Incentives, Wages, and Retention Among Direct Support Professionals: National Core Indicators Staff Stability Survey

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4 Scopus citations


Direct support professionals (DSPs) provide a range of supports in a variety of settings to people with intellectual and developmental disabilities (IDD) who count on these supports to live, work, and contribute in their communities. Despite this, high annual DSP turnover rates are problematic. DSP turnover is disruptive to people who receive supports as the lack of stable, reliable supports can negatively impact their important day-to-day outcomes (e.g., safety, community participation, and choice). Turnover also comes at a cost to provider organization in the hiring and training of new employees. To retain DSPs, organizations offer incentives (e.g., bonuses, retirement plans, health insurance). This study utilized National Core Indicators® (NCI®) Staff Stability Survey 2018 data to examine the relationships between wages, different types of incentives, including benefits (e.g., paid time off, access to health insurance, disability insurance, wage bonuses, health incentives programs, etc.) to annual turnover in participating states in the United States. Results indicated that incentives were not positively associated with DSP retention. Staff wages were the most notable factor associated with differences in DSP retention rates, along with the state in which the organization was located as well as organization vacancy rates.

Original languageEnglish (US)
Pages (from-to)113-127
Number of pages15
JournalIntellectual and developmental disabilities
Issue number2
StatePublished - Apr 2022

Bibliographical note

Funding Information:
Development of this article was supported by Grant #90RTCP0003 to the Research and Training Center for Community Living from the National Institute on Disability Independent Living and Rehabilitation Research, U.S. Department of Health and Human Services. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not therefore necessarily represent official NIDILRR policy. We would like to thank Dorothy Hiersteiner from HSRI, and Mary Lou Bourne and Laura Vegas from NASDDDS for their input into this manuscript.

Publisher Copyright:


  • IDD
  • National Core Indicators
  • direct support professional
  • incentives
  • turnover

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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