Long-Term Supports and Services for People with IDD: Research, Practice and Policy Implications


Key Findings:

  • In the United States family members are the primary providers of long-term services and supports (LTSS) for people with IDD. More than three of every four people with IDD of all ages live in the home of a family member (Braddock et al., 2015, Larson et al., 2015).
  • Of the people with IDD receiving governmentally funded LTSS, the majority live with a family member. For those who did not live with a family member, the majority shared a home for six or fewer people with disabilities (Braddock et al., 2015; Larson et al., 2015).
  • The number of people with IDD living in institutional settings has declined dramatically over the last five decades. The number in state IDD facilities with 16 or more residents declined from 194,650 in 1967 to 23,802 (operating in 38 states) in 2013 (Braddock et al., 2015); in state psychiatric facilities from 37,641 in 1960 to 803 in 2013; and in nursing facilities from 45,843 in 1988 to 24,696 in 2013 (Larson et al., 2015).
  • Medicaid provides federal financial participation to fund LTSS for people with IDD through more than a dozen different State Plan and Waiver funding authorities. Medicaid funding constituted 78% of LTSS funding for people with IDD in 2013 (Braddock et al., 2015).
  • Three decades of deinstitutionalization studies have found that people who move from institutions to smaller community settings demonstrate having more skills (adaptive behavior) after the move (Larson, Lakin, Hill, 2013). Outcomes have been shown to be better in settings for three or fewer than settings for four or more (Ticha, Hewitt, Nord, & Larson, 2013).

Suggested Citation

Rizzolo, M., Larson, S., & Hewitt, A. S. (2016). Long-term supports and services for people with IDD: Research, practice and policy implications. In Critical issues in intellectual and developmental disabilities: Contemporary research, practice, and policy (pp. 89–107). American Association on Intellectual and Developmental Disabilities. https://www.researchgate.net/publication/298214355_Long-term_supports_and_services_for_people_with_IDD_Research_practice_and_policy_implications


Book Chapter 
American Association on Intellectual and Developmental Disabilities


  • Housing and residential services
    • Family supports/in-home services
  • Specific disability
    • Intellectual/developmental disability (IDD)