Crain’s Exclusive: Half of New York direct support professionals experience housing or food insecurity, report shows

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About half of New York’s direct support professionals who work with individuals with intellectual and developmental disabilities experience housing or food insecurity, a new report shows.

The report, released this morning and shared first with Crain’s, was commissioned by New York Disability Advocates, a statewide coalition representing more than 300 nonprofit providers and surveyed about 4,500 DSPs across the state on their economic security.

It found that about half of respondents experience food insecurity and half experience housing insecurity, with women of color most likely to lack reliable access to enough food and men of color most likely to be impacted by housing challenges. About two-thirds of respondents experience one or the other insecurity, and nearly a third of those surveyed said they struggle to meet their households’ financial demands.

Additionally, 44% of the DSPs surveyed have a college degree, but almost 80% make $20 per hour or less. According to Mike Alvaro, the chief executive of the Cerebral Palsy Associations of New York State and NYDA president, the average starting salary for a DSP at a nonprofit agency is about $34,000 upstate and $37,000 downstate.

The report’s findings underscore providers’ argument that the state must address years of chronic underfunding, Alvaro said. Nonprofit providers have argued for years that low Medicaid reimbursement rates, which are their primary source of funding, have caused high turnover and vacancy rates. This has eroded access to services, advocates say, particularly at nonprofit agencies which make up the majority of organizations serving New Yorkers with disabilities.

As a result, providers are calling on the state to address these issues through the next budget. While the governor’s executive budget for fiscal 2025 included a 1.5% COLA, advocates have renewed their push for Hochul to include a higher 3.2% COLA and $4,000 direct support wage enhancement per worker in her final agreement.

A 3.2% COLA would compensate for the annual rise in inflationary costs providers experience, allowing them to maintain operations, according to Alvaro. He added that the measures would represent a “first step” in closing the gap between what DSPs earn at nonprofits and what they earn at disability service organizations operated by the state. The starting salary for DSPs in the second group is about $49,000 upstate and $55,000 downstate, he said.

“The state has recognized the value of these jobs,” Alvaro added. “Unfortunately for the voluntary sector, we are almost 100% dependent on Medicaid.”

Previous Hochul budgets have included COLAs, he added, which he called a “huge improvement” over the previous administration. But more investment is needed to stabilize the sector.

The report also shows that 85% of respondents are satisfied with their work, but only a quarter are satisfied with their pay. This gap leads to a workforce that is less productive than it could be, said Marco Damiani, the chief executive officer of AHRC New York City which serves more than 15,000 people annually. According to the survey, more than half of DSPs often experience psychological distress.

“It’s not optimizing the benefit of those people that do the work,” he said. “Think about what they could do. Think of how much better the work could be. Think about how much longer they would stay with us.”

To that end, he said, the COLA and enhancement would help providers pay more competitively and cover the costs needed to offer robust benefits, which could increase employee satisfaction and improve retention. Alvaro acknowledged that New York faces a difficult budget year, but said the measures are a “necessary correction” to bolster the industry.

Elected officials have joined providers in their call on Hochul to include the measures in the final version of her budget. According to NYDA, state Sens. John Mannion, Brad Hoylman-Sigal and Pete Harckham and Assemblywomen Rebecca Seawright and Jessica Gonzalez-Rojas have all signed onto letters of support for the COLA and wage enhancement, some since the executive budget was released.

Tim Ruffinen, a representative from the budget division of the governor’s office, said Hochul “deeply cares” about rebuilding the workforce that cares for vulnerable New Yorkers. The 1.5% COLA included in the executive budget would bring the state’s investment in COLA increases to about $1.4 billion over the last three years, he added.

As Hochul tries to solve the $4.3 billion budget gap, she will work with legislators to find a solution to serve New Yorkers’ needs, he said. The governor and the legislator must reach an agreement on the final budget by April 1.