In Summary
- DSPs are essential because they help people with disabilities live independently while also enabling family members to work and support themselves and their families financially.
- Missouri is facing a DSP shortage driven in part by insufficient Medicaid reimbursement rates, leaving families without enough support, and sometimes keeping people in hospitals or facilities longer than necessary.
- The DSP Act is a step toward addressing the crisis by recognizing DSPs as a distinct occupation in federal labor data. Missourians can help by urging their elected officials to support the act.
At Easterseals Midwest, our mission is to support people with disabilities and their families. If there’s one group that epitomizes that mission, it’s Direct Support Professionals, more commonly known as DSPs.
DSPs are essential to Easterseals Midwest and the wider disability community because they help people with disabilities thrive and live independently. Their work also allows family members the ability to join the workforce.
The DSP role is in crisis because of a nationwide shortage, but there is legislation on the horizon that could make a difference.
In honor of DSP Week happening Sept. 13-19, 2026, we wanted to share more information about why DSPs are so critical, what’s causing the shortage, and how you can help.
The Importance of DSPs
DSPs are defined as essential workers who offer direct support to people with disabilities, older adults, and veterans. They help the people they serve with tasks like getting dressed, making meals, and getting to where they need to go. They can also manage medications and monitor health concerns to mitigate any emergencies.
DSPs can support every facet of a person’s life- whether that be in living independently or maintaining a job with proper employment supports. The DSP role is to genuinely serve as a helping hand but also provide connection to a population that may be otherwise isolated.
The work of DSPs also supports our economy. DSPs help people with disabilities live independently which means their family members and loved ones can work and support themselves. If DSPs did not exist, family members would often be the primary caregivers which means they would likely have to leave the workforce or reduce hours, causing families financial strain.
The DSP Shortage
Missouri specifically continues to face a significant shortage of direct support professionals (DSPs). One of the primary factors is that Medicaid reimbursement rates have not kept pace with the rising cost of delivering services, making it challenging for providers to offer competitive wages and keep the workers they need.
And there are consequences beyond staffing. When community-based providers don't have enough DSPs to serve people with developmental disabilities, individuals may remain in hospitals or intermediate care facilities longer than medically or otherwise necessary. In some cases, that can cost the state as much as three times what community-based support would cost.
The shortage is causing strain on Missouri families. According to a study conducted by the Missouri Developmental Disabilities Council, more than 67% of people with disabilities and their families said it was extremely difficult to get and keep staff. More than 29% said the difficulty makes them worry about their health and safety.
Governor Mike Parson passed a bipartisan spending package in 2021 to help, which was the initial step in the right-direction to right-sizing reimbursement rates. However, there is still a long way to go.
What the DSP Act Could Do
However, there is legislation on the horizon that is a step in the right direction.
Last month, a U.S. Senate committee voted to advance S. 3211, the “Recognizing the Role of Direct Support Professionals Act,” or DSP Act.
If enacted, the legislation would recognize DSPs as a distinct occupation in federal labor data, allowing for more accurate workforce tracking and giving policymakers better data to strengthen the workforce and support the disability community.
