Since the 1960s, living arrangements for people with intellectual or developmental disabilities (IDD) have shifted from institutions to smaller, community-based settings, supported by Medicaid Home and Community-Based Services (HCBS). Between 2000 and 2020, the number of individuals living in their own homes rose from 73,147 to 154,634, and those in host/foster homes or small group settings increased from 78,680 to 148,629. Group settings of four or more decreased from 251,239 to 247,754. States should continue expanding access to smaller, person-centered living options.
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