Barriers and Facilitators of Community Living for People with Intellectual and Developmental Disabilities

Session Submission Type: Panel

Abstract

Adults with intellectual and developmental disabilities (IDD) and autistic young adults experience high rates of material hardship and heavy reliance on public programs. To fully integrate into the community, these adults need access to employment, housing, nutrition, and health care services. Each of these service areas has its own set of programs and administrative processes, which can create challenges in navigating support systems. This panel brings together mixed-method and large-scale quantitative evidence on how income supports and disability services can lessen barriers to community living and financial insecurity. Across studies, we emphasize beneficiary-centered measurement, program accessibility, and the policy levers states and agencies can use to reduce inequities while supporting autonomy and participation.

The first paper uses in-depth interviews with low-income, food-insecure adults with IDD and family members of children with IDD (2024–2025) to show how disability-related barriers shape multiple dimensions of food security and complicate access to SNAP and charitable food supports. The second paper focuses on health care and analyzes 2021–2023 T‑MSIS data for over one million adult Medicaid Home and Community-Based Service (HCBS) recipients with IDD to estimate which service types predict transitions from own/family homes to congregate or institutional settings, using regression and time-to-event methods to assess risks and disparities. The third paper also considers Medicaid, drawing upon semi-structured interviews with adults with IDD (and, when relevant, their care partners) to document administrative burdens in Medicaid and SSI and the tension between independence and benefit loss. Finally, the fourth paper focuses on independence resulting from employment, and reports findings from a survey of more than 3,500 autistic young adults and follow-up qualitative interviews to describe schooling completion, employment experiences, and access to transition services during the move from school-based to adult systems.

Together, the papers connect poverty and income support policy to service delivery and lived experience, offering actionable insights for improving benefit design, reducing administrative burden, strengthening HCBS, and advancing economic security and community inclusion for disabled people.

Policy Area

• Poverty and Income Policy

Chair

• Jody Schimmel Hyde, University of Michigan Ann Arbor

Discussants

• Stephanie Rennane, RAND Corporation

• Amanda Spishak-Thomas, Rutgers University

Organizer

• Jody Schimmel Hyde, University of Michigan Ann Arbor

Individual Presentations

• The complex food insecurity context experienced by people with intellectual and developmental disabilities in the U.S. - Presenting Author: Debra Brucker, University of New Hampshire

• Medicaid Home and Community-Based Services and residential changes among adults with Intellectual and Developmental Disabilities - Presenting Author: Ian Moura, Brandeis University; Non-Presenting Co-Author: Laurin E Bixby, Brandeis University; Non-Presenting Co-Author: Arkady A. Levine, Brandeis University

• Experiences of Supplemental Security Income and Medicaid for Adults with Intellectual and Developmental Disabilities - Presenting Author: Jamie Koenig, University of Wisconsin-Madison

• Views about employment from young adults on the autism spectrum: Evidence from a national survey - Presenting Author: Ankita Patnaik, Mathematica