Creating equitable healthcare access for individuals with Intellectual and Developmental Disabilities (IDD) requires collaboration, advocacy, and systemic transformation. In a recent discussion, dedicated professionals—Dr. Megan Carter, and Dr. Kathy Wagner—shared their perspectives on the challenges and solutions in providing quality healthcare for individuals with IDD. Emma Richardson, Director of Health Programs at Special Olympics Washington, plays a key role in driving initiatives that bridge critical healthcare gaps by fostering collaboration and advocating for policy reforms.
Identifying Barriers to Quality Care
Dr. Megan Carter, an audiologist and clinical director, highlights significant challenges in assistive technology access and continuity of care. Many individuals with IDD rely on caregivers for medical appointments, but inconsistencies in caregiver availability lead to lapses in care. In audiology, Dr. Carter sees how patients struggle with hearing aid use and maintenance due to these gaps. Medicaid further complicates access, as many audiologists, especially in rural areas, cannot afford to accept it due to low reimbursement rates, forcing some patients to travel over 100 miles for care. Additionally, Medicaid’s restrictive hearing aid policies leave many without necessary treatment.
Dr. Kathy Wagner, a gastroenterologist, echoes these concerns and highlights logistical and communication challenges. Reliable transportation remains a major hurdle, and frequent caregiver turnover disrupts medical histories, affecting treatment continuity. She also points to Medicaid reimbursement as a barrier—while many specialists want to see patients with IDD, low reimbursement rates limit their capacity, leading to long wait times and administrative burdens.
Other healthcare providers further emphasizes financial constraints, stating that low state healthcare reimbursement makes it nearly impossible for most private dentistry practices to accept patients with IDD. In dentistry, pediatric specialists trained in IDD care exist, but adult patients have far fewer options. Additionally, the lack of provider training in IDD care, coupled with safety concerns, deters many from treating these patients. They stress the need for more specialized clinics and a referral system to connect general dentists with providers who can offer comprehensive care.
Addressing Systemic Challenges
Despite these challenges, Dr. Carter and Dr. Wagner, emphasize the importance of policy change and resource allocation to improve access to care for individuals with IDD. Dr. Carter calls for reforms in Medicaid policies to streamline authorization processes and increase reimbursement rates, which would allow more providers to accept Medicaid patients. She also advocates for expanded transportation assistance programs, as many of her patients in rural areas struggle to reach her clinic.
Dr. Wagner stresses the need for better support systems for caregivers. Since many individuals with IDD rely on caregivers for appointment scheduling, communication, and adherence to treatment plans, ensuring well-trained and adequately compensated caregivers is crucial. She suggests that increased funding for caregiver wages and training programs could improve continuity of care and reduce the communication breakdowns that often occur in her practice.
The anonymous provider further emphasized the need for specialized clinics dedicated to treating patients with IDD. They suggested that creating a referral network for general dentists to direct patients to these specialized clinics would ensure more individuals receive the appropriate level of care. Additionally, they pointed out the importance of training future healthcare providers, advocating for more exposure to IDD care in dental schools and medical training programs. They also suggested offering Continuing Education Units (CEUs) on IDD treatment, particularly through online programs, to make such training more accessible to practicing providers. If providers had more opportunities to gain hands-on experience treating individuals with IDD, they would be more confident in providing safe and effective care.
The Path Forward
The insights from Dr. Carter, Dr. Kathy Wagner, and the anonymous provider highlight the urgent need for systemic change in how healthcare is delivered to individuals with IDD. From Medicaid reform to improved caregiver coordination and expanded access to assistive technology, a multi-faceted approach is essential to closing the healthcare gap. Addressing barriers such as transportation, communication, and reimbursement rates will be critical in ensuring that individuals with IDD receive the care they deserve. With strong advocacy and strategic collaboration, the future of IDD healthcare is moving toward a more inclusive and equitable model.
