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How Bethesda Lutheran Turned DSPs into Leaders

Bethesda Lutheran Communities is a service provider for individuals with intellectual and developmental disabilities. The organization is based in Wisconsin but has programs in 13 states, serving more than 1,800 people.

In 2017, Bethesda launched its DSP Leadership Team to engage and empower its direct support professionals. DSPs who have been with Bethesda for at least a year can apply to join and must submit letters of support from their supervisor and a colleague. The team has one member from each of Bethesda’s nine regions. Team members receive a yearly stipend of $500 and are paid their hourly wage when attending or participating in team activities.

The stated purpose of the DSP Leadership Team is to “create transparent and constructive engagement between direct support professionals and regional/corporate leadership at Bethesda.” Its goals are to:

  • Promote a collaborative relationship among DSPs and all corporate and regional staff
  • Establish greater understanding and appreciation of different perspectives and to address employee concerns and issues
  • Encourage, celebrate and recognize DSPs and provide an organization-wide network for DSP support
  • Actively solicit employee feedback; evaluate and recommend strategies for improving employee engagement


We interviewed Mark Hagen, Bethesda’s Corporate Director of Public Policy, about the program.

Q: What was Bethesda’s thought process and goal when setting up the DSP Leadership Team?

A: We had been toying with the idea for a long time of how to better engage DSPs. We’re in 13 states, and one of the problems we have is that some of the DSPs who aren’t in the home state of Wisconsin where we’re headquartered feel alienated. We felt that selecting certain DSPs to come to Watertown, to meet with leadership, to have leadership talk to them, to see if there are problems unique to certain regions that maybe we’re not hearing about… Those are some of the concerns we were trying to address.

That was the genesis of the program. It was started by our CEO Mike Thirtle and our then-COO Lori Anderson. They thought this would be a good model to pursue, so we fine-tuned their ideas and rolled it out about two years ago.


Q: What have you been able to learn about the work and lives of DSPs through the Leadership Team?

A: Leadership, legislators, elected officials—as much as they say they understand what’s happening in the field, they don’t get it. They don’t understand the day-to-day challenges. They don’t know what it’s like to miss your child’s soccer game because the person who was supposed to relieve you at the group home not only didn’t show up but just quit. They’ve got these challenges in their personal lives that are exacerbated by worker shortages and staff vacancies in addition to the pressures of supporting the lives of human beings.

They said, “We know within five minutes if someone will be around in two weeks or not.” They feel like that’s always hanging over their heads because they’ll look at the schedule and say, “Well, that person’s scheduled and I bet they’re not even going to be here.” It’s surprising how really tuned in they are to who’s going to stay and who’s not because of their experience.

After talking with our HR department about what they think is important in a DSP—what attributes, what characteristics, what experiences—I think the Leadership Team feels like HR has a better idea of the type of candidate we’re looking for.


Q: What did the DSPs learn about the management and operations of Bethesda Lutheran?

A: For all of them, this is really the first time they’ve been immersed in the decision-making process—why decisions are made, how they’re made, and that programs aren’t rolled out just because we’re looking for ways to make DSPs lives more complicated, but that we’re trying to meet a government mandate or new reporting or auditing procedures. I think they have a better appreciation of Bethesda.

Before the first face-to-face meeting, I asked them to read the white paper on the DSP workforce crisis that ANCOR did. They were shocked. The comments, almost unanimously, were, “We just thought Bethesda didn’t know what it was doing. We didn’t know this was a national problem. We didn’t know all other providers were going through it.” While it didn’t make their lives providing supports any easier, it did change their perception of the organization.

As their understanding of the rationale that goes behind the processes and the policies increased, their eagerness to adapt to it and embrace it increased as well.

As a result of the conversations I had with the DSP Leadership Team, I decided to do a weekly newsletter that goes to all staff. It’s a public policy advocacy newsletter, where we talk about what’s working, how different states fund services differently. We’re really trying to do a better job of educating DSPs on how the system works, what it means to them, and better engage them in the process so they know what’s at stake. Our DSP Leadership Team is really driving some of our DSP advocacy efforts on the state level.

I developed an advocacy module that we use in DSP training in our Relias platform. As we look to our first transition to new DSP Leadership Team members (terms are two years staggered) we are looking at developing an onboarding and training module incorporating feedback from outgoing and existing team members.


Q: What kind of feedback have you received from the DSPs on the Leadership Team?

A: This will be the third November now they’ve come into town, to Watertown. Our CEO always makes sure he takes time to sit down and talk to them and let them know how much he appreciates the time and effort they’ve been putting into it. They have lunch with our board of directors who give them that same message.

They feel like it not only honors them but it honors their colleagues. I know they’re telling people about this team and really encouraging people to apply for a position on it. All of the members so far have found great value in it and feel much more valued as a member of the team.

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