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Supporting People with IDD to Transition to the Community

By Carli Friedman, CQL Director of Research

Community transition services help people with intellectual and developmental disabilities (IDD) with their move from either an institution to a community setting, or a congregate community setting to an individual community setting. These services can be used to help people with IDD pay for necessary items to set up a basic household, such as securing leases, paying for moving expenses, paying for furniture or kitchen supplies, and utility deposits. The aim of this study was to examine how states provided community transition services in Medicaid HCBS for people with IDD. To examine this, we analyzed Medicaid HCBS waivers from across the nation in fiscal year (FY) 2021.

In FY 2021, less than half of the 107 Medicaid HCBS programs for people with IDD – only 28 states – offered community transition services. In total, 2,405 out of 860,000 people with IDD with HCBS were projected to receive community transition services. While $7.2 million was projected for community transition services, this amounted to only 0.02% of all HCBS spending in FY 2021. The average spending per person on community transition services was $2,303.

Average Spending Per Person on Community Transition Services

Stacked bar graph. $1 to $1,000 = 37.5%. $1,001 to $2,000 = 21.9%. $2,001 to $3,000 = 21.9%. $3,001 to $4,000 = 9.4%. $4,001+ = 9.4%.

“Transitioning from an institutional setting to a community-based setting, or from a congregate community-based setting to an individual community-based setting is a time of critical importance in people with IDD’s lives. Not only does it represent a time of disruption and uncertainty in people with IDD’s lives, how the household is established lays the foundation for people with IDD’s long-term stability and security to ensure they are able to stay in that home. For these reasons, community transition services… are necessary to help turn a house into a stable home for people with IDD… [Yet,] despite being relatively low cost, community transition services were not widely implemented in IDD HCBS” (Friedman, 2022).

This article is a summary of the following journal manuscript: Friedman, C. (2023). Moving home: Community transition supports for people with intellectual and developmental disabilities. Disability and Health Journal, 16(2), 101419.