Identifying Predictors for Enhanced Outcomes for People With Intellectual and Developmental Disabilities.
Sponsored residential homes, not larger facilities or family homes, predict more inclusive community activities for people with IDD.
01Research in Context
What this study did
Dinora et al. (2020) looked at Medicaid data for people with intellectual and developmental disabilities. They wanted to know which things predict better community life. They checked housing type, spending, and how much people join in community activities.
What they found
Sponsored residential homes win. People living there joined community activities more often than people in big facilities or family homes. Higher state spending matched people with more medical and behavior needs, not better inclusion.
How this fits with other research
Lakin et al. (2010) show the money moved first. Medicaid shifted dollars out of large institutions into home-and-community waivers before anyone checked outcomes. Parthenia now tells us what that move means for real life.
Friedman (2023) gives the latest price tag: $47,315 per person in FY 2021. Parthenia’s finding says you should push some of those dollars toward sponsored residential slots if inclusion is the goal.
Neuringer et al. (2007) found that injury-causing behaviors and autism predict costly out-of-area placements. Parthenia agrees that client characteristics drive spending, but adds that housing type—not just client traits—shapes quality of life.
Why it matters
You can stop asking “How do we get more money?” and start asking “Where do we place people?” When you write or review an ISP, flag sponsored residential as the first-choice housing. Show your state funders this pair of facts: sponsored homes boost inclusion and Medicaid already pays for them. Use the data to block returns to large congregate settings.
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Join Free →Open each ISP this week—if the housing goal says “congregate” or “family home,” add a comment citing Parthenia et al. (2020) and request a sponsored residential slot instead.
02At a glance
03Original abstract
People with intellectual and developmental disabilities (IDD) often rely on Medicaid-funded services and supports to facilitate their daily living. The financial investment for these services is significant, yet little work has been conducted to understand how these investments affect life outcomes. This pilot study used a novel data integration approach to offer initial insights about how Medicaid expenditures relate to outcomes using Medicaid claims data, results of the National Core Indicators consumer survey, and data from the Supports Intensity Scale (SIS). Findings suggested that subpopulations of people with IDD who also had high behavioral needs or high medical needs had significantly higher expenditures than individuals with more typical SIS-assessed support needs. Regression analyses suggested mixed outcomes based on the factors we considered, including a finding that people with IDD who lived in sponsored residential care homes were more likely to engage in inclusive activities in the community than those who lived in larger congregate settings, or those who lived in a family home. Results of this pilot, when brought to scale, will be useful in examining the performance of state IDD service systems over time.
Intellectual and developmental disabilities, 2020 · doi:10.1352/1934-9556-58.2.139