The Case for Inclusion 2022 tells the story of community IDD services in two parts: one focused on the cracks and faults in the current system, and one focused on policy objectives for rebuilding a foundation of inclusion. Part 1 is intended as a data-driven review of the extent to which state programs are supporting people with IDD to be included in the community, while Part 2 builds on the challenges outlined in Part 1 to deliver specific action plans tailored to a range of actors. We offer a brief interlude between these two main sections to reflect on the need for more intersectional data to truly understand how key challenges play out differently for people representing diverse communities.


The Challenges


Part 1 of this report leverages the best available data over four of the Case for Inclusion’s issue areas: Addressing a Workforce in Crisis, Promoting Independence, Promoting Productivity and Tracking Health, Safety & Quality of Life. Among its many findings, the Case for Inclusion 2022 finds that:


  • 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

Leave a Reply

Your email address will not be published.