SupportingPeoplewithDevelopmental

Disabilities:TheImpactofLowWagesand
theMinimumWageDebateonthe

DirectSupport
ProfessionalsWorkforce
AJointPublicationof:

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SupportingPeoplewithDevelopmentalDisabilities:
TheImpactofLowWagesandtheMinimumWageDebateontheDirect
SupportProfessionalsWorkforce

EXECUTIVESUMMARYNOVEMBER2015

Over110,000DirectSupportProfessionals(DSPs)arethelynchpinofthesystemofsupportsfor
peoplewithdevelopmentaldisabilities,with97,000workingfornotforprofitagencies.This
reportincorporatessurveydatafrom131notforprofitagenciesthatemploymorethan64,000
oftheseDSPs.

Thesehighlytrainedprofessionalsarewhymorethan100,000NewYorkersleadsafe,fulfilling
lives.

Fundingforthesalariesoftheseprofessionals,whichcomesfromtheMedicaidprogram,is
insufficienttopaycompetitivewages,leavingtheseprofessionalsinchronicshortsupply.

Surveyrespondentsreportneeding5,300DSPstofillcurrentlyvacantpositionsthis
representsastatewidevacancyrateof8%.

TheshortageofDSPsresultedinaninordinatedependenceonovertimewithsurvey
respondentsreportingmorethan2.9millionhoursinoneyear.

TheStatesdecisiontoraisetheminimumwageforfastfoodworkersandstateworkers
withoutaddressingwagesofDSPswillmakeDSPwagesevenlesscompetitive,exacerbatingthe
DSPshortageandjeopardizingthesupportsforpeoplewithdevelopmentaldisabilities.

Wageincreasesmustbeimplementedinanequitablefashionforallhumanserviceworkers.
EquitablewageincreaseforDSPsmustbefundedthroughadequateproviderrateincreases.

WeapplaudGovernorCuomoformakingtheminimumwageapriority.Wesupportthehard
workingemployeesofthefastfoodindustryandstateworkforce,butourDSPs,whoare
responsibleforsupportingthelivesofsomanyspecialNewYorkers,deserveattentionaswell.

ShouldminimumwageincreasesleaveDSPsbehindmanywillconsiderchangingjobs,leaving
thepeopletheycareaboutbehindtoworkinanotherfield.

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EXECUTIVESUMMARYNOVEMBER2015(Continued)

80%ofagenciessurveyedindicatethatDSPstaffturnoverandpoorretentionisalreadya
seriousproblem,withunattractivewagescitedasoneofthebiggestchallengestorecruitand
retainworkers.DSPwagesturnoverisalreadycloseto20%peryear.

WeaskGovernorAndrewCuomoandthestatelegislaturetofundincreasesforproviderrates
toincreaseDSPwagesandthewagesforotherlowwagedevelopmentaldisabilitysupport
workerssuchascooksandmaintenanceworkerswhosupportindividualsinthecommunity.

Almostallofthefundingforprogramsservingpeoplewithdevelopmentaldisabilitiescomes
fromtheMedicaidprogram.Unlikeforprofitbusinesssector,notforprofitagenciesdonot
havetheabilitytoincreasepricesorreducethereturntoshareholderstoincreasewages.

The20162017statebudgetshouldincludeMedicaidfundingtoincreaseDSPand
developmentaldisabilitysupportworkerwagesacommensurateamounttothefirsttwosteps
oftheCommissionerofLaborapprovedincreaseinthefastfoodminimumwagethatwill
happenonDecember31,2015andDecember31,2016.

Fundingthesewageincreaseswillincentivizequalifiedandcompassionatepeopletopursue
employmentinaprofessionthathelpsmorethanonehundredthousandNewYorkerswith
developmentaldisabilitiesleadproductive,fulfilling,andsafelivesintheircommunities.

Specialeducationprovidersservingchildrenwithdisabilitiesfacesimilarobstacles;yearsof
statefundingfreezesorpaltryincreasesthatpreventsincreasingthewagesforlowpaid
teacherassistantsandteacheraidsatspecialneedspreschoolsandschoolageprograms.
Theseprogramsfacesimilarstaffingchallengestoovercomerecruitmentandretention
difficulties.

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WHOAREDIRECTSUPPORTPROFESSIONALS?
DirectSupportProfessionals(DSPs)assistpeoplewithdisabilitiestoleadproductivelivesandto
participatefullyintheircommunities.DSPsareemployedbyproviderorganizationstoprovidesupport
servicestomanyofNewYorksmostvulnerablecitizens.DirectSupportProfessionalsworkingroup
residentialsettings,independentapartmentsandhomes,andinrecreationalandtherapeuticday
supportsettings.Theyarecaringandcommittedindividualsworkinglonghourstoprovidenecessary
care,24hoursaday,toindividualswithdevelopmentaldisabilities.Theyfindtheworkthattheydo
supportingtheseindividualsfulfillingandrewardingandofteneffectivelyserveaspartoftheir
extendedfamily.

DIRECTSUPPORTPROFESSIONALS(DSPs)ASSUMENUMEROUSRESPONSIBILITIES
DSPshavetheresponsibilitytoensurethatpeoplewithdevelopmentaldisabilitiesaresafe,lead
fulfillinglives,andreceiveattentionforcomplexmedicalandtherapeuticneeds.

DSPsprovidethesupervisionandcoordinationnecessarytomanagethedailyactivitiesofthe
peopletheysupportsuchaseating,dressing,hygiene,employment,andrecreation.

ADSPsupportsthedeliveryofphysicalandbehavioralhealthservicesinbothroutineandcrisis
situations.ThisrequiresDSPstonavigatethehealthcaresystemwhileworkingwithmedical
professionalstoadministermedicationsandattendtoavarietyofcomplexmedicalneeds.

DSPsteachindividualslifeskillssuchashomecareactivities,foodpreparation,personalcare
management,moneymanagementandsocialmanagementskills.

DSPsareadvisors,assistingindividualsinmakingcomplexdecisions.

DSPsserveascompanionslisteningtoandsupportingindividualsinsocialoutingsand
gatherings.Formanyindividuals,DSPsareacriticalpartoftheirextendedfamily.

BeingaDSPisphysicallystrenuouswork.Itofteninvolvestheliftingandmovingofindividuals
intheperformanceofdailyactivitiessuchasbathing.DSPsprovidewalkingassistanceandhelp
peoplewithlimitedmobilityandinwheelchairsgetaround.

DSPstransportindividualstomedicalappointments,therapeuticprogramming,jobs,aswellas
recreationalactivitieswithinthecommunity.

DSPsmustbeproficientinunderstandingandcommunicatingcomplexinformationtoothers
viadailylogs,progressreportsandotherelectronicmechanisms.Theymustdealwithan
enormousburdenofpaperworkessentialtoregulatorycompliance.

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DIRECTSUPPORTPROFESSIONALSMANAGECHALLENGING
SITUATIONS
Providingsupportservicestoindividualsisnotanentryleveljob.It
demandsanexperiencedworkforcethatispatient,compassionate,
andresilient.DSPshelpindividualsachievedignitybysupporting
ActivitiesofDailyLiving(ADLs).

DSPsassistinfeedingpeoplethatmayneedit.

Theyaddressandmayassistinmeetinghygienicneedssuch
asbathing,teethbrushing,toileting,hairgroomingand
helpingindividualstogetdressed.

DSPsaretrainedtoknowhowtodealwithcombative
behaviorsthatincludescreaming,yelling,cryingand
aggressivephysicalcontactandexpressions.

DSPshelppeoplewithdisabilitiesbuildrelationships
includingmoderatinganddeescalatingvolatilepeersocial
interactions,ensuringasafeandhealthyenvironment.

DIRECTSUPPORTPROFESSIONALSRECEIVEEXTENSIVETRAININGS
ANDCERTIFICATIONS
InthewordsoftheNYSOfficeforPeoplewithDevelopmental
Disabilities(OPWDD)DirectSupportProfessionalsarethecoreof
NewYorkssystemofsupportsforindividualswithdevelopmental
disabilities.Theirjobsrequiretechnicalandvaluesbasedskillsthat
makelifechangingdifferencesinthelivesoftheindividualsthey
support.DSPsmustthereforereceiveveryintensivetrainingina
widevarietyofcriticalareas.ThecorecompetenciesforDSPscanbe
foundontheOPWDDwebsiteat:
http://www.opwdd.ny.gov/opwdd_careers_training/training_opport
unities/core_competencies.
Afulllistoftrainingsrangingfromabusepreventiontoeldercareis
availableat:http://www.opwdd.ny.gov/node/3653.

CHECKSAND
BALANCES:
OVERSIGHTAND
REGULATORY
SYSTEMS
Caringforandprovidingsupport
servicestovulnerableindividualsis
subjecttotheoversightofmany
entitiestoprotectthesafetyand
wellbeingofindividualswith
developmentaldisabilities.DSPs
andtheiremployersareheldtothe
higheststandardsof
accountability.Thisrequiresthem
tonavigatealengthyand
complicatedjobapplication
process,includingacriminal
backgroundcheck.Themultiple
regulatorylayersmonitoringand
overseeingDSPsinclude:

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Internalmechanisms
administeredbyprovider
organizations
Levelsofsupervisoryand
managementoversightto
includeaninterdisciplinary
teamofprofessionals
QualityAssuranceteams
NewYorkStateOfficefor
PeoplewithDevelopmental
Disabilities
NewYorkStateJusticeCenter
fortheProtectionofPeople
withSpecialNeeds
Auditsandoversightbya
varietyofagenciesincluding
theInspectorGeneral,Office
oftheStateComptroller,and
NYSAttorneyGeneral.

Trainingsinclude:

Annualtraininginmedicationadministration,firstaid,CPR,safebehavioraldeescalationand
intervention,safety,andOSHAregulations.

TraininganddemonstrationonthejobinCoreCompetenciesadoptedbytheNYSTalent
DevelopmentConsortium.TheCompetenciesarebrokendownintosevengoalscoveringall
aspectsofanindividualslife.

TraininginaCodeofEthicscurriculumdevelopedbytheNationalAllianceforDirectSupport
Professionals(NADSP)tofacilitateandcopewithethicaldilemmasfacingindividualsconsistent
withthehighestprofessionalstandards.

DIRECTSUPPORTPROFESSIONALSAREDIFFICULTTORECRUITANDRETAIN
Providingsupportservicesfor100,000NewYorkerswithdevelopmentaldisabilitiesandtheirfamilies
isanenormouschallengeforproviderorganizations.NonprofitproviderorganizationsrelyonDSPs
forthehandsonsupport,withoutwhichtherewouldbenocare.Buttheintensedemandsofbeinga
DSPleadtohighturnoverrates.
ProviderorganizationsmustcompetewithotherindustriesinrecruitingDSPs,particularlythefastfood
industrywhichhasrecentlybeenmandatedtoimplementa$15perhourminimumwage.Asthe
followingchartillustrates,thefastfoodindustryconstitutesahugeworkforcewithmanypotentialjob
opportunitiesforthoseDSPswhofeeloverburdenedandunderpaid.

120,000
110,000
100,000
90,000
80,000
70,000
60,000
50,000
40,000
30,000
20,000
10,000
0

MagnitudeoftheDSPWorkforceinNYS

NUMBEROFDSPs

FASTFOODWORKERS(ChainRestaurants)

NYSFastFoodWageBoardDatawasusedtoestimatethattherearebetween101,700and124,000
fastfoodworkersatchainrestaurants.
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Morethan80%ofagenciessurveyedindicatethatDSPstaffturnoverandpoorretentionisaserious
problem.

DSPTurnoverImpactsSupportsforPeoplewith
DevelopmentalDisabilities

VerySeriousProblem

SomewhatSeriousProblem

Other

HumanServiceprovidersarealreadyexperiencingsignificantchallengesrecruitingand
retainingstaffduetoanimprovingeconomyandatighteningjobmarket.

Agenciesreportedneedingmorethan5,300DSPstofillpositionscreatedbyastatewide
vacancyrateof8%.
o ThisshortageofDSPsresultedinmorethan2.9millionovertimehoursatthe131
respondingagenciesduring2014.

Agenciessurveyedreportaoneyearturnoverrateof19%forDSPs,requiringaninvestmentof
$5,000intrainingandothercostsforeachnewemployeehiredtofillthosevacancies.Major
impedimentstorecruitmentandretentionofDSPsincluded:
o Wageandbenefitpackagesthatwerenotattractive
o Insufficientnumbersofqualifiedapplicants

ArecentsurveybytheUniversityofMinnesotaindicatesthattheaverageturnoverratefor
DSPsinNYSis25%annually,amongmorethan130communitybasedprovidersofservicesto
peoplewithdevelopmentaldisabilities.

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MultipleSourcesHighlightHighAnnualDSPTurnover
30%
25%
20%
15%
10%
5%
0%
NYSStudybyUofM

ProviderSurvey

COMPENSATIONFORDIRECTSUPPORTPROFESSIONALS
DirectSupportProfessionalsassumenumerousdailyresponsibilitieswhichtheymustperform
accordingtothehighestprofessionalstandards.Theyworkunderthestrictscrutinybymultiple
oversightagencies.Theirworkiscriticaltothewellbeingandsafetyofthethousandsofpeoplewith
developmentaldisabilitiestheyserve.However,withoutpayingthemadecentwagerecruitmentand
retentionissuesposeanenormousthreattothepeoplewithdisabilitieswhorelyonDSPs.
AccordingtoCMSToolkit,CoverageofDirectServiceWorkforceContinuingTrainingwithinMedicaid
PolicyandRateSetting,Linkingwageincreasestoworkersadvancementintrainingprograms(i.e.
careerpathways,apprenticeships,credentialing,orcertificationprograms)representsanimportant
coordinatedstrategythatmaybeimplementedonthestatelevel(HarrisKojetinetal.,2004).
OfferingbenefitpackagestoemployeesincludingDirectServiceProfessionalshasproventobeauseful
recruitingtoolinthepast.However,changesinhealthcarecoverageforallemployeeshassomewhat
reducedtheeffectivenessofbenefitsasarecruitmentstrategyputtingmorepressureonbetterwages
torecruitandretainemployees.
AsNewYorksminimumwageincreases,alongwithchangesinwagesfortheFastFoodindustry,itwill
bemoreimportantthanevertoproportionallyincreaseDSPwagestoattractqualityprofessionals.

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GOVERNMENTSROLEANDRESPONSIBILITY

Organizationsthatprovideservicestovulnerablepopulations
havelittletonocontrolovertheirabilitytoincreaseDSPwages.
Mostareheavilydependentuponfundingfromgovernment,
especiallyNewYorkStatesMedicaidprogram.Infact,90%of
fundingforprogramsservingpeoplewithdevelopmental
disabilitiesisMedicaid.Increasesinwagescanonlybeachieved
whengovernmentdecidestofundsuchincreases.Therefore,a
minimumwageincreasedependsalmostentirelyonincreasesin
governmentrates,feesandcontracts.

BEYOND
WILLOWBROOK
THEROADTO
REALIZINGTHE
DREAM

NewYorkState,inconjunctionwiththefederalgovernment
whichpays50%ofMedicaidcosts,hasanobligationtoprovide
sufficientfundingsothatDSPscanmakeafairwage.

The1978WillowbrookConsent
Decreeledtothesubsequent
closureofWillowbrookStateSchool
onStatenIslandafterthedisclosure
ofthehorrificconditionsatthatand
otherinstitutionsservingpeople
withdevelopmentaldisabilities.

FastFoodWageIncreasesWillLeave
DSPsBehind

50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%

2015
2016
2017
LastEightYears
Recommended
Recommended
TotalWage
IncreaseFunding
Increasein
Increasein
MinimumWagefor MinimumWagefor ForDSPsOverLast
FastFoodWorkers FastFoodWorkers
EightYears
(NYC)
(outsideofNYC)

A2%COLAforDSPsequatestoapproximately20centsperhour.

Anincreaseintheminimumwageforonlyonesegment
oftheworkforcewillgivethefastfoodindustryan
insurmountablecompetitiveadvantageinattracting
employees.

TheaftermathofWillowbrookledto
arevolutionincareforpeoplewith
developmentaldisabilities.It
broughtthemoutofinstitutionsand
intocommunitiesthroughoutthe
Stateandnation,restoringtheir
rightsasfullcitizens.Todaythat
revolutioncontinuesthroughajoint
federal/Stateinitiativeknownasthe
TransformationAgenda.Through
ittheStatealong,withtheCenters
forMedicare&MedicaidServices
(CMS),haveidentifiedaseriesof
sharedgoalstoimprove
opportunitiesforindividualswith
developmentaldisabilitiesinthe
areasofemployment,integrated
living,andselfdirectionofservices.
Meetingthegoalsofthisinitiative
willrequiretheservicesofahigh
qualityDirectSupportProfessional
workforce,whichispaidafairwage.

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FastFoodWorkersWillHaveSignificantlyHigher
StartingSalariesThanDSPs
Recommended2017FFMinimumWage(outsideofNYC)
AverageStartingDSPWAGE2014Region4Upstate
AverageStartingDSPWAGE2014Region3Upstate
Recommended2017FFMinimumWage(NYC)
AverageStartingDSPWAGE2014HudsonValley
AverageStartingDSPWAGENYCmetroarea
0

DSPs

10

12

14

16

FFWorkers

EvenexperiencedDSPswillfeelthepinch.Thedifferencebetweentheaveragesalaryandthe
startingsalaryrepresentstheincreasesthatproviderscanpaytoemployeesastheygain
experienceandexpertiseovertime.Providersneedtonotonlybeconcernedwithhowentry
levelwagescomparetotheproposedfastfoodminimumwage,butalsomaintainingthespread
betweenentrylevelwagesandaveragewagestomaintainthecareerladdersandincremental
paydifferentialsthathavebeenachievedbymanyexperiencedDSPs.

WithoutEquitableIncreases,EvenExperiencedDSPs
WillFeelthePinch
Average2014DSPWageRegion4Upstate
Average2014DSPWageRegion3Upstate
Average2014DSPWageHudsonValley
Average2014DSPWageNYCMetropolitanArea
$15FastFoodMinimumWage
10

11

12

13

14

15

16

Unlikeprivateindustry,notforprofitagenciesthatsupportpersonswithdevelopmental
disabilitiescannotincreasethewagesofDSPswithoutacorrespondingrateincreasefromthe
State.

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WHATCANBEDONE?
Fundingminimumwageincreasesfortheprofessionalswho
supportpeoplewithdevelopmentaldisabilities
DecentpayforDSPsmustbeanobjectofintenseadvocacyinthe
faceofchangestotheminimumwagefortheentireworkforcein
generalandfastfoodworkers,inparticular.

WeaskGovernorAndrewCuomoandthestatelegislaturetofund
increasesforproviderratestoincreaseDSPanddevelopmental
disabilitiessupportworkerwagesandincentivizequalifiedpeople
eagertotakeonthisintegralroleinsupportingourStates
neediestcitizens.

The20162017statebudgetshouldincludeMedicaidfundingto
increaseDSPwagesandthewagesofdevelopmentaldisability
supportworkerssuchasdrivers,cooks,andmaintenanceworkers
acommensurateamounttothefirsttwostepsofthe
CommissionerofLaborapprovedincreaseinthefastfood
minimumwagethatwillhappenonDecember31,2015and
December31,2016.

CONTACTUS
MargaretRaustiala

ALIA

(631)5211458

mrconsultinginc@gmail.com

BarbaraCrosier

VP,GovernmentRelations
CPNYS

(518)4360178

bcrosier@cpofnys.org

J.R.Drexelius,Jr.

GovernmentAffairsCounsel
DDAWNY

(716)3167552

jrdrexelius@gmail.com

WinifredSchiff

Assoc.ExecutiveDirectorfor
GovernmentalAffairs
IACNY
(212)6456360
wini@iacny.org

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SCHOOLSSERVING
STUDENTSWITH
DEVELOPMENTAL
DISABILITIES(4410&
853)

KatieMayo
AssociateExecutiveDirector
NYSACRA

(518)4497551
katiem@nysacra.org

BenGolden
Assoc.ExecutiveDirectorfor
GovernmentalAffairs
NYSARC,Inc.
(518)4398311
goldenb@nysarc.org

MichaelSeereiter
President/CEO

NYSRA
(518)4492976
michael@nysrehab.org

Preschoolandschoolageprograms
forpeoplewithdevelopmental
disabilitiesfaceasimilarworkforce
struggle.Asurveyof96providers
thatservemorethan17,000
studentsshowsagrowingvacancy
rateforteacherassistantsand/or
teacheraides(CFRcodes
228,230,232,243,265).Thesejobs
titlesrequireskilledindividualswho
areresponsibleforprovidingday
todaysupportforchildrenwith
complexneeds.Morethan60%of
therespondingschoolsindicated
thatretentionandturnoverof
teacherassistantsandaideswasa
seriousproblem.Manyagencies
havestartingsalariesthatareclose
tothecurrentminimumwageand
averagewagesforsomejobtitles
areinthe$11to$13dollarrange.
Theseschoolsarealreadystruggling
withyearsofnearlyflatfunding
thatdoesnotkeeppacewithcost
increases.Morethanhalfof
respondentsindicatedtheywill
havetoincreasestartingsalariesfor
somepositionsasof12/31/15,
despitealackoftuitionincreases,
tomatchthenewrequired
minimumwageforfastfood
workers.Tominimallykeeppace
withthealreadyapprovedincreases
inminimumwageforfastfood
workersinNewYorkState,tuition
reimbursementforthevarious
teacheraide/teacherassistant
positionsmustbeincreaseda
commensurateamount.