On the Backs of Workers


Video: Invaluable: The Unrecognized Profession of Direct Support1

“We were able to deinstitutionalize and provide opportunities for people with disabilities to live in the community on the backs of the workers. We willingly planned and implemented community supports with staff who were being paid less, who had access to less stability, fewer benefits. We did that because of a good thing. We wanted people with disabilities to live in the community, but the way we could afford it was on the backs of the worker and we’ve never caught up, we’ve never caught up.” – Amy Hewitt, Director, Institute on Community Integration University of Minnesota.

The direct support workforce is large and one of the highest-demanded and anticipated growth areas in the U.S. No matter how much DSPs might love their jobs, they need to be able to support themselves and their families. Low wages and lack of affordable benefits are universally identified by agencies, DSPs, and people who receive supports as the most significant issue.2 The following data about the workforce represents 20 states that participated in the 2018 NCI Staff Stability survey:

In addition to low wages and lack of affordable benefits, career pathways rarely exist for DSPs. There are no required credentials that ensure DSPs have met the knowledge requirements and demonstrated proficiency in skills needed for the job, nor to certify a person’s commitment to the profession. With few opportunities for growth and development there’s little increased earning potential, and many DSPs leave the profession.2

What can we do to fix this crisis?

Invaluable: The Unrecognized Profession of Direct Support is a documentary film by he Institute on Community Integration, University of Minnesota exploring the underappreciated and underfunded work of direct support professionals (DSPs), the people who support individuals with intellectual and developmental disabilities in living full lives as members of their communities. Through stories and interviews with DSPs, family members, advocates, and people with disabilities from across the country, the film honors the complexity of the work and the immense value it provides to individuals receiving support. And it asks us to take action now in strengthening the DSP workforce before the system collapses. Read more about “Invaluable” here.


  1. Invaluable: The Unrecognized Profession of Direct Support. Directed by Jerry Smith. Institute on Community Integration, University of Minnesota, 2019. https://ici.umn.edu/product/invaluable/main
  2. Hewitt, Amy; Macbeth, Joe; and Kleist, Barbara. “The Direct Support Workforce Crisis: A Systematic Failure.” Impact, Volume 31, Number 1, https://ici.umn.edu/products/impact/311/Systemic-Failure/#Systemic-Failure. Accessed September 1, 2019.


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