Community-Based I/DD Providers Turning Away New Referrals and Programs as Staffing Shortages Rage

A new survey from the American Network of Community Options and Resources shows that nearly 80% of community-based I/DD providers are turning away new referrals as the industry continues to grapple with the fallout from the coronavirus pandemic and the current stresses put on the industry by staffing and financial shortages.

In February 2020, the American Network of Community Options and Resources conducted a survey of providers of community-based I/DD services to try and understand how they experience the human and financial impacts of the DSP workforce crisis.

The results of that survey found providers were already discounting services at alarming rates, turning away new referrals, delaying the launch of new programs and were generally struggling to adhere to quality standards


Then came the pandemic.

Throughout the last 18 months or more, ANCOR has been fielding thousands of calls about these same issues that are now worse for obvious reasons. ANCOR conducted a second five-week survey starting in August of 2021 and received 449 responses.

“As anticipated, the challenges to maintain services and quality standards have increased dramatically with the immediate and drastic exodus of DSPs from the field,” ANCOR’s survey review said. “By nearly every count, providers find themselves in a significantly more precarious situation than the ones that described their operations in early 2020.”


The new survey found that 77% of providers are turning away new referrals because of a shortage of staff members. The nearly 8 in 10 respondents who indicated that they had turned away or stopped accepting new referrals represents a 16.7% increase since the start of the pandemic.

The limited number of available providers has left individuals with high support needs traveling significant distances outside of their communities to seek support and care, thereby furthering their risk of exposure to COVID-19.

Meanwhile, more than half of respondents said they discontinued programs or services because of low staffing and 84% said they delayed the start of new programs that would have helped a new wave of patients trying to get help.

“As the infrastructure of services deteriorates without the ability to provide staffing, there are nearly 600,000 people languishing on states’ HCBS waiting lists,” the report read. “States will remain unmotivated to reduce waiting lists when no providers are available to provide support after authorization.”

The shortages and insufficient support is also a financial burden. Nearly 30% reported spending more than $500,000 a year in costs related to high turnover and vacancy rates, while nearly 1 in 6 respondents (18%) reported spending more than $1 million a year. That’s a pretty penny for community providers that were significantly underfunded to begin with.

ANCOR said a significant deferral response is necessary to combat these issues.

With the new public health and economic pressures of COVID-19, the very infrastructure of supports and services is held together by a shoestring of dedicated providers nationwide,” the report read. “Without significant investment in the DSP workforce, it is only a matter of time before people with I/DD and their families completely lose access to the options and resources needed to remain in their homes and in the community.”

ANCOR supports President Biden’s $400 billion investment in the Medicaid Home and Community Based Services (HCBS) program and is calling on Congress to pass it in order for these providers to adequately do their jobs in such a dire environment.

“A failure to adequately invest will also hinder lawmakers’ efforts to create equity and opportunity in their states and communities, as a failure to invest in the DSP workforce is a failure to invest in a community of more than one million professionals who are predominantly women and people of color,” the report’s conclusion read.

Written by Patrick Filbin

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