WASHINGTON—ANCOR, an organization consisting of providers of disability services to those with intellectual and developmental disabilities, conducted a survey of 469 community-based providers of intellectual and developmental disabilities services across 48 states and the District of Columbia. The findings, which were published in a report titled "The State of America's Direct Support Workforce Crisis 2025," showed a number of providers are feeling the impact of staff shortages across the United States.
The report discusses how states confronting budget shortfalls due to expiring COVID-19 era funding have or are considering cutting resources while states that haven’t been forced to consider cuts are likely to do so in 2026 and beyond as they prepare for nearly $1 trillion in reduced federal Medicaid funding as a result of the budget reconciliation legislation signed into law on July 4, 2025.
"These and an array of other factors threaten to worsen a shortage of direct support professionals (DSPs) that has long been at crisis levels, but was finally starting to show signs of improvement. Despite improvement, however, the best available data suggest that turnover rates continue to hover near 40% nationally, while average vacancy rates range between 12% to 15% nationally."
Key findings in the report include:
- 88% of providers experienced moderate or severe staffing shortages in the past year, a slight improvement from 90% in 2024.
- 62% of providers reported turning away new referrals due to inadequate staffing, down from 69% in 2024 but still well above pre-pandemic levels.
- 29% of providers were discontinuing programs or service offerings due to staffing shortages, a modest improvement from 39% last year.
- 59% of providers intended to delay the launch of new programs, down from 64% in 2024.
- 52% of providers were considering further cuts to programs if recruitment and retention challenges failed to subside, a dramatic increase from 34% in 2024, representing the single greatest year-over-year increase.
- 56% of providers reported their organization delivers services in an area where few or no other providers offer similar services, comparable to 57% in 2024.
- 59% of providers who offer case management services struggled to connect people with services due to a lack of available providers, an increase from 57% in 2024.
- 36% of providers were experiencing more frequent reportable incidents, which survey findings indicate are contributed to by high turnover and vacancy rates, down from 45% in 2024.
- 62% of providers indicated they were struggling to achieve quality standards due to staffing challenges.
"Our intent is for these findings to serve as a call to action for policymakers," ANCOR said in the report. "The most meaningful way to address the direct support workforce crisis is through marked federal and state engagement, targeted at strengthening the workforce and making a concerted commitment to investing in Medicaid-funded community supports for people with [intellectual and developmental disabilities]."