By Clare Bratten

NASHVILLE, TN — Every day, workers who earn a wage of $10 an hour leave their night shifts or show up early in the morning at houses across Nashville. Their job as Direct Support Professionals is to help people with intellectual and developmental disabilities get out of bed, get dressed, get showered, eat their breakfast or fix nighttime meals and prepare for bed and other chores of daily life. Without the daily help of these Direct Support Professionals, life would be impossible in a home environment for most of the disabled clients who qualify for Medicaid Services. 

Queshawn Starks is one Direct Support Professional. It is work she finds fulfilling. But with a salary set at $10 an hour, even with overtime, it puts renting her own apartment out of reach. 

One of her clients is Pat Medlin. Ms. Medlin was eating her breakfast on a sunny day while Queshawn mopped an already spotless kitchen and answered a few questions about her work. 

 “I’m 24, I grew up in Nashville TN.  I went to work with my Mom one day, she was working here, (and) I said I wanted to work here. I just like the environment. Taking care of them

Queshawn Starks helps Pat Medlin with meals, personal care and other chores of daily life.

[the disabled], it seemed like you were really helping somebody. Right out of high school, I applied for a job and I’ve been here ever since.”  

“I had one client when I first started, who was in a wheelchair. He could pretty much do everything on his own, he could still transfer (from the chair); he just needed help with a shower and preparing his meals, or transport to activities because he didn’t drive. Another client was blind who needed assistance throughout the house.”

“When I first started, my shift was 3pm to 9. Then my shift changed from 3pm to 11 pm.  Some days I would pick up overtime and work from 7 in the morning until 11 at night.”

While her client, Pat Medlin, is dependent on the help of Direct Support Professionals (DSPs) like Queshawn Starks, Queshawn’s salary of $10 per hour is actually set by the department of Intellectual and Development Disabilities (DIDD) for the state which allocates certain funds for salaries. The DIDD budget only funds DSP pay for those who support people with intellectual or developmental disabilities who qualify for a 1915c Medicaid Home and Community Based Services waivers.  It is the DIDD who pays DSP providers an average hourly wage of $10.

Working in the same home for another client is a DSP named Etang Ekanem who said he is originally from Nigeria. He also picks up more shifts to earn more.  

“For the first shift I work eight hours. The second shift I do eight hours. Sometimes I go in for a third shift of eight hours,” said Etang. 

When asked when he sleeps, he answered. “It’s not about sleep. It’s about what concerns me which is the money to take care of my family,” said Etang. He agrees that a higher wage of $15 an hour would make it possible to eliminate one of his several shifts and see more of his family. “For what I’m earning now at the end of the month, sometimes it is not enough to pay my rent, pay my phone bills and other bills I have to take care of,” he said. 

Queshawn says the salary is so low that she cannot afford to move out and still lives with her mother.  She would like to have her own apartment. 

The Tennessee Community Organization (TNCO), an advocacy labor group for nonprofits, is pushing to get the state to pay such workers a wage of $15 an hour. At her current rate of $10 per hour, Queshawn and Etang could make more per hour working at starting wages at Walmart or Target, therefore retaining such DSP workers is a problem for the DIDD. A spokesperson for the program said there are currently 7,000 active clients in the program, with many more needing such support. 

Tennessee Community Organization website characterizes the need for an adequately staffed and fairly paid DSP workforce as a “crisis.” 

A statement on the TNCO website, argues: “DSPs need and deserve . . .competitive compensation for the high level of specialization and responsibility their positions require and their irreplaceable role in delivering continuity of care.”