Frontline Initiative: Making Direct Support a Career

My name is Tammy and I’ve been a Direct Support Professional (DSP) for 36 years. I live in Minnesota Senate District 45B, in a suburb of Minneapolis. I started my career working with children who had complex medical disabilities as well as developmental disabilities. Most didn’t speak and those who did only spoke a few words. All relied on wheelchairs for transportation and most needed physical assistance with every aspect of their lives. Later, I worked with adults. Some had extremely challenging, often violent, behaviors. Many had mental health conditions in addition to developmental disabilities. Over the years, I estimate I have worked with 35 people very closely and another 100 people though working in various homes and participating in trips. I became a guardian for one of the kids I first worked with. She wasn’t expected to live past her teens. Her love of life and general feistiness served her well and she died two days short of her 48th birthday.

The diverse needs of the individuals I have worked with has meant that I have needed considerable training in wide-ranging topics. Passive range of motion, seizure care, therapeutic positioning, communication and daily living cares were used daily in my first job. I also learned to replace a g-tube, med administration, postural drainage and other techniques to clear lungs. CPR and First Aid are universally required. Before starting at my current job, we had extensive training and on-going support on preventing and de-escalation of violent behaviors. There were many additional trainings on supporting people with various mental health conditions. For my role as a DSP, I have also learned about the cycle of sexual offense to help keep people from re-offending. Changing medical needs also necessitate further training. Using C-Pap machines, catheterization, sterile post-op wound care, dementia care, and end-of -life pain management are only some of those areas.

One of the biggest challenges at work in recent years has been budget cuts. Seven percent may not seem like much to a legislator, but during previous budget cuts, we had already eliminated most of the extras. When they tried to “catch us up” from previous cuts, inflation had exceeded the amount returned to us. Trying to cut 7% out of an already bare-bones food budget is impossible, especially when trying to meet federal guidelines of what people need to eat to be healthy. The providers I work for pay for many of the topical medications that are no longer covered by Medicare or insurance. The individuals we support don’t make much money. The people we support would have to do without topical medications if providers could not purchase them. I’ve gone for years at time without a raise. The raises we do get are usually one or two percent. Our health care costs go up far more than that every year. I need to work 10–20 hours of overtime per pay period to pay my bills. Due to having to care for my mom I could not work overtime for eight years. Five years later, I am still climbing my way out of $40,000 of debt with no end in sight. Almost all DSPs who I work with have a second job. One co-worker works seven days a week.

I’ve gone for years at time without a raise. The raises we do get are usually one or two percent. Our health care costs go up far more every year. I need to work 10–20 hours of overtime per pay period to pay my bills.

One of the most critical things I would like to see are wage increases that are tied to the rate of inflation. We are currently going backward. As the population ages, we will need much more training in care for people with dementia. A lot of the people with Down syndrome are only prescribed the expensive Alzheimer’s drugs because of much advocacy by their parents or guardians. When we know that there are medications that can help a person with Alzheimer's, why should they have to fight for current standard care? People with intellectual disabilities need quality care from DSPs who will hold themselves and others accountable to a high standard.