MENTAL RETARDATION VOLUME 41, NUMBER 4: 276–285 AUGUST 2003 276 American Association on Mental Retardation Statewide Study of the Direct Support Staff Workforce David W. Test, Claudia Flowers, Amy Hewitt, and Jill Solow Abstract Issues of recruitment and retention related to the direct support staff and how these issues affect the lives of people with developmental disabilities were investigated. Major findings included the following: (a) High direct support staff turnover and vacancy rates have negative consequences for many people who receive supports. (b) Direct support staff provide a vast array of services and have numerous job titles and job descriptions. (c) Direct support staff are inadequately compensated and often have to work more than one job. (d) Turnover rate and recruitment is a serious problem. The need to develop the role of the direct support staff into a valued profession is discussed and considerations for research and practice are provided. Challenges regarding direct support staff re- cruitment, compensation, and turnover have been documented since the inception of community sup- ports for people with disabilities (Lakin & Bruin- inks, 1981; Larson, Lakin, & Hewitt, 2002). These same problems of finding, keeping, and adequately compensating direct support staff continue to plague the community support industry today (AN- COR, 2001; Heneman & Schutt, 2001; Hewitt & Lakin, 2001). Many investigators have argued that the ability to find, train, and keep direct support staff is one of the biggest barriers to continued de- institutionalization and the ability to sustain cur- rent community supports (ANCOR, 2001; Califor- nia State Auditor, 1999; Colorado Department of Human Services, 2000; Hewitt & Lakin, 2001; Hewitt, Larson, & Lakin, 2000; Lakin & Hewitt, 2002). There are numerous factors that have influ- enced the direct support workforce. The move to community supports and services and away from in- stitutional services has greatly increased the number of people needed to provide supports to people with disabilities. For example, in June 1977, approxi- mately 40,424 people with developmental disabili- ties lived in community residential settings (places with 15 or fewer residents), whereas in 2000, the number increased to 289,143 (Prouty & Lakin, 2001). The United States economy, the labor market, and the demographic makeup of the United States are affecting the recruitment of direct support staff. Persistently low unemployment rates make it diffi- cult for community human service agencies to find people who want to take direct support positions (Colorado, 2000; Heneman & Schutt, 2001; John- ston, 1998) because people looking for jobs have many options. Direct support is a high burnout pro- fession (Jacobson & Ackerman, 1990). Burnout for direct support staff is often caused by the working hours, demands of the job, and lack of respect and societal value for this work. Varied roles and ex- pectations for direct support workers (Taylor, Brad- ley, & Warren, 1996) have also played a part in staff burnout and training difficulties. A national study regarding these issues has not been completed since 1992 (using 1990 data) (Braddock & Mitchell, 1992). Although the direct support workforce has not been studied on a na- tional level for more than a decade, the challenge with finding, keeping, and training direct support staff has been identified in several national policy efforts, including the Developmental Disability Act of 2000 (Title III, Section 204) and the New Free- dom Initiative (Centers for Medicare and Medicaid Services, 2002). In a few recent state studies, in- vestigators have gathered some data on vacancy rates, turnover, and wages of the direct support workforce. Vacancy rates reported in these studies ranged between 8% and 17% (Hewitt et al., 2000;