Massachusetts is facing a structural failure in its disability services system, due to a failure to support the workforce. This does not only have a real human cost; it also creates an economic loss for the Commonwealth.
Direct Support Professionals (DSPs) are responsible for the daily care, safety, and well-being of individuals with intellectual and developmental disabilities (IDD) and autism. As of October 2024, in the state of Massachusetts, a staggering 19% of DSP roles were vacant, resulting in an estimated 2,400 adults with IDD and autism being unable to attend day or employment services. These programs offer critical care to individuals with IDD and autism and provide a sanctuary for them to form relationships, create routines, and work in their communities. As a result of this shortage, many are losing out on beneficial opportunities and necessary services.
Additionally, with advancements in medicine and social services, individuals with IDD and autism are living longer, and their needs are becoming more complex. As a society, we need more accessible and affordable long-term care solutions to serve this growing population of older individuals. Instead, we are seeing the opposite. Human service agencies and direct support care groups are limiting services and closing their programs, creating immense barriers and restricting care for the most vulnerable.
To address the critical worker shortage, Massachusetts must prioritize benefits and training and improve pay for DSPs. By doing so, the state government will signify the importance of community and government support in direct support roles, ultimately improving the direct support labor crisis.
Better benefits and access to comprehensive training resources will encourage more people to pursue a career in the direct support profession. Support from employers can help to improve staff morale and lower rates of employee burnout, making it easier for direct support staff to prioritize their physical and mental wellbeing. While benefits can help to improve the labor crisis by lowering rates of burnout, better pay rates are necessary to create a long-lasting solution to the shortage.
DSPs are currently paid a median rate of $20.79 an hour for life-affirming care. That is not sustainable. The physical, mental, and emotional work required of DSPs does not equal the current median pay rate and is ultimately contributing to employee burnout and turnover. According to the Association for Developmental Disabilities Providers, turnover exceeds 40% annually among direct support professionals, negatively impacting the individuals they serve.
This labor shortage is not simply a staffing issue. It is a systemic risk with fiscal and operational consequences. Insufficient staffing disrupts service delivery, increases reliance on costly emergency interventions, and drives long-term expenditures on healthcare. Every day that this problem persists, it strains the Commonwealth’s budget, threatens the viability of community-based care, and negatively impacts communities across the state. Increasing salaries is short money for the increase in benefits and savings Massachusetts will reap in return.
In her first FY26 budget draft, Governor Maura Healey proposed an increase of $34 million for human services rates – but this is not sufficient. This amount will neither stabilize the workforce, nor address the scale of the retention problem.
The Arc of Massachusetts and our advocacy partners have requested a targeted $100 million investment, which would bring median rates of pay for entry level DSPs to $22.35 per hour. This would bring pay rates from the 53rd percentile to the 63rd percentile, according to the Bureau of Labor Statistics – still modest by any labor market standard, but a necessary step to stop losses and maintain operational continuity across the sector.
This ask is not about sentiment. It is a matter of fiscal responsibility, system performance, and service delivery. The current wage structure undermines workforce stability, disrupts care, and ultimately costs the state more by creating additional strains on the healthcare system.
Unfortunately, our request to Massachusetts’ state government has not yet been successful. Our proposed amendment failed in the House and in the Senate, leaving us with one last hope: Governor Healey herself.
We urge Governor Healey to use the tools available to her – administrative action, budget reallocations, and emergency funding – to address this workforce crisis directly. Delay will cost more to individuals with IDD and autism, their families, direct support providers, and the Commonwealth at large. Inaction will cause continued harm to communities.
The time for legislative solutions has passed. Governor Healey has long been an ally to the IDD and autism community and The Arc. We urge the governor to respond to this crisis.
Brian Cusack is the Board President of The Arc of Massachusetts, the Waltham-based nonprofit organization that enhance the lives of people with intellectual and developmental disabilities and autism and their families through advocacy for community supports and services.