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.