A total of 497,354 people were on state waiting lists for Medicaid home and community-based services, and full-time vacancy rates for direct support professionals had risen to 16.5%, according to the Case for Inclusion 2024 report released by ANCOR and United Cerebral Palsy on March 6, 2024.
What the report found
The report tracks how well states support people with I/DD to live in their communities. It used nearly 80 measures across six issue areas, including the workforce, community inclusion and waiting lists, according to ANCOR.
Part-time vacancy rates for DSPs reached 20.3%, the report said. It also noted that 17 states and the District of Columbia had closed their state-run institutions.
The report's title framed its message: states needed to turn temporary progress, much of it paid for with pandemic relief money, into long-term sustainability.
Why this mattered for providers and DSPs
Vacancy rates that high mean agencies run with one in six full-time DSP jobs empty. That shows up as overtime, canceled services and slower intake for people coming off waiting lists. For provider agencies, the report gave national numbers to bring to state budget debates as federal relief funds neared their March 2025 spending deadline.