Thirtieth Anniversary Issue on Progress and Priorities in Direct Support

Direct Support Workforce Update communicates relevant research, policy, and practice updates to direct support professionals (DSPs) who support people with intellectual and developmental disabilities (IDD). If you have a question or topic, you’d like us to address in Direct Support Workforce Update, please email frontline-dsp@umn.edu

What guidance is there for learning about the revised NADSP Code of Ethics?

The National Alliance for Direct Support Professionals (NADSP) is excited to share that we are releasing a revised version of our flagship tool, the NADSP Code of Ethics, in June 2026.

For more than 25 years, the NADSP Code of Ethics have served as a guide for DSPs, helping them resolve the ethical dilemmas they face every day and encourage them to achieve the highest ideals of the profession.

In 2025, NADSP partnered with the University of Minnesota’s Institute on Community Integration to launch a thoughtful, rigorous, and inclusive revision process involving focus groups, validation sessions, consensus-building efforts, and more. Participants included subject matter experts, people with lived disability experience, DSPs and frontline supervisors from across the country. This comprehensive process resulted in the revised NADSP Code of Ethics.

So how does this impact you? We’re sharing some guidance and action steps for you moving forward:

• Provider organizations should endorse the revised NADSP Code of Ethics, sending a message to their employees about the importance of achieving the highest ideals of the profession.
• DSPs should adopt the NADSP Code of Ethics, by embracing it, teaching it, and integrating its tenets into your work and decision-making.
• Once released, we ask you to share the NADSP Code of Ethics with stakeholders – staff, people supported, families, etc. The next issue of Frontline Initiative will include stories on tenets of the Code of Ethics.
• We invite you to participate in our free, public webinar officially launching the revised NADSP Code of Ethics. Monthly ‘lunch and learn’ webinars will be available about each NADSP Code of Ethics tenet.

While the current version of the NADSP Code of Ethics is still publicly available, it was important to notify you ahead of the June 2026 release to plan and prepare.

What updates are there on advancing a Standard Occupational Classification for DSPs?

During the current 2026 congressional session, bills S.3211 and H.R. 6137, collectively titled the Recognizing the Role of Direct Support Professionals Act were introduced to target policy reforms aimed at strengthening how DSPs are recognized and counted within federal workforce systems.

• At the center of both bills is a directive to the Office of Management and Budget (OMB) to consider establishing a distinct occupational code for DSPs within the federal Standard Occupational Classification (SOC) system. At present, DSPs are grouped inconsistently under broader job categories such as personal care aides or home health aides, which fails to reflect the complexity and scope of their work supporting individuals with intellectual and developmental disabilities.
• The bills emphasize that DSPs play a unique and essential role in promoting independence, community inclusion, employment participation, and daily living support that differ from healthcare support occupations. By recognizing DSPs as a unique profession, we would gather more accurate data on workforce size, geographic distribution, wages, and turnover.
• A key policy feature of both bills is mandatory accountability. If OMB does not create a DSP classification during the current revision cycle, it must formally report its reasons to Congress. This provision prevents administrative inaction and preserves congressional oversight.
• Improved classification is also tied directly to workforce stabilization. The bills cite a national DSP turnover rate of approximately 39 percent. Better data would help federal and state agencies more effectively interpret labor shortages and design recruitment and retention strategies.
• Importantly, the bill is budget-neutral. This means that it does not create new programs, and does not mandate federal spending. It focuses instead on administrative improvements within existing systems.

Currently, S.3211 is at the Committee on Homeland Security and Governmental Affairs. and H.R. 6137 is at the Committee on Education and Workforce. Even though the Bills are in different committees in the Senate and House, their policy goals are fully aligned: improving workforce data, elevating the role of direct support professionals, and supporting long-term stability in home- and community-based services.

How will potential funding cuts threaten Medicaid Home and Community-Based Services?

There is growing concern about potential cuts to Medicaid Home and Community Based Services (HCBS) and what that could mean for people with disabilities, older adults, families, and the direct support workforce.

Across the country, a broad coalition of national organizations, including The Arc of the United States, ANCOR, TASH, the American Association on Intellectual and Developmental Disabilities, and Caring Across Generations, has spoken with urgency about the risks these policy proposals pose. These groups do not always agree on every issue, but they are aligned in recognizing that reductions to HCBS would cause significant harm.

This concern is also being voiced by current elected officials from both political parties in Congress and in States:

• Representative Don Bacon (Republican, NE-02), Member of Congress, has warned against making deep Medicaid cuts that would harm people who rely on the program.
• Representative David Valadao (Republican, CA-22), Member of Congress, has worked within his caucus to push back on proposals that would significantly reduce Medicaid coverage.
• Senator Patty Murray (Democrat, Washington), United States Senator, has warned that reductions in federal health funding would weaken care systems and harm vulnerable populations.
• Representative Jennifer McClellan (Democrat, VA-04), Member of Congress, has emphasized that Medicaid cuts would strain already fragile service systems and risk loss of coverage.
• Governor Josh Shapiro (Democrat, Pennsylvania) has made strengthening services for people with disabilities and the direct support workforce a clear priority, recognizing the importance of HCBS to families across the Commonwealth.
• Governor Spencer Cox (Republican, Utah) has emphasized the need to maintain access to health care coverage and ensure stability for vulnerable populations who depend on programs like Medicaid.

What stands out is the shared concern about consequences. Leaders in both parties recognize that Medicaid is not just a budget line. It is essential infrastructure for people with disabilities, older adults, and families. DSPs are already stretched thin. Workforce shortages persist, and wages remain too low. Further reductions in funding will make recruitment and retention even more difficult, putting the people we support at risk.

Families are under similar strain. Many have stepped in to fill service gaps, often at great personal cost. The idea that families can absorb even more responsibility ignores the reality that they are already doing everything they can.

What gives us some measure of hope is this: there is bipartisan recognition that the stakes are real. When leaders in both parties raise concerns about the impact of Medicaid cuts, they are pointing to the same truth. Cuts to HCBS will be felt immediately by people with IDD, older adults, families and the direct support workforce.

Learn more about what’s happening at the Institute on Community Integration, University of Minnesota, sign up for FYI.

Learn more about what’s happening at the National Alliance for Direct Support Professionals (NADSP)