Direct Support Workforce

The Center for Medicaid and CHIP Services (CMCS) has released an Informational Bulletin stressing the pivotal role of worker registries in mitigating the nationwide shortage of direct support workers, particularly within Medicaid-covered home and community-based services (HCBS). The bulletin underscores that these registries, serving as a vital link between service recipients and qualified workers, can significantly improve beneficiary access to essential services. Emphasizing the importance of balancing safety concerns with beneficiary choice, CMS encourages states to educate both workers and beneficiaries about the voluntary or mandatory nature of registry participation....

This report describes the current state of the direct support professionals (DSP) workforce as a crisis. DSPs promote participation in the U.S. economy, and yet the average DSP wage is $10.72, most work two or three jobs, and the average annual DSP turnover rate is 45%. This report explores how these issues affect individuals, families, and human services systems; the factors that contribute to these issues; and promising practices to strengthen the direct support workforce.