Developmental Disability Services and Policy

Session Submission Type: Panel

Abstract

People with Intellectual and Developmental Disabilities (I/DD) represent approximately 4% of children and 1.25% of adults. People with I/DD face significant health care costs and, because of long-term services and supports needs, are at greater risk of institutionalization or placement in congregate care residential settings. In 2023, state and federal policymakers spent approximately $105 billion on long-term services and supports and income support payments to people with I/DD across the lifespan. Unfortunately, this population has not received adequate focus from policymakers, owing to its relatively small size, unique provider network, and the complexities of service-provision to many people with I/DD. Using a diverse array of Medicaid, Social Security Administration, and survey data, this panel will explore the shifting policy and care landscape for people with I/DD. Jiebiao Wang will present research on the impact of ambient temperature changes on Emergency Department utilization for people with I/DD in New York State, presenting evidence that environmental heat stress results in increased ED utilization at moderate temperatures but suppresses ED utilization for psychiatric services and heat-sensitive conditions at higher temperatures. Ari Ne'eman will present research on the impact of state Medicaid and vocational rehabilitation agencies phasing out the using of sheltered workshops beginning in 2016 on employment and day habilitation services utilization for adults with I/DD, showing evidence that the reduction in sheltered workshop utilization had a positive causal effect on competitive employment for young adults with I/DD while causing some substitution from sheltered work to day habilitation services. Lauren Peterson will present findings on the most common Medicaid eligibility pathways for children and adults with I/DD enrolled in Home and Community Based Services waivers, which assist people with I/DD to reside in the community, showing that people with I/DD access Medicaid via a diverse array of eligibility pathways, many of which rely on disability-specific authorities that permit flexibility in financial eligibility.

Policy Area

• Health Policy

Chair

• Jaeyoung Jang, University of North Carolina, Charlotte

Discussant

• Harold Alexander Pollack, University of Chicago

Organizer

• Ari Ne'eman, Harvard University

Individual Presentations

• What Happens When States Shift Away from Sheltered Workshops? - Presenting Author: Ari Ne'eman, Harvard University

• Medicaid Eligibility Pathways among Adults and Children with Intellectual and Developmental Disabilities - Presenting Author: Lauren Andren Peterson, Boston University

• Ambient Temperature and Emergency Department Utilization Among Individuals with Developmental Disabilities - Presenting Author: Jiebiao Wang, The University of Chicago