The following is from a press release issued by Ball Consulting Group on November 19, 2025:
FRAMINGHAM, Mass. (Nov 19, 2025) – The Association for Developmental Disabilities Providers (ADDP) today released its annual workforce survey, which found that labor shortages across residential and day programs supporting individuals with intellectual and developmental disabilities (IDD), including Autism and brain injuries, remained significant, even as vacancy rates have shown modest improvements over the past year. At the same time, rising costs – particularly sharp increases in health insurance premiums – are placing new financial strain on providers.
The survey, conducted in September 2025, is the fourth in a series that began in March 2023 and reflects responses from 77% of ADDP’s member provider organizations that employ nearly 26,000 staff statewide.
“While we have seen meaningful progress, the system remains fragile,” said Stephanie Costa, president and CEO of ADDP. “Providers have worked hard to stabilize staffing, yet the cost environment is becoming increasingly untenable. Health insurance premiums are rising at double-digit rates in many cases, which directly impacts providers’ ability to offer competitive wages and retain skilled staff. Without sustained investment, the gains we have made will be hard to maintain.”
Like past surveys, the data pertains to staffing across six programs operated by ADDP’s members: Adult Long-Term Residential, which represents the largest program; Day Habilitation; Community-Based Day Supports; Supported Employment; Shared Living; and Adult Foster Care.
The overall staff vacancy rate decreased from 19% in 2024 to 15% in 2025, which marked the third consecutive year of gradual improvement. However, vacancy levels still remain well above the statewide job opening rate of just over 4%, and several positions – especially licensed nurses and clinicians – continue to be a recruitment challenge. Nearly 4,000 positions are currently vacant.
The 2025 survey added two questions about health insurance premium changes in response to growing concern by providers about increases in health plan costs. Nearly 90% of providers reported increases in health insurance premiums this year, with an average increase of 11%. Many providers reported that they had to scale back plan offerings to manage increases – and that if they had not done so, premiums would have risen even further. Several provider agencies also indicated that they absorbed a greater share of insurance costs to prevent unaffordable employee premium increases.
“The human services sector works because people show up every day to support individuals, families, and communities,” said Costa. “Protecting stability in this system is how we protect stability for the most vulnerable residents in our communities. Continued state investment in boosting provider reimbursement is essential.”
Other key findings include:
- Most providers still reported double-digit vacancies, as only 35% of providers reported vacancies of 10% or under;
- Hard-to-fill roles persist, with Licensed Practical Nurse vacancies at 28% and other clinician vacancies at 19%;
- The highest vacancy rates were in the Adult Long-Term Residential (group home) program and Shared Living, at 16% each;
- Some of the decrease in group home vacancies from 26% two years ago to 16% in 2025 is likely attributable to 2024 Department of Developmental Services rate increases;
- Community-Based Day Supports program vacancies declined, from 20% to 14%;
- Day program waitlists continued to decline from 2,400 people in 2024, but 1,800 individuals are still unable to access services; and
- Vacancies fell across all regions; the Metro region remained highest at 17%, while Central and Western Massachusetts were lowest at 11%.
About ADDP
As a prominent statewide association, the Association of Developmental Disabilities Providers (ADDP) represents more than 130 human service organizations that provide a wide range of services to individuals with IDD, including Autism, and who have brain injuries. ADDP’s mission is to promote and ensure the strength of its community-based providers so that they can be successful in improving access, quality, and the value of services in the community.
Contact:
Izzy Nickel, Ball Consulting Group
Phone: 617-243-9950; Email: izzy@ballcg.com