One of the biggest challenges in meeting the needs of individuals with intellectual and developmental disabilities (IDDs) has been difficulty recruiting and retaining staff. Direct support professionals (DSPs), in particular, are in high demand and are vital to assisting with activities of daily living and administering many critical aspects of an individual’s life plan goals— yet there hasn’t been enough of them for decades. And this shortage has only worsened following the COVID-19 pandemic.
In a recent survey of IDD service providers, 83 percent of 718 respondents said they had turned away or stopped accepting new referrals due to DSP staffing challenges. More than 6 in 10 said they had even discontinued programs or services because of insufficient DSP staffing.
The direct support workforce crisis is primarily attributed to an inability of providers to offer wages that are competitive with those of hourly-wage industries, such as fast food, retail, and convenience stores, notes the American Network of Community Options and Resources (ANCOR), a national, nonprofit trade association representing private community IDD service providers.
DSP wages have stagnated at $12-$13 per hour at the median—a wage that doesn’t match the increased cost of living across most of the country. It is also difficult to improve as organizations continue to struggle in a challenging reimbursement environment.
At the same time, staff retention has been tough for many organizations. Across states, the turnover ratio for DSPs ranges between 28.5% to 87.5%, with a weighted average turnover ratio of 43.3%, according to ANCOR. In addition, vacancy rates for full-time positions ranged from 8.9% to 28.6%.
With such upheaval and gaps in staffing, providers who use DSPs must make the most of their limited staff and focus on systems to ensure continuity of services. Unfortunately, many IDD service providers still use paper-based systems, making it difficult to efficiently complete tasks and share information and IDD data consistently and completely.
As IDD service providers address labor challenges, technology can help ease some of the burdens on existing staff and aid in the coordination of services and uniformity of documentation practices.
When examining technology options with an eye to easing staff burden, several aspects of disability care/case management software are fundamental to consider.
DSPs are busy and often have little experience with using technology on the job. Therefore, any EHR solution must be relatively easy to learn and use. Technology with too many options that are irrelevant to the user or that proves cumbersome to use can actually work against retention efforts.
Instead, IDD service administrators should look for software that enables staff to quickly record notes and find information in a way that is intuitive. An EHR designed specifically for IDD service settings will provide the best user experience. For example, consider how Core Solutions’ Cx360 EHR for IDD services is designed around role-based workflows to aid user experience. The right information is available at the right time when delivering a service, so the user doesn’t have to search. Prompts for decisions and assessments occur as they are needed. Workflows are always relevant, so each task leads directly to the next one in a process. Also, because the technology uses configurable templates and modular design, the foundation of the workflows is always the same. This setup makes it easier for users to teach others in the same role and to adjust templates for custom needs over time.
Another area to consider when assessing EHRs for IDD services is how tasks are managed. Staying on top of essential tasks in a busy IDD service setting can be challenging and contributes to the amount of stress on staff. Therefore, having the right systems to manage tasks and build accountability with minimal burden on staff is essential to any IDD disability software system.
An EHR should make it easy to build and adhere to service plans. Having built-in accountability around tasks can save staff valuable time and improve outcomes. For example, with Cx360, the user can identify an individual’s needs, which then automatically flow through as valued outcomes to a person-centered life plan/service plan. Program administrators can then assign staff to the actions needed to achieve quality outcomes. The technology also supports automated task scheduling and notifications. As a staff member completes one task, the next task in the process is immediately generated and routed for completion. As a result, staff can efficiently complete assessments, build service plans, execute service processes, and verify task completion at each step.
One of the biggest influences on staff efficiency and effectiveness is the ease of communication. An organization’s staff does not deliver IDD services in a vacuum. The best service experience and outcomes occur when the service provider also has visibility into the individual’s needs and progress taking place with others, such as primary care physicians, specialists, clinicians, care coordinators, and therapists. Core’s Cx360 is built with interoperability in mind. It makes it easy for providers to securely exchange progress notes and care plans with one another using common industry standards.
Also critical to the coordination of care is a secure means to exchange assessments and other communications with parents, guardians, and others who may be involved in helping the individual achieve life plan goals, such as designated representatives with a school or employer. In these instances, an easy-to-use, secure portal for communication and IDD data sharing as part of the IDD disability care/case management software is paramount.
Options for staff communication should also be examined. Capabilities such as mobile access to the platform and the ability to deliver telehealth can make it easier for staff to provide services over a larger geographic area or beyond traditional office hours. As organizations struggle to drive the most efficiency from limited staff, such flexibility within the IDD disability software system can be essential.
One of the most significant factors around staff retention is job satisfaction. Many DSPs first get into the field because they genuinely want to help individuals with IDD needs. Therefore, it’s essential that any technology also enable staff to recognize their role in making a difference and help them achieve the best outcomes for the individuals they serve.
Cx360 makes it easy for staff to document and track progress consistently. The entire system is designed to improve the quality and efficiency (or “value”) of service delivery. Prompts help ensure documentation is complete and accurate. Workflow templates assist in evidence-based goal setting. Customizable dashboards enable users to see bigger-picture trends and achievements. Having consistent, measurable progress points is rewarding for the service provider and those receiving services and facilitates achieving better outcomes.
The DSP shortage continues to be a pressing concern for IDD service providers. The industry is charged with maintaining programs and delivering high-quality services while facing an extremely difficult recruitment and retention environment. As organizations struggle to do more with less and manage the challenges of high turnover, the right automation can play a significant role. User experience, task management, communications, and goal-setting insights play a substantial role in a DSP's success and satisfaction with their position. The most successful EHR adoptions will occur with those organizations that view a technology’s features and benefits through the lens of optimizing staff efficiency and effectiveness.
Discover How Core’s Cx360 Can Help Improve Staff Efficiency
Schedule a demo today to discover how Cx360 for IDD services can help your organization make the most of your staff’s efforts: https://www.coresolutionsinc.com/idd-ehr-software.