The Case for Inclusion 2019

Key Findings

Key Findings

Published regularly since 2006, the Case for Inclusion assesses all 50 states and the District of Columbia on 58 measures indicating how well state programs are supporting people with intellectual and developmental disabilities (I/DD). These 58 measures span seven key issue areas: Addressing a Workforce in Crisis, Keeping Families Together, Promoting IndependencePromoting ProductivityReaching Those in Need, Serving at a Reasonable Cost and Tracking Health, Safety & Quality of Life.


Nationally, the Case for Inclusion 2020 finds:


  • The total number of people with I/DD on waiting lists for Home and Community Based Services increased by 49,000, from 424,000 in the last report to 473,000 in this year’s report. Ten states saw decreases in the number of people on their HCBS waiting lists, while 23 states saw their waiting lists grow.
  • Nationally, the turnover rate for direct support roles was 43.8%. In large part, this can be explained by low median hourly wages for DSPs, which stood at just $12.09 nationally.
  • The percentage of people with I/DD working in integrated employment—meaning they are participating in a program that is supporting them to work alongside people without disabilities—crept upward by just one percentage point, from 19% in the Case for Inclusion 2019 to 20% this year. Across the nation, there were 127,000 people with I/DD working in competitive employment, up from 124,000 in last year’s report. Whereas only seven states in the Case for Inclusion 2019 could boast that more than one-third of its residents with I/DD were engaged in competitive employment, that number increased to 10 states in 2020.
  • There was an increase of two percentage points in the number of people with I/DD engaged in self-direction, from 11% in FY 2017 to 13% in FY 2018.

For the complete Case for Inclusion 2020 findings, download the report.