Wages, staffing, training, and the people who do direct support work.
Workforce · New York
A federal judge gave final approval Nov. 10, 2026 to a $162 million wage settlement for about 200,000 downstate New York CDPAP caregivers paid by PPL. Payments are expected in early 2027 if there are no appeals, and workers don't need to file a claim.
November 10, 2026 · Federal Court Grants Final Approval for Historic $162 Million Settlement for New York Home Care Workers · 4 min
Workforce · North Carolina
North Carolina's $0.30-per-unit Innovations direct care raise now starts Oct. 1, 2026, not July 1, under a Nov. 10 NC Medicaid bulletin. The add-on, the $21.3 million in state funds and the attestation rules are unchanged; retro pay back to Oct. 1 waits on LME/MCO validation.
November 10, 2026 · Innovations Waiver Direct Care Worker Wage Increase Clarity · 4 min
Workforce · Research
A Boston College study released Oct. 20, 2026 finds 12 of 234 Medicaid waiver policy tests changed aides' or nurses' pay, hours or unemployment. Most effects were negative and tied to self-direction and paid family care.
October 20, 2026 · How Do Medicaid LTC Policies Impact Jobs and Wages of Nurses and Aides? · 2 min
Maine leaves about 30,000 hours of home care undelivered each week and needs at least 2,300 more direct support workers, MECEP estimates cited as the Portland Press Herald revisited the shortage Oct. 15, 2026.
October 15, 2026 · Maine has a shortage of home health workers. Is there any way to fix it? · 1 min
Workforce · Technology
AI is still rare in direct care but growing, and can ease paperwork without replacing hands-on work, the Bipartisan Policy Center said Oct. 14, 2026. It flags privacy, errors and bias as the main risks.
October 14, 2026 · AI's Impact on the Direct Care Workforce · 1 min
Workforce · Labor
A New York CDPAP caregiver filed NLRB charges against 1199SEIU and PPL on Oct. 13, 2026, challenging the union drive for 190,000 personal assistants. She also asked to join the election case, arguing Public Partnerships LLC is not their employer.
October 14, 2026 · Public Partnership, LLC, Case 03-RC-395461 · 1 min
Workforce · New York
New York lawmakers on Oct. 8 pushed S10320/A11424, which would give human services workers one background clearance that carries between jobs. OPWDD providers and the Justice Center would have to accept it in place of a repeat check, with exceptions for federal rules and safety.
October 8, 2026 · Fahy, McDonald Introduce Legislation to Cut the Red Tape and Streamline the Human Service Provider Background Check Process · 2 min
Workforce · Workforce
The Pennsylvania Homecare Association says more than 112,000 home-care shifts go unfilled each month as Medicaid rates trail neighboring states. A Oct. 4 Philadelphia Tribune feature put average aide pay at about $14–$15 an hour.
October 4, 2026 · Pennsylvania home care shortage strains workers, vulnerable residents · 1 min
Workforce · Employment law
The EEOC sued St. Louis Arc on Sept. 30, alleging the disability nonprofit denied a pregnant worker light duty, forced her onto leave and fired her. The suit cites the Pregnant Workers Fairness Act.
September 30, 2026 · EEOC Sues St. Louis Arc for Pregnancy Discrimination · 1 min
Workforce · Workforce survey
ANCOR’s 2026 survey finds 85% of 524 I/DD providers still report moderate or severe staffing shortages. Fifty-five percent turned away referrals, and home-based and day habilitation cuts doubled versus 2025 as Medicaid funding pressure mounts.
September 30, 2026 · The State of America's Direct Support Workforce Crisis 2026 · 2 min
Workforce · Workforce research
Brookings found Sept. 29, 2026, that fewer than half of LTSS direct care workers stay in those roles a year later. CPS data for 2010–2025 put average wages near $16–$17 an hour, with leavers gaining up to about $2.70.
September 29, 2026 · Who enters and who exits direct care jobs in long-term care settings? · 1 min
Workforce · Workforce
About 190,000 New York CDPAP caregivers filed with the NLRB in September 2026 for a union election that would put them under 1199SEIU.
September 24, 2026 · New York CDPAP Workers File For Union Election · 1 min
Workforce · Reference
DSPs build independence and community life for people with I/DD, while PCAs mainly help with daily care; federal rules treat the two jobs apart.
September 21, 2026 · 42 CFR 440.167: Personal care services (eCFR) · 5 min
Workforce · The workforce
ANCOR urged agencies to seek mayoral proclamations and send thank-you messages during DSP Recognition Week, held Sept. 13-19, 2026.
September 20, 2026 · Direct Support Professional Recognition Week 2026 · 1 min
Workforce · Reference
A DSP is the paid staff member behind community life for people with I/DD, and federal Medicaid rules classify DSPs as direct care workers.
September 16, 2026 · 42 CFR 441.302: State assurances, including the direct care worker definition (eCFR) · 5 min
Workforce · Reference
DSPs support people with I/DD in community life; CNAs give basic care under nurses and need 75+ hours of federal training to work in nursing homes.
August 31, 2026 · 42 CFR 483.152: Requirements for approval of a nurse aide training and competency evaluation program (eCFR) · 5 min
Workforce · Harrisburg
A Pennsylvania bill heard Aug. 18, 2026, HB 1939, would index ID/A rates to inflation each Oct. 1 and require matching percentage raises for DSPs.
August 28, 2026 · Heffley, House Human Services Committee Reviews Direct Service Provider Reimbursement Bill · 2 min
Workforce · Bargaining
Washington has proposed holding the $37.42 hourly labor rate for about 80,000 consumer-directed caregivers flat in fiscal 2028, as of Sept. 26, 2026. SEIU 775 seeks $38.40; the deadline is Oct. 1.
August 17, 2026 · As WA caregiver union pushes for pay hike, state seeks wage freeze · 4 min
Workforce · Federal
S. 3211, asking federal officials to consider counting DSPs as their own occupation, cleared a Senate committee unanimously in early August 2026.
August 6, 2026 · NADSP Policy Update: Unanimous Senate Committee Vote Advances DSP Bill · 1 min
Workforce · The data
A 2026 poster using National Core Indicators data puts average DSP pay at $17.86 in 2024, up from $12.22 in 2018, still short of a living wage. Higher pay still went with lower turnover.
July 8, 2026 · Should I stay or should I go? Incentives, wages, and retention among direct support professionals revisited post COVID (2026 AAIDD poster) · 3 min
Workforce · North Carolina
North Carolina's budget, signed July 7, 2026, adds $21.3 million a year in state funds, about $59.4 million with federal match, to Innovations rates.
July 7, 2026 · Council welcomes General Assembly's investment in direct support professional workforce · 3 min
Workforce · Frederick
Maryland self-direction families said in June 2026 that July 1 wage cuts and September hour limits would undo the care their paid relatives provide.
June 26, 2026 · Maryland disability pay cuts leave families fighting for stability · 2 min
Workforce · Research
Medicaid home care users grew faster than providers from 2019 to 2023, reaching 65.65 per provider, according to a chartbook released April 27, 2026.
May 12, 2026 · Home care recipient growth outpaces providers · 1 min
Workforce · Minnesota
Minnesota disability providers told the Star Tribune in April 2026 that a federal immigration enforcement surge rattled their thin workforce.
April 21, 2026 · Minnesota's Caregiving Workforce Was Already Short-Staffed. Then ICE Came · 1 min
Workforce · Pennsylvania
Pennsylvania's 2025 DSP compensation study, released April 7, 2026, found average pay of $18.53 an hour and turnover steady at 41%. 18.2% of DSP positions were vacant.
April 7, 2026 · 2025 Pennsylvania Direct Support Professional & Front Line Supervisor Compensation Study · 3 min
Workforce · Research
A Case for Inclusion snapshot released Jan. 14, 2026, put 2023 DSP turnover at 39.7%, the first reading under 40% since 2014, with pay at $17.20.
January 27, 2026 · Medicaid Cuts Put Disability Services At Risk, Advocates Warn · 2 min
Workforce · Research
Forty-eight states reported DSP shortages in KFF's 2025 survey of state Medicaid officials, published Jan. 5, 2026, the most of any home care job.
January 5, 2026 · Payment Rates for Medicaid Home Care Ahead of the 2025 Reconciliation Law · 2 min
Workforce · New Jersey
New Jersey raised DD service rates Jan. 1, 2026, to fund a raise of about 46 cents an hour for DSPs and DSP supervisors. Providers had to add it to base pay by March 1, retroactive to Jan. 1.
December 30, 2025 · FY26 Increases to Medicaid Service Rates, Supports Program and Community Care Program Budgets, and DSP and DSP Supervisor Wages · 2 min
Workforce · Research
An AARP and National Alliance for Caregiving report from October 2025 finds family caregiving burdens vary widely by state. It estimates 63 million family caregivers nationwide.
October 31, 2025 · Family Caregivers Struggling In Some States More Than Others · 1 min
Workforce · The workforce
ANCOR's 2025 workforce survey, released Oct. 29, 2025, found 52% of I/DD providers weighing more program cuts, up from 34% in 2024. 88% reported moderate or severe staffing shortages.
October 29, 2025 · Shortage of Direct Support Workers Persists as Service Providers Brace for Medicaid Funding Reductions · 2 min
Workforce · Workforce
Medicaid community attendants in Texas get a $13 hourly base wage under the budget passed May 31, 2025, backed by nearly $1 billion in state revenue.
May 31, 2025 · Texas Legislature approves $338 billion state budget · 1 min
Workforce · Workforce
Families fought Gov. Gavin Newsom's May 2024 plan to delay California's final rate reform phase a year, saving $613 million but stalling raises. About 150,000 workers would wait.
May 7, 2024 · The 2024-25 Budget: Department of Developmental Services · 1 min
Workforce · Workforce
DSPs and DSP supervisors in New Jersey were due a raise of about $1.75 an hour in base pay by March 1, 2024, funded by a Jan. 1 rate increase.
January 2, 2024 · Direct Support Professional (DSP) and DSP Supervisor Wage Increases, and Corresponding Updates to Fee-for-Service Reimbursement Rates and Program Budgets · 1 min
Workforce · Workforce
North Carolina told legislators July 20, 2023, that $18 DSP pay in Innovations and private ICFs would take $78.2 million a year in state money. The total, with federal funds, is $242.1 million.
July 20, 2023 · BH I/DD Tailored Plan PMPM Adjustment Recommendations Regarding Wages for Direct Support Personnel · 1 min