Performance Improvement 2007. Who Has an Intellectual or Developmental Disability, Who Provides Their Care, and How Will That Change in the Future?



This study provided a comprehensive view of the supply and demand for "direct service professionals," individuals who help persons with intellectual or developmental disabilities. Intellectual disability consists of having low intellectual functioning and limitations in conceptual, social, and practical skills needed for everyday life. Individuals with developmental disabilities have limited functioning in three or more "activities of daily living." These activities are: capacity for independent living, economic self-sufficiency, learning, mobility, receptive and expressive language, self-care, and self-direction. Direct support professionals are paid to provide a wide range of day-to-day services to persons with intellectual or developmental disabilities. These professionals include direct care staff, aides, home health assistants, respite care providers, and personal care attendants. By providing services such as habilitation, health needs, personal hygiene, employment, transportation, recreation, house-keeping, and home management support, they enable individuals to live, work and function in their communities.

Direct support professionals are essential to the quality of life, health and safety of more than 1 million Americans with intellectual or developmental disabilities in need of long-term services and support. An estimated 4.3 million Americans with intellectual and/or developmental disabilities live in residential settings, their own homes or with other members of their families. Ensuring access to and quality of professional support is key to realizing goals established in various statements of national purpose with regard to full citizenship and inclusion of individuals with intellectual or developmental disabilities. In June 2003 there were an estimated 874,000 full-time equivalent direct support personnel assisting intellectually and/or developmentally disabled individuals in group residential settings, family homes, their own homes, community jobs, vocational and day training settings, and other service settings.

The current study estimated that by 2020, 1.2 million direct service professionals will be needed in order to provide an estimated 1.4 million individuals with intellectual or developmental disabilities with needed residential, vocational and other support. This is an increase of about 323,000 jobs, roughly 37% more such professionals than in 2003. Most of the increase will be due to increases in population, life expectancy among persons with the disabilities, aging of family caregivers, and use of increased types of home and community-based services. This increased demand will occur at a time when the labor supply of adults age 18-39 years, who traditionally have filled these jobs, is expected to increase only by 7%. Meeting future demand for support professionals will be difficult to achieve through regular recruitment alone. Attracting new personnel and improving retention will be essential.

Many industries will compete for the direct care workers, including the rapidly growing long term services and supports systems for aging persons with disabilities. Compensation, working conditions, career opportunities and job design will be key to retaining personnel and attracting new workers. Providing adequate levels of high quality, committed and stable direct support will need sustained effort by many actors. Work will be needed across federal, state and local governments, education and training institutions, workforce investment systems, faith-based organizations, service provider organizations and support professionals themselves. These groups and institutions will need to shape support roles into ones that offer those who enter these positions enough opportunity and respect to consider them viable careers.

Report Title: The Supply of Direct Support Professionals Serving Individuals with Intellectual Disabilities and Other Developmental Disabilities: Report to Congress
Agency Sponsor: ASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Drabek, John, 202-690-6443
Performer: Department of Health and Human Services (HHS); Washington, DC
PIC ID: 8349

View full report


"PerformanceImprovement2007.pdf" (pdf, 717.63Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®