Crisis of Care by the Numbers
the number of trained Direct Support Professionals who leave the industry each year.
1 in 5 Positions Unfilled
Services provided 24 hours a day 365 days a year. No way to shut our lobby or reduce hours.
The work of a Direct Support Professional is a complex job. It is not low-wage work. DSPs provide care for people who have some of the most significant needs in our society. They provide this care in the most intimate aspects of people’s lives. They teach complicated skills, support with challenging behaviors, and assist with complex medical and medication needs. This is not a low-wage, low skilled, low responsibility job. We trust these people to keep the individuals they serve and the community safe. It is a job whose compensations should AT LEAST exceed the compensation of jobs in fast food, warehousing, hospitality, and other industries with low-skill, entry-level positions.
The chart above illustrates the alarming turnover rate among caregivers across the DSDP service system. The blue and orange lines show how turnover decreased dramatically in the years following large funding increases from the state (which resulted in pay increases for caregivers). And, the trends show that when labor rates increase but funding doesn't keep pace, turnover increased significantly.
Most industries consider annual turnover greater than 20% to be concerning. Our industry's best year was 42% in 2017 following helpful increases from legislators. Annual turnover is now 92%. This is alarming and totally unsustainable. People with disabilities are struggling to develop connections with their caregivers because caregivers are not staying long enough to understand their needs.
The chart on the left shows that right now, 1 in every 5 positions in the DSPD private provider system is vacant. That’s 20%!!
This 20% caregiver vacancy rate is even more alarming when you consider that residential providers are not in a position to reduce hours. People with disabilities do not suddenly have fewer needs because caregivers are not available to help them.
The ONLY option is for caregivers who are choosing to stay (the remaining 80%) to work even longer hours. The system would have already imploded if it weren't for caring DSPs who are placing people over their personal lives. And they are doing it at a tremendous personal cost.
The chart on the right shows that of those caregivers who are leaving, two thirds are leaving within the first 6 months. This is terrible for continuity of care for people with disabilities. Those staff who do remain are burnout and frequently consider whether they too should leave the industry.
This chart shows just how far behind DSPD caregiver wages are compared to other industries. And the trend from 2020 to 2021 shows that the problem is getting worse.
The bottom blue line shows average starting wages for entry-level caregivers in the DSPD caregiver system over time.
The red line shows overall average wages for caregivers in the DSPD system. This red line INCLUDES higher paid front-line supervisor positions.
The rest of the lines show overall average wages for NON-SUPERVISORY positions in other industries.
People with disabilities in Utah deserve highly skilled, well trained, and fairly compensated caregivers.
This chart compares wage projections for the DSPD caregivers system and the retail industry.
With no increase in rates from DHS or appropriations from the Utah legislature, caregiver wages will fall even further behind what people can expect to make if they get a job working at Walmart or Wendy’s.
Urgent and significant increases in funding are NECESSARY to keep wages even in the ballpark (on the low end) of being competitive with the broader labor market.
Support Coordinators in the DSPD service system are independent caseworkers who help individuals with disabilities and their families to access services with DSPD and private providers.
According to a survey conducted by DSPD, independent Support Coordinators report that this crisis is getting A LOT worse:
Almost 100% of Support Coordinators report that DSPs working to the point of exhaustion is getting worse in the past 6 months.
Almost all individuals served are having their choices and community access limited.
Over 88% of Support Coordinators report that lack of staffing is leading to profound health and safety concerns.
This data is perhaps the most alarming and concerning.
People are being displaced.
People are losing their services.
Programs are closing.
Individuals who are new to services and have come off the years-long DSPD waiting list for funding are now unable to access services they need.
75 individuals -- 3% of clients represented in the sample -- have already lost their residential placements and have been discharged to their families, institutional placements, or homelessness.
Data presented here comes from five sources:
1.The Utah Department of Human Services DSPD Direct Care Staff Increase Report. This report was provided by DSPD to the Office of Legislative Fiscal Analyst on August 31, 2020. It summarizes data compiled and verified by DSPD based on appropriation reports from the ten largest DSPD providers from January 1, 2014 through December 31, 2019.
2.The DSPD Direct Support Provider Survey conducted in January 2022. This survey went to all current independent Support Coordinators in the DSPD system. With a Support Coordinator response rate of 52% representing 64% of all DSPD clients. The full survey report can be accessed on the updates page of this website.
3.The Utah Association of Community Services (UACS) provider surveys conducted in 2021. UACS represents dozens of providers in the DSPD service system, comprising a large majority of all services delivered by providers in the DSPD services system. This survey data represents a large sample of providers who responded to the UACS surveys.
4.US Bureau of Labor Statistics average hourly earnings in July of each year of all employees on private, nonfarm payrolls by industry sector, seasonally adjusted.
5.Advertised wages on Indeed.com as of January 24, 2022.