Translating policy principles into practice to improve health care access for adults with intellectual disabilities: A research review of the past decade

Abstract

This article extracts principles from two Surgeon General reports, Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation (2002) and Call to Action to Improve the Health and Wellness of Persons with Disabilities (2005), and combines them with the Objectives from Chapter 6 of Healthy People 2010 to create a policy framework. This framework is used to review literature from the past decade on access to health care and health promotion for persons with intellectual and developmental disabilities (IDD). Review of the literature indicates an emerging evidence base for health promotion programs for persons with IDD. Research in health care and health promotion access requires improvements in surveillance and measurement of quality of life, as well as increased participation of persons with IDD and their families in its implementation. While international guidelines for primary health care have been developed for people with IDD, US guidelines are specialty focused and address specific conditions. Despite its recognized importance, there is surprisingly little information on training programs for health care providers to improve care of persons with IDD. Financing of health care continues to threaten access to comprehensive care for persons with IDD, particularly regarding coordination of care and availability of providers who accept Medicaid patients. Community-based sources of health care have been slow to emerge, and there is clear need for assumption of responsibility for providing care to persons with IDD. Future US policy should include consideration of environmental factors in health care access.

Identifying State Resources and Support Programs on E-Government Websites for Persons with Intellectual and Developmental Disabilities

“…Consequently, we need to focus attention on resources that provide both formal and informal services that can support a quality of life to “age in place,” as individuals with I/DD are aging and will outlive family caregivers, creating uncertainty for future care giving, health care, and housing needs. Families are struggling to find adequate lifelong care and services, especially those that enhance or support quality of life needs [10, 30]. …”

Cash and Counseling: A Model for Self-Directed Care Programs to Empower Individuals With Serious Mental Illnesses

“…Very few workers or consumers reported being exploited and the fraudulent use of the cash benefit was extremely rare (Schore et al, 2007). The Arkansas C & C evaluation team has found that participation in the program resulted in good health outcomes (Krahn & Drum, 2007;Simon-Rusinowitz, Mahoney, Loughlin, & Sadler, 2005).…”

Aging Adults With Intellectual Disabilities

“…There is a dearth of US studies on programs to improve clinician training on ID, 8 and the modest extant literature regarding clinician preparation indicates inadequate or absence of formal training on ID. 9 Currently, there is no curriculum requirement for US medical schools specifically to teach competency in the provision of care to persons with ID. Not surprisingly, many physicians are ill prepared to recognize symptoms or appropriately examine patients who have the physical limitations, communication difficulties, or behavioral issues that often coexist in persons with ID.…”