Disparities in Service Use and Expenditures for People With Intellectual and Developmental Disabilities in California in 2005 and 2013.

Harrington et al. (2016) compared California service records from 2005 and 2013. They looked at who got services and how much money was spent. The team focused on people with intellectual or developmental disabilities.

They counted the number of clients, types of services, and dollars paid. Kids, adults, men, women, and different race groups were all tracked.

Service gaps stayed the same or grew. Children, minorities, and girls received fewer hours and lower-cost supports. Overall, the system left the same groups under-served eight years later.

Titlestad et al. (2019) and Dudley et al. (2019) explain why these gaps persist. Both reviews say U.S. health surveys lack simple IDD flags, so states under-count adults and miss need. Charlene’s data prove the surveys are missing reality on the ground.

Nord et al. (2013) already showed that most employment supports fail to produce real wages. Charlene’s dollar figures back up that review: money is low and outcomes are weak for the same population.

Eldridge et al. (2025) zooms in on California again, this time for substance-use treatment. That study finds almost no IDD-ready programs, extending Charlene’s point that the state’s service array is thin.

If you write plans or authorize hours, expect built-in shortage. Budgets may be capped lower for girls, minorities, and kids even when needs are equal. Flag these patterns in your reports and ask for higher, fair limits. Push for data fixes too; better IDD codes in state files can justify the dollars you request.