Earlier today, ANCOR, PHI, and NADSP sent a joint letter of support regarding the Support S. 3211, the Recognizing the Role of Direct Support Professionals Act to the ranking Chair and commitee members of the Senate Homeland Security and Governmental Affairs Committee. You can read the full letter below. 

Dear Chair Paul, Ranking Member Peters, and Committee Members:

We write in support of the Recognizing the Role of Direct Support Professionals Act (S. 3211), a bill that would help to create a standard occupational classification (SOC) for direct support professionals (DSPs). This legislation will ensure that as the Office of Management and Budget (OMB) revises the standard occupational classification system, it considers the importance of creating a code for DSPs.
The creation of a distinct occupational classification for DSPs is a necessary first step in addressing a decades-long workforce crisis that threatens individuals with disabilities’ access to critical supports and services through the Medicaid Home and Community-Based Services (HCBS) program. The HCBS program supports individuals with disabilities to live full and independent lives in their homes and communities. The foundation of these services are the DSPs who not only provide essential caregiving services but also promote independence and community inclusion through services that range from employment coaching and career development to assistance with relationship building and decision-making. The supports DSPs provide help individuals with disabilities avoid unnecessary institutionalization and hospitalization.

The critical supports provided by DSPs are threatened by a longstanding workforce crisis that will be exacerbated by pending Medicaid reductions. According to the most recent Staff Stability Survey conducted by National Core Indicators® Intellectual and Developmental Disabilities (NCI), the national turnover rate among DSPs is nearly 40% and ranges as high as 54% in some states. The loss of DSPs across the field has left many individuals without stable access to home and community-based supports. In fact, a 2025 survey of community providers across the country demonstrates that the lasting impact of the lack of sufficient investment into the Medicaid HCBS program has led to a continued exodus of DSPs from the field, forcing providers to stop accepting new referrals, delay the implementation of new programs and, in some instances, shutter existing services altogether. This is consistent with state reporting—a 2025 report of states’ home and community-based programs revealed that 48 states were experiencing a shortage of direct support professionals.As noted, without access to community-based supports, individuals with disabilities are left without consistent access to critical support and at a higher risk for hospitalization and institutionalization.

There is currently no mechanism to comprehensively collect employment and wage data specifically about DSPs. Without comprehensive data, the totality of the direct care workforce crisis cannot be properly assessed. A unique DSP occupational code will ensure the U.S. Bureau of Labor Statistics can accurately capture employment and wage data specific to the profession, which will in turn assist federal and state policymakers to inform and impact future policy. Accurate and comprehensive data on DSPs is crucial for understanding the workforce crisis and developing effective solutions. Designating DSPs as a distinct occupation will provide the necessary granularity to capture their unique contributions, challenges, and workforce trends.

Without an occupational code, DSPs are often inaccurately and inconsistently incorporated into a variety of SOCs that do not capture their full spectrum of work activities in a variety of home and community settings. DSPs provide supports that are primarily funded by Medicaid and cover a wide range of services. A DSP’s work is interdisciplinary and distinct—DSPs perform tasks geared toward supporting self-direction and independence, such as developing and implementing effective strategies to teach people new skills, helping people communicate with and use assistive technology devices, supporting individuals to find and retain jobs and work toward their personal career goals, and helping people connect socially and participate in recreation activities, education, cultural events, spiritual activities, and civic functions. Accordingly, DSPs typically receive comprehensive training centered around supporting independence, teaching decision-making skills, and fostering community living and social participation. As noted in a 2017 report from the President’s Committee for People with Intellectual Disabilities, a DSP’s “role is much more focused on being community navigators” and accordingly, the training for DSPs centers on a social model rather than a medical model.

Such differentiations, not only in job responsibilities but also in training, point to the distinction between DSPs and other occupations currently represented in the federal occupational classification system. To ensure the greatest level of accuracy in federal data collection, DSPs must have their own distinct occupational code.

The Recognizing the Role of Direct Support Professionals Act will help ensure federal recognition of the critical role DSPs play in providing supports for people with disabilities and will help in addressing the ongoing DSP workforce crisis by ensuring there is adequate data collection to inform future policymaking. Last Congress, both the Senate Homeland Security and Governmental Affairs Committee and the House Education and Workforce Committee unanimously passed nearly identical versions of the Recognizing the Role of Direct Support Professionals Act. We urge your support once again for this important legislation in this Congress and ask you to move this legislation forward for a vote.

Thank you for your consideration of this important issue. Please reach out to Jake McDonald, PHI’s State Policy Advocacy Specialist, at jmcdonald@phinational.org if you have any questions.

Sincerely,

Barbara Merrill
Chief Executive Officer
ANCOR

Joseph M. Macbeth
President and Chief Executive Officer
National Alliance for Direct Support Professionals

Jodi M. Sturgeon
President and Chief Executive Officer
PHI