A state comparison of vocational rehabilitation support of youth with intellectual disabilities' participation in postsecondary education

The association between the Patient Protection and Affordable Care Act and healthcare affordability among US adults with intellectual disability

BACKGROUND

Historically, US adults with intellectual disability (ID) experience worse healthcare access than the general population. However, the implementation of the Patient Protection and Affordable Care Act (ACA) may have reduced disparities in healthcare access.

METHODS

Using a pre-ACA 2011-2013 sample and a post-ACA implementation 2014-2016 sample from the National Health Interview Survey data, we examined the association between the ACA's introduction and healthcare access among adults with ID (N = 623). Negative binomial regression models were used to test the association between the ACA and the total number of foregone healthcare services. Binary logistic regression was used to explore whether the ACA's implementation was associated with the increased likelihood of possessing health insurance as well as the decreased likelihood of any and particular measures of foregone healthcare services due to cost.

RESULTS

The study provides evidence that the ACA's implementation was associated with the decreased likelihood of the total number and any foregone care services owing to cost. Findings also revealed that the ACA's implementation was associated with expansion of health insurance coverage and decreasing instances of foregone care services for medical care, dental care, specialist visit and mental care among adults with ID. However, persons with ID were still at a higher risk of foregone prescription medicines, follow-up medical care and eyeglasses due to cost in the post-ACA years.

CONCLUSIONS

The study provides evidence that healthcare access among Americans with ID improved after the ACA's implementation. However, challenges in access to follow-up care, eyeglasses and prescription medicines persist and require policy solutions, which extend beyond the ACA's provisions.

A comparison of the college experience for students with and without disabilities

Students with intellectual and developmental disabilities (IDD) have joined the ranks of college students in pursuit of personal independence, community integration, and employment. To achieve these aims, there is a need for a strong understanding of the college experience for students with IDD, including identification of the academic, social, and personal challenges they face as well as the supports that are available to address those challenges. This research provides preliminary insights into the college experience for students with IDD by comparing the perceptions, attitudes, and activities of students with IDD to those of students without disabilities and students with mild learning disabilities (MLD). Our data suggest a number of similarities in the college experience for students with and without disabilities such as similar influences from family and teachers with respect to attending college. In addition, some surprising advantages expressed by students with IDD were found, such as reporting greater ease in developing close friendships than students with MLD. Considerations and discussion on the ways in which students with IDD benefit from the additional supports and services provided to them are also discussed.

Employment, Income, and SSI Effects of Postsecondary Education for People With Intellectual Disability

The low employment rates of individuals with intellectual disability (ID) are a major concern. This study examined the effect of postsecondary education on employment atrnd earnings for individuals with ID and the effect of state variation on those outcomes. Rehabilitation Services Administration 911 (RSA-911) files for 2008-2013 were analyzed (n = 11,280 individuals with ID). Multilevel modeling techniques were used to understand state variation, such as various economic and programmatic features that influence outcomes. Postsecondary education was associated with increased employment, increased weekly earnings, decreased reliance on Supplemental Security Income (SSI) benefits. Policy implications are discussed.

Supporting Postsecondary Education Programs for Individuals With an Intellectual Disability

As postsecondary education (PSE) programs for individuals with an intellectual and developmental disability (IDD) emerge across the country, it is crucial that these programs involve adult agency partners to enhance planning and service delivery, thereby increasing the likelihood that the skills obtained during these experiences will lead to improved employment outcomes. The present study aims to extend the current knowledge base regarding PSE programs’ and vocational rehabilitation (VR) agencies’ collaborative roles and activities. The present study examines state VR involvement with PSE programs as perceived by PSE administrators, specifically, the extent to which PSE and VR are collaborating, and the roles and activities rehabilitation counselors perform during this collaboration. Findings indicate that PSE administrators report variability in both the levels of collaboration with state VR agencies and the understanding of VR roles. Furthermore, data show that the majority of respondents felt VR seldom or never provide services beyond financial assistance. Implications for research and practice are also discussed.