Objective

To determine whether the Office for People With Developmental Disabilities (OPWDD) provided adequate oversight of non-profit service providers’ use of funding to recruit and retain direct support professionals. The audit covered various workforce stabilization initiatives with different funding sources, such as federal and State, administered by OPWDD during the period from April 2021 through March 2025, as well as OPWDD activities related to those initiatives through December 2025.

About the Program

In New York, there are approximately 127,000 people—34% of whom are children—with developmental disabilities, including intellectual disabilities, cerebral palsy, Down syndrome, autism spectrum disorders, Prader-Willi syndrome, and other neurological impairments. OPWDD is responsible for coordinating services for individuals with developmental disabilities, providing long-term care such as habilitation and clinical services, as well as residential support services, for over 40,000 people, primarily in community settings. Additional support services include family care, employment support, and vocational training. OPWDD provides services directly through its 13 Developmental Disabilities Services Offices, and through a network of over 500 non-profit service providers (hereafter referred to as Providers).

An integral part of OPWDD’s service delivery system is its over 110,000 direct support professionals, who are the backbone of the service delivery system, in the field every day helping people with developmental disabilities live independent and productive lives. However, a shortage of direct support professionals, nurses, and clinical staff that was worsened by the COVID-19 pandemic has affected its ability to provide the necessary and quality services to support people with intellectual and developmental disabilities and their families. Significant staff shortages have caused many Providers to close programs or reduce operations. According to the National Core Indicators Staff Stability data for 2020, New York’s turnover rate for direct support professionals averaged 36%, and vacancy rates ranged from 17% for full-time positions to 21% for part-time positions within OPWDD’s system. To address these concerns, OPWDD issued several bonuses and supplemental one-time payments and enacted State budget cost‑of‑living adjustments (COLAs) to help Providers retain and recruit direct support professionals. Federal funding through the American Rescue Plan Act (ARPA) allowed OPWDD to make investments in the direct support professional workforce. OPWDD’s ARPA spending plan offered four main incentive payments for direct support professionals, including: COVID Service Incentive (for those employed at least 90 days between March 17, 2020 and September 1, 2021 and on the date of payment distribution), Vaccination Incentive (for being fully vaccinated against COVID-19 and employed on the date of payment distribution), Longevity Incentive (for those employed during State fiscal year 2020–21 and through September 2021 and on the date of payment distribution), and Retention Incentive (for those employed at some point during State fiscal year 2021–22 and on the date of payment distribution). Additionally, outside of ARPA funding, to further stabilize its Provider workforce, OPWDD offered a one-time Direct Service Retention Bonus (Retention Bonus) and in recent years, the annual State budget included a provision for OPWDD, among other agencies, to establish a fiscal year COLA to address the effects of inflation on rates of payment, contracts, and any form of reimbursement for their programs and services. Starting in fiscal year 2024–25, the budget language specified the use of COLA for a targeted salary increase of 1.7% for certain eligible employees, including direct care staff. According to OPWDD, as of September 2025, it had paid out $1.5 billion in ARPA workforce stabilization initiatives to 395 Providers and $148.4 million in Retention Bonus payments to 312 Providers.

Key Findings

Certain weaknesses in how OPWDD oversaw various incentive payments resulted in inconsistent distribution of these payments to direct support professionals, which could work counter to the bonus and incentive programs’ intention to retain and recruit this critical workforce sector. While OPWDD has established some processes to monitor select incentive programs (generally those funded with ARPA monies), in some cases, ineligible direct support professionals received payments they were not entitled to, and some eligible individuals did not receive payments. For example:

• We identified five employees who were eligible for Retention Incentive payments but did not receive them. Based on the Providers’ data, these employees collectively could have received $8,363 in total payments.
• One Provider made a $1,667 Retention Incentive payment to an employee who was not eligible.

Although the value of payments with issues was relatively small, identifying and addressing eligibility issues is crucial to ensuring a critically understaffed workforce is receiving fair treatment in accordance with requirements and that OPWDD’s efforts are achieving the goal of incentivizing these employees. If employees are eligible for certain incentives and do not receive them, Providers risk those employees feeling slighted and possibly disincentivized, working counter to the programs’ intention. For example:

• Providers did not follow OPWDD’s requirements for establishing distribution plans that would provide transparency to their employees on how the Provider intended to distribute certain funds. OPWDD has also not developed a process to monitor that COLA funds are used to support these employees.
• OPWDD has also not assessed the overall effectiveness of the incentive payments on stabilizing the workforce that serves individuals with intellectual and developmental disabilities and supports OPWDD programs.
• Despite efforts to stabilize the direct support professional workforce, shortages remain an issue. Of 507 Providers we surveyed to identify challenges with recruiting and retaining direct support professionals, 240 responded as follows: 83% (198 Providers) were implementing strategies to combat staffing challenges; 70% (169 Providers) were dealing with direct support professional staffing shortages; and 39% (93 Providers) needed to turn away individuals seeking services due to staffing shortages.

Key Recommendations

• Develop and implement policies and procedures for current and future incentive payments, including COLA, which include but are not limited to:
  • Performing reviews of payments, as frequently as OPWDD determines to be practical, to determine whether they are appropriately paid out in accordance with OPWDD’s requirements.
  • Reviewing Providers’ distribution plans for accuracy and adherence to requirements.
• Determine and provide communication to providers on how excess funding will be handled.
• Assess and document the overall impact and effectiveness of incentive efforts to recruit and retain direct support professionals.