Average hourly wages for direct support professionals rose from $12.22 in 2018 to $17.86 in 2024 at the agencies in National Core Indicators workforce data, and agencies that paid more still had lower turnover.
The findings come from "Should I stay or should I go? Incentives, wages, and retention among direct support professionals revisited post COVID," a poster presented at the 2026 AAIDD annual meeting and posted by National Core Indicators in July 2026. The authors are Sandra L. Pettingell, Julie Bershadsky and Amy Hewitt of the University of Minnesota, Dorothy Hiersteiner of the Human Services Research Institute, and Laura Vegas of the National Association of State Directors of Developmental Disabilities Services.
What the study compared
The team repeated a 2022 study that used 2018 data to test how wages, benefits and incentives relate to DSP turnover. The question was whether those relationships held after pandemic-era wage increases and workforce spending under the American Rescue Plan Act.
Both years come from the NCI State of the Workforce survey, which is completed by payroll and human resources staff at provider agencies. The 2024 analysis covered 2,491 agencies in 26 states and the District of Columbia, employing 260,404 DSPs. The 2018 analysis covered 2,608 agencies and 275,379 DSPs.
What held from 2018 to 2024
In both years, higher wages were linked to lower annual turnover. In the 2024 model, each additional dollar of average hourly pay went with about 1.6 percentage points less turnover, compared with about 2.9 points in 2018.
Also in both years, higher vacancy rates and pay or referral bonus programs were linked to higher turnover, not lower. In 2024, two more factors went with higher turnover: a lower share of part-time DSPs and offering life insurance.
Benefits and incentives
More agencies offered most benefits in 2024 than in 2018. Health insurance rose from 69% to 72% of agencies, dental from 65% to 70%, vision from 57% to 66%, and retirement plans from 55% to 67%. Wage bonuses rose from 44% to 62%, and pay or referral bonus programs from 45% to 57%. Employer-sponsored disability insurance was the exception, flat at 30%.
The authors' caveats
The authors suggest several reasons incentives were tied to higher turnover. The survey measured only economic incentives and left out factors such as workplace relationships, professional development and meaningful work. How well incentives work may also depend on how they are carried out, whether staff helped design them, and whether they match what employees want. None of that was in the data. The analysis shows associations, not cause and effect.
They also note that fewer part-time positions may reduce scheduling flexibility and put more strain on full-time staff.
Still not a living wage
The authors conclude that wages have risen since 2018 but "are still not at a living wage and need to rise further to have meaningful impact." Turnover, they write, continues to affect workforce stability, and other strategies are needed alongside pay.
Why this matters for providers and DSPs
For agencies making the case for higher rates, the poster adds multi-state evidence from two separate years that pay goes with retention. It also suggests looking hard at referral and sign-on style bonuses, which in both years went with higher turnover, and at whether flexible part-time roles help keep staff. For DSPs, the data confirm that pay has risen by more than $5 an hour since 2018 and is still short of a living wage.