Poster #61 - Implementation Gap: What Is Hindering Organizations Serving People with Disabilities from Providing Human-Rights–Framed Services?

• In Event: Saturday Poster Luncheon

Abstract

The Americans with Disabilities Act (ADA) of 1990 guarantees legal protections for the rights of individuals with intellectual and developmental disabilities (IDD), ensuring non-discrimination and full societal participation. Complementing this, Home and Community-Based Services (HCBS), supported by Medicaid waivers, advance community inclusion as a cornerstone of disability services. Public organizations are tasked with enacting these rights-based policies through best practices that operationalize human rights principles. Yet, substantial gaps persist in practice. According to the 2022–2023 National Core Indicators (NCI) report, while 80% of people with disabilities surveyed felt respected, only 40% felt they could exercise their rights. Just 46% chose their regular day activities, 24% selected their living arrangements, and only 23% had control over who they lived with, highlighting limited autonomy and decision-making power.

This study examines how organizational best practices influence the implementation of human rights for individuals with IDD. It specifically explores how Leadership, DEI (Diversity, Equity, and Inclusion) policies, and Human Resources strategies impact service areas related to autonomy, choice, and control, community living, and stakeholder participation. The analysis is grounded in Critical Disability Theory (Gillies, 2014), the Theory of Individual Quality of Life (Verdugo & Shacklock, 2016), Institutional Theory, and Implementation Theory—integrating conceptual perspectives to assess both organizational behavior and policy enactment.

Using a mixed-methods sequential explanatory design, the study draws on data from the Organizational Priorities and Practices Inventory (OPPI), collected from over 230 disability service organizations across more than 40 states. A Priorities–Practices Gap Index was developed to measure the disconnect between stated values and actual practices. Quantitative analysis revealed statistically significant relationships: organizational practices' performance strongly predicted the implementation of human rights-aligned practices (β = .619, SE = .074, t = 8.38), and performance in human rights priorities was also predictive (β = .747, SE = .064, t = 11.58). The most significant implementation gaps were found in domains requiring structural or cultural transformation: Community Living, Employment, and Engagement (M = 0.548); Staff Participation (M = 0.546); and Autonomy, Choice, and Control (M = 0.541).

Qualitative data from more than 10 semi-structured interviews further illuminated administrative, cultural, financial, ontological, and bureaucratic barriers to enacting human rights policies. These findings underscore the complexities of translating policy into practice, particularly in systems requiring both technical capacity and cultural change.

This study contributes to the growing scholarship on rights-based service delivery in the disability sector. Integrating theoretical frameworks with empirical evidence identifies the organizational conditions that support or hinder the realization of human rights for people with IDD. Crucially, the findings underscore that durable, transformative change in public disability services demands not only evidence-based practices but also sustained partnerships that promote shared accountability and inclusive decision-making. In doing so, this research supports the development of resilient, collaborative policy solutions informed by practice and grounded in the lived experiences of people with disabilities.

Author

• Monica Doraida Mesa-Alvarez, University of Delaware
  Presenting Author