Change in US Self-Directed Funding Prevalence for Adults with Intellectual Disability: A Multi-State, Decade-Long Comparison.

This study documents changes between 2012-13 and 2022-23 in the percentage of U.S. adults with intellectual disability (ID) using self-directed (SDF). We analyzed National Core Indicators SDF data from 22 states. Overall percentage prevalence grew from 11.6% to 17.1% but with much variation between states in prevalence and growth of SDF use. The increase was larger for family-home dwellers (21.8%-32.9%) than own-home residents (11.0%-15.4%). We found vastly higher growth in SDF use in these 22 states over the same decade for non-ID populations. Among people with ID, access to SDF was strongly related to state of residence and living arrangement. Robust growth and high prevalence of SDF use in certain states may provide models for other states to emulate.