By Amy S. Hewitt
Director
Institute on Community Integration
University of Minnesota
For half a century, the US has been achieving one of the most important civil rights victories most Americans have never heard of: closing the large institutions that once warehoused people with intellectual and developmental disabilities. In 1967, nearly 200,000 people lived in state-run facilities that isolated, neglected, and often abused them. Today, because of decades of advocacy, exposés, bipartisan action, and families who chose to keep their children at home, fewer than 16,000 remain. More than a million people now live in communities — in their own homes, with family, or with host or foster families — with safer, fuller lives and greater opportunities.
Across the nation, people with disabilities are again ending up in emergency rooms, psychiatric units, homeless shelters, segregated schools, and even jail. Not because of their disabilities, but because the systems meant to support them are failing. Direct support professionals are leaving jobs they can no longer afford to keep. Service providers are closing. Waiting lists are growing. Families are once again being told to lower their expectations. We are sliding backward — not for lack of solutions, but for lack of action on what we already know. Decades of research show that people with intellectual and developmental disabilities can work in real jobs, learn in inclusive classrooms, and contribute to civic life when the right supports are in place. Inclusion benefits everyone. Students learn alongside classmates with diverse strengths. Communities gain volunteers and taxpayers. Families gain stability.
Only a quarter of adults with disabilities have integrated jobs. Few use self-directed services. Fewer than one in five students with intellectual disability spend most of their day in general education. The service system reaches only a fraction of those who need support. We have allowed compliance checklists to stand in for outcomes. We have allowed outdated funding structures to block change. And we have allowed a critical workforce to remain invisible.
We need to focus on rebuilding and respecting the workforce. Direct support professionals and educational assistants are essential. They support people with complex needs, handle challenging situations, and carry major responsibility. They deserve competitive wages, benefits, training, and a career pathway. We also need physicians, nurses, psychiatrists, and allied health professionals well trained to support people with intellectual and developmental disabilities.
What matters is whether people can work, build relationships, live safely, and participate in their communities. Programs should be held to these outcomes, not just minimum regulatory standards and paperwork. Disability is not an illness to treat; it is a form of human diversity that sometimes requires support. Policies should place responsibility not only on service agencies but also on schools, employers, faith communities, recreation programs, and local governments. Communities must be accountable too.
