Ep. 649 The True Cost of DSP Turnover in Developmental Disability Services
Rancho Mesa’s Alyssa Burley sits down with Vice President of the Human Services Group Sam Brown to talk about the true cost of direct support professional turnover within the developmental disability services industry.
Show Notes: Subscribe to Rancho Mesa's Newsletter
Host: Alyssa Burley
Guest: Sam Brown
Producer/Editor: Megan Lockhart
Music: "Home" by JHS Pedals, “Breaking News Intro” by nem0production
© Copyright 2026. Rancho Mesa Insurance Services, Inc. All rights reserved.
Transcript
Alyssa Burley: You’re listening to Rancho Mesa’s StudioOne™ podcast, where each week we break down complex insurance and safety topics to help your business thrive.
I’m your host, Alyssa Burley, and I’m joined by Sam Brown, Vice President of the Human Services Group with Rancho Mesa. Today, we’re going to talk about the true cost of direct support professional turnover within the developmental disability services industry.
Sam, welcome to the show.
Sam Brown: Thanks for having me. Glad to be here.
AB: Many people understand that direct support professional (DSP) turnover creates staffing challenges, but in a recent article you wrote, you point out that it also creates hidden financial and insurance costs. So will you explain how employee turnover impacts an organization's overall risk profile and insurance expenses?
SB: Yeah, let's talk about that. I think it's something that nationally has been gaining traction. California, it's probably been something that's been on our clients' minds for many years. So with wage inflation, it can be difficult to attract the right employees just away from other industries, for example. I mean, you can go work in a fast food restaurant and make well over $20. Losing employees, especially in the DSP role, is going to thin out that. staff population, meaning that they're probably going to have to assume some responsibilities for those employees that left while they're filling the ranks. It's also going to add a lot of costs to the organization as they market the position, interview, hire, onboard, train, get certified perhaps with first aid. So there's a lot of costs that go into that. Now, when you also see employee turnover, there’s a couple of things you might expect. You might start to see some EPLI claims if they felt like it was a stressful environment or I'm not going to offer any other reasons why EPL claims would be submitted, but it could happen. You could see post-term workers' compensation claims. You could also see that the staff who remain might file workers' comp claims just because they're getting a little bit overworked as well. So that's just on the safety side for the employees. On the liability side, you could see less experienced either in the industry or with our particular employer, less experienced employees handling responsibilities without the proper training or maybe less of it. It could be that there's a liability there as they're handling the duties. So it's varied.
AB: All right, with Medicaid reimbursement rates often limiting an organization's ability to increase wages, what are some practical steps nonprofits can take to improve retention, reduce risk, and better support their direct support professionals?
SB: Yeah, and obviously this falls outside of the purview of Rancho Mesa, but we are lucky where we talk with clients about what's working, what's not. We talk to HR professionals that have similar clients to us. Over the years, we've definitely picked up on a few things that we think are working, that we know are working. Obviously, number one would be competitive compensation and benefits. Oftentimes in the nonprofit world, if the wage is a little bit down, the benefits package is usually very rich, and that's with a lot of intention. So that's very helpful and appreciated by the workforce. Of course, you want to invest in training and professional development of your employees. So if they're going to be in your building, might as well make sure that they're trained and they're going to appreciate that. And when you train employees, typically they remain employed longer. You know, you really want to try to strengthen some supervisor support as well, some empathy there. You know, hopefully those supervisors can hear the warning signs of someone who may be burned out or frustrated or, you know, looking around. Training those supervisors with some empathy training can be really important.
Of course, recognize and reward performance, right? I mean, Rancho Mesa is a good example of that. We have our one-of-one awards. We've got QR codes all over the office where you can take a quick snapshot and recognize somebody. Any employer can do that. And if you're using Safety One, you can do that too. And that's one of the first examples I bring to our clients to say, hey, we do a fun thing. It's right there on the coffee maker every morning, and they usually smile and like. that idea. You know flex scheduling can really help, especially as they're dealing with family issues, make it easy for them to deal with those family issues.
And then I'm sure a lot of employers do this, probably don't call it this, but stay interview, right? We all know what an exit interview is, but what about a stay interview? Rather than waiting for that person to leave, proactively ask current employees, what's working? What's not? What would you like to see happen a little bit differently? So, you know, that and then, of course, right now, just leveraging technology to reduce administrative burden. I think that's a big one as well. Everyone feels it and appreciates it. And I think that means that they can do the things in their job that they like doing and more of it.
AB: Yeah so in your recent article you also highlighted the important role an insurance advisor can play beyond simply providing coverage. What are the most important conversations nonprofit leaders should be having with their insurance broker to help control costs and strengthen risk management?
SB: Yeah, I mean, all of these exposures to liability or workplace safety should be part of the conversation at the pre-renewal meeting. I mean, really throughout the year as well as different programs come on or come off. Had a call yesterday from a client that just said, hey, in our residential program, we're having a little bit of difficulty with our tenants. Where does our insurance jump in? Where do we potentially have a shortcoming? So it was a really good conversation. initiated by the CFO, which I appreciated. But she also knows we're meeting next week for the pre-runal. So perhaps just having that on the calendar really got her and her C-suite thinking of some questions to raise even before the meeting. Regardless of the timing, it was a really good conversation.
In regards to the particular issue regarding turnover, it would be easy for the producer or broker as well as the C-suite or whoever you're working with to look at the data together to really understand, okay, are we seeing the impact of turnover in our workers' comp claims history? And if so, let's address it. Is it by department? Is it by tenure? Is it by... age of the population I mean the data is all there so what can we do to learn from it and it could be that turnover is not the issue but maybe it's shoot time of day oh those late shifts are really resulting in injuries so the data is important and it's easier than ever to aggregate it and learn from it.
You know, good questions to ask as well is, hey, do our limits still fit our exposure? At one point we had a nervous board member and we had $20 million limits. Is that still appropriate? Well, we can have those conversations. Or we're pursuing a new contract. There are higher limits needed. Is this something that's achievable? And if so, what's the cost? And if the cost is, you know, exorbitant, then shoot, maybe we don't pursue that contract. So we'd never want insurance to be in the way of growth or pursuing contracts, but the reality is there's a cost associated with it. And then, you know, I always think it's important for either the broker to kind of put a fresh coat of paint on or for the insured to ask, hey, what loss control or risk management resources are available from either the carrier or Rancho Mesa, the insurance agency. You know, whether it's training modules or toolbox talks, the safety app, which we call Safety One, our HR compliance library and HR hotline, incident reporting tools to make things more uniform and bring new hires up to speed as well as supervisors. Again, these are all things that, hey, if we've had a really quiet claims year, they may have forgotten all this, which would actually be good news. We want them to know going into the renewal, hey, this is here. Make sure you disseminate this information appropriately so different supervisors as well as department heads have this information.
And then I alluded to it earlier, but I think what's really important is making sure that the incident reporting for workers' comp or workplace injuries is uniform and strong. We've just found that when that's in place, it illuminates claims reporting lag. It eliminates employee confusion. It eliminates litigation rates. It reduces claims cost, claims duration. It improves employee morale. We are really banging on the drum of creating a uniform claims reporting process, and our clients are seeing the benefits of it. And then I think it's a fair question for clients to ask, how do we get favorable pricing that considers our excellent hiring practices, our below average turnover rate, if that's the case, and our safety trainings. You know, hey, what are we doing to make sure that this information is getting in the hands of underwriters so they can price us appropriately or lower? So fair question. And, you know, all that information is music to our ears because we want to put it in front of the underwriters.
AB: Yeah, those are all really good things to consider. Anything else you'd add?
SB: Probably the last one would just be within the nonprofit and human services market. We are still in a hard market where carriers are reducing limits, increasing deductibles, reducing appetite even. Hey, we used to write boys and girls clubs and maybe they don't any longer so for example. But I think it's a fair question just to ask the agent, you know, hey, how are we positioned for a hard market cycle in the liability lines? And, you know, given the sector's exposure to abuse, molestation, and professional liability claims, how are we doing? So standing shoulder to shoulder in those conversations throughout the policy term usually results in really sound coverage, some really risk management policies, procedures, and culture. and then a really successful partnership.
AB: All right. So Sam, if listeners have questions about their risk management strategies, what's the best way to get in touch with you?
SB: Yeah, I can be reached at (619) 937-0175 or email is sbrown@ranchomesa.com
AB: All right. Well, Sam, thanks for joining me in Studio One.
SB: Yeah, thanks for having me.
AB: Of course. Thank you for tuning in to our latest episode produced by StudioOne™. If you enjoyed what you heard, please share this episode and subscribe. For more insights like this, visit us at RanchoMesa.com and subscribe to our weekly newsletter.