According to reports provided by all states in the United States on June 30, 2003, persons with intellectual and/or developmental disabilities (ID/ DD) receiving residential supports outside the homes of family members under the auspices of the state mental retardation and/or developmental disabilities agencies for the first time exceeded 400,000 persons. The 402,281 persons receiving residential supports outside their family home represented a 93,297 person (30.2%) increase from 308,984 residential service recipients a decade earlier. As a point of comparison between 1982 and 1993, we found that residential service recipients increased by 65,849 (26.7%). Indexed for the size of the U.S. population, the number of residential service recipients per 100,000 of the general population increased from 105.2 in 1982 to 120.7 in 1993 to 142.9 in 2003. Increases in residential service recipients were evident in all states during the 1993 to 2003 period. Summaries by residential setting size indicate that during the period the number of people living in settings of 16 or more residents decreased by 42,765 (37.1%) nationally. Decreases were reported in all but 3 states, which had a combined total increase of 26 institution residents. The number of people in settings of 7 to 15 residents also decreased, although by only 2,188 people (3.9%), with increases occurring in 15 states. The number of people with ID/DD living in residential settings of 6 or fewer residents changed most notably; the number more than doubled during the decade, increasing by 138,248 people (100.8%). Increases occurred in all states. Figure 1 shows changes in total U.S. residential service recipients by size of residential setting; nationally, nearly three quarters (74.3%) of the growth in settings for 6 or fewer residents was accounted for by the 102,711 person increase within places that 3 or fewer people with ID/DD lived. Despite the increase in actual and population-indexed numbers of persons with ID/DD receiving residential services, reports from 36 states maintaining data on persons waiting for residential services (with 67.9% of all residential service recipients) indicated that such services would need to be expanded by 18.7% to accommodate persons known to be waiting for residential services. Applying this statistic to all states, we found an estimated 75,300 persons waiting for residential services in June 2003. Among factors propelling the growing demand for residential services are increased longevity (and total “service-years”) of persons with ID/DD; the aging of parents and other family members who had supported people with ID/DD without formal residential supports; increased attractiveness of the growing array of community services; increased access for states to federal sharing of the costs of providing community residential supports, and other factors.
Among the factors moderating the growth in residential services demand has been the rapid increase in supports provided to individuals with ID/ DD living with family members. In June 2003, states reported that there were 500,004 individuals with ID/DD and/or family members receiving various forms of assistance in the family home. This compares with a reported 205,121 individuals/families supported in 1993 (Braddock et al., 1995). Table 1 summarizes the growth in residential service recipients among the states between 1993 and 2003. It shows changes in number of residential services recipients in settings with 6 or fewer, 7 to 15, and 16 or more residents.
Source: Prouty, R., Smith, G., & Lakin, K.C. (Eds.). (2004). Residential services for persons with developmental disabilities: Status and trends through 2003. Minneapolis: University of Minnesota, Research and Training Center on Community/Institute on Community Integration.