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Remote Supports for People with IDD in HCBS

By Carli Friedman, CQL Director of Research

Remote support services leverage technology to provide support to people with intellectual and developmental disabilities (IDD) from a remote location, rather than in-person. Remote supports can help promote self-determination, independence, and autonomy, while also helping people feel safer and more secure. Remote supports may also be able to help compensate for direct support professional (DSP) shortages. For these reasons, the aim of this study was to examine how states provided remote supports to people with IDD in their Home- and Community-Based Services (HCBS) waivers. To do so, we analyzed fiscal year (FY) 2021 HCBS 1915(c) waivers from across the nation that served people with IDD.

We found 10 states provided stand-alone remote support services in their HCBS waivers for  more than 3,000 people with IDD. States most commonly described their reason for offering remote supports was to promote people with IDD’s independence, health and welfare, and to replace/reduce the need for in-person services.

In addition to only a fraction of states offering these services in their waivers, how remote supports were provided varied widely across waivers and states. For example, while Alabama projected providing almost 10% of its waiver recipients with remote supports, West Virginia projected providing these services to only 0.22% of the people with IDD served by its HCBS programs. In addition, average annual spending per person ranged from $15,300 (Ohio) to $83 (Maine; see figure below).

Remote Supports: Average Annual Spending Per Person

Average spending per person: Ohio $15,276, West Virginia $11,410, Indiana $10,344, Montana $8,938, Connecticut $8,775, Illinois $3,000, Maryland $1,860, Virginia $80, Alabama $204, Maine $83

“While our study found growth in the number of HCBS waivers providing remote support services to people with IDD between FY 2013 and FY 2021 (7% versus 18% respectively), the overwhelming majority of people with IDD receiving HCBS in FY 2021 (99.65%) were not projected to receive these services. Moreover, among those waivers providing remote support services to people with IDD, there was vast variation in service allocation as well as how safeguards were implemented. Further attention to remote supports in HCBS is necessary to ensure that people with IDD who want to utilize these services are able to do so” (Friedman, 2023, p. 8).

This article is a summary of the following journal manuscript: Friedman, C. (2023). Remote monitoring support services for people with intellectual and developmental disabilities. Journal of Policy and Practice in Intellectual Disabilities. https://doi.org/10.1111/jppi.12463