RISP Data Bytes

Background

The size and type of non-family settings in which people with intellectual and developmental disabilities (IDD) live has shifted over the last 20 years. With increasing access to Medicaid Home and Community-Based Services (HCBS) funding, more people with IDD are living in individualized settings.

Key Finding

The number of people with IDD getting services while living in settings other than the home of a family member increased 27 percent from 423,485 in 2001 to 538,452 in 2021. During that time, the number of people living in group settings shared by four or more people decreased 6 percent from 256,680 to 240,004. The number of people living in a host or foster home or group setting shared by three or fewer people increased 82 percent from 86,563 to 152,669. The number of people living in their own home increased 76 percent from 80,242 to 145,779.

A horizontal stacked bar chart shows the number of people with IDD living in various non-institutional settings. There are five bars each representing a year beginning in 2001 through 2021 in five-year increments. Each bar contains three segments that represent group settings of four or more people, host/foster homes or group settings of three or fewer people, and own home settings.

· In 2001 there were 256,680 individuals living in a group setting of four or more, 86,563 living in a host/foster or group setting of three or fewer, and 80,242 living in their own home.

· In 2006 there were 258,085 individuals living in a group setting of four or more, 85,563 living in a host/foster or group setting of three or fewer, and 104,386 living in their own home.

· In 2011 there were 267,569 individuals living in a group setting of four or more, 101,423 living in a host/foster or group setting of three or fewer, and 126,998 living in their own home.

· In 2016 there were 255,872 individuals living in a group setting of four or more, 146,625 living in a host/foster or group setting of three or fewer, and 141,388 living in their own home.

· In 2021 there were 240,004 individuals living in a group setting of four or more, 152,669 living in a host/foster or group setting of three or fewer, and 145,779 living in their own home.

Recommendations

Living arrangements for people with IDD who do not live with a family member have shifted away from larger group homes to individualized settings. Those settings include the person’s own home, host or foster family homes, and group homes shared by three or fewer people. This is possible as states have increased access to supports in individualized settings. People living in smaller settings make more choices about their daily lives (Houseworth et al., 2018). States should continue to reduce the use of group settings of four or more people and to expand access to support offered in a person’s own home, a host or foster family home, or very small group settings.