Issue:
Direct Support Professionals (DSPs) are essential workers who provide daily care, services and supports to people with intellectual and developmental disabilities (IDD) 24 hours a day, 7 days a week. Caring for people with complex needs is a rewarding yet challenging job, which requires ongoing training, high-level of responsibility, and skill.
This workforce shows exemplary strength through good times and bad, demonstrating their ardent commitment to the people they support every day. These are not just jobs, they are professional careers and must be treated as such.
Nonprofit provider agencies funded by the Office for People with Developmental Disabilities (OPWDD) employ nearly 100,000 DSPs, and deliver 85 percent of the needed services to approximately 140,000 people with IDD in New York State. Almost all funding for these agencies comes from the government.
Statewide reimbursement for voluntary sector DSP salaries has increased only very modestly over the past decade, but still puts starting wages at or barely over minimum wage. By contrast, DSPs in state-operated programs receive consistent step increases year after year, with the current starting wage nearly 35% higher than the voluntary sector, a difference of $55,000 versus $39,000 and upward. Additionally, many of our most knowledgeable DSPs are being lost to higher-paying entry-level job sectors, which continue to increase their hourly wages.
In a 2025 report, the NYS Comptroller noted that compared to other New York employers, average annual nonprofit wages were nearly 24% lower than in the private sector and nearly 14% lower than the public sector.[1] Moreover, nonprofit providers supporting people with IDD are tracking far worse compared to the average state non-profit wages. The contributions, ingenuity, and dedication of our workforce are immeasurable. We cannot afford to lose their skills and insight. However, the federal government and New York state struggle to acknowledge their contributions.
Many of our DSPs are Asset Limited, Income Constrained, Employed (ALICE), with income above the Federal Poverty Level (FPL), but not enough to afford basic expenses in the county where they live. Between ALICE households and those living in poverty, an estimated 48% of households in New York were below the ALICE Threshold in 2023. Households below the ALICE Threshold are forced to make impossible choices — like deciding whether to pay for utilities or a car repair, whether to buy food or fill a prescription. Workers below the ALICE Threshold often perform the jobs that keep our economy functioning smoothly, much like DSPs[2]
Topline data from a 2024 study from Miami University and summarized by New York Disability Advocates (NYDA) show that:[3]
- 49% of DSPs surveyed experience food insecurity, and 48% experience housing insecurity.
- 33% of DSPs surveyed experience both food and housing insecurity, and 64% experience one or the other.
- There is a “Satisfaction Gap” among DSPs: 85% of those surveyed report being satisfied with their work, but only one in four are satisfied with their pay.
- Low pay and long hours make work-life balance ‘impossible’ and eventually leads to burnout and high turnover rates.
- 4 out of 5 DSPs make under $20/hour, significantly less than a living wage
- Half of DSPs report experiencing food and housing insecurity
- DSPs struggle with childcare costs and availability of flexible childcare hours to cover shift work
- Most DSPs are women and are disproportionately high percentage are Black, Indigenous, and People of Color (BIPOC)
- Staff vacancies are the primary reason providers are unable to meet the needs of New Yorkers with IDD
- Undervaluing care work disproportionally harms women, people of color, and people with disabilities
Without adequate funding, IDD providers cannot offer competitive wages to recruit and retain the skilled direct support staff that provide the foundation of care for New Yorkers with IDD. Without immediate action, this crisis will continue to force service reductions, program closures, and loss of supports for people with IDD throughout the state. With approximately 5,000 people on waitlists for supports and services, resolving the workforce crisis is pivotal in order to fully address the needs of New Yorkers with IDD.
It is absolutely critical that we secure the funding necessary to pay our DSPs a wage commensurate with their ability, experience, and performance. We have already seen valuable DSPs leave the field due to the hardship they face. If we do not act, many years of progress toward community integration, choice, and deinstitutionalization for people with IDD will be lost. DSPs are our front-line essential workers and deserve more.
Cost increases related to mandated fringe benefits, repairs and maintenance, utilities, food, supplies, transportation, and insurance have resulted in significant financial pressures. Nonprofit provider agencies are solely funded through Medicaid and are thus unable to increase reimbursement for services to compensate for increased costs of operations. Since 2020, the cost of living has increased more than 25% due to inflation. Over that time, NYS increased provider rates by less than 16%
Although recent state investments have begun to stabilize our system, strengthen supports, and more fairly compensate Direct Support Professionals for their skill and responsibility, the state cannot squander the opportunity to continue investments that had long been overlooked.
[1] https://www.osc.ny.gov/files/reports/pdf/critical-role-of-nonprofits-in-new-york.pdf?utm_medium=email&utm_source=govDelivery
[2] https://www.unitedforalice.org/introducing-ALICE/new-york
[3] https://ddawny.org/wp-content/uploads/2024/12/NYDA_DirectReportProfessionalsReport.pdf
Call to Action: Address the Critical Workforce Shortage
We call on the governor and legislature to support people with IDD in the FY27 NYS budget by:
Increasing Medicaid rates
Include a 2.7% Targeted Inflationary Increase (TII) in the FY27 NYS Budget to ensure funding accounts for the increased cost of living and providing services. Medicaid rates go beyond just addressing wages. Rates for programs and services are all-inclusive and support the whole person.
The TII will simply adjust for inflation to cover the increased cost of food, benefits, transportation, utilities, medical supplies and more. If Medicaid reimbursement does not cover rising costs, providers cannot sustain services, pay fair wages, or maintain the facilities where people work.
We propose a series of initiatives to support the direct support Careforce by creating opportunities for affordable housing, childcare and healthcare for essential frontline staff:
Support the Careforce Housing and Affordability Package
This package of bills would support affordable housing for the direct support Careforce by:
- Establishing an Employer-Assisted Housing (EAH) Matching Grant Program
- Enacting the Careforce First-Time Homebuyers Program
- Creating a targeted housing preference within affordable housing developments
The bills below have already been introduced for reference:
- S.8672 establishes an Employer-Assisted Housing (EAH) Matching Grant Program for the nonprofit human services workforce. This proposal would provide a 50 percent State match—up to $3,000 per worker per year—on employer contributions for housing assistance. Eligible uses would include security deposits, rent stabilization, emergency rental arrears, and first-time homebuyer costs such as down payments and closing fees.
- S.8675 enacts the Careforce First-Time Homebuyers Program, offering below-market mortgage financing and forgivable down payment assistance to eligible care workers. Low wages, limited savings, and high borrowing costs often make homeownership unattainable for DSPs and other frontline staff.
- S.8676 creates a targeted housing preference within affordable housing developments for members of New York’s care workforce. This preference would help ensure that DSPs and other frontline workers can live in the communities they serve, strengthening workforce stability and reducing one of the most persistent financial pressures facing the Careforce.
Including a Child and Dependent Care Credit
The Arc New York supports the Governor’s proposal to enhance the New York Child and Dependent Care Credit. As noted above, there are myriad quality of life barriers faced by our frontline workforce. They not only support people with IDD, but many also have children and dependents under the age of 13 at home. This tax credit also applies to dependents who are who are physically or mentally incapable of caring for themselves. The reformed refundable credit would provide a greater benefit to families and reduce complexity in claiming the credit.
Child and dependent care are often one of the most substantial expenses for families, and these costs are especially burdensome for those who struggle with basics such as housing and food. Providing relief for this care has the potential to increase retention, stability, and reliability, which are also vitally important for people with IDD and their quality of life. Eligibility for the credit would be limited to full-year New York residents.
Restarting the Healthcare Enhancement Program
Provider agencies and staff have been significantly impacted by the sharp rise in insurance premiums that are unfortunately familiar for all New Yorkers. On average, agencies have experienced a nearly 17% percent increase in health insurance costs over the past two years, and are projecting that will be compounded by an additional 12% surge in 2026. On average, nonprofit agencies already devote more than 10% of their operating budgets to insurance expenses. Many providers are faced with the choice between absorbing these increases, reducing benefits, or passing increases on to staff, negating the progress toward improved compensation.
New Yorkers are feeling the result of federal changes to the Essential Plan and Affordable Care Act. Individuals and families must consider eligibility and affordability in new ways. This new reality has the potential to transfer additional insurance costs to nonprofit providers, many of which are struggling to cover existing employees, while maintaining operations on a stretched budget.
The program would provide an allocation of $2,500 per eligible employee to participating providers. Funds could be used to establish or enhance health insurance coverage, or to reduce out-of-pocket costs for frontline staff, ensuring care workers can access affordable coverage without further straining nonprofit agency budgets.
In addition, we propose the state and federal government to:
Creating a Standard Occupational Classification (SOC)
At the federal level, Direct Support Professionals are not designated with their own SOC by the Bureau of Labor Statistics. Without an SOC, DSP wage and occupation data is not captured and federal lawmakers cannot allocate funds towards supporting this critical workforce. As a result, it diminishes the true impact of the workforce crisis, hinders opportunities for professional advancement, certifications, and the pursuit of a life-long career. We must acknowledge that DSPs deserve a path forward and people with IDD deserve a passionate advocate at their side daily. We also call on state decision makers to engage with federal representatives to support this legislation.
We support (H.R.6137/S.3211) Recognizing the Role of Direct Support Professionals Act, to accomplish this goal
Continuing to Fund and Support Joint Credential and Career Ladder Programs for DSPs
The Arc New York has long advocated for NYS to support, recognize, and fund career and skill advancement opportunities for DSPs. The state announced in fall 2025 the extension of the successful pilot program between New York State and the National Association of Direct Support Professionals (NADSP) E-Badge Academy, which provides national certifications for DSPs. Additionally, $32 million has been provided through 2030 to support micro-credentials across 21 State University of New York (SUNY) campuses. We call on state decision makers to continue their support for these valuable programs, increase funding, and availability.
In addition, the state must implement a statewide Career Ladder Program, which will provide a pathway to an associate’s degree in the human services field for those DSPs who have participated in the credentialing program and offer it at no cost to the participants. The program must provide job-specific higher education and career development to frontline workers in health, education, and human service occupations.
The Arc promotes and protects the human rights of people with intellectual and developmental disabilities and actively supports their full inclusion and participation in the community throughout their lifetimes.
