The Case for Inclusion 2024: Transforming Temporary Progress into Long-Term Sustainability
Download the Case for Inclusion 2024 as a PDF
The Case for Inclusion 2024 summarizes outcomes related to community inclusion across three data snapshots. Highlighted within each data snapshot are key findings derived from nearly 80 measures spanning six of the Case for Inclusion’s seven issue areas: Addressing a Workforce in Crisis, Promoting Independence, Reaching Those in Need, Serving at a Reasonable Cost, Keeping Families Together and Tracking Health, Safety & Quality of Life.
Following these data snapshots, our policy blueprint for sustainable services summarizes the current legislative and administrative environment,offering specific policy solutions tailored to the 118th Congress, the Biden administration, state governments, providers and other community partners.
Key Findings
The key findings report summarizes the most pressing issues from the Case for Inclusion 2024. Among the top findings in the Case for Inclusion 2024:
- Hourly wages for direct support professionals (DSP) wages increased from $13.61 in 2020 to $14.41 in 2021. This marks the second consecutive year of wage increases made possible, at least in part, to temporary emergency funding authorized in response to the COVID-19 pandemic.
- Vacancy rates for both full- and part-time DSP positions increased substantially, with full-time vacancy rates increasing to 16.5% and part-time vacancy rates increasing to 20.3%. Meanwhile, turnover among DSPs remained virtually unchanged, from 43.6% in 2020 to 43.3% in 2021.
- Nationally, there were 497,354 people with IDD on state waiting lists for home- and community-based services (HCBS) waivers. More than 4 in 5 (80.5%) people with IDD waiting for home- and community-based services lived in one of just five states: Texas, South Carolina, Florida, Illinois and North Carolina.
- Seventeen states and the District of Columbia have closed all of their large, state-run institutions for people with IDD. This is an increase from 16 states in last year’s Case for Inclusion, as Kentucky became the latest state to fully deinstitutionalize. Additionally, there were 1,357 fewer people with IDD living in a large, state-run institution in 2019 than in 2018.
- Thirty-eight states participated in the federal Money Follows the Person program, earmarked to support older adults and people with disabilities to transition from institutions into home- and community-based settings. This represents an increase after multiple years of modest declines, with Kansas and New Hampshire rejoining the ranks of states offering this valuable program.
- Eighteen demonstration waivers that include initiatives to address social determinants of health have been approved, while 17 more are pending. Primary social determinants of health impacting people with IDD include food security and affordable, accessible housing.
The key findings report includes details on these and many other insights, as well as an Advocacy Blueprint for what all of us can do to support more inclusive state and federal programs. Thank you for your advocacy on behalf of people with IDD.