In the world of organizations that provide support services to adults with disabilities, there is no greater challenge than the current shortage and turnover rate of direct support staff. While the impact to these organizations is mission-critical, the impact on the people they support is far greater because it’s personal. In the book, Whole Community, I point to an important but often overlooked element of the crisis—Friendship. Here’s an excerpt:
Ask people who live in a group home or supported apartment who their best friends are and you will likely hear a list of people who are paid teachers and caregivers. Given the high rates of turnover among staff who work in the developmental disability field, this is a huge problem. Among direct support professionals (sometimes called caregivers or aides), the annual turnover rate in 2015 averaged 45 percent. This is a critical and expensive issue among professional support organizations who will need to absorb the costs of using temporary agency staff, of filling positions, and of training new staff. From the viewpoint of the individual receiving support, the cost is different and far more tragic. Simply put, nearly half of the people they count as their closest friends will walk out of their lives this year with a two-week notice, and they will never be heard from again.
That is not to be at all critical of paid caregivers who find themselves in a very complex and often no-win situation. The work is difficult, the hours are long, and, since Medicaid funding fails to keep pace with need, caregiver pay is alarmingly low.
But their relationship is unique. This is not an isolated medical appointment in which professional distance is more easily accomplished. Rather, it is assisting, interacting, sharing, laughing, advocating, comforting, and teaching. It is all day, every day, and a far deeper relationship is a natural result. It looks like friendship and often acts like friendship, but there is always something artificial about it. It is cast in a world of paid benevolence and interaction that is more concerned with clinical outcomes than with spontaneity and mutuality. It is relationship held at arm’s length. As Hans Reinders observes, “We have come to use rights and choice to plug the hole that the lack of friendship has left behind.”
Faith communities stand to offer a distinct alternative because they are places where true friendships are developed and nurtured. Set apart as “special”, people with disabilities often live their lives in artificial relationships and experiences. Perhaps they long for something that is real, natural, unpaid and authentic. In Receiving the Gift of Friendship: Profound Disability, Theological Anthropology, and Ethics, Reinders writes, “Friendship is special because it is freely chosen. Our friends want us as their friend for our own sake. No other relationship, either professional or kinship, can give what friendship gives.” 
 “Addressing the Disability Services Workforce Crisis of the 21st Century.” American Network of Community Options and Resources. https://cqrcengage.com/ancor/file/ZuL1zlyZ3mE/Workforce%20White%20Paper%20-%20Final%20-%20hyperlinked%20version.pdf (Accessed July 16, 2017).
 Reinders, J.S., Receiving the Gift of Friendship: Pr4ofound Disability, Theological Anthropology, and Ethics. Grand Rapids:Eerdmans Publishing. 2008.
 Reinders, J.S., Ibid.