Search This Blog

Monday, March 14, 2022

Waiting Lists and Shortages

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for adults with intellectual and developmental disabilitiesHome and Community-Based Services (HCBS) are particularly important.

The ANCOR Foundation and United Cerebral Palsy have published the Case for Inclusion 2022.  Some findings:

  • Nationally, the average DSP turnover rate in 2020 increased by about one percentage point to 43.6%. Meanwhile, vacancy rates for full-time direct support positions increased from 8.5% in 2019 to 12.3% in 2020—a roughly 45% increase. 
  • As of 2018, 16 states and the District of Columbia had closed their last remaining large, state-run institutions. Joining the ranks of states to have fully deinstitutionalized since last time the Case for Inclusion reported these data are Montana and Tennessee. 
  • 1 in 5 (21.1%) people with IDD who received employment or day supports were participating in an integrated employment service. Within the 33 states that report that they collect data on the number of people working, 19.3% of individuals participating in integrated employment services were working for pay. 
  • There were 589,940 people on states’ waiting lists for home- and community-based services nationally. Nearly 4 in 5 (78%) of those waiting were concentrated in just five states. Because this key findings report cannot cover every data point across all 80 measures contained in the Case for Inclusion’s seven main issue areas, we invite you to learn more and explore the data at 
The report confirms that Texas is a hellhole for people with disabilities: 
  • "Strikingly, more than 78% of people on states’ waiting lists live in the five states with the largest waiting lists: Texas (323,434), Ohio (68,644), Louisiana (27,509), Florida (21,864) and Illinois (19,354)."
  • "States that had the largest number of PRFs in operation were Texas with 13, Ohio with eight and Illinois with seven. In terms of the number of people living in PRFs, Texas and Illinois had the dubious distinction of topping that list, with 2,969 and 1,664 residents, respectively, followed by New Jersey, with 1,325 people with IDD living in a PRF."