by Bob Policastro
Apr 1, 2026
Direct Support Professionals (DSPs) provide life-sustaining care for individuals with intellectual and developmental disabilities and complex medical needs.
For more than three decades, I have worked with families caring for medically fragile children and young adults. Many also live with intellectual and developmental disabilities (I/DD) and rely on services, supports, and dedicated Direct Support Professionals (DSPs) to live safe and stable lives.
Today, the care system they depend on is under growing strain.
As the founder and executive director of Angela’s House and board member of New York Disability Advocates (NYDA), I have seen how consistent, high-quality care can transform the lives of these families. I have also seen how quickly that stability can fall apart when the system supporting it is pushed too far.
That is exactly what is happening right now.
Across Long Island, the cost of living continues to climb at a pace that far outstrips the funding available to nonprofit providers supporting individuals with I/DD. In fact, the seven most expensive places to live in New York State are all located on Long Island. Housing, utilities, transportation, healthcare, and insurance costs keep climbing year after year.
Those rising costs are not abstract. They directly affect the care system that thousands of vulnerable New Yorkers depend on every day.
According to internal NYDA survey data, providers saw workers’ compensation costs increase by 4 percent, utility costs rise by more than 13 percent, and insurance costs jump by 13.3 percent between 2023 and 2025.
These are essential costs required to keep programs open and individuals safe. Yet funding has not kept pace with the real cost of delivering care.
That gap is fueling a growing workforce crisis.
On Long Island, a Direct Support Professional earns roughly $20.64 per hour. A warehouse worker earns about $27.39 per hour, often with fewer responsibilities and far less specialized training.
For many workers, the choice becomes simple. They leave the field.
When experienced DSPs walk away, the impact is immediate. Individuals with I/DD, many of whom rely on routine and trusted relationships, suddenly lose caregivers they depend on. Families lose stability and peace of mind.
Continuity of care is not optional. It is essential to the health, safety, and dignity of people with disabilities.
That is why the 4 percent Targeted Inflationary Increase proposed by the Senate and Assembly must be included in the final state budget. Without this adjustment, providers across Long Island will continue to struggle to recruit and retain the workforce this system depends on. This modest adjustment would help providers stabilize wages, retain experienced staff, and keep critical services running.
Healthcare costs are also rising rapidly. Health insurance premiums across Long Island have increased by nearly 12 percent in the past year alone, adding even more pressure for nonprofit providers. Organizations are doing everything they can to maintain quality coverage for their employees, but the math is becoming harder to make work.
When benefits erode, workers pay more out-of-pocket, delay care, or take on medical debt. That is unacceptable for the professionals who dedicate their careers to caring for individuals with complex medical needs.
While the Executive Budget and one-house proposals did not include the Healthcare Enhancement Program, the need it addresses has not gone away. Such initiatives once helped reduce out-of-pocket costs for workers and funding cuts have weakened those supports at the very moment they are needed most. This remains a critical issue that should be addressed beyond the budget process. Restoring healthcare assistance would not only help workers. It would strengthen the entire I/DD workforce.
For Long Island families, the stakes are real. They depend on a stable workforce to provide life-sustaining care for individuals with intellectual and developmental disabilities and complex medical needs.
Without funding that reflects the true cost of living in our region, stability is at risk.
As budget negotiations continue in Albany, lawmakers face a clear choice. They can invest in the workforce that makes New York’s disability service system possible, or allow the strain on providers, workers, and families to deepen.
The strength of New York’s I/DD system depends entirely on the people who deliver care every day.
Investing in that workforce is how we protect the dignity, safety, and stability of some of our most vulnerable neighbors.
Bob Policastro is the founder and executive director of Angela’s House and a board member of New York Disability Advocates (NYDA).
Opinions expressed are solely those of the writer(s) and do not necessarily reflect the opinions of Able News at The Viscardi Center and/or The Viscardi Center.