The State of America's Direct Support Workforce Crisis 2026

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Connections - 05.27.26

How to Go From Managing to Thriving in 2026

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Providers in the intellectual and developmental disabilities (I/DD) field are navigating a familiar set of challenges — workforce shortages, high turnover, increasing service demand, and ongoing regulatory complexity. But what’s shifting is how organizations are responding.

Rather than trying to manage growing complexity, many I/DD leaders are focusing on operational efficiency: creating clearer, more connected ways for staff to learn, perform, and deliver care.

At its core, operational efficiency means delivering high-quality, person-centered services while reducing friction across daily workflows. And for many organizations, the most important question right now is: Where can we make meaningful progress quickly?

Instead of large-scale transformation efforts, forward-looking organizations are prioritizing small, repeatable improvements. They’re focusing on faster access to actionable insight, more consistent workforce practices, and systems that simplify — rather than add to — staff responsibilities. Critically, these improvements are happening alongside service delivery, not on top of it.

Where friction shows up in I/DD organizations

In I/DD services, inefficiencies are rarely due to lack of effort. More often, they stem from systemic challenges that make it harder for teams to operate consistently.

Decision-making is one example. Leaders often lack clear, timely visibility into workforce readiness — especially across dispersed teams and community-based settings. Instead of relying on broad or delayed reporting, high-performing organizations are narrowing their focus to key indicators, such as staff competency in high-support or high-risk scenarios, making it easier to act early and effectively.

Workforce capacity is another major pressure point. In I/DD, capacity depends not just on staffing levels, but on how quickly direct support professionals (DSPs) and clinicians can be onboarded, trained, and supported in their roles. Traditional training approaches don’t always translate into confidence on the job. More effective models embed learning and competency validation into everyday work, reinforcing skills over time and improving consistency in care.

In partnership with ANCOR, Relias’ 2025 DSP Survey Report highlights that workforce factors like onboarding effectiveness, career development, and supervisor support play a significant role in staff satisfaction and retention — reinforcing the importance of ongoing training and development strategies.

Explore the 2025 DSP Survey Report

Fragmented systems also create an unnecessary burden. Many I/DD providers rely on separate tools for training, compliance tracking, and performance management, leading to duplicate work and limited visibility. Rather than attempting a full overhaul, organizations making progress are simplifying high-friction processes first — like onboarding or annual training — where improvements can quickly reduce administrative strain.

Four practical ways to build efficiency

Operational efficiency in I/DD services is built through consistent practices that support both staff and the individuals they serve:

  • Align around priority outcomes. Focus on areas with the greatest impact, such as reducing time-to-productivity for DSPs or strengthening competency in person-centered supports.
  • Reinforce expectations over time. Move beyond one-time training to continuous, role-based learning with regular feedback and skill validation.
  • Integrate data into daily decisions. Ensure supervisors and program leaders can see real-time insights into staff readiness and performance.
  • Simplify the systems behind the work. Reduce duplication and streamline tools so staff can focus more on care and less on administrative tasks.

Efficiency that supports better outcomes

For I/DD organizations, operational efficiency isn’t just about internal performance — it directly impacts quality of life for the people they support. When staff are confident, workflows are clear, and systems are aligned, organizations see faster onboarding, improved retention, and more consistent, person-centered care.

The opportunity isn’t to add more initiatives. It’s to reduce friction in the work that already exists. By focusing on alignment, simplification, and continuous reinforcement, I/DD organizations can build a more stable workforce and deliver stronger outcomes over time.

Jordan Baker is the Content Marketing Manager at Relias.