A recent report by the Montana Developmental Disabilities Planning Advisory Council (2001) described that, on average, turnover among direct service staff during the year 2000 was 120%. The report argued that such a high rate of turnover directly threatened the quality of services provided to persons with developmental disabilities. Two independent samples (N=266 and N=649) of adult consumers of State developmental disabilities service programs provided preliminary evidence supporting the report’s assertion. Each sample participated in surveys assessing limitation associated with secondary conditions as experienced by these consumers. Descriptive statistics indicated that a change in direct service staff was experienced by approximately one half and two thirds of the participants in each sample, respectively. Alarmingly, further descriptions revealed that turnover was experienced more consistently in a vulnerable subgroup of consumers than in a more resilient subgroup of consumers. Specifically, 94% of older consumers with greater disability severity experienced a change in direct service staff , whereas 26% of younger consumers with lessor disability severity experienced a change in direct service staff. Furthermore, regression analyses indicated that experience with turnover was a significant predictor of increased limitation associated with secondary conditions, of more injury-related secondary conditions, and of higher rates of health care utilization. To emphasize the practical significance of these findings, reported health care utilization data were linearly transformed using average Medicaid costs for specific services. These transformed criterion variables illustrated that direct service staff turnover was related to higher Medicaid costs.
Learning Objectives: At the conclusion of this session, the participant (learner)will be able to: 1. Discuss turnover in direct service staff serving adults with developmental disabilities. 2. List potential roles formal support stability have in the prevention of secondary conditions. 3. Recognize the relationships existing between turnover, stress, and the experience of secondary conditions.
Keywords: Personal Assistance, Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Montana University Affiliated Rural Institute on Disabilities, The University of Montana, 52 Corbin Hall, Missoula, MT 59812
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.