HCBS Provides Specialized Medical Equipment to People with IDD

Posted on September 19, 2024

By Carli Friedman, CQL Director of Research

Specialized medical equipment includes reusable medical equipment, called durable medical equipment, such as wheelchairs, hospital beds, and Hoyer lifts. It also includes disposable medical equipment, called nondurable medical equipment, such as gloves and incontinence supplies. Not only can specialized medical equipment be life sustaining for some people with intellectual and developmental disabilities (IDD), it also can help improve health, independence, and quality of life.

For these reasons, the aim of this study was to examine how states allocated specialized medical equipment in their Medicaid Home- and Community-Based Services (HCBS) programs for people with IDD. To do so, I analyzed Medicaid HCBS 1915(c) waivers from across the United States for fiscal year (FY) 2021.

Among the 71 different types of specialized medical equipment services in HCBS for people with IDD, about half provided both durable and non-durable medical equipment to people with IDD.

Types of Specialized Medical Equipment in HCBS

In total, $61 million was projected for specialized medical equipment. However, only about 4% of people with IDD who received HCBS in FY 2021 were projected to receive specialized medical equipment. In addition, there were significant differences in if, and, how, states made specialized medical equipment available in their HCBS programs. While 40% of states did not provide specialized medical equipment in their waivers for people with IDD, among those that did, they projected providing these services to between 0.02% to 55.7% people with IDD.

% of People with IDD Projected to Receive Specialized Medical Equipment

“When we examined specialized medical equipment for people with IDD in HCBS, we found more than half of states and waivers offered specialized medical equipment. However, only a small fraction of people with IDD (4%) were projected to receive these services, and only a small proportion of total HCBS spending was projected to be spent on these services (0.14%). In addition to helping promote community living and integration, for some people with IDD, specialized medical equipment can actually be life sustaining; as such, it is critical that unmet needs for specialized medical equipment not go unaddressed” (Friedman, 2024).

This article is a summary of the following journal manuscript: Friedman, C. (2024). Specialized medical equipment for people with intellectual and developmental disabilities in Home and Community Based Services. Journal of Policy and Practice in Intellectual Disabilities, 21(4), e12525. https://doi.org/10.1111/jppi.12525.