How to Reduce DSP Turnover: 7 Retention Strategies for I/DD Providers

If you manage direct support professionals (DSPs), turnover isn't an abstract number. It's the open shift you end up covering yourself, the new hire you spent weeks training who stopped showing up, and the person you support who has to get used to yet another unfamiliar face.

The good news is that turnover isn't spread evenly across a DSP's career. Most of it happens early, in the part of the job that managers shape most directly: how people are hired, brought on and supported in their first months. This guide walks through what national data shows and seven practical steps backed by research in I/DD services.

What the data says about DSP turnover

The most detailed national picture comes from the National Core Indicators-IDD State of the Workforce survey. The 2024 survey covered 3,936 provider agencies in 26 states and D.C. and reported data for calendar year 2024:

• Turnover: the weighted average DSP turnover ratio was 37.1%, ranging from 16.7% to 53.7% across states.
• Vacancies: among agencies that track full- and part-time positions separately, an average of 9.7% of full-time and 13.2% of part-time DSP positions were vacant on Dec. 31, 2024.
• Early exits: of DSPs who left their agency in 2024, 63.7% had been there less than a year, and 40.7% had been there less than six months.
• Most exits are a choice: 72.1% of separations were voluntary. Another 21.8% were terminations for performance issues or policy violations.

ANCOR's 2025 workforce survey of 469 provider organizations in 48 states and D.C. shows what that churn costs. 88% reported moderate or severe staffing challenges in the past year, and 36% said they were seeing more frequent reportable incidents because of staffing shortages.

The takeaway: if nearly two in three people who leave do so in their first year, the first year is where retention is won or lost.

Step 1: Measure your turnover the same way, every year

You can't tell whether anything is working without a baseline. NCI calculates each agency's turnover ratio as:

DSPs who separated during the year ÷ DSPs on payroll on Dec. 31

Using the same formula lets you compare your numbers with NCI's state and national figures. Two extra cuts make the number far more useful:

• By length of service. Count how many leavers had worked less than 6 months, 6 to 12 months, and longer. If most of your exits happen early, put your energy into hiring and onboarding.
• Voluntary vs. involuntary. A spike in terminations points to hiring and training problems. A spike in resignations points to the job itself, supervision or pay.

Review the numbers by site or house, too. Turnover often clusters under particular supervisors or schedules.

Step 2: Give candidates a realistic job preview

A realistic job preview (RJP) gives applicants an honest picture of the job, including both its rewards and its hard parts, so they can decide whether it's right for them before they accept. According to NCI, 80% of agencies already offer one, so the question is usually whether yours is doing its job.

A chapter on RJPs from the University of Minnesota's Institute on Community Integration summarizes the research:

• RJPs delivered after a job offer but before the applicant accepts were more effective at reducing turnover than ones given at first contact.
• RJPs that involve a conversation, where the applicant can ask questions, were the most effective. Written RJPs also helped.
• Formats include structured observations at the work site and meetings with current DSPs, the people they support and family members.

In practice, that might mean a short paid visit to the home or program, time with an experienced DSP who will talk candidly about the hard parts, and a clear explanation of schedules, pay and expectations before the candidate says yes.

Step 3: Treat onboarding as training, not paperwork

In a group randomized controlled study published in Intellectual and Developmental Disabilities in 2015, sites whose DSPs received a competency-based training intervention had a significant decrease in annual turnover compared with control sites, after controlling for multiple factors. The authors described quality training as a long-term investment in reducing turnover.

The opposite also shows up in research. In a 2024 study in Inclusion, University of Minnesota researchers analyzed open-ended answers from 1,423 DSPs and 517 frontline supervisors to a national survey fielded in mid-2022. Participants described a "self-perpetuating" cycle: supervisors busy covering open shifts didn't have time to onboard and train new hires, those new hires felt unprepared and left early, and the vacancies created more open shifts.

To break the cycle:

• Schedule onboarding like a shift. Block time for training and job shadowing and protect it from being pulled for coverage.
• Check skills, not just attendance. Have a supervisor or experienced DSP observe and sign off on key skills for each person supported.
• Keep a clear record of what each new hire has completed and what's next. Our guide to tracking employee training in a care agency covers how.

Step 4: Pair every new DSP with a peer mentor

The same 2024 study recommends mentoring, noting that it has been shown to reduce turnover, including in high-stress jobs such as teaching and nursing when used with new employees. When supervisors have limited time, experienced DSPs can mentor newer ones. In formal peer mentoring, the mentor helps the new DSP build confidence and competence and learn how the organization works.

A simple setup works:

• Choose mentors who are good at the work and want to teach, and recognize their extra role.
• Schedule shifts so mentor and mentee actually work together during the first weeks.
• Set regular check-ins, and have the mentor tell the supervisor when a new hire is struggling, before they quit.

Step 5: Protect your frontline supervisors' time

Frontline supervisors carry a lot of retention on their shoulders. NCI found an average of 10 DSPs for every frontline supervisor in 2024. The Inclusion study found that when supervisors spend their days filling shifts, DSPs are left without coaching and feel unsupported. Its authors suggest making sure supervisors get the support, mentorship and coaching they need before tackling DSP retention, and having leadership listen to supervisors about why staff leave. They also note that people are often promoted into supervision without preparation for a leadership role.

We've covered the supervisor role, its core skills and its training in detail in our DSP supervisor and group home manager guide, so we won't repeat it here. The retention point is simple: if supervisors are always on the floor covering shifts, they can't do the onboarding, mentoring and coaching that keep people.

Step 6: Give DSPs a voice and recognize their work

A study of 323 direct care workers at five community organizations serving adults with I/DD, published in Research in Developmental Disabilities, found that work overload and limited participation in decision-making were associated with higher burnout. The authors stressed the importance of strong social support at work.

Many agencies already have tools for this. In NCI's 2024 survey, 57.1% of agencies used DSP recognition programs, 52.4% used DSP engagement surveys and 21.6% included DSPs in agency governance.

Ideas that cost little:

• Ask DSPs for input on schedules, routines and plans for the people they know best, and tell them what changed as a result.
• Run a short anonymous survey once or twice a year, and share the results and your response.
• Make recognition specific, such as naming what a DSP did and why it mattered for the person supported.
• Hold stay interviews with DSPs at key points in their first year, asking what keeps them and what might make them leave.

Step 7: Build a career path with credentials and pay steps

DSPs who can see a future in the role have a reason to stay in it. In NCI's 2024 survey, 32.6% of agencies used DSP career ladders, 30.6% supported staff in earning a credential, and 29.1% offered bonuses, stipends or raises tied to credentials.

The National Alliance for Direct Support Professionals (NADSP) offers a three-tier certification: DSP-I, DSP-II and DSP-III. DSP-I requires 15 E-Badges, including 50 hours of accredited education; DSP-II requires 30 E-Badges, including 100 hours. NADSP says anecdotal evidence suggests that employees who complete rigorous credential programs stay on the job longer.

A ladder can be as simple as:

• A clear set of steps (for example, DSP, then DSP-I certified, then DSP-II or mentor), with the training and experience each step requires.
• A raise, stipend or title change at each step, if your budget allows.
• Paid time to complete coursework, and supervisors who talk about the path from the first week.

Pay still matters. The 2024 Inclusion study cites research showing wages are positively associated with DSP retention. NCI reported a 2024 median DSP hourly wage of $18.39 and found that only one participating state paid DSPs a median wage at or above a living wage for one adult. Most I/DD providers can't set rates on their own because Medicaid reimbursement sets the ceiling, so being transparent about pay steps and adding credential-based raises where you can is one of the few levers in your control.

A first-year retention checklist

How Training & eTracking Solutions can help

Training & eTracking Solutions has supported human services organizations since 2010 and has trained more than 200,000 professionals. TES is an NADSP Accredited Education provider, and our courses count toward NADSP's DSP-I and DSP-II, so the training your DSPs complete can also move them up a career ladder.

Our library of 400+ courses and programs includes options for each step above:

• Onboarding and core skills: Direct Support Professional courses and The NADSP Code of Ethics and the Direct Support Profession
• Supervisors: Introduction to Supervision, Giving and Receiving Feedback and the Workplace Leadership & Team Development program
• Stress and workload: Stress Management for Managers and Stress Management for Employees

You'll find more tools for supervisors and program leaders on our I/DD manager resources page, and our overview of who DSPs are and why they matter is a good piece to share with new hires and board members.

Want help building onboarding and career-path training for your DSPs? Contact our team.

Survey figures in this article come from the NCI-IDD 2024 State of the Workforce survey and ANCOR's 2025 survey, which reflect participating agencies and states rather than every provider. Your own turnover and vacancy rates may differ.