One Size Fits All Does Not Fit Medicaid's Most Vulnerable

Abstract

Over the past two decades, community inclusion and ensuring that people with intellectual and developmental disabilities (I/DD) have access to care and services within their homes and in the community has been at the forefront of the disability community and their advocacy efforts. One of the overarching themes of the Americans with Disabilities Act (ADA) is, “Community Integration for Everyone.” The concept of “integration for everyone” incorporates the idea that people with disabilities would access services in the community as people without disabilities, including healthcare services spanning primary and preventive care to specialized healthcare. In a perfect world, people with I/DD would have a primary care provider who includes them into a practice that serves the varying needs and conditions of all individuals and that they would have access to specialists when appropriate. Because most individuals who have I/DD have relatively mild variations of the condition, relying upon the existing healthcare system is logical and reasonable.