IDD Leader

Turnover doesn’t start with direct support professionals—it starts with supervision.

In this episode, host Nate Beers sits down with Helena McGuire from Melmark to unpack why supervisors are the single biggest lever for retention—and how Melmark has intentionally built systems that help supervisors succeed instead of burn out.

Rather than relying on motivation or charisma, Melmark invests in behaviorally grounded supervision systems that make expectations clear, feedback consistent, and performance support sustainable. The result? Stronger teams, better outcomes, and dramatically reduced turnover.

This is Part 1 of a two-part conversation. In this episode, we focus on why supervision matters so much and what most organizations get wrong when trying to “fix turnover.”

Episode Timeline

00:00 – Why supervisors are the real turnover fix
03:45 – The hidden cost of underdeveloped supervisors
08:20 – From good intentions to strong systems
13:10 – What effective supervision actually looks like
18:05 – The revolving door problem
22:40 – Supporting supervisors before burnout
27:15 – Why training alone isn’t enough
32:10 – Setting up Part 2: onboarding and retention

Learn More:

To learn more about Melmark and their mission-driven work across multiple states, visit:
https://www.melmark.org/

Free Upcoming Sessions for IDD Leaders

This episode is part of a broader conversation about building a stronger, more stable workforce.

Nate is collaborating with the University of Minnesota’s Institute on Community Integration (ICI) on an upcoming free virtual series:
Direct Support Leadership Lens: Strategies for a Stronger Workforce

These sessions are designed for leaders who want practical, behaviorally grounded strategies to reduce turnover and support supervisors more effectively.

Learn more and register at: https://iddleader.com

🎧 Be sure to listen to Part 2 (Episode 67), where Helena breaks down Melmark’s onboarding approach and how they’ve achieved just 11% annual turnover.

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Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

Turnover in human services can feel endless—but it doesn’t have to be.

In this episode, Nate Beers shares what he learned in 2025 from conversations with providers across the country who are actually winning the turnover battle. These aren’t perfect organizations—and none of them found a magic fix. What they did do was make clear, intentional decisions about their workforce… and stick with them.

You’ll hear real examples of what’s working right now, including:

• What thriving providers do differently when it comes to onboarding and welcoming new staff
• How one simple, ongoing question dramatically improved retention
• Why investing more in staff upfront often leads to less overtime, fewer vacancies, and lower costs
• How scheduling, feedback loops, and staff voice can quietly reshape culture
• Why your next “tipping point” might be closer than you think

If you’re a leader who’s tired of chasing short-term fixes—and wants a workforce that’s healthier, more stable, and proud to work where they work—this episode is for you.

Episodes Referenced in This Episode:

• Ep. 24 – How One Provider Transformed Their Onboarding
  (Vocational Training Center – Fargo, ND)
• Ep. 28 – Staff Empowerment Elevates Retention
  (DSP Council from Welcome House)
• Ep. 33 – What Happens When You Invest in Your People?
  (Core Services)
• Ep. 43 – Leveraging AI in Human Services
  (Dr. Syard Evans, Arkansas Support Network)
• Ep. 44 – Turning Organizational Values Into Daily Actions
  (Dr. Syard Evans)
• Ep. 49 – From 4 Employees to 100: How This IDD Agency Scaled Without Losing Their Heart
  (CARES of Western PA)
• Ep. 50 – From Family Startup to IDD Industry Standout
  (CARES of Western PA)
• Ep. 53 – The Retention Strategy No One Talks About
  (Dr. Michael Strouse, Good Life Innovations)
• Ep. 54 – How “Professional Neighbors” Are Transforming IDD Care
  (Dr. Mike Strouse)
• Ep. 55 – One Simple Question Doubled Staff Retention
  (CHI Friendship)
• Ep. 56 – What Really Keeps Staff in Disability Services
  (CHI Friendship)

Related Conversations on Workforce Advocacy

• Ep. 59-60 - NADSP (National Alliance for Direct Support Professionals)
  Conversations on professional recognition, advocacy, and elevating the DSP workforce
• Ep. 57-58 - NASDDDS (National Association of State Directors of Developmental Disabilities Services) & HSRI (Human Services Research Institute)
  Discussions on policy, funding, and national workforce trends
• Ep. 47-48 - National Leadership Consortium on Developmental Disabilities (NLCDD)
  Leadership development, systems change, and long-term workforce sustainability

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Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

In this short holiday episode, host Nate Beers shares an unexpected moment at home that turned into a leadership wake-up call — the kind that sneaks up on you, disarms you, and ultimately makes you better.

What begins as a normal, chaotic family dinner quickly turns into a powerful reminder about the difference between reacting and responding — not just as parents, but as leaders of teams, programs, and organizations. Nate pulls back the curtain on how even seasoned leaders can slip into stress-driven reactions… and how a simple, honest comment from his 10-year-old became a gift worth passing on.

Inside the episode:

--The surprising moment that shifted Nate’s whole evening
--Why leaders often default to “fix mode” (and how it backfires)
--A practical way to notice what’s happening in your body before it leaks into your leadership
--How high-performing organizations actually solve problems
--Why the way we solve problems can sometimes reinforce them
--A simple mental reframe that turns stress into creativity and connection
--How this applies directly to workforce challenges and turnover in IDD services
--A reflective action step you can use today

Whether you’re an Executive Director, Program Manager, HR leader, or frontline supervisor, this episode offers a calming breath, a grounded perspective, and a gentle invitation to lead with more intention — especially when things get messy.

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Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

What does it really take to build services that last—not just through the next budget cycle, but for the next decade?

In this conversation, host Nate Beers sits down with Tim Sohosky from RCPA to talk about the long game in disability services: how change actually happens, why efficiency alone isn’t enough, and what leaders need to pay attention to now if they want their organizations—and their people—to thrive long-term. This is Part 2 of their conversation.

They explore:

• How advocacy moves from frustration to real system change
• Why outcomes matter more than ever (and what we’re measuring wrong)
• The hidden strain leaders feel when innovation collides with regulation
• What sustainable leadership looks like five to ten years out
• How building a bench of future leaders protects everything you’re working toward

This episode isn’t about quick fixes. It’s about perspective, patience, and making decisions today that future leaders—and the people you support—will thank you for.

TIMESTAMPS
00:00 – Why leadership isolation is a real challenge in this field
01:03 – Why hearing what other providers face actually matters
02:36 – How RCPA collaborates with other associations
06:34 – How a single provider concern becomes an advocacy priority
09:32 – Why advocacy takes time—and why it still matters
10:23 – The constant tension between efficiency and regulation
14:59 – Why outcomes matter more than incident-free care
20:32 – Innovations that are actually helping providers right now
26:07 – Building future leaders before you need them
32:24 – Looking 5–10 years ahead: risks, opportunities, and the long game
36:34 – Final reflections on leadership and sustainability

Learn more about RCPA:
👉 https://www.rcpa.org

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Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

In today’s episode, podcast host, Nate Beers, sits down with Tim Sohosky, IDD Director at RCPA (Rehabilitation and Community Providers Association), to uncover one of the most overlooked advantages available to leaders in the IDD field: your provider association.

If you’ve ever felt like you’re leading in isolation, drowning in vacancies, or constantly reacting to new regulations—you’re not alone. And you don’t have to keep going solo. Tim shares insider insights on how high-performing leaders stay ahead of staffing challenges, influence policy before it hits their agencies, and tap into resources that make their jobs easier (and their teams stronger).

This is part one of a two-part conversation loaded with practical wisdom and real-world leadership moves you can use immediately.

🔗 Resources Mentioned:
RCPA Website: https://www.rcpa.org

“7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams” (Free PDF): https://iddleader.com/burnout

00:00 – The surprising truth: some agencies are winning the staffing battle
01:10 – Nate’s “doorstop” story and the theme of overlooked resources
03:09 – If you became CEO today: Tim’s first 3 moves to stabilize staffing
07:22 – Tim’s background from DSP to COO to statewide association leader
11:04 – What provider associations actually do (and why leaders need them)
15:27 – Managed care, performance-based contracting, and how leaders can stay ahead
18:54 – Biggest lessons learned from PA’s rollout—and what leaders in other states should do now
23:37 – Why some organizations thrive while others drown (and the leadership behaviors that set them apart)
30:05 – Game-changing recruitment strategies and the power of authentic communication
34:48 – Why formal DSP recognition matters (and how legislation could reshape the field)
35:55 – Nate’s Action Move: Why leaders must ask for help (and where to start)

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Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

Supervisors rarely intend to burn out their teams—but the early warning signs are easy to miss until turnover, drama, and exhaustion take over. In today’s episode, Nate breaks down The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and what agency leaders can do to stop the cycle.

These subtle patterns show up long before resignations do—and once you see them, you can’t unsee them. Most importantly: they are fixable with better coaching, clearer expectations, and healthier leadership habits.

If your teams feel stretched thin, inconsistent, or stuck in “burn-over,” this episode will help you quickly diagnose what’s happening underneath the surface.

TIMESTAMPS
00:00 – Why burnout isn’t an individual weakness
01:08 – Holiday story & how unclear norms fuel staff burnout
08:18 – Danger Sign #1: Staff learn expectations through gossip
10:13 – Danger Sign #2: Supervisors go days without 1:1 connection
12:37 – Danger Sign #3: New staff hardly see their supervisor in the first 72 hours
14:03 – Danger Sign #4: Supervisors say they’re “too busy” to coach
16:27 – Danger Sign #5: Supervisors avoid conflict until it explodes
20:16 – Danger Sign #6: Supervisors celebrate completion, not progress
23:22 – Danger Sign #7: Supervisors assume burnout is personal resilience—not workload or leadership
27:02 – Action moves & free resource: The 7 Quiet Danger Signs Tool

Download the free tool: https://iddleader.com/burnout
Learn about the Leadership Lab: https://iddleader.com/leadership

Referenced Episode
Episode 35 – "The 3-Sentence Script for Any Tough Employee Conversation"

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Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

If you’ve ever felt trapped in the cycle of high vacancy and high turnover, this episode will feel like oxygen.

In Part 2 of my interview with Joe Macbeth and Dan Hermreck of NADSP, we dig into the data, the myths, and the practical steps that are actually helping agencies go from 40% turnover to 10% turnover — with DSP credentialed staff.

If you lead an IDD provider agency, this is essential listening.
If you care about building a more stable, skilled, and respected DSP workforce… even more so.


TIMESTAMPS

00:00 - Why the industry treats 40% turnover as “normal”
03:07 - The hidden cost of relying on intuition instead of competency
07:22 - What agencies with 10% DSP turnover do differently
11:48 - Why credentialing changes culture — not just résumés
15:09 - What states are finally recognizing about DSP skills
18:41 - The fight for fair DSP classification (and why it matters)
22:14 - How frontline supervisor credentialing could change everything
26:55 - What leaders must challenge if they want real retention

Links & Resources

Learn more about NADSP’s E-Badge Academy:
https://nadsp.org/services/the-nadsp-e-badge-academy/

Get “The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams”
Learn how high-retention agencies spot — and fix — these issues fast.
https://iddleader.com/burnout

Send us Fan Mail

Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

“Born” in the Oval Office? Yes—NADSP’s origin story is wilder than you think.
In this episode, Joe Macbeth and Dan Hermrick from the National Alliance for Direct Support Professionals join Nate to unpack the surprising beginnings of NADSP, the national movement they’ve sparked, and why DSP credentialing is becoming one of the most effective tools for solving turnover and elevating the profession.

We talk about the Pope, policy, real outcomes, and what provider leaders need to know right now to build a more stable, high-quality workforce.

SHOW NOTES
00:00 - Intro
02:43 - The Pope story — and what it reveals about DSP competence
08:27 - Introductions: Joe & Dan and NADSP’s mission
10:32 - “Born in the Oval Office”: The surprising founding story
17:16 - What the e-Badge Academy actually is and how it works
27:41 - What changes when DSPs become credentialed

🔗 Helpful Links

Learn more about the NADSP E-Badge Academy:
https://nadsp.org/services/the-nadsp-e-badge-academy/

Send us Fan Mail

Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

Wages up. Turnover down. Still not enough.

In Part 1, we looked at the progress: DSP wages are rising, and turnover is finally trending down. But in this episode, we explore what’s driving the next wave of change—and the new rules that could reshape DSP pay, policy, and funding for years to come.

I’m joined again by Laura Vegas (NASDDDS) and Dorothy Hiersteiner (HSRI), who oversee the National Core Indicators State of the Workforce Survey—the nation’s most comprehensive data set on DSP wages and stability. Together, we dig into the major shifts happening right now at the federal and state levels—and what they mean for provider agencies and state leaders on the ground.

In this episode, we cover:
• What the new CMS “80% rule” means for DSP wages and rate setting
• How states are using workforce data to push for funding and reform
• The growing link between training, credentialing, and pay
• Why provider participation in data collection is more important than ever
• Real examples of states turning data into lasting workforce change

Whether you’re a provider leader, a policy director, or anyone who cares about the future of this workforce, this episode helps you connect the dots between policy, funding, and the people who make services possible.

Explore the data and organizations mentioned:
➡️ NASDDDS → https://www.nasddds.org/
➡️ HSRI → https://www.hsri.org/
➡️ NCI Staff Stability Survey → https://idd.nationalcoreindicators.org/staff-providers/

Show Notes / Timestamps

00:00 – How lawmakers are using NCI workforce data to shape bills
00:56 – Episode setup: why this conversation matters for providers
02:30 – What the new CMS “Access Rule” really means
06:18 – What providers should be tracking now to prepare
06:48 – Linking funding to training, credentialing, and outcomes
10:30 – Statewide training platforms and portability for DSPs
13:33 – How states are using workforce data to drive advocacy
17:21 – What’s keeping state DD leaders up at night
21:44 – Why better pay and career paths could change everything
23:12 – How provider participation in surveys influences federal policy
27:12 – Why small and mid-sized providers need to be represented in data
28:10 – Finding and learning from positive outlier agencies
32:05 – How NCI data sparks innovation across states
32:36 – Where to find the data and connect with NASDDDS and HSRI
34:34 – Closing reflections and next steps

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Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout

Are DSP wages finally improving—or are we still far from solving the workforce crisis? 

In this episode, Laura Vegas (NASDDDS) and Dorothy Hiersteiner (HSRI) unpack what the National Core Indicators State of the Workforce Survey reveals about turnover, tenure, and wages across the country—and what that means for your organization. 

Explore more:
NASDDDS → nasddds.org

NCI Staff Stability Survey → idd.nationalcoreindicators.org/staff-providers 

Send us Fan Mail

Quick Question:

Do your frontline supervisors sometimes unintentionally contribute to staff turnover? It happens so easily because... Most supervisors were never trained to lead.  Get The 7 Quiet Danger Signs Your Supervisors Are Burning Out Their Teams and learn how high-retention agencies spot — and fix — these issues fast. https://iddleader.com/burnout