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Change in US Self-Directed Funding Prevalence for Adults with Intellectual Disability: A Multi-State, Decade-Long
Roger J Stancliffe1, Yi-Chen Wu1, Renáta Ticha1
1University of Minnesota, Minneapolis, MN.
Intellectual and Developmental Disabilities
|August 12, 2026
Summary
Self-directed funding (SDF) use among U.S. adults with intellectual disability (ID) increased significantly from 2012-13 to 2022-23. Growth varied by state and living situation, with higher increases for those in family homes.
Area of Science:
- Public Health
- Disability Studies
- Healthcare Policy
Background:
- Self-directed funding (SDF) models are increasingly explored for supporting adults with intellectual disability (ID).
- Understanding trends in SDF utilization is crucial for policy development and resource allocation.
- Previous research has not comprehensively documented national shifts in SDF use among this population over a decade.
Purpose of the Study:
- To analyze changes in the percentage of U.S. adults with intellectual disability (ID) utilizing self-directed funding (SDF) between 2012-13 and 2022-23.
- To examine variations in SDF prevalence and growth across different states and living arrangements.
- To compare SDF growth trends in the ID population with non-ID populations.
Main Methods:
- Analysis of National Core Indicators Self-Directed Funding data from 22 U.S. states.
- Comparison of SDF usage percentages for the 2012-13 and 2022-23 periods.
- Stratification of data by living arrangement (family home vs. own home) and state.
Main Results:
- Overall SDF prevalence among U.S. adults with ID increased from 11.6% to 17.1% between 2012-13 and 2022-23.
- Growth in SDF use was substantially higher for individuals living in family homes (21.8% to 32.9%) compared to those in their own homes (11.0% to 15.4%).
- SDF use growth for non-ID populations significantly outpaced that for the ID population over the same decade; state of residence and living arrangement were key factors influencing access.
Conclusions:
- Significant national growth in SDF use among adults with ID occurred over a ten-year period, with notable disparities based on living situation.
- The findings highlight the need for state-specific strategies to address variations in SDF access and utilization.
- States with robust SDF growth and high prevalence may offer valuable models for other states seeking to expand these services.
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