Affiliations: Institute for Community Inclusion, University of Massachusetts Boston, Boston, MA, USA
Note: [] Address for correspondence: Allison Cohen Hall, PhD, Institute for Community Inclusion, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA. Tel.: +1 480 264 7215; Fax: +1 617 287 4352; E-mail: allison.hall@umb.edu
Abstract: Funding is a central tool for improving the quality and range of employment service options. While outcome-based funding models are more common in the Vocational Rehabilitation system, there is a need for funding structures in intellectual and developmental disabilities (IDD) service systems that signal a clear preference for high-quality, cost-effective integrated employment outcomes. In an environment of increasing fiscal demands and limitations, and expansion of self-directed services and individualized budgeting, state IDD systems must engage in rate-setting and funding discussions that are rooted in their priorities and long-term goals. This paper explores rate-setting methodologies, rate structures, and incentives for integrated employment, and the relationship between funding, policies, and priorities. A detailed analysis within five states yields lessons for other state IDD systems as they contend with evolving funding structures that respond to fiscal pressures and demands. Implications include the need for funding to be seamless, goal-focused, and connected to and consistent with larger systems strategies.
