Factors impacting access to community services by people with intellectual disabilities

Background: People with intellectual disabilities increasingly live in smaller community settings rather than institutional settings. Home- and community-based services (HCBS) are a type of long-term care in which services and supports are provided in people’s homes and communities. HCBS are essential for people with disabilities to remain in the community. Method: The 2015-2016 National Core Indicators survey data, along with other datasets, were used to determine how factors impacted service utilization and additional services needed for adults with intellectual and development disabilities (I/DD) in the US. Three groups of factors were used: individual, interpersonal, and public policy factors. Results: Variables within each of the three groups of factors affected access to HCBS. Of significant note within individual factors, older adults received more services and had fewer additional services needed. Black respondents received fewer services and had more additional services needed. A higher problem behaviors score and use of mobility aids were associated with greater utilization and more additional services needed. Better health was associated with significantly fewer additional services needed. Within interpersonal factors, results indicated that people who lived in group homes received more services than people living in their own or family homes. Additionally, individuals with community jobs received more services. A notable public policy finding indicated people who lived in a state with a Balancing Incentive Program (BIP) got more services but also had additional services needed. Conclusion: This study examined factors not studied previously and indicates that future research should look at different factors to better understand their impacts on access to HCBS for people with I/DD.