Policy Implications, Eligibility, and Demographic Characteristics of People With Intellectual Disability Who Access Self-Directed Funding in the United States.

Kuenzel et al. (2021) looked at who gets self-directed funding (SDF) in the U.S. SDF lets people with intellectual disability control their own service dollars.

They pulled a big national data set. They checked age, living place, and state rules.

Older adults get SDF less often. People in group homes also get less. Living with family or on your own raises the chance.

State policy matters most. Some states make SDF easy. Others add layers of paperwork.

McConkey (2005) saw the same pattern in the U.K. Carers got help only when the adult had high care needs. Age and carer income were ignored.

Harrington et al. (2009) found that younger adults in California filled state centers. Elizabeth et al. now show older U.S. adults are the ones shut out of SDF. Same age skew, different service.

Amaral et al. (2019) found group-home living lowered hospital risk. Elizabeth et al. show it also lowers SDF access. The setting protects from admission but blocks choice.

If you write SDF plans, know the age cliff. Start the process before the person turns 55. If the client lives in a group home, team early with the guardian to show how SDF can pay for extra staff hours or community classes. Push your state for clear, short applications. These steps turn policy on paper into real choice for the people you serve.