Policy Research Brief, Vol. 30, No. 1

Research Issue

People with intellectual and developmental disabilities (IDD) are overrepresented in the criminal legal system. Less than 1% (0.79%) of the U.S. adult population has IDD, but between 2–10% of people in jails, prisons, or awaiting trial have IDD.

Over the past 50 years, about 175,000 people have left large state-run institutions and moved into homes in their communities. Increasingly, many of these people move between institutions and the criminal legal system. In 2019, 268 (29%) people moving into large state-run institutions came from correctional facilities. 94 (17%) of those leaving large state-run institutions moved into a jail, prison, or other correctional facility. While these numbers are relatively small, these data still indicate a larger problem of institutionalization and incarceration of people with IDD.

Study Background

The Residential Information Systems Project at the University of Minnesota has tracked living arrangements for people with IDD who get Medicaid or state funded long-term supports and services since 1977. The annual RISP survey of state IDD agencies asks about types and sizes of the places people with IDD getting supports live. RISP also asks about people admitted to or discharged from large state-run institutions. This Policy Research Brief describes services as of June 30, 2019.

Policy Recommendations

To support people with IDD at risk of involvement in the institutional and criminal legal systems, we propose the following policies:

• Grow the Medicaid Home and Community-Based Services system. This would create more opportunities for people with IDD to thrive in their communities. This requires higher Medicaid reimbursement rates to ensure that eligible people can find workers to provide needed services.

• Stabilize the direct support workforce. Create a Standard Occupational Classification for direct support workers to improve their status and recognition.

• Understand and fight against social exclusion of and discrimination against Black, Indigenous, and people of color (BIPOC) with IDD. BIPOC are overrepresented in the criminal legal system due to systemic racism. More research on BIPOC with IDD in the criminal legal system is needed.

• Increase law enforcement training and alternatives to better support people with IDD in crisis. Education and resources for police can decrease the number of people with IDD in the criminal legal system. Using crisis intervention teams alongside or instead of police may also lead to better outcomes, especially for people with IDD.

• Support self-advocacy training initiatives. Learning about their rights, how to talk to the police, and how to speak up for themselves and others can help people with IDD have safer interactions with the criminal legal system.

• Improve screening for IDD in jails. Many people in jail have undiagnosed IDD, so they do not receive appropriate supports. Improving screening would help more people transfer out of jail to home and community-based services.

• Educate lawyers on supporting people with IDD. Lawyers need to understand the disability services system and how to communicate with people with IDD to effectively represent them in the criminal legal system.

Key Findings

In 2019, one of every three people (29%, 268 people) moving to large state-run institutions were leaving correctional facilities.

Bar chart showing the proportion of people admitted to state-run institutions in 2019 by where they moved from. 5% moved from their own homes or host or foster family homes. 16% moved from group homes of one to six residents. 5% Moved from group homes of seven to 15 residents. 5% moved from state or nonstate IDD facilities of 16 or more residents. 8% moved from nursing homes, assisted living facilities, or boarding homes. 14% moved from mental health facilities. 18% moved from the homes of parents or other relatives. 29% moved from correctional facilities.

Of the people leaving large state-run institutions in 2019, 94 people (17%) moved to a correctional facility.

Bar chart showing the proportion of people who were discharged from large state-run institutions in 2019 by where they moved to. 8% moved to their own or host or foster family homes. 40% moved to group homes of one to six residents. 3% moved to group homes of seven to 15 residents. 7% moved to state or nonstate IDD facilities of 16 or more residents. 8% moved to nursing homes, assisted living facilities, or boarding homes. 9% moved to mental health facilities. 8% moved to homes of their parents or other relatives. 17% moved to correctional facilities.

The percent of people with IDD moving between large state-run institutions and the criminal legal system increased between 1985 and 2019.

Line graph showing the proportion of people who were admitted to large state-run institutions from correctional facilities with a green dotted line, and the number of people discharged from large state-run facilities to correctional facilities with a solid dark blue line. The proportion of people with IDD who moved to large state-run institutions from correctional facilities was 2% in 1985, 3% in 1989, 4% in 1994, 10% in 1998, 13% in 2002, 8% in 2008, 13% in 2012, 22% in 2018, and 29% in 2019. The proportion of people with IDD who moved from large state-run institutions to correctional facilities was 0% in 1985, 1% in 1989, 0% in 1994 and 1998. 3% in 2002, 2% in 2008, 1% in 2012, 9% in 2018, and 17% in 2019.