Direct Support Professionals Offer Their Ideas To Address Staffing Crisis for Those with IDD

/ August 15, 2023

By Robin Wilmoth

In recent times, the Department of Intellectual and Developmental Disabilities and other organizations have had many discussions about the current and future workforce situation in home and community-based services and explicitly addressing the direct support professional role.  Direct support professionals are those workers who provide the supports and care to an individual with an intellectual or developmental disability that he or she needs to live the kind of life they want. After meeting with several key stakeholder groups, DIDD and others determined that they needed to hear the voice of DSPs throughout Tennessee.  There was a proposal to begin DSP workforce advisory groups in all three of Tennessee’s grand regions, groups made up solely of DSPs.

This proposal was presented to the DIDD Programs Operations Unit under the Workforce Development Program, and the advisory groups would be facilitated by Workforce Development staff. The hope was that this work will elevate the status and value of DSPs by discussing current and ideal work environments, promoting best practices, and providing necessary knowledge and skills all within DIDD and Tennessee.  The proposal was approved, and the DSP Workforce Advisory Group initiative was formed in May 2022.

Four Major Areas of Concern

Below is a summary of the four major areas the workgroups identified as critical to advancing the role of the DSP workforce statewide as they moved forward with their work.

  1. Acknowledging the rewards of being a direct support professional
  2. Addressing the challenges of being a DSP
  3. Effective ways to enhance the role of a DSP
  4. Effective and achievable measures to improve job requirements

From these areas identified, the primary goal of these workgroups was to develop recommendations and strategies to produce outcomes that could be measurable for the DSPs, the provider agencies and to benefit and grow the role of DSPs.  These would enhance the lives of the DSPs and those with disabilities receiving services throughout Tennessee.

The Key Strategies Deemed Vital to This Workforce

  • Strive for better matchups between DSPs and the people they support.
  • Create DSP mentoring programs within provider agencies, so DSPs can enhance their skills and possibilities for advancement.
  • Focus on professional growth and acknowledgement of the DSP and the important role they play.

The final report outlines the potential benefits of each of these strategies in terms of better retention of DSPs, happier DSPs, and better satisfied individuals with disabilities, as well as potential cost savings for the provider agencies in terms of having to constantly recruit, hire and train new DSPs.

The Advisory Group was Intentionally Diverse

Medicaid Waiver provider agencies who support individuals in the old 1915c waivers were approached to participate in this project voluntarily.  Those interested submitted applications for DSPs within their agencies who they felt would be excellent advisory board members based on their work performance and abilities.  The agencies and the DSPs selected committed to getting a better understanding of and educating everyone on the valued role of the DSP, what creates a good work environment, and becoming subject matter experts on the work in this field.  The DSP representatives agreed to participate in all discussions and subsequent activities to achieve the desired outcomes.

The DSP Workforce Advisory Groups formed were composed of regional DSPs, but placing a selection emphasis on the following:

  • Cultural diversity, including diversity in age
  • Male staff, due to a predominantly female workforce
  • A mixture of short- and longer-tenured staff with one, five, 10, and 15-plus years in the field

DSP Workforce Advisory Groups were set up in East, Middle and West regions of the state.  The groups began meeting in July 2022 and ran through July 2023.  The initial focus of these workgroups was to define the role of the DSP, discuss the history of DSPs, and listen to DSPs explain, in their own words, what they felt the DSP’s role to be.

Their work is contained in the 2022-2023 DIDD DSP Workforce Advisory Group Paper.  The final work was presented to DIDD Commissioner Brad Turner on July 26, and DIDD has shared the report with Tennesseans through its weekly newsletter, Open Line, which can be found here: .

We want to offer special acknowledgment Advisory Group members and the provider agencies represented.  None of this would have been possible without their hard work, dedication, and sharing of their dreams.

2022/23 Workgroup Members:

  • Kenneth Buchannan
  • Carolyn Osbourne
  • Megan Kethley
  • Kenneth DeRossitt
  • Kim Gardner
  • Odell Elliott
  • Cheri Loftis
  • Cynthia Webb
  • Cassandra Duke
  • Eddie Fuller
  • Barbara Neal
  • Cynthia Pettigrew
  • Kim Gardner
  • Dianna Wooldridge
  • Diane Michael
  • Douglas Kinch
  • Shauna Silverheart
  • Robin Wilmoth-DIDD
  • Billy Worsham-The Arc of Tennessee

Provider Agencies:

  • Compassionate Care
  • Core Services
  • Emory Valley
  • Loving Arms
  • New Horizons
  • Pacesetters
  • Progressive Directions
  • Pauline and Thomas
  • Saint Johns
  • Sevita/D & S
  • TrueVision

I want to thank Robin for sharing this information, and I especially want to thank the direct support professionals who gave of their time and brainstorming abilities to create this plan to tackle an issue that truly does threaten our nation’s system of home- and community-based supports and services. I also very much appreciate the Medicaid Waiver provider agencies that allowed their DSPs to take part in this project. When agencies are so very short-staffed, I know it’s difficult to give these key staffers the opportunity to take time away to participate in these advisory workgroups. As the parent of a young adult who has an enormous amount of difficulty getting and keeping good staff members, I am eager to see these strategies put in place. I would encourage any of you who receive home- and community-based services or you think you may in the future to advocate with your provider agencies, your managed care organizations and your lawmakers. Let them know these efforts are so very important to you and your loved ones. If you have questions or concerns, please contact me at Thanks for reading.

Robin Wilmoth is the director of Workforce Development at DIDD. Robin has worked in the IDD field in Tennessee for more than 35 years in many capacities within DIDD and the waiver provider agency field.  She started out as a DSP in the mid 1980s and has been in her current position with DIDD since 2016.

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