Frontline Initiative: Making Direct Support a Career

The code for a Certified Nursing Assistant is 31-1014. The code for a Home Health Aide is 31-1121. The code for a Personal Care Aide is 31-1122. But these six digits aren’t just numbers. These codes unlock endless information and very practical possibilities for those who have pursued that career. So how does this relate to direct support professionals (DSPs)?

DSPs don’t have one. They work anonymously.

Standard Occupational Classifications

The Standard Occupational Classification (SOC) system is used by federal agencies to classify workers into occupational categories. With the insight gathered through an SOC code, governmental agencies, individual organizations, and everyday citizens can uncover otherwise unavailable information about that occupation. How do wages in the occupation compare with similar industries? What are future employment trends? How are issues in our society affecting employees? The answers to these questions will affect your work, your career, and the quality of lives for people you support.

As DSPs face increasing demands and piling job responsibilities – despite inadequate wages and insufficient recognition – they need acknowledgement at the federal level to make dramatic and overdue changes happen. An SOC code can be used to set reimbursement rates for services that compensate DSPs. It can also improve data analysis of staff turnover and shortages. An SOC code can demonstrate the contributions of your occupation.

Although people with intellectual and developmental disabilities (IDD) are often referred to as the “most vulnerable” in our population, many today are fully participating members of their communities, living in integrated settings and seeking meaningful employment. Much of this progress can be attributed to the tireless work of roughly 1.3 million DSPs. DSPs wear numerous hats. You provide medical support and advance community inclusion. You facilitate services and provide emotional support. You ensure health and safety, and much, much more. Despite this unique and critical skill set, DSPs receive an average hourly wage well below the federal poverty level for a family of four.

Many people with IDD today are fully participating members of their communities, living in integrated settings and seeking meaningful employment. Much of this progress can be attributed to the tireless work of roughly 1.3 million DSPs. Despite this unique and critical skill set, DSPs receive an average hourly wage well below the federal poverty level for a family of four.

The impact of not having an SOC code

Currently, DSPs are misclassified in labor reports as personal care assistants or home health aides. These job classifications do not adequately represent the skill requirements of a DSP. To confront this, the National Alliance for Direct Support Professionals (NADSP) is leading a nationwide effort to establish a direct support professional standard occupational code. The NADSP has built an on-line petition via change.org that currently has nearly 19,000 signatures to share with the US Office of Management and Budget, demanding that the office Establish a Direct Support Professional Standard Occupational Classification. We ask you to join us in taking a bold stance, advocating as one, and banding together under this nationwide initiative for a professional identity because DSPs should not have to work anonymously anymore.

Although it may not be easy to spot, the lack of an SOC code has important consequences:

• Negative Implications for Service Reimbursement Rates. When states do not have a system of classifying the roles of direct support professionals, they struggle to set appropriate reimbursement rates for services. These reimbursement rates impact what DSPs are paid.
• Lack of Data for Identifying Workforce Shortages. Without a standard occupational code, there is no real measure for identifying staffing needs, gaps in services, and risks for cessation of services. The SOC can provide information to inform decision makers about how many staff are needed and where shortages exist. This will lead to developing long-lasting approaches to address the workforce crisis.
• Devaluation of the Workforce. Despite the fact that a DSP's work requires complex skills, thoughtful compassion, diverse care, and deep medical knowledge, there is a failure to identify this position on the scale it deserves. A SOC would create understanding of both the contributions and the struggles of the workforce. This will help the workforce to get the recognition it deserves.

Next steps to establish a SOC

In March of this year, U.S. Senators Maggie Hassan (D-NH) and Susan Collins (R-ME) introduced bipartisan legislation to address the critical need for more DSPs in the workforce. The Recognizing the Role of Direct Support Professionals Act would revise the Bureau of Labor Statistics’ classification system. It would include the title of “Direct Support Professional.” It would ensure clearly defined job duties, training requirements, and better data on the pressing workforce challenges.

While getting approval for an SOC code will not be easy to do, nor solve every challenge facing DSPs, it is a critical step towards ensuring that our workforce receives the professional recognition that it deserves. The NADSP is monitoring this issue closely and we have begun to build a coalition of direct support professionals, the provider community and other advocates to address this as the number one issue facing the direct support workforce. Earlier this year, the NADSP established a Direct Support Professional Advisory Council that includes 12 DSP leaders to help us share information, build momentum and get more DSPs to become more involved in public policy and advocacy