Agencies providing support in the intellectual and developmental disabilities (I/DD) services sector are facing an unprecedented workforce crisis. Individuals with I/DD are moving out of large congregate settings and into dispersed settings in the larger community, increasing the need for staff. Direct support professional (DSP) turnover is at a historic high (over 50% based on a turnover study by the Ohio Provider Resource Association). For agencies, it is increasingly difficult to find and maintain staffing to support their current clients. Agencies rely on DSPs working overtime to continue to ensure individuals with I/DD get the support they need.


CERIIDD analyzed payroll overtime data for direct support professionals (DSPs) from Ohio I/DD services providers. The dataset included a total of 32,758 DSP payroll work weeks.

Results and Discussion

  • 76% of all weeks worked by DSPs included some amount of overtime
  • 18% included overtime equivalent to two or more full days of work
  • Only 24% had no overtime

DSPs often need to work at two different employers to meet their financial needs, however, this analysis was unable to account for such occurrences. Medicaid rates paid to agency providers typically do not include a component for any level of overtime. As provider rates remain stagnant or are not indexed to inflation, the ability for I/DD services providers to deliver quality services and continuity of care diminishes. In order to continue supporting individuals with I/DD to live the most independent and community-based life, the workforce crisis must be addressed.

Data Brief: Direct Support Professionals and Overtime (pdf)