This is not a staffing shortage. It is a workforce crisis. And we cannot hire our way out of it.
By Precious “Preciosa” Myers-Brown, the Voice of Enabling Technology™
For decades, the disability and aging services field has tried to solve the workforce problem with the same tired playbook: job fairs, signing bonuses, pizza days, fresh recruiting ads, the occasional “thank you” email. None of it has worked, and not because the people running agencies do not care. They care deeply. The reason it has not worked is that the crisis is structural, and you cannot fix a structural crisis with a retention strategy.
Direct Support Professionals are underpaid, under-respected, overworked, and under-supported. They are burned out, emotionally exhausted, and carrying too many roles inside a system that was never designed to hold them. The crisis did not begin with COVID, but COVID exposed everything the field had been trying to hide.
So let me tell you what is actually happening out there.
What does the DSP staffing crisis really look like?
Forty-eight hour shifts are not a horror story. They are a Tuesday. When someone calls out and you are obligated to meet staffing ratios under the traditional model, there is no other option, so staff just get stuck. When I worked as a DSP, I cannot count how many times I got stuck on shift. After already working 12 hours, I would push through to 18, then get pulled into an overnight for another 12, only to learn the next shift was short too. I have worked 48-hour shifts. I have worked 72-hour shifts. And I was not my best self for any of them.
This is more common than the field wants to admit. What you end up with is bodies in a house, people who are present but no longer on point. The same dilemma plays out in any industry that depends on focused, alert humans. I do not want a tired surgeon operating on me, and I will reschedule my own appointment if my doctor is out. But the people we support do not have that privilege. They simply have to accept it.
And this exhaustion is not happening at the margins of the field. According to the data referenced in Tech Equity, roughly 7 million Americans are living with intellectual or developmental disabilities, with about 1.5 million enrolled in HCBS waiver programs. The workforce expected to support those lives is in structural collapse, and the math has been impossible for years.
Why hospitals already solved a problem we are still ignoring
Here is what most leaders miss about the workforce equation: hospitals already solved this problem decades ago.
In any ICU, you will find a heart monitor, a blood pressure monitor, and a pulse oximeter. Each one performs a different function, but they do not work in isolation. They function as a team. If one alarms, the next one is alerted. They communicate with each other. When the nurse misses something because she is on rounds with another patient, the machines tell her when someone needs a code.
The most acute care settings in the country trust technology to fill the gaps that human attention cannot cover. So why do we still resist doing the same thing for people who are not in an acute situation but absolutely still need support? The answer is not safety. The answer is habit. We built this system in 1988 and we have been protecting that habit ever since.
The hidden reason good DSPs leave the field
There is a deeper problem the industry rarely talks about, and that is the Protection From Harm framework.
In many states, the regulatory mindset operates under automatic blame. A person falls while two staff are assisting other residents in other rooms. Even though it was physically impossible to be in three places at once, even though everyone was within ratio, the framework still requires an investigation, the removal of the staff member, and investigative leave without pay, sometimes for months. Nobody can tell that DSP how long the investigation will take. Their life stops. Their bills do not.
DSPs know this. They feel this. They fear this. And this is exactly why good people leave the field.
How does enabling technology actually change the equation?
Enabling technology does not replace the DSP. It protects her.
When I implement hybrid enabling technology environments, I am layering remote sensors, two-way audio, safety alerts, and remote supports into the day-to-day fabric of a home. That means a DSP can safely assist one person in the bathroom while remote support monitors the living room, while environmental sensors watch for risk, and while alerts track movement. If something does happen, clinicians can see the actual sequence of events instead of relying on memory and fear.
That changes everything. No more staff being punished for impossible situations. No more workers afraid to clock in. No more investigative leave for being human in a system that was never designed for the demands it places on them.
Technology in this field does not just support the people receiving services. It protects the people providing the services. That is why quality DSPs stay when technology is present, and that is why providers must adopt enabling technology if they want to stabilize their workforce.
The bottom line for providers, leaders, and policymakers
The care system is not collapsing because people stopped caring. It is collapsing because we are trying to solve 2026 problems with tools designed for a system built in 1988. We cannot keep building the future of care on the backs of an exhausted workforce.
The good news is that we do not have to.
This article is drawn from Chapter 1: The New Normal of Care and Chapter 7: The Future Workforce of Tech Equity: Freedom Through Enabling Technology by Precious “Preciosa” Myers-Brown, published by House of CINO. Available now in paperback, hardcover, and ebook at techequitybook.com/get-the-book.
