This comprehensive report, prepared by John O’Brien, Connie Lyle O’Brien and Chalrie Galloway of Responsive Systems Associates, explores the effectiveness of residential service workers in Washington’s developmental services system. It dives deep into the roles, challenges, and accomplishments of direct service staff across five residential models: tenant support programs, small and large group homes, community IMRs, and state-operated institutions. Through case studies, interviews, and policy analysis, the study highlights key issues like staff training gaps, pay disparities, and the tension between “home” and “program” environments. It also examines how state and federal policies impact service delivery and offers actionable recommendations to improve productivity and quality of life for residents. Packed with insights, the report emphasizes the importance of community presence, competence building, and status enhancement for people with developmental disabilities. Whether you’re a policymaker, service provider, or advocate, this document provides valuable strategies for creating more inclusive and effective residential services.