions to their issues and celebrating their successes. They drive individuals to appointments, administer medication, help them make friends and assist them in interacting with community members.

To refer to DSPs are the “forgotten front-line” would imply that at one time DSPs were recognized as essential service providers. They have not been forgotten; they have been overlooked. The Department of Labor does not categorize DSPs as health-care workers. When PPE gear was issued to essential workers, DSPs were very low on the list, despite the fact they work with a medically fragile, vulnerable population. DSP work is not glamorous, well-recognized or highly paid. Nearly all the services provided by DSPs are funded through Medicaid with very little third party or private pay funds. Supports and services are lifelong and are provided 24 hours a day, 7 days a week, 365 days a year. We cannot afford to overlook DSPs any longer.

The Iowa Association of Community Providers represents over 130 community-based organizations, employing more than 30,000 employees in Iowa who offer community-based mental health and disability services. Those organizations, of which Nishna Productions, Inc. is one, support more than 160,000 Iowans in need of mental health and disability services. Services are provided in all 99 counties and contribute annually $1.3 billion to Iowa’s economy. We cannot afford to overlook DSPs any longer.

DSP turnover has nearly doubled in Iowa since 2015 (August 2019, IACP survey). The most common factors are low wages, few opportunities for advancement and no performance-based incentives. Combined with longer life expectancies, higher levels of needs, and growth in the population of individuals with disabilities means that there is a higher demand for a population of workers that is already experience a shortage. We cannot afford to overlook DSPs.

Community providers and their staff need policies and funding systems that recognize, reward and incentivizes the work they do. If changes are not made, the DSP work force crisis will continue to grow unchecked.

Please add your voice to ours as we plead with our legislators to look at us. Look at the individuals we serve. Look at the staff caring for them. Look at the antiquated reimbursement rates and lack of recognition DSPs face.

Write to your legislators. Share your stories and why agencies like Nishna Productions, Inc. are so vital to the communities they serve and the individuals they care for.

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