An estimated 90% of agencies that serve people with Intellectual and Developmental Disabilities are struggling with staffing of Direct Support Professionals (DSPs). One of the main contributing factors to this shortage is the high employee separation rate, which ranges from 30% to 40% within the first year of employment.
The DSP is on the frontlines assisting with life skills, mobility, cooking, advocacy, and most of all, emotional support. The strength of the DSP staff measures the effectiveness of any residential program. Shortages of DSPs have contributed to a waiting list for New York State residential placement facilities that is as long as seven years, affecting an estimated 11,500 people. On Long Island, just under 3000 people are on the residential waiting list.
How does pay in non-union and unionized state facilities vary?
The salaries of DSP workers are in sharp contrast to those of upper management. At one of the largest non-unionized private agencies on Long Island, Family Residences and Essential Enterprises (FREE), which serves approximately 4,000 individuals, the starting pay for Direct Support Professionals (DSPs) is $16.97 per hour. However, CEO Robert Budd’s salary is $457,517 per year, and CFO Christopher Long, Ed.D., is drawing a salary of $430,402 per year, not counting additional reimbursed expenses.
Collectively, all salaries for top management at FREE amount to $640 annually for each resident, which is compounded by the overall costs of the services the agency provides. The salary of the Commissioner of the New York State Office for People with Developmental Disabilities (OPWDD), Willow Baer, is $195,779, and the Deputy Commissioner, Eileen Haynes, earns $176,403 per year, excluding expenses. The OPWDD serves approximately 130,000 people with developmental disabilities. All New York State DSPs are represented by the Civil Service Employees Association (CSEA), and average a starting salary of $25 an hour.
How does the Direct Support Professional’s retention rate compare between union and non-union agencies?
For New York State, the average length of employment for a DSP is 49% of the workforce serving longer than 36 months, and 25% leaving the field within the first six months. Overall, New York State has a lower employee separation rate than the national average. CSEA Union representative Mathew Cantore explains,
“The unfortunate reality is that the field of direct care is struggling to recruit and retain staff. There is a significant graying of the workforce that needs to be addressed by the State and the Office for People with Developmental Disabilities (OPWDD). With that as the backdrop, there are real opportunities for upward mobility in the field of direct care. In a unionized environment, we advocate for advancement based on merit and fitness, within the guidelines outlined in our collective bargaining agreement. We often hear horror stories in the private sector that mobility and advancement are based more on who you know and who likes you, as opposed to merit, fitness, and contractual fairness. We also ensure a strong voice in the workplace, provide a living wage, contractual protections and benefits, as well as member benefits, to unionized workers. All this undoubtedly helps with recruitment and retention.”
Compounding the shortage of DSP workers is the uncertainty surrounding the future of Medicare and Medicaid. Residential care for the intellectually and Developmentally Disabled community is mainly funded by Medicaid. According to the Congressional Budget Office, the recently passed House of Representatives bill, H.R. 119 (“One Big Beautiful Bill Act”), would cut Medicaid by $716 billion over the next decade, potentially resulting in the loss of coverage for as many as 15 million people by 2034.
Additional changes in the House Bill include an additional mandated eligibility check, which would create longer waiting lists for residential placement. According to the New York State Department of Health, the first and second congressional districts, which encompass southwestern and eastern Suffolk County, have 155,000 people receiving Medicaid, who may face a reduction in their coverage. As many as 20,000 people in these districts will lose their benefits. The effect of these cuts would not only affect residents receiving care, but also those who provide it.
In addition to the near-crisis level of an employee shortage, these projected budget constraints can further exacerbate waiting lists and negatively impact the quality of service. The solution may not only be in higher wages provided by the union, but also in effective advocacy of the Intellectual and Developmental Disabled community.
