Incentives, Wages, and Retention Among Direct Support Professionals: National Core Indicators Staff Stability Survey

Abstract

Direct support professionals (DSPs) provide a range of supports in a variety of settings to people with intellectual and developmental disabilities (IDD) who count on these supports to live, work, and contribute in their communities. Despite this, high annual DSP turnover rates are problematic. DSP turnover is disruptive to people who receive supports as the lack of stable, reliable supports can negatively impact their important day-to-day outcomes (e.g., safety, community participation, and choice). Turnover also comes at a cost to provider organization in the hiring and training of new employees. To retain DSPs, organizations offer incentives (e.g., bonuses, retirement plans, health insurance). This study utilized National Core Indicators® (NCI®) Staff Stability Survey 2018 data to examine the relationships between wages, different types of incentives, including benefits (e.g., paid time off, access to health insurance, disability insurance, wage bonuses, health incentives programs, etc.) to annual turnover in participating states in the United States. Results indicated that incentives were not positively associated with DSP retention. Staff wages were the most notable factor associated with differences in DSP retention rates, along with the state in which the organization was located as well as organization vacancy rates.

Is paid sick leave bad for business? A systematic review

“…Fourteen of the studies included the passage of a state or local mandate as a stimulus for studying associations with PSL 12,15,16,19–21,23–28,35,42 . Outcomes were measured in terms of the individual unit of analysis except for eight studies that used the organization 16,23,24,40,41,44,47,48 and seven studies considered the region as the unit of analysis 12,19–21,26,28,35 …”

“…The most common data sources were the Medical Expenditure Panel Survey (MEPS) 22,[30][31][32][33][34] and Census sources including the Current Population Survey (CPS), 12,26 Bureau of Labor Statistics (BLS), 24,35 and American Time Use Survey (ATUS). 15,36 Additional data sources include the National Health Interview Survey (NHIS), 27,[37][38][39] National Core Indicators (NCI), 40,41 the Centers for Disease Control (CDC), 16,21,42 and The Shift Project. 25,29 Ten other panel data sources were used 16,19,20,26,28,[43][44][45][46][47] along with 12 unique data sets collected independently by the study's authors.…”

“…9,18,23,48,49 Fourteen of the studies included the passage of a state or local mandate as a stimulus for studying associations with PSL. 12,15,16,[19][20][21][23][24][25][26][27][28]35,42 Outcomes were measured in terms of the individual unit of analysis except for eight studies that used the organization 16,23,24,40,41,44,47,48 and seven studies considered the region as the unit of analysis. 12,[19][20][21]26,28,35 The following is a focused discussion of study findings with regard to the specific proximal and distal business variables.…”

“…Of the nine studies researching retention, five observed an individual unit of analysis, 18,30,46,51,52 while the remaining four investigated associations at the organizational level. 40,41,47,48 Generally, the organizational studies specified rates of turnover, whereas the individual studies focused on individual employee retention. In five studies, researchers did not establish a significant relationship between PSL and personnel turnover.…”

“…In five studies, researchers did not establish a significant relationship between PSL and personnel turnover. 40,41,[46][47][48] However one of these studies found "paid days off for other reasons" was associated with 1.98 times higher turnover for registered nurses and 6.09 times higher turnover for licensed practicing nurses. 47 Alternatively, Houseworth found that while PSL was not related to annual turnover, offering PSL had a moderate and significant association with fewer resignations within the initial 6 months of employment.…”