ADDP survey: provider vacancies fall but thousands of IDD support roles remain unfilled
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Summary
A 2025 survey of developmental disability providers shows vacancy rates fell from 19% to 15% year-over-year, but nearly 4,000 positions remain unfilled and rising health-insurance costs are straining providers’ ability to pay competitive wages.
BOSTON — An Association of Developmental Disabilities Providers (ADDP) survey released to the Workforce Support Subcommittee in September 2025 found that overall staff vacancy rates among community-based intellectual and developmental disability (IDD) providers declined from 19% in 2024 to 15% in 2025, but substantial gaps persist.
The survey, presented Sept. 2025 by ADDP President and CEO Stephanie Costa and Vice President Mandy Nichols, covered 132 provider organizations; 102 participated (about 70% of membership). The series began in March 2023, allowing ADDP to track trends across multiple years.
ADDP reported that the share of providers with vacancy rates under 10% rose from 27% in 2024 to 35% in 2025. Program-level vacancy improvements included adult long-term residential services (reported at about 16%) and community-based day supports (about 14%), but providers still reported that nearly 1,800 people are waiting for day services and roughly 4,000 positions remain unfilled systemwide.
“Staff vacancy rates have declined for the third consecutive year,” Nichols said during the presentation, while noting that the system is “not close to full capacity.” The presenters cautioned that even with improvements, vacancy levels remain several times higher than the statewide job openings rate.
The survey highlighted particularly acute shortages for licensed practical nurses (LPNs) — reported at 28% vacancy — and for clinicians, whose vacancy rate rose in 2024 then declined in 2025. Direct support professional vacancies were reported at about 15%.
ADDP added questions this year about health insurance costs. “Nearly 90 percent of respondents reported premium increases averaging 11%,” Nichols said. The organization reported that, without plan adjustments by employers, average increases would have exceeded 12%, and about 14% of providers would have faced premium jumps above 20%. ADDP said rising premiums constrain providers’ ability to offer competitive wages and benefits and hamper recruitment and retention.
Costa told the subcommittee that investments by the Commonwealth, including those referenced as “chapter 2 57” in the presentation, appear to have helped reduce vacancy rates, but she cautioned that other pressures — including immigration policy shifts and broader affordability concerns — could reverse gains.
Members pressed presenters on survey design, data burdens and gaps. Commissioner Leo Sarkisian praised the report’s clarity but asked whether additional data (on training, turnover and populations waiting for residential supports) could be added in future rounds. Commissioner Chris White and others discussed potential external guests for future meetings, including officials involved with apprenticeship programs and workforce pilots.
ADDP said it plans to run the survey again in the fall and the subcommittee invited the presenters to return. The subcommittee also discussed convening a panel with representatives from other states and workforce programs to compare approaches.
The subcommittee’s immediate next steps include outreach to potential guest speakers and follow-up with ADDP to monitor health-insurance impacts ahead of the next survey.
