The Costs of Care: Disability Support Workers Contemplate the Neoliberalization of Disability Supports

Background: In Ontario (and across Canada, the UK and Australia), state-level care for intellectually disabled people has long been fraught: feminized and correspondingly undervalued; and historically tied to population-level management in total institutional facilities that relied on an austerity ideology and created conditions of routine physical and sexual abuse. A deinstitutionalization movement successfully pressured sector-wide reorganization of public resources, but implementation happened in the context of the neoliberal rollback of public programming that limited political imagination and policy design. Ontario’s most recent transitions into direct funding have been restructuring developmental services. Objectives: This paper presents findings from a research project conducted in partnership with an Ontario-based disability service agency. Front-line workers, all women, who support intellectually disabled people with daily activities in order to facilitate living in community, reflected on how direct funding operates in a time of neoliberal crisis, restructuring care work in a way that produces adverse impacts for disabled people and care workers alike. Method: The research team ran three phases of focus groups, each with a different protocol, with disability service workers November 2024 through April 2025. Fourteen workers were recruited for this study, all women with 17 to 38 years of professional experience in disability service provision. The research team conducted thematic analysis with transcripts. Results: Participants reported that funding is not enough to lift disabled people above the provincial poverty line, and the direct funding model means the province has scaled back funding allocated to agencies. This has created a twinned problem, on either side of the care relation, where disabled people lack the means to cover all their costs of living and service workers see their now reimbursed hours cut. Further, workers reported that the restructuring of funding has opened up unregulated private or for-profit options for disability service provision that drive down wages for the workers employed and generate efficient models of care, including congregate living – which signals a return to the institutionalization that community living was meant to negate.