Thirtieth Anniversary Issue on Progress and Priorities in Direct Support

For three decades, Frontline Initiative has documented, amplified, and reflected the voices of direct support professionals. Over that same period, the National Alliance for Direct Support Professionals (NADSP) has worked alongside our colleagues from the University of Minnesota’s Institute on Community Integration to shape a profession that is rooted in values, skills, and advocacy. As Frontline Initiative celebrates its 30‑year anniversary, I think it’s appropriate to take a closer look at the organization that helped make this publication and a national movement possible.

The NADSP was founded in 1996, during a period of major transformation in disability services. Across the country, states were accelerating the shift away from institutional models toward a community-based, person-centered support system. During this shift, direct support work was becoming more complex, but those doing the work remained largely invisible, under-compensated, and undervalued.

Joseph M. Macbeth

We emerged from a simple but powerful premise from the report to President Clinton by the President’s Committee for People with Intellectual Disabilities (PCPID). The report was one of the first to formally identify and communicate the impending workforce crisis to government. In it, the PCPID shared the idea that “Quality is defined at the point of interaction between the staff member and the individual with a developmental disability.” That quote, often attributed to John F. Kennedy, Jr., who was a member of the PCPID and an early ideological influence on the NADSP, placed direct support professionals at the center of quality, ethics, and outcomes for those who receive services.

Defining the Profession

From the start, the NADSP was an advocacy organization and a professional home where direct support professionals could define who they are, what they stand for, and what they need to perform their work. One of NADSP’s earliest and most enduring accomplishments was the development of our Code of Ethics . Beginning in 2000, direct support professionals from across the country, along with self-advocates, families, and researchers, came together to articulate the ethical foundations of the direct support practice. The Code, first released in 2001, laid out nine tenets that continue to guide direct support practice today. Tenets include person-centered supports, advocacy, integrity, and community inclusion.

The Code of Ethics did something revolutionary. Its’ premise is that direct support requires an ethical, values-driven profession, not just what an organization believes to be right or wrong. It also became a common language and a road map that remains one of the most widely used ethical frameworks in the disability field.

The NADSP also played a central role in advancing national workforce standards. We worked in collaboration with the U.S. Department of Labor to align direct support roles with nationally validated Community Support Skill Standards. It contributed to the first federal apprenticeship standards for direct support professionals in 2009.

Over the years, direct support professionals have embraced the NADSP for various reasons, often shaped by the challenges and opportunities of the time. In the early years, much of our energy centered on visibility and identity, which asked the system to see our work as a highly skilled, values-based profession deserving of respect. The Code of Ethics, Frontline Initiative, the Community Support Skill Standards and early advocacy efforts reflected a workforce collectively asserting our voice for the very first time.

As the disability service systems evolved, it slowly embraced professional development and recognition, but there remains a long way to go. The creation of our E‑Badge Academy certification program offers a portable, stackable recognition of competence-based work. These certifications have since been adopted and funded by numerous states and provider organizations across the country as part of career pathways.

More recently, especially in the wake of the COVID‑19 pandemic and the magnified national workforce crisis, direct support professionals have become more engaged with advocacy and public policy. The NADSP’s national policy initiatives, like establishing a distinct occupational classification for direct support professionals require direct engagement with members of Congress. These activities continue to underscore the importance of direct support professionals speaking for themselves and sharing their stories about low wages, lack of career ladders, and the need for professional recognition.

Future Priorities

As we look toward our next chapter, several priorities stand out. First is continued professionalization without losing our values. The NADSP remains committed to ensuring that certifications, professional development, and career ladders improve person-centered values, ethical decision-making, and partnership with people who receive services.

Our second focus is policy influence rooted in direct support professional experience. NADSP’s future work will emphasize and amplify direct support professional voices in federal and state policymaking, especially as workforce shortages continue to threaten access to home and community-based supports and services.

Finally, we will continue to invest in community and storytelling, a role perfectly aligned with Frontline Initiative. Sharing direct support professional experiences, lessons learned, and the evolving practice remains essential to sustaining our profession.

For 30 years, Frontline Initiative and NADSP have grown alongside one another, shaped by the voices of direct support professionals who support people in living fully included lives. That shared history is not just something to celebrate; it is something to carry forward, together.