High vacancy and turnover rates continue to plague human services providers serving individuals with intellectual and developmental disabilities, but improvements were seen in services which received higher state reimbursement, according to an industry survey released today by the Association for Developmental Disabilities Providers (ADDP), a statewide association representing community-based human services providers.
“High vacancy rates, which limit the capacity of the provider system, remain relatively unchanged between March and October,” said ADDP President and CEO Ellen Attaliades. “The place where vacancies are decreasing is in day programs, which have received long-term increases in reimbursement rates and re-engagement and admission incentive payments for Day Habilitation programs. It is also notable that the waiting lists for those programs declined as well, meaning more people were able to receive services or return to programs.”
The survey of ADDP members, conducted in October 2023, captures vacancy rates and other workforce-related metrics across key residential day programs serving individuals with intellectual and developmental disabilities, including autism and brain injury. Seventy-seven percent of ADDP’s 134 members responded to the October survey. It is the second in a series that began in March 2023.
The survey focuses on staffing across six programs operated by ADDP’s members: Adult Long-Term Residential (ALTR); Day Habilitation; Community-Based Day Supports (CBDS); Supported Employment; Shared Living; and Adult Foster Care.
Staffing vacancies declined anywhere from 2% to 6% in all of the day programs: Day Habilitation, CBDS and Supported Employment. Of these, Day Habilitation received a rate increase of 33% in July and CBDS and Employment programs were projected to see increase expenditures of more than 14%. Vacancies increased slightly in two residential-based service areas, which did not receive rate increases in 2023.
Vacancy rates for licensed practical nurses (LPNs) was reported to be 33% overall, and 35% in ALTR programs, which serve adults with varying levels of medical and developmental complexities. Although the overall vacancy rate dropped 2% for Direct Support Professionals (from 28% to 26%), the total number of vacant DSP FTEs remains high at 5,010, with 3,867 DSP positions remaining vacant in ALTR programs. Vacancy rates across all programs are reported to be 24%.
Respondents also reported that nursing, Community Health Worker, and clinician positions are the most challenging to fill and have the highest turnover rates ranging between 25% and 31%. LPNs had the highest six-month turnover rate at 31%, which is concerning because these positions are vitally important in residential programs.
Other key findings include:
- More than 67% of respondents reported vacancy rates between 11% and 40%;
- Staff vacancy rates were highest in Southeastern Massachusetts, the only region that increased from the March 2023 survey;
- A total of 1,470 individuals are waiting for Day Habilitation services – 711 were formerly enrolled and 759 are new referrals;
- A total of 1,247 individuals are waiting for CBDS and Supported Employment – 504 were formerly enrolled and 743 are new referrals.
ADDP will continue to repeat this survey on a regular basis to track trends over time.
About ADDP
As a prominent statewide association, the Association of Developmental Disabilities Providers (ADDP) represents 134 human service organizations that provide a wide range of services to individuals with intellectual and developmental disabilities including autism, and to individuals who have brain injuries. ADDP’s mission is to promote and ensure the strength of its community-based providers so they can be successful in improving access, quality, and the value of services in the community. For more information, visit www.addp.org.