A Direct Support Professional (DSP) is someone who works directly with people who have intellectual or developmental disabilities (IDD). Usually, DSPs offer specialized support aimed to help people realize their full potential. They help people with disabilities to become integrated and engaged in their community by assisting with everyday tasks, such as housekeeping, meal preparation, attending appointments, and running errands. Depending on the patient's condition, these support professionals may also administer medications, develop a behavioral management plan, and maintain medical records for the people they are attending to.

At The Center our DSP's are called "Care Coaches" as our focus is to develop independent living skills, encouraging agency for our Members.

In the past, DSPs were trained as caregivers. However, over the last few decades, the needs of those being served have evolved. Thus, the role of DSPs consequently began to change in order to adapt to the changing needs, and DSPs now take on different aspects and roles than those of caregivers. It is no longer about doing things for people, but about helping them to learn how to do things for themselves. 

The Difference Between a DSP and a Caregiver
Qualifications usually vary from state to state, but the primary role of a DSP is to provide support. This is different from caregiving or providing in-home healthcare. A caregiver or home health aide will do things for their clients, such as picking out and purchasing groceries. On the other hand, a DSP will work with people that they are supporting in order to help them do things on their own, like choosing their own groceries and paying the cashier. DSPs teach people with disabilities how to do things independently, whereas caregivers perform tasks for them. 

Skills That Make a Good DSP 
There are several different skills that define a good DSP, including:

• Calmness and Composure - Individuals with intellectual and developmental disabilities can't always express themselves in ways that are easy to understand. It is therefore important for DSPs to remain calm and think through solutions even in stressful moments. Thus, DSPs are people with the ability to keep calm and composed in difficult situations that they face in their daily practices. 

 

• Dependability and Punctuality - Being on time is important both for co-workers and for the individuals that DSPs support. For most people, whether you have a disability or not, a routine is key to staying balanced and comfortable. 

 

• Adaptability - Two days in the life of a DSP are never the same. One day they may be teaching their clients how to manage their budget, and the next they might be volunteering with them. With different activities, there come different demands. Not only are DSPs expected to readjust to new activities and environments, but their client's moods and actions will likely fluctuate as well. After all, people with IDDs are human beings and they face good and bad days. DSPs need to adapt to the situation and their client's shifting behavior during the time they spend together. 

 

• Being Observant and Intuitive - DSPs are the frontline support for individuals and they should be able to tell when something isn't quite right. Even family members or doctors might not be able to notice when something is off, so it's important that DSPs are keyed into what is normal and abnormal for the people they support. 

 

• Compassion - Clients need to know their DSPs have their backs in any given situation. Without that trust, motivation declines, and the relationship will simply fall apart. With this in mind, DSPs must exercise empathy, kindness, and grace when spending time with their clients. DSPs are interested in making the lives of their companions better and need to show that commitment to helping others day in and day out. 

 

• Interpersonal Skills and a Strong Sense of Teamwork - Providing support for another person, sometimes around the clock, is a team-oriented task that requires a lot of coordination and flexibility. Being a DSP means being part of a team that must work smoothly and collaboratively. 

Direct Support Professional Duties and Responsibilities 
DSPs help individuals with IDDs by providing them with safe living environments, helping them with daily tasks, and teaching them life skills. Direct support professionals commonly help with the following tasks: 

• Keeping the patient safe from hazards. For instance, a DSP would keep sharp knives in locked drawers and store household cleaners in locked cabinets.
• Monitoring an individual’s behavior toward themselves and others, as well as maintaining patients' records of problems and progress. 
• Reporting any instances of suspected abuse, neglect, or exploitation to the appropriate authorities so that protective service specialists can investigate the situation if necessary. 
• Helping individuals with tasks like cooking, cleaning, showering, toileting, shopping, and managing money. 
• Teaching patients tasks that they can ultimately learn to do for themselves.

DSPs can work with adults as well as children. DSPs and the individuals with IDDs they support usually feel a great sense of accomplishment when an individual learns to complete a new task by themselves.  

How to Become a Direct Support Professional 
There are no formal requirements to become a direct support professional, though some training is needed. Many direct professional jobs require a Cardiopulmonary resuscitation (CPR) certificate and on-the-job training. Other positions require completion of a caregiver training program. Training programs, such as those offered by the Red Cross and local hospitals, help you study the basics of home-based care to gain the skills and qualifications you need to fulfill your responsibilities in this career. For someone to increase their job opportunities, they can obtain certification through the National Alliance for Direct Support Professionals (NADSP).  

Direct Support Professional Training Training and mentoring are necessary components to assist the DSP with tools and knowledge so they can support a person in the most successful way. Web-based training for DSPs is available in some states. The web-based courses and lessons usually lay the foundation of information that sets a standard of practices. However, the second component, mentoring, usually assists DSPs to transfer their training information and knowledge to the worksite and the individuals they support. Both training and mentoring work hand in hand.

Training and mentoring must include practical "how-to" skill-building. Training sessions involve lectures, discussions, and exercises. Mentoring involves a process of observation, practice, guided discussions, and a review of written materials, such as individual support plans and progress notes. These techniques are key components of ongoing training and mentoring. They assure that the DSP is truly able to apply his or her knowledge in an effective way during their jobs. 

Case Study Example In the 2020 Tokyo Olympics, Becca Meyers, a swimmer seen as a favorite to win gold, canceled her plans to compete in the Paralympics after being told that she can't be accompanied by her DSP to Tokyo. Olympic and Paralympic Committee (USOPC) officials said that they didn't have space for her to bring an aide due to the coronavirus restrictions on athletic delegations. The Becca Meyers case shows how important DSPs are in helping their clients in their daily life activities. 
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New Transitions Center is a community-based organization focused on enhancing the lives of young adults with special needs and the loved ones who support them in the Roanoke, Texas area. The Center supports young adults with varying degrees of intellectual, developmental, and physical disabilities, including those who may need assistance with ambulation and personal hygiene. Find out how you can help us fulfill our mission and maintain a low enrollee-to-caretaker ratio by donating to our cause, exploring our events and campaigns, or contacting us to join as a community partner today!

In response to the COVID-19 Delta Variant spreading, reopening of schools, and pending fall/winter flu season there is a concern to ensure safety and reduce exposure to primarily COVID-19. The below plans are in place at The Center, based on CDC Recommendations and local Health Department guidance.
 
The primary objective is to avoid temporary closure and prepare for contingencies if a Member or staff get sick from COVID-19 or the flu. These guidelines have been adapted due to the nature of our services and are to be adhered to by active Members, their immediate family and all staff.

• The below guidelines are current as of September 1, 2021 and in effect through Dec 31, 2021.
• They are subject to be changed or modified at the discretion of The Center leadership and Board of Directors.
• An attempt to notify Member parents and staff will be made to update any changes as soon as possible.

 
Vaccination Standards

• All Staff/Members are required to be fully vaccinated unless they have a medical condition preventing them from receiving the COVID-19 vaccination as the COVID-19 vaccines protect people from getting infected and severely ill AND significantly reduce the likelihood of hospitalization and death.
• Proof of vaccination (date of last vaccination and type) is recorded on Staff/Member file.
• It is encouraged that all close family and household members of all Staff/Members are also vaccinated to limit exposure and transmission at home.
• For people who are vaccinated and still get infected (i.e., “breakthrough infections”), there remains a risk of transmission to others therefore we implement added precautions and best practices as stated below. Learn more about breakthrough infection risk HERE

 
First a few clarifications:
What is considered fully vaccinated?
An individual is considered “fully vaccinated” at 2 weeks from final vaccination injection (including third booster when available for COVID-19) and subsequent annual booster when available for either COVID-19 or Seasonal Influenza. It is expected after 2 weeks from vaccine that the immune system has developed an adequate response to preventing transmission and severe complications of COVID-19.
 
What is considered an exposure to COVID-19?
Close contact <6 feet apart and >15 minutes, with or without protection (ie face masks) with someone who has any of the below, whether you are fully immunized or not:

• Recently tested positive for COVID-19
• Displayed COVID-19 or flu-like symptoms regardless of if they have tested positive for COVID-19

 
What are the Symptoms of concern?
COVID-19 symptoms are of primary concern but signs of the Seasonal Flu are also of concern at The Center due to the impact on staffing. Major symptoms that present for both viruses include: Coughing, Fever >100 degrees F or Chills, Body Aches
 
What happens if a Member or Staff has tested positive for COVID-19? What are the self-quarantine guidelines?
The general rule of thumb is to remain isolated until 72 hrs has passed with no active symptoms OR until you have at least 1 Negative COVID-19 test. Below is the “window of exposure” and quarantine timeline we consider and adhere to for each exposure or positive COVID-19 test:

• Exposure Date is the day in which you were potentially exposed to COVID-19, this is within 2 days of symptoms beginning or within 2 days of testing positive.
• The Window of Exposure is the timeline for an opportunity of transmission. This window is considered to begin at the Exposure Date and extend up to +5 additional days. The Transmission Risk is high if the duration and extent of exposure is >15 min and < 6 ft apart at any point within the window of exposure.
• If a Staff/Member tests positive for COVID-19 the Self - Quarantine Timeline is to remain isolated:

 
UN- VACCINATED

• WITH OR WITHOUT SYMPTOMS: Remain isolated for at least 10 days from exposure date or until 72 hrs have passed with no symptoms AND at least a Negative COVID-19 test is required before returning to The Center.

FULLY VACCINATED

• WITHOUT SYMPTOMS: Exposure Risk level is taken into consideration but in general transmission risk is very low. Staff/Member attendance is allowed but with additional safety precautions required until a Negative COVID-19 test is confirmed. Additional safety precautions include 2x a day symptom checks, required mask wearing, eating, and drinking in isolation from other Staff/Members as well as added hand washing.
• WITH SYMPTOMS: Remain isolated until 72 hrs have passed with no symptoms AND a Negative COVID-19 test is required before returning to The Center.

 
*If within your household others may have tested positive for COVID-19 all household members should be symptoms free for 72 hrs before Staff/Members return to The Center. 
*For Staff - to support self-quarantine - PTO/Sick Time is applied if available.

What about if you are unsure about your risk of exposure as a Staff/Member? Do you still need to self-quarantine?
The medical community is constantly learning more about how COVID-19 is transmitted but it is important to recognize that individuals can transmit the virus and may be infectious even if they themselves are not showing any signs or symptoms of COVID-19. Fully vaccinated individuals can still transmit the virus, although this is less common. It is also important to remember that the Flu virus is highly infectious and can live on hard surfaces for up to 24 hours which is why adhering to added precautions and best practices is recommended.
 
To ensure the safety of our community and avoid unnecessary closures we recommend that at least an at-home COVID-19 Rapid Test is taken if there is any concern – regardless of vaccination status. These can be purchased at local pharmacies for ~$24 and include 2 at-home tests. The results are available within 15 min and have a high confidence/reliability score to PCR-Lab Test results. Based on the at-home test results follow the above guidelines.
 
What qualifies as a negative COVID-19 Test?
A Negative COVID-19 test is considered a confirmed negative PCR-Test (lab test) or 2 consecutive at-home tests taken per instructions with both tests resulting as negative.  We expect that proof of test is communicated by providing either a screen shot of lab test or a picture of an home test.
 
Closure Disclaimer
The Center has a small but mighty team. If staff members are out sick, unable to work AND we cannot accommodate alternative staffing we may have to temporarily close or modify our services until staffing needs are resolved. We acknowledge that this is inconvenient especially if we are unable to provide advanced notice. We will try our best to build support for staffing such as volunteers and substitute part-time staff BUT we have financial limitations that restrict these options. In addition, if we have to temporarily close our services the duration and costs of closure may prevent our ability to successfully reopen. We are confident that if we maintain a common agreement on General Safety and Social Distancing Guidelines amongst staff and Members, we will stay healthy, safe, stable and remain open. Membership credits for temporary closures are at the discretion of the Executive Director.
 
NTC Community Safety and Social Distancing Guidelines for Staff, Members and Families
(Regardless of Vaccination Status)
 
We ask that our staff, active Members and their families in addition to the above adhere to the below safety and social distancing guidelines whenever possible:

• Get vaccinated and encourage those in your household and community to get vaccinated
• Continue to practice social distancing and reasonable precautions including: Wear a mask when outside of their home and unable to adhere to social distancing >6ft apart or indoors (does not need to be a medical grade mask)
• Encourage care givers to wear masks when in close proximity to Member, regardless of vaccination status
• Stay at least 6 feet away from people when outside of the home and avoid crowds of more than 10 people
• Limit activity outside of the home to essential activities (grocery shopping, pharmacy, medical appointment ect) and try to have a designated person in the home who conducts these activities, limiting them to 1x a week if possible.
• Practice frequent handwashing, throughout the day and especially before and after eating and after using the restroom
• Be diligent about your own personal health and adhere to reasonable precautions by do not attending our program if you have experienced any symptoms, do not feel well or someone in your immediate family has experienced any of the below symptoms:

-        Recent fever?
-        Recent coughing?
-        Difficulty in breathing or shortness of breath?
 
*If a Member or Staff presents with any symptoms, we ask that The Center staff is notified ASAP so we may proceed with necessary precautions to maintain the safety of our staff and community. Staff are instructed to inform parents if there are any concerns or symptoms arise while at The Center.
 
Daily Arrival and Departure Protocol

• Handicap spot is for who is unloading, we will have a carpool style line. Staff will rotate helping with unloading. 
• Staff will meet clients in their car. Parents should unload individuals from vehicles. 
• Staff takes temperature at the car. If any signs or illness or temperature arise, they will be turned away from the program that day.
• As soon as a Member enters the building, hands will be washed or sanitized.  
• Departure will work the same. One loading at a time in the handicap spot.

 
Key Program Changes

• Staff will document their own and temperature and health screening questions (upon arrival) and any changes to temperature or health concerns daily
• Staff will document Member temperature and health screening questions (upon arrival) and any changes to temperature or health concerns daily
• Staff will wear masks throughout the workday
• Staff will support frequent handwashing of Members
• No program activities related to making food for consumption or cooking life skills
• Activities will be based off materials that do not need to be shared and each Member will have designated materials that will be isolated for their personal use
• Extra sanitizing on surface items used during the activity day
• No snack time
• At lunchtime Members will be reasonably physically separated
• Posters for handwashing and COVID-19 signs and symptoms will be posted for visual reminders and cues.

 
Sterilization Protocol - for Staff to Follow at The Center

1. Daily Space Sterilization
   1. Each morning and each afternoon the handrails, chairs, table surfaces, doorknobs, bathroom toilets, sinks and common areas of the facility space will be wiped down with high grade disinfectant.
   2. Supplies for respiratory hygiene and cough etiquette, including 60%-95% alcohol-based hand sanitizer (ABHS), tissues, no touch receptacles for disposal, and facemasks will be stocked and available for use by staff and Members
   3. Deep cleaning of entire space at least 2x a week

 

1. Member Sterilization
   1. Members will be required to wash their hands frequently throughout the day. They must wash their hands before and after eating and using the restroom.
   2. Staff will ensure that Members properly wash hands and monitor hygiene throughout the day.

 
References and Resources:
Tarrant County COVID-19 Vaccination Registration Link
COVID-19 Vaccination Resources
Compass Pharmacy – The Center Partner for Reduced Flu Vaccine Rates and Resources Monica Boyd, PharmD
CVS Drive Thru Testing - Appointment Only
CDC - Coping with Stress
CDC - Symptoms of Coronavirus COVID-19
CDC - Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection (Interim Guidance)
CDC - Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic
CDC – Possibility of Breakthrough Infections