Case for Inclusion

The annual Case for Inclusion is a comprehensive data tool assessing how well state programs are supporting people with I/DD.

Since 2006, United Cerebral Palsy (UCP) has published the annual Case for Inclusion has been a leading source for data assessing how well state Medicaid programs serve people with intellectual and developmental disabilities (I/DD) and their families. The most comprehensive report of its kind, the Case for Inclusion gives lawmakers, advocates and other disability champions a sense of the scope of the challenges we face—a necessary first step to creating a roadmap for how to drive progress in the states to ensure that individuals with I/DD are included, supported and empowered in the community.

Beginning in 2019, the ANCOR Foundation and its Included. Supported. Empowered. campaign began partnering with UCP to publish the Case for Inclusion. The Foundation decided to invest in this valuable resource because of our belief that transactional data and transformational stories, when paired together, can be invaluable in inspiring action toward positive change.

The Case for Inclusion 2020 was published in early February 2020. Among the key findings:

  • The total number of people with I/DD on waiting lists for Home and Community Based Services increased by 49,000, from 424,000 in the last report to 473,000 in this year’s report. Ten states saw decreases in the number of people on their HCBS waiting lists, while 23 states saw their waiting lists grow.
  • Nationally, the turnover rate for direct support roles was 43.8%. In large part, this can be explained by low median hourly wages for DSPs, which stood at just $12.09 nationally.
  • The percentage of people with I/DD working in integrated employment—meaning they are participating in a program that is supporting them to work alongside people without disabilities—crept upward by just one percentage point, from 19% in the Case for Inclusion 2019 to 20% this year. Across the nation, there were 127,000 people with I/DD working in competitive employment, up from 124,000 in last year’s report. Whereas only seven states in the Case for Inclusion 2019 could boast that more than one-third of its residents with I/DD were engaged in competitive employment, that number increased to 10 states in 2020.
  • There was an increase of two percentage points in the number of people with I/DD engaged in self-direction, from 11% in FY 2017 to 13% in FY 2018.

To learn more about the Case for Inclusion and access the latest data, visit