Rethinking Workforce Investment, Technology and the Future of Direct Support in IDD

The direct support professional (DSP) workforce is in crisis. ANCOR's State of America's Direct Support Workforce Crisis 2025 surveyed 469 provider organizations across 48 states. According to the results, 88% of respondents reported experiencing moderate or severe staffing shortages, and 62% of providers said they had to turn away new referrals due to lack of staff. Further compounding concerns, on the subject of future programs, 52% of those surveyed said they’re considering more cuts of recruitment fails to improve. For providers serving individuals with intellectual and developmental disabilities (IDD) and autism, these numbers represent a threat to the quality, consistency and safety of care. 

At the 2025 IDD & Autism Leadership Summit, I hosted a session titled "Breaking the Status Quo" that brought together experienced IDD provider leaders to examine what's driving this crisis, what progressive organizations are doing to respond and where technology fits into a sustainable solution. 

The Weight of the DSP Role 

Jess Fenchel is Chief Operating Officer at Access Services, a Pennsylvania nonprofit serving 14 counties across urban, suburban and rural settings. She described a regulatory environment that has layered expectations onto DSPs without ever removing old ones. 

"Very rarely in our systems do we see the system go back and remove expectations as the system evolves," Fenchel said. "You don't have a lot of opportunity for creativity or innovation." She framed the full scope of the DSP role with striking clarity: "We love to know that our DSPs are operating behaviors of a nurse, a cook, a driver... but more than anything, we know the DSP is holding the most critical role, which is a primary relationship of a friend while managing these complexities." 

Lisa Pompa, National Director of Enterprise Applications at Devereux Advanced Behavioral Health, a national behavioral healthcare nonprofit serving approximately 11,000 individuals annually across 12 states, echoed the challenge. "The thing that adds that complexity is an organization that spans many states. You have different requirements in [different states]. Everyone has their standards, and oftentimes we're guided by a very old policy." 

Investing in Career Pathways Vs. Revolving Doors 

Both organizations have moved beyond surface-level retention strategies to build structured, multi-track career development programs rooted in the belief that the DSP role is a foundation of high-quality individualized care. 

Devereux developed a program called ASCEND, designed specifically to give behavioral health care workers career guidance, one-on-one coaching, financial assistance and skills development. The results have been tangible. "We now have direct care [mentors] that are our nurses, our teachers, our behavior analysts, who can come back and [coach] the staff,” Pompa shared. 

Access Services has taken a similar approach through the lens of credentialing. Fenchel described the organization's embrace of the National Association of Direct Support Professionals (NADSP) credentialing framework as a culture-wide commitment. 

"[We’re] creating a NADSP culture. It's part of our value reimbursement model here in Pennsylvania, but we don't want to just meet the minimum. We want to embrace this as a culture at Access Services," Fenchel said. "We want our DSPs to have more influence on our organization." 

Technology as a Gift to the Workforce 

A central theme of the session I hosted was the role technology can play in reducing the administrative burden that compounds DSP burnout. I shared a recent encounter I had with a residential staff member named Deborah: exceptional in her day-to-day work with individuals who had complex, pervasive needs, yet flagged by her manager as a performance concern. The reason? Her documentation was consistently poor. When asked about it directly, Deborah explained that her generation found typing long narrative notes nerve-wracking and that barrier was undermining her standing in a role where she excelled. 

"We now have technology in place that basically eliminates the need to do that," Ross noted.  

That technology is Bells Document Assistant, which Access Services has deployed to allow staff to document in their first language, receive prompts that improve note quality and reclaim time previously lost to administrative tasks. Fenchel also pointed to automated scheduling tools that reduce reliance on manual processes, improve staff-to-consumer matching and help prevent burnout from repeated shift overloads. 

"The better our data, the better our documentation, the better our risk management," Fenchel concluded. 

For Devereux, the focus has been consolidating documentation into myAvatar to eliminate the need for direct care staff to enter the same information across multiple platforms. Lisa described the downstream benefit: cleaner data that becomes an advocacy tool with funders when individuals require higher staffing ratios or additional services. 

The Horizon: Smart Homes, Predictive Analytics and Person-Centered Innovation 

The conversation moved beyond current tools to explore what's emerging. Fenchel described Access Services' plans to expand into smart home technology and she reframed how the field typically thinks about it. 

"If we can use technology to prompt individuals through routinized behaviors like ADLs, meds, etc., I think there's a lot of opportunity there to reduce the need for routinized prompting," Fenchel predicted. 

Pompa described Devereux’s exploration of privacy-preserving radar technology to monitor vitals and sleep patterns in care facilities. She also described a longer-term vision for predictive analytics that could match individuals with the right program and staffing model at the point of admission. "The data is increasing daily. We're going to be able to use [it] to have a good first, last, best placement with individuals that we serve." 

Advice for Leaders: Culture Before Technology 

As the session closed, panelists offered direct advice for leaders navigating technology investment decisions. 

Pompa’s counsel was grounded in the importance of organizational alignment. "Everyone needs to buy in from the get-go, and it's a nonnegotiable... partnering with families, partnering with siblings — to be able to have their voice in the technology as well, to make sure that the problem that we're solving is well defined." 

Fenchel framed the challenge as a discipline of change management: "It's understanding why are we doing it, who is impacted by it, what outcome are we seeking to achieve, what support does every impacted person need to fully adopt this change... You make a commitment to this digital culture, a digital infrastructure, and then you just keep building and building and opportunities come from that."