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Assistive Technology for People with IDD in Medicaid HCBS

By Carli Friedman, CQL Director of Research

Assistive technology can help assist people with activities of daily living (ADLs). It also helps promote independence and self-determination, and is associated with increased health and quality of life outcomes. Yet, about one-third of people with intellectual and developmental disabilities (IDD) who need assistive technology do not have access to it. In fact, some assistive technology can be quite expensive and difficult to access. For these reasons, the aim of this study was to examine how states offered assistive technology for people with IDD in their Medicaid Home- and Community-Based Services (HCBS) waivers. To do so, I analyzed fiscal year (FY) 2021 HCBS waivers from across the United States.

I found that 71% of states provided assistive technology to people with IDD in FY2021. In fact, $34.9 million of spending was projected for assistive technology services. However, less than 3% of people with IDD receiving HCBS were projected to receive assistive technology services in FY2021. In fact, the percentage of people with IDD projected to receive assistive technology services varied significantly by state (see Figure).

Percent of People with IDD Projected to Receive Assistive Technology

A map of the united states indicating the percent of people with IDD receiving assistive technology per state. It ranges from 0% in 12 states to 25.01% in New Jersey.

“Assistive technology promotes continuity and security, helps people exercise and realize their rights, increases relationships, and is a source of empowerment, and thus should be available to everyone…In fact, as a result of these benefits, as well as the increased health, independence, and employment benefits associated with assistive technology, assistive technology is not only cost-effective but also has a return on investment (ROI) of $9 for every $1 spent on AT (Blauwet et al., 2020; World Health Organization & United Nations Children’s Fund, 2022). Thus, a few thousand dollars in spending per person on assistive technology in IDD HCBS has the potential to result in tens of thousands of dollars in benefits in improvements in health, independence, welfare, employment and reduced support costs per person… Everyone that needs assistive technology should have access to it; the most prominent funding mechanism for LTSS for people with IDD should reflect this” (Friedman, 2023, pp. 6-7).


This article is a summary of the following journal manuscript: Friedman, C. (2023). Assistive technology for people with intellectual and developmental disabilities in the United States in Home-and Community-Based Services. Disability and Rehabilitation: Assistive Technology.