COVID-19 DSP Staffing Crisis Response

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin



The Division of Developmental Disabilities (DDD) recognizes that COVID-19 has had a significant impact on provider operations over the course of the pandemic. In particular, it has exacerbated the nationwide staffing crisis impacting providers, which is leading not only to provider fatigue and stress but also reduced capacity, closures and consolidations. Through flexibilities provided under Appendix K, the DDD will be allowing the following through the end of the fiscal year (June 30, 2022). These changes coincide with changes already allowed under UPDATED - V.2.1 - COVID-19 DSP Training (DD.20.023 FINAL). Providers should also review the Staffing Crisis Flexibilities Q & A for additional ideas and/or support.

Reporting Requirements for DSP Training:

The DDD has made several temporary changes to assist agencies in securing employees to work in DSP positions. The changes are allowed only during the COVID 19 staffing crisis period as defined by the DDD. After the COVID 19 staffing crisis period, all training requirements will revert to the DDD's standard rules. All modified DSP training reports must be sent to the DDD, Bureau of Quality Management (BQM). Training reports must include, at a minimum the following:

  • the agency that trained the DSP
  • the name and social security number of the DSP
  • the start and completion date of modified training and the trainer

Once the staff member has completed the full standard DSP training, this is to be communicated to and submitted to IDPH for registration on the Health Care Worker Registry.

Failure to report the individuals trained through the modified DSP courses will invalidate the DSP training and prohibit the individuals from working as DSPs.

The agency will continue to be required to submit the 120-day waiver for all DSP's hired through the Modified DSP curriculum who haven't completed the entire standard DSP approved curriculum within the first 120 days. These should be sent to Reimbursement for DSP training will be given after completion of the complete standard DSP curriculum training.

Changes to eligibility for DSPs:

  • Providers shall prioritize First Aid / CPR training for all DSPs, however, DSPs are permitted to work without First Aid / CPR certification as long as there is at least one other First Aid / CPR certified staff member working within the immediate work area or home at the same time.
  • Staff can be shared between agencies (including out of state agencies). The hiring agency can contact the potential staff member's current agency to confirm the necessary background checks and fingerprints have been completed. This should be documented by interagency emails. Please cc The hiring agency must check the Healthcare Worker Registry to confirm the potential staff member is listed.

We want to remind providers that Certified Nursing Assistants (CNAs) may be hired as DSPs and are able to forgo the full DSP training. CNAs only need to take the 3-hour Abuse & Neglect course and the associated OJT. They must receive any additional training required to meet the individual's needs including any de-escalation and prevention methods identified based on behavioral needs, behavior plans, and risk assessments.

Changes to eligibility for current employees to allow for redeployment:

  • Staff qualified under any service definition (examples below) in any of the Division's three Home and Community Based Waivers or any other IDHS Medicaid waiver programs may be redeployed as a DSP.
    • For example, Personal Support Workers, Job Coaches, Vocational Specialists, Behavior Therapists, Personal Assistants, QIDPs, etc. can all be redeployed to be a DSP in a residential or Community Day Service setting.
  • Staff who are redeployed must receive training from the DSP modules to fill any knowledge gaps that might exist between their current role and the DSP role.
  • It is the agency's responsibility to determine what additional training is needed for redeployed staff based on the individual needs of the client, their behavior plan and their risk assessment.
  • Individualized training on de-escalation and prevention methods must be given based on any behavioral needs the individuals served have.
  • DSPs can work alone if they have a First Aid/CPR Card that is valid.

Changes to DSP Training:

A Modified Direct Support Person (DSP) Curriculum can be used during the crisis period to accelerate on-boarding DSPs. The following modules/sections must be completed prior to working alone.

  • Module 3 - Abuse and Neglect Prevention, Recognition and Intervention- 3 hours
  • Module 4: Human Interaction and Communication- 4 hours
  • Module 6 - Basic Health and Safety (include minimally the following areas)-10-15 Hours
    • Section 1 - Introduction to Basic Health & Safety
    • Section 3 - Vital Sign & Symptoms
    • Section 5 - Assisting with Activities of Daily Living
    • Section 6 - Environmental and Individual Safety
  • The full Direct Support Person (DSP) Training curriculum can be completed in up to 240 days, as opposed to 120 days.
  • The agency should submit the 120-day waiver for all DSPs going through the extended DSP training period (240 days). The completed Form 1291 should be sent to Reimbursement for training will be given after completion of the standard DSP curriculum training.
  • On-The-Job Training (OJT) should still be completed as they are applicable to the required module / section intervention competencies. This information is listed in the Interventional Competencies Table of Contents on pages 5-6 of the DHS Direct Support Person Training Program.
  • The training modules omitted during the crisis period must be completed once the DDD determines the staffing crisis period to be over.
  • Individualized training on de-escalation and prevention methods must be given based on any behavioral needs the individuals served have.
  • OJT supervision can be provided using a remote video process (FaceTime, Zoom, Skype, etc.). It should be documented on the OJT competencies that it was reviewed remotely.
  • Abuse & Neglect and Individualized training on de-escalation and prevention methods should not be delayed and must be based on the needs of the individuals.

Current Temporary Medication Administration Training Guidance:

  • The basic 8-hour medication administration training class can be given by webinar.
  • Basic 8-hour medication trainings can be transferable between agencies (including out-of-state agencies). The hiring agency should contact the agency who provided basic medication training to the staff to confirm the staff was trained and passed the Medication Authorization Test. The hiring agency will request a copy of the 8-hour medication training document/roster and a copy of the Initial Medication Authorization Test for their personnel file.
  • RN Trainer continues to have the discretion to determine if a staff member does not demonstrate competency to administer medications.
  • For a newly Authorized DSP (ADSPs), if the RN trainer cannot complete the first CBTA in person, the RN Trainer can use a remote video process (FaceTime, Zoom, Skype, etc.).
  • CBTA trainings for new clients may be provided over the phone if the ADSP has experience passing medications with other clients. It should be documented on the CBTA that it was done remotely.
  • CBTA completion on inhalers, suppositories, eyedrops and eardrops that cannot be done in person, must be provided by a remote video process (Facetime, Zoom, Skype). It should be documented on the CBTA that it was done remotely.
  • The RN Trainer can electronically sign documents with a typed signature provided that after the crisis period is over, they go back and sign/date each document.
    • For example, new "medication change forms" can be completed electronically, and the nurse can type their name. After the crisis period, they should print the document and sign and date it on the date that it was printed.
    • This should be done for any other document the RN Trainer is not able to print or sign in person

Effective Date:


The information contained herein should not be considered a substitute for the appropriate official statutes, rules, regulations, or the advice of legal counsel.