The State of America’s Direct Support Workforce Crisis 2023

For the fourth consecutive year, ANCOR has measured the impact of the direct support workforce crisis on community-based providers supporting people with intellectual and developmental disabilities (I/DD). By assessing the impact of the direct support workforce crisis on community-based providers on a consistent set of measures for four years, the 2023 edition of the State of America’s Direct Support Workforce Crisis is the first to shed light on longitudinal trends.

This year’s survey garnered responses from 581 distinct provider organizations that together support people with I/DD in 45 states and the District of Columbia. Although data from this year’s effort shows measurable improvements in several key areas between the time of data collection and a year prior, the national provider community remains a long way off from where it was prior to the COVID-19 pandemic.

In The News

• Nearly All Community-Based Providers Faced Moderate to Severe Staffing Shortages in 2023 (Home Health Care News, January 5, 2024)
• HCBS Staffing Shortages Lead to Severe Cuts to Programs, Services, New Report Finds (McKnight’s Home Care, January 4, 2024)
• Investments Needed After Study Unveils HCBS Workforce Crisis (Inside Health Policy, January 2, 2024)
• Survey of Disability Service Providers Finds Deepening Crisis (Disability Scoop, January 2, 2024)
• 60% of I/DD Providers Thinking About Shutting Down Services (Behavioral Health Business, December 22, 2023)

Key Findings

Among the key findings from the State of America’s Direct Support Workforce Crisis 2023 include:

• 95% of respondents indicated they had experienced moderate or severe staffing shortages in the past year.
• More than half (54%) of respondents indicated they deliver services in an area where few or no other providers deliver similar services.
• More than three-fourths (77%) of respondents reported turning away new referrals in the past year due to ongoing staffing shortages.
• 72% of respondents reported that they had experienced difficulties adhering to established quality standards due to ongoing staffing challenges.
• Of those respondents that reported offering case management services, fully three-fourths indicated they had experienced difficulties connecting people with services due to a lack of available providers.

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