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Monday, January 14, 2019

The Case for Inclusion and the Future of Services

The huge baby boom generation is now entering old age, so the number of Alzheimer’s patients will soar.  Competition for suitable workers could drive up the costs of care.   And those costs will rise just as overall government budgets are getting tighter.  The aging of baby boom generation will mean fewer workers paying taxes and more seniors drawing benefits, simultaneously squeezing revenues and expenditures at all levels of government.   “People assume the state will be there to help with their child,” financial planner John Nadworny says, “but that’s a really risky bet.”   
Published regularly, the Case for Inclusion assesses all 50 states and the District of Columbia on 30 measures that paint a picture on how well state programs serve individuals with intellectual and developmental disabilities (I/DD). These 30 measures are broken down into five key issue areas: Promoting Independence, Promoting Productivity, Keeping Families Together, Serving Those in Need and Tracking Health, Safety & Quality of Life.
Nationally, the Case for Inclusion 2019 finds:
  • Nearly 424,000 individuals with I/DD—75,000 more than in the previous Case for Inclusion report—were on states’ waiting lists to receive Medicaid-funded Home and Community-Based Services.
  • Only fourteen states and the District of Columbia had closed all large, state-operated institutions that warehouse individuals with I/DD.
  • For the first time this year, the Case for Inclusion incorporates states’ participation in the National Core Indicators (NCI) staff survey into the scoring process that determines’ state rankings. Participation in this survey is critical as it helps shed light on what we know to be a significant workforce crisis among Direct Support Professionals, the frontline staff who make community integration possible. Twenty-four states had participated in the most recent NCI staff survey.
  • Thirty-three states, one more than in 2016, meet what’s known as the 80/80 Home and Community Standard, meaning that 80% of all individuals with I/DD are served in the community and 80% of all resources support their ability to be part of the community and live in homes with fewer than seven residents.
  • Just 16 states, up from 15 in 2016, support a large share of families (at least 200 families per 100,000 state residents) through support services that empower individuals with I/DD to remain living in their family home.
  • Only 15 states, unchanged from the 2016 report, successfully placed at least 60% of individuals in vocational rehabilitation jobs.
  • Just 15 states, also unchanged from 2016, report that at least 10% of residents with I/DD use self-directed services, which allow them to design the supports they receive based on their specific needs.
For the complete Case for Inclusion 2019 findings, download the report.
From the report:
Demographic trends increasing demand include the increase in Autism diagnoses,  increased longevity of people with I/DD, aging family caregivers needing more assistance to care for their loved ones with I/DD, and demand from baby boomers. Simultaneously,  fewer women are being born into the labor pool – and the DSP [Direct Support Professional] workforce is predominantly female. This promises unmet demand for support unless we take action soon.