Disability service providers across the United States are warning of more cuts to essential programs that support people with intellectual and developmental disabilities. the financial strain on these organizations has reached a critical point. Many providers are operating at a loss, and some have already reduced services or closed programs. The root of the crisis lies in stagnant Medicaid reimbursement rates that haven’t kept pace with inflation or rising labor costs. This has made it increasingly difficult for providers to recruit and retain direct support professionals, the frontline workers who assist disabled people with daily living needs, employment, and community participation.
The workforce shortage is particularly severe. Low wages and high turnover have long plagued the field, but recent economic pressures have made the situation worse. Home care turnover is at its highest level in six years, indicating a widespread retention crisis. The turnover rate in home healthcare has risen by more than 14% over the last three years, reaching 79.2%, according to the data in Activated Insights’ 2024 Benchmarking Report.
Providers are struggling to fill positions, leading to reduced capacity and long waitlists for services. Some agencies have had to rely on temporary staff or pay overtime, further straining their budgets. Others have been forced to turn away new clients or limit the hours they can provide.
I’ve experienced this shortage firsthand due to cerebral palsy. Prior to the pandemic, In my first three semesters of college, I had three different personal care assistants (PCAs). The lack of dependable PCAs added to my stress. I didn’t want to be worried about getting to class on time or using the bathroom. These are basic needs, and when the system fails to provide consistent support, it undermines disabled people’s ability to participate fully in education and society.
Advocates are calling on lawmakers to take immediate action. They’re urging state and federal governments to increase funding for disability services, raise Medicaid reimbursement rates, and invest in the direct support workforce. Without intervention, they warn, the system could collapse—leaving thousands of disabled people and their families without the support they need to live independently and with dignity.
This crisis is not just about budgets; it’s about lives. Disability service providers play a vital role in helping disabled people participate fully in their communities. Cuts to these services threaten the progress made over decades in promoting inclusion, autonomy, and human rights. The time for action is now. Policymakers must prioritize disability services and ensure that the most marginalized members of society are not left behind.
Sources:
Diament, Michelle. “Disability Providers Nationwide Considering More Cuts.” Disability Scoop, Disability Scoop, 10 Nov. 2025, http://www.disabilityscoop.com/2025/11/10/disability-providers-nationwide-considering-more-cuts/31724/.
Martin, Audrie. “Caregiver Turnover, Referral Rejections Continue to Increase in Home Care.” Home Health Care News, Aging Media Network, 15 Aug. 2024, homehealthcarenews.com/2024/08/caregiver-turnover-referral-rejections-continue-to-increase-in-home-care/.