The Health Risk Screening Tool (HRST®): Changing Outcomes for People with IDD by Detecting Risks Earlier

The Health Risk Screening Tool (HRST®): Changing Outcomes for People with IDD by Detecting Risks Earlier

 

Providers supporting people with intellectual and developmental disabilities (IDD) know that health issues rarely appear overnight. In many cases, subtle changes in behavior, energy, mobility, appetite, or routine may signal an emerging medical concern. These changes can be early indicators of illness or even risk of death if not addressed. When these early signs go unnoticed, what begins as a manageable issue can escalate into a behavioral crisis, an emergency department visit, or even a hospitalization.

For organizations responsible for supporting people with complex needs, identifying those early warning signs is one of the greatest challenges in delivering safe, effective support. Staff must interpret behavioral changes, communicate across interdisciplinary teams, and make decisions with limited clinical information. Without structured systems for identifying medical risk, opportunities for early intervention are often missed.

A recent pilot implementation of the Health Risk Screening Tool (HRST) within Threshold Residential Services provides insight into what can happen when those early warning signs are systematically identified and addressed. The HRST gives answers to key health risk questions and supports assessment across different age groups.

 

A Pilot Focused on Proactive Health Monitoring

 

Threshold Residential Services implemented HRST screenings for 51 adults with intellectual and developmental disabilities receiving residential services. The screenings were conducted between August 2024 and January 2025, and they were designed to identify potential health risks across multiple areas that commonly contribute to medical instability in people with IDD.

The HRST evaluates 22 areas of health risk, including factors such as eating and nutrition, bowel function, skin integrity, falls, aggression, and self-injury. Each screening generates a Health Care Level (HCL), which reflects a person’s overall level of medical risk and helps guide monitoring and care planning.

To evaluate the impact of HRST implementation, Threshold Residential Services compared outcomes from calendar year 2024, before HRST screening was implemented, with outcomes from calendar year 2025, following implementation.

The results were striking.

 

Fewer Behavioral Crises Following HRST Implementation

 

One of the most notable outcomes observed during the pilot was a significant reduction in behavior-related unusual incidents. In 2024, the organization recorded 55 behavior-related unusual incidents involving peer aggression, self-injurious behavior, or destruction of property. In 2025, following HRST implementation, that number dropped to 24.\

This represents a 56% reduction in behavior-related incidents.

Behavioral changes are often among the earliest indicators that something may be medically wrong. Pain, discomfort, infection, or other health concerns can manifest as agitation, withdrawal, or aggression, particularly when someone has difficulty communicating their symptoms.

By helping teams identify potential medical risks earlier, HRST screening supported more proactive responses to emerging health concerns. Addressing those concerns earlier likely prevented situations that might have otherwise escalated into behavioral crises. This highlights the importance of early intervention, ensuring everyone’s health and safety are prioritized.

 

Reductions in Hospitalizations and Emergency Department Visits

 

The pilot also demonstrated measurable reductions in acute medical utilization.

Unanticipated hospitalizations declined from 8 in 2024 to 4 in 2025, representing a 50% reduction. Using a conservative estimate of $30,000 per hospital admission, this reduction represents approximately $120,000 in avoided hospital costs.

Emergency department utilization also declined, from 7 visits in 2024 to 4 in 2025. Based on national cost estimates for emergency department visits among people with IDD, this reduction represents approximately $16,290 in avoided costs.

Combined, these reductions represent an estimated $136,290 in direct medical cost avoidance in a single year.

What’s more, these figures do not include additional operational costs associated with hospitalizations and emergency visits, such as staff supervision, transportation, documentation, care coordination, or disruptions to daily programming.

 

Health Care Access and Quality for People with IDD

 

Access to high-quality health care is a critical factor in determining health outcomes for people with intellectual and developmental disabilities. Unfortunately, many people with IDD encounter significant barriers, such as limited health insurance coverage, high out-of-pocket costs, and a shortage of providers trained to address their specific needs. These challenges can delay diagnosis and treatment, increasing the risk of health problems and certain diseases.

To deliver effective care, health care providers must consider each person’s intellectual functioning and adaptive behavior when developing individualized health care plans. Tailoring services to the unique needs of people with intellectual and developmental disabilities ensures that preventive measures, such as screening tests, are accessible and meaningful. Early identification of health risks allows for timely intervention, reducing the likelihood of more serious health issues in the future.

Family and supporter involvement is also essential. Parents and supporters often have valuable insights into the person’s needs, preferences, and daily routines, which can inform support planning and improve outcomes. By prioritizing accessible, person-centered health care and involving families and supporters in the process, providers can help people with IDD achieve better health and a higher quality of life.

 

Stability Matters for People with IDD

 

While cost savings are an important outcome for health systems and provider organizations, the impact of preventing medical crises extends far beyond financial measures.

Hospitalizations and emergency department visits can be particularly disruptive for people with IDD. Sudden changes in environment, unfamiliar medical settings, and interruptions in daily routines can increase stress and anxiety, sometimes leading to regression in skills or behavioral instability.

Preventing those destabilizing events helps people maintain their routines, remain engaged in their communities, and continue building independence.

For provider organizations, fewer crises also mean more stable environments for both the people they support and the staff delivering care. Expanding proactive health monitoring through a health risk screening tool can help more people access preventive support and ensure that those at risk receive timely interventions to address emerging health concerns.

 

A Shift from Crisis Response to Prevention

 

The findings from the Threshold Residential Services pilot reinforce an important shift taking place across disability services and healthcare systems more broadly: moving from reactive crisis management to proactive health monitoring.

Structured health risk screening tools like the HRST give teams a consistent framework for identifying medical concerns earlier and coordinating responses across interdisciplinary care teams. Rather than waiting until a crisis occurs, providers are better equipped to intervene before health conditions escalate.

While additional research across larger populations will further strengthen the evidence base, the results observed in this pilot highlight the potential impact of proactive health risk screening within residential service settings.

For organizations supporting people with intellectual and developmental disabilities, earlier detection of health risks can mean fewer crises, fewer hospitalizations, and better outcomes for the people they serve.

 

Additional Resources:

 

 

Dental Health for People with IDD: Why Prevention, Access, and Support Matter More Than Ever

Dental Health for People with IDD: Why Prevention, Access, and Support Matter More Than Ever

Oral health remains one of the most critical yet frequently overlooked components of overall well-being for individuals with intellectual and developmental disabilities (IDD). Present from birth, IDDs can profoundly shape an individual’s development across every stage of life. Though often treated as peripheral to broader medical care, dental health is in fact deeply intertwined with physical health outcomes, quality of life, and the prevention of avoidable hospitalizations. Because many IDD-associated conditions affect multiple body systems simultaneously, a truly comprehensive approach to care is essential.

During a recent IDD Perspectives webinar featuring Dr. Craig Escudé, President of IntellectAbility, and Dr. Allen Wong, a renowned global leader in special care dentistry, one message came through clearly: improving dental health for people with IDD requires a shift toward prevention, training, and person-centered support. Assistance in planning and managing support services is crucial, often involving the creation of a personalized support plan, called an ‘individual support plan,’ which is regularly reviewed to meet the person’s needs.

Introduction to Dental Health Challenges

People with intellectual and developmental disabilities (IDD) often encounter unique dental health challenges that can significantly affect their overall well-being. Intellectual disability, characterized by significant limitations in intellectual functioning and adaptive behavior, can make it more difficult for individuals to maintain good oral health routines. Developmental disabilities—a broader category that includes lifelong conditions affecting physical, learning, language, or behavior—can also impact dental health in various ways.

These challenges may affect an individual’s ability to communicate dental concerns, follow oral hygiene routines, or access appropriate dental care. Understanding the connection between intellectual disability, developmental disabilities, and oral health is crucial for providing the right support and ensuring that every individual receives the dental care they need to thrive.

Understanding Intellectual Disability and Its Impact on Dental Health

For individuals with intellectual disability, challenges in adaptive functioning can make it difficult to maintain consistent oral hygiene routines, describe pain or discomfort, or adapt to new environments, such as a dental office. For example, someone with cerebral palsy may have limited muscle control, making it hard to brush or floss their teeth effectively. Individuals with autism may experience sensory sensitivities that make dental visits overwhelming, while those with a brain injury might struggle with memory or communication, further complicating oral health care.

Research from the National Institute of Dental and Craniofacial Research (NIDCR) highlights that people with intellectual and developmental disabilities are at a higher risk for oral health problems, including tooth decay, gum disease, and oral infections. These risks often result from a combination of factors: difficulties with daily oral hygiene, limited access to dental care, and underlying medical conditions that can affect the mouth and teeth. The NIDCR has made dental and craniofacial research in this area a priority, recognizing the need for tailored approaches to improve outcomes for this population.

Addressing these unique needs requires a personalized approach. Adaptive dental equipment, such as specially designed toothbrushes or flossing aids, can help individuals with limited physical ability maintain better oral hygiene. Using fluoride toothpaste and demonstrating proper brushing and flossing techniques are essential steps in preventing dental disease. Social skills training and support can also empower individuals with intellectual disabilities to communicate their needs and navigate dental appointments with greater confidence.

Families and supporters play a crucial role in maintaining oral health for people with intellectual and developmental disabilities. This includes helping with daily routines, scheduling regular dental check-ups, and advocating for specialized dental care when necessary. Education on oral health, tailored to the individual’s learning style and abilities, can make a significant difference in long-term outcomes.

In addition, individuals with an intellectual disability may be eligible for disability benefits and support services that can help cover the cost of specialized dental care, adaptive equipment, and oral health education. Organizations such as the American Association on Intellectual and Developmental Disabilities (AAIDD) offer valuable resources and guidance to families and professionals seeking to improve oral health for this community.

Ultimately, understanding how intellectual disability and other developmental disabilities affect oral health is key to providing effective, person-centered support. By recognizing the unique challenges faced by individuals with intellectual and developmental disabilities and working collaboratively with families, caregivers, and dental professionals, we can help ensure that everyone has the opportunity to achieve and maintain good oral health—improving quality of life and overall well-being.

Why Oral Health Disparities Exist in IDD Populations

One of the biggest challenges in IDD dental care is a lack of access and preparedness within the healthcare system. Many dental and medical professionals receive little to no training in treating people with IDD, which leads to discomfort, avoidance, and ultimately fewer care options. As Dr. Wong explained, clinicians often “don’t treat what they’re not comfortable with,” creating systemic gaps in care.

These gaps are compounded by social determinants of health. Transportation barriers, limited insurance coverage (especially under Medicaid), and long travel distances to qualified providers all contribute to missed or delayed dental visits. In addition, individuals with IDD may need to qualify for specific dental programs or support services, such as the TxHmL program, based on meeting certain eligibility requirements, which can further complicate access to care. What may appear as non-compliance is often the result of structural challenges—not a lack of willingness to receive care.

 

The Hidden Impact of Poor Oral Health

 

Dental health is a gateway to the entire body. Poor oral health can trigger widespread inflammation, allowing bacteria from the mouth to enter the bloodstream and affect multiple systems. Infections originating in the mouth can spread to other parts of the body and may present with a range of symptoms, such as fever, swelling, or changes in behavior, which caregivers should monitor closely. Research and clinical experience show links between oral disease and conditions such as cardiovascular disease, pneumonia, diabetes complications, and even cognitive decline.

For people with IDD, who may already have complex health profiles, this connection is even more significant. Oral health issues can also contribute to pain, behavioral changes, and decreased quality of life, often without being immediately recognized as the root cause.

 

Understanding the Real Causes of Dental Issues

 

It’s easy to assume that cavities are simply the result of poor brushing habits, but the reality is more complex. Oral health is largely driven by the environment within the mouth—specifically, the balance of bacteria and acidity.

When saliva is healthy and neutral in pH, it helps protect teeth and prevent decay. But many people with IDD take medications that reduce saliva production, leading to dry mouth and increased cavity risk. Frequent snacking, dehydration, and acidic beverages can further disrupt this balance, creating conditions that allow harmful bacteria to thrive. Dental issues are more likely to occur in situations where these risk factors are present, especially for individuals with intellectual and developmental disabilities whose physical, intellectual, or emotional development may impact their ability to maintain oral hygiene.

This shift toward an acidic environment leads to demineralization, stripping essential minerals from teeth and making them more vulnerable to decay. The good news is that this process is reversible with the right preventive strategies.

 

Prevention Over Intervention: A New Approach to Dental Care

 

One of the most important takeaways from the discussion is that dental care should not begin in the dentist’s chair. It should start long before the appointment. Prevention is more than a clinical responsibility; it’s a shared effort between providers, supporters, and caregivers.

At home, supporters can help prepare people with IDD for successful dental visits by introducing simple, familiar routines. Practicing opening the mouth, counting teeth, or using a flashlight to simulate an exam can reduce anxiety and build trust. Developing social, academic, and other skills, such as communication and problem-solving, is also essential for helping individuals with IDD feel more comfortable and confident during dental visits.

Even small steps, like watching videos of dental visits or completing paperwork in advance, can make a significant difference.

Equally important is understanding sensory preferences. Bright lights, unfamiliar sounds, and long wait times can quickly become overwhelming. By communicating these needs to dental offices in advance, supporters can help create a more accommodating, person-centered experience.

 

Building Better Dental Experiences Through Trust

 

For many people with IDD, the biggest barrier to dental care is the experience. Trust takes time, and successful visits often require flexibility. Instead of trying to complete everything in one appointment, providers and supporters should focus on what the person can tolerate in that moment.

This might mean shorter visits, gradual exposure, or multiple appointments to complete care. Bringing comfort items, using familiar communication tools, and allowing the person to signal when they need a break can all contribute to a more positive experience.

When dental care is approached as something done with a person rather than to them, outcomes improve, not just clinically, but emotionally as well.

 

Role of Support Systems in Dental Health

 

Support systems—including family members, supporters, and healthcare professionals—are essential for promoting and maintaining dental health in individuals with intellectual and developmental disabilities. These support networks assist with daily oral hygiene tasks, help schedule and attend dental appointments, and advocate for the individual’s needs within the healthcare system. For individuals living in a group home, coordinated support is essential for maintaining daily oral hygiene and ensuring access to dental care.

The National Institute of Dental and Craniofacial Research (NIDCR) offers valuable resources to guide families and providers in supporting oral health for people with IDD. Additionally, support systems can help individuals navigate the process of qualifying for disability benefits and accessing specialized dental care services. Regular dental care also helps detect early signs of diseases like cancer, diabetes, and HIV/AIDS, which can manifest as infections or oral symptoms. By working together, these networks ensure that individuals with intellectual and developmental disabilities receive the comprehensive dental and craniofacial care they deserve.

Dental Care Considerations

Providing dental care for individuals with intellectual and developmental disabilities requires thoughtful planning and adaptation. Specialized equipment, such as adaptive toothbrushes, and a supportive, comfortable environment can make dental visits more successful. The Centers for Disease Control and Prevention (CDC) recommends regular dental check-ups, consistent oral hygiene, and a balanced diet to help prevent common oral health problems such as tooth decay and gum disease.

People with intellectual disabilities may face increased risk for dental disease due to factors such as poor nutrition, tobacco use, or side effects from medications. By offering tailored support and following best practices, caregivers and dental professionals can help individuals with intellectual and developmental disabilities maintain good oral health and overall well-being.

 

Minimally Invasive Solutions Are Changing the Game

 

Advancements in dentistry are making it easier to treat cavities without invasive procedures. One of the most promising tools discussed in the webinar is silver diamine fluoride (SDF), a topical treatment that can stop cavity progression, reduce sensitivity, and strengthen teeth—all without drilling or anesthesia.

SDF represents a major shift toward minimally invasive care, especially for people who may struggle with traditional dental procedures. It allows providers to stabilize dental issues quickly while creating time for desensitization and future treatment planning.

These types of innovations are critical in expanding access to care and reducing the need for more complex interventions later.

 

The Role of Training and System Change

 

Improving oral health outcomes for people with IDD is not just about individual actions—it requires systemic change. Organizations like the American Academy of Developmental Medicine and Dentistry are working to ensure that healthcare professionals receive the training they need to provide competent, compassionate care.

New initiatives, such as national IDD-focused curricula for dental education, are helping bridge the knowledge gap and prepare future providers to meet the needs of this population.

But training alone isn’t enough. True progress will require continued advocacy, policy changes, and a commitment to equitable care across healthcare systems.

 

Moving Forward: A Prevention-First Mindset

 

The future of dental health for people with IDD depends on a shift in mindset—from reactive treatment to proactive prevention. By addressing barriers to access, improving provider training, and equipping supporters with practical tools, we can reduce preventable dental issues and their broader health consequences.

Oral health is foundational to overall health. And for people with IDD, investing in prevention is essential.

 

Additional Resources:

Rural Health Transformation Program: What Healthcare Reform Means for Access, Coverage, and Disability in Rural America

Rural Health Transformation Program: What Healthcare Reform Means for Access, Coverage, and Disability in Rural America

 

Across rural America, healthcare reform is no longer theoretical. It’s happening in real time.

The Rural Health Transformation Program (RHTP) is driving billions of dollars into rural health systems, with the goal of improving access, expanding coverage, and strengthening healthcare providers across rural communities. But as these plans take shape across states and fiscal years, a critical question remains:

Who is this transformation actually reaching—and who is still being left out?

 

Rural Health in America Has an Access and Coverage Problem

 

Rural health has long been defined by gaps in access.

Across rural areas, people face:

  • Fewer healthcare providers
  • Limited hospital infrastructure
  • Longer travel times to receive care
  • Reduced access to specialty services

Patients in rural communities often struggle to find the help they need to access care, facing unique barriers that can make it difficult to obtain necessary services.

These challenges directly impact health coverage outcomes for patients, particularly those relying on Medicaid and Medicare in rural communities.

Hospitals in rural America are closing or consolidating. Healthcare providers are stretched thin. And access to consistent, preventative care remains limited.

The Rural Health Transformation Program was designed to address exactly these issues—by investing in systems that improve access and stabilize healthcare delivery across rural areas.

The Rural Health Transformation Program Is Reshaping Healthcare Plans Nationwide

 

Under the Rural Health Transformation Program, states are developing healthcare plans that focus on:

  • Expanding access to healthcare
  • Strengthening rural hospitals
  • Supporting healthcare providers
  • Improving coverage and care coordination
  • Investing in long-term system sustainability across fiscal years

For many people in rural areas, these changes could be the difference between accessing life-saving, sustaining health care and not.

These plans are not static—they evolve year over year for the next five years, with funding tied to outcomes and performance.

That means states are being pushed to demonstrate real improvements in:

  • Access to services
  • Health coverage utilization
  • Chronic disease outcomes
  • System-wide efficiency

But while these plans are comprehensive, they are not always inclusive.

 

Program Funding and Structure: How the Rural Health Transformation Program Works

 

The Rural Health Transformation Program is one of the most ambitious investments in rural health care America has ever seen. With a total commitment of $50 billion spread over five fiscal years, the program is designed to address the unique challenges facing rural areas—ensuring that access to quality health care is not determined by geography.

Each fiscal year, beginning in 2026 and continuing through 2030, $10 billion in funding will be made available to qualifying states approved to participate in the program. This annual allocation is intended to provide consistent, reliable resources for rural hospitals, clinics, and health care providers, allowing them to plan, innovate, and deliver better care over time.

The program’s structure is built around accountability and results. States must submit detailed plans outlining how they will use the funding to improve access, strengthen rural health systems, and address the needs of their communities. Funding is tied to measurable outcomes, ensuring that every dollar invested leads to real improvements in health care delivery and coverage for rural Americans.

By distributing resources over multiple fiscal years, the Rural Health Transformation Program aims to give rural communities the stability and support they need to make lasting changes. This approach not only helps hospitals and providers adapt to evolving health care needs, but also ensures that individuals and families in rural areas can count on better access to care—now and in the future.

For organizations and agencies working to support people with disabilities and other vulnerable populations, understanding how this program is structured is key to finding new opportunities for collaboration, funding, and improved health outcomes. To learn more about how your state can participate or to find resources for your organization, visit the official program website or contact your state health department.

 

Disability Is Still Missing From Rural Healthcare Reform

 

Disability health—especially for people with intellectual and developmental disabilities (IDD)—is often absent from large-scale healthcare reform conversations.

And yet, the data is clear.

People with disabilities experience:

  • Higher rates of hospitalization
  • Increased reliance on emergency services
  • More complex chronic health conditions
  • Lower access to preventative care

In rural communities, these challenges are intensified.

Limited access to trained healthcare providers, fewer hospitals, and fragmented coverage systems create additional barriers for people with disabilities trying to navigate care.

This is where the Rural Health Transformation Program has the potential to make a difference—but only if disability is intentionally included in how these plans are designed.

 

Access Is About the Right Care

 

Expanding access is one of the primary goals of rural healthcare reform.

But access is not just about getting someone into a hospital or in front of a provider.

It’s about whether that care is:

  • Appropriate
  • Informed
  • Preventive rather than reactive

For people with disabilities, access often breaks down at the point of care.

Even when hospitals are available and healthcare providers are accessible, there may be gaps in training, communication, and understanding that impact outcomes.

That means increasing access without improving provider readiness does not fully solve the problem.

 

Medicaid, Medicare, and Coverage Gaps in Rural Communities

 

Coverage is another central focus of the Rural Health Transformation Program.

In rural America, a significant portion of the population relies on Medicaid and Medicare for health coverage. These programs play a critical role in ensuring access to hospitals, providers, and essential services.

However, coverage alone does not guarantee access.

Gaps still exist in:

  • Provider availability
  • Service delivery
  • Care coordination across systems

For people with disabilities, these gaps can result in:

  • Delayed care
  • Increased emergency department visits
  • Higher long-term healthcare costs

This is where healthcare reform must go beyond expanding coverage—and focus on how that coverage translates into real, usable access.

 

Rural Hospitals and Providers Are Under Pressure

 

Rural hospitals and healthcare providers are central to the success of the Rural Health Transformation Program.

But they are also operating under significant strain.

Workforce shortages, financial pressures, and increasing demand are forcing hospitals and providers to do more with less—especially across multiple fiscal years where funding and performance are closely tied.

Healthcare providers in rural areas are expected to:

  • Deliver high-quality care
  • Manage chronic disease
  • Navigate Medicaid and Medicare systems
  • Adopt new technologies
  • Improve outcomes

All while serving populations with increasingly complex needs.

Without targeted support—including training related to disability health—these expectations become difficult to meet.

 

The Opportunity Within Rural Healthcare Reform

 

The Rural Health Transformation Program represents one of the largest investments in rural health in recent history.

It has the potential to:

  • Improve access across rural communities
  • Strengthen hospitals and healthcare providers
  • Expand coverage through Medicaid and Medicare
  • Reduce long-term healthcare costs
  • Improve outcomes across populations

But transformation does not automatically lead to equity.

If disability is not explicitly included in rural healthcare plans, the same disparities will continue—just within a more modernized system.

 

The Bottom Line

 

Rural healthcare reform is advancing quickly.

Access is expanding. Coverage is evolving. Healthcare providers and hospitals are adapting to new expectations.

But the success of the Rural Health Transformation Program will ultimately be measured by who benefits from it.

Because improving rural health in America isn’t just about systems.

It’s about making sure those systems work for everyone—including people with disabilities.

 

Take the Next Step

 

The Health Risk Screening Tool (HRST®): Changing Outcomes for People with IDD by Detecting Risks Earlier

The Health Risk Screening Tool (HRST®): Changing Outcomes for People with IDD by Detecting Risks Earlier

The Health Risk Screening Tool (HRST®): Changing Outcomes for People with IDD by Detecting Risks Earlier

 

Providers supporting people with intellectual and developmental disabilities (IDD) know that health issues rarely appear overnight. In many cases, subtle changes in behavior, energy, mobility, appetite, or routine may signal an emerging medical concern. These changes can be early indicators of illness or even risk of death if not addressed. When these early signs go unnoticed, what begins as a manageable issue can escalate into a behavioral crisis, an emergency department visit, or even a hospitalization.

For organizations responsible for supporting people with complex needs, identifying those early warning signs is one of the greatest challenges in delivering safe, effective support. Staff must interpret behavioral changes, communicate across interdisciplinary teams, and make decisions with limited clinical information. Without structured systems for identifying medical risk, opportunities for early intervention are often missed.

A recent pilot implementation of the Health Risk Screening Tool (HRST) at Threshold Residential Services provides insight into what can happen when those early warning signs are systematically identified and addressed. The HRST provides answers to key health risk questions and supports assessment across different age groups.

 

A Pilot Focused on Proactive Health Monitoring

 

Threshold Residential Services implemented HRST screenings for 51 adults with intellectual and developmental disabilities receiving residential services. The screenings were conducted between August 2024 and January 2025 and were designed to identify potential health risks across multiple areas that commonly contribute to medical instability in people with IDD.

The HRST evaluates 22 areas of health risk, including factors such as eating and nutrition, bowel function, skin integrity, falls, aggression, and self-injury. Each screening generates a Health Care Level (HCL), which reflects an individual’s overall level of medical risk and helps guide monitoring and care planning.

To evaluate the impact of HRST implementation, Threshold Residential Services compared outcomes from calendar year 2024, before HRST screening was implemented, with outcomes from calendar year 2025 following implementation.

The results were striking.

 

Fewer Behavioral Crises Following HRST Implementation

 

One of the most notable outcomes observed during the pilot was a significant reduction in behavior-related unusual incidents. In 2024, the organization recorded 55 behavior-related incidents involving peer aggression, self-injurious behavior, or destruction of property. In 2025, following HRST implementation, that number dropped to 24.

This represents a 56% reduction in behavior-related incidents.

Behavioral changes are often among the earliest indicators that something may be medically wrong. Pain, discomfort, infection, or other health concerns can manifest as agitation, withdrawal, or aggression, particularly when individuals have difficulty communicating their symptoms.

By helping teams identify potential medical risks earlier, HRST screening supported more proactive responses to emerging health concerns. Addressing those concerns earlier likely prevented situations that might otherwise have escalated into behavioral crises. This highlights the importance of early intervention, ensuring their health and safety are prioritized.

 

Reductions in Hospitalizations and Emergency Department Visits

 

The pilot also demonstrated measurable reductions in acute medical utilization.

Unanticipated hospitalizations declined from 8 in 2024 to 4 in 2025, representing a 50% reduction. Using a conservative estimate of $30,000 per hospital admission, this reduction represents approximately $120,000 in avoided hospital costs.

Emergency department utilization also declined, from 7 visits in 2024 to 4 in 2025. Based on national cost estimates for emergency department visits among people with IDD, this reduction represents approximately $16,290 in avoided costs.

Combined, these reductions represent an estimated $136,290 in direct medical cost avoidance in a single year.

What’s more, these figures do not include additional operational costs associated with hospitalizations and emergency visits, such as staff supervision, transportation, documentation, care coordination, or disruptions to daily programming.

 

Health Care Access and Quality for People with IDD

 

Access to high-quality health care is a critical factor in determining health outcomes for people with intellectual and developmental disabilities. Unfortunately, many people with IDD encounter significant barriers, such as limited health insurance coverage, high out-of-pocket costs, and a shortage of providers trained to address their specific needs. These challenges can delay diagnosis and treatment, increasing the risk of health problems and certain diseases.

To deliver effective care, health care providers must consider each person’s intellectual functioning and adaptive behavior when developing individualized health care plans. Tailoring services to the unique needs of people with intellectual disability or developmental disabilities ensures that preventive measures, such as screening tests, are accessible and meaningful. Early identification of health risks allows for timely intervention, reducing the likelihood of more serious health issues in the future.

Family and supporter involvement is also essential. Parents and supporters often have valuable insights into the individual’s needs, preferences, and daily routines, which can inform support planning and improve outcomes. By prioritizing accessible, person-centered health care and involving families and supporters in the process, providers can help people with IDD achieve better health and a higher quality of life.

 

Stability Matters for People with IDD

 

While cost savings are an important outcome for health systems and provider organizations, the impact of preventing medical crises extends far beyond financial measures.

Hospitalizations and emergency department visits can be particularly disruptive for people with IDD. Sudden changes in environment, unfamiliar medical settings, and interruptions in daily routines can increase stress and anxiety, sometimes leading to regression in skills or behavioral instability.

Preventing those destabilizing events helps people maintain their routines, remain engaged in their communities, and continue building independence.

For provider organizations, fewer crises also mean more stable environments for both the people they support and the staff delivering care. Expanding proactive health monitoring through a health risk screening tool can help more people access preventive support and ensure that those at risk receive timely interventions to address emerging health concerns.

A Shift from Crisis Response to Prevention

 

The findings from the Threshold Residential Services pilot reinforce an important shift taking place across disability services and healthcare systems more broadly: moving from reactive crisis management to proactive health monitoring.

Structured health risk screening tools like HRST give teams a consistent framework for identifying medical concerns earlier and coordinating responses across interdisciplinary care teams. Rather than waiting until a crisis occurs, providers are better equipped to intervene before health conditions escalate.

While additional research across larger populations will further strengthen the evidence base, the results observed in this pilot highlight the potential impact of proactive health risk screening within residential service settings.

For organizations supporting people with intellectual and developmental disabilities, earlier detection of health risks can mean fewer crises, fewer hospitalizations, and better outcomes for the people they serve.

 

Additional Resources:

 

Prevention Saves Lives and Dollars: The Cost-Saving Power of HRST

Prevention Saves Lives and Dollars: The Cost-Saving Power of HRST

 

A Smarter Investment in Healthcare

 

Healthcare costs continue to rise, and for organizations supporting people with intellectual and developmental disabilities (IDD), finding ways to deliver excellent care while protecting resources is a constant challenge.

The Ohio Department of Developmental Disabilities (OH DODD)’s evaluation of the Health Risk Screening Tool (HRST®) shows that prevention is the answer. The HRST was developed by and is exclusive to IntellectAbility to help organizations assess health risks for people with IDD.

 

What is the HRST?

 

The HRST is the leading screening tool for intellectual and developmental disability (IDD) risk management and support. It is a HIPAA-compliant, web-based rating instrument developed to detect health destabilization in at-risk populations and ensure that proper care and support are provided at all times to avoid unnecessary suffering and death.

The HRST monitors for health risks associated with various intellectual, developmental, and physical disabilities, which specifically affect systems of the body and the person’s ability to engage in life. This provides all supporters with the information needed to respond appropriately.

By identifying risks early, the HRST allows teams to assess an individual’s ability to perform daily activities and monitor body health, enabling action before issues become emergencies. The HRST assigns risk levels based on established criteria.

The HRST provides valuable information that helps teams understand and learn about health risks. This can lead to significant benefits for both individuals and organizations. Early identification of health risks can also support eligibility for disability benefits.

 

What Ohio Found

 

Supporters eligible to participate in the evaluation made one thing clear: the HRST makes a real difference.

  • 79% expected fewer ER visits.
  • 69% expected fewer unnecessary medications.
  • 77% expected overall cost savings.

To ensure ongoing monitoring and support, regular HRST assessments should be scheduled over time.

Organizations looking for similar positive outcomes can use the HRST to support their teams and improve care. Consistent use of the HRST at different times helps maintain health and prevent emergencies.

Every avoided hospitalization or fall isn’t just a financial win. It means someone’s life was made safer, healthier, and less traumatic.

 

From Reactive to Proactive Risk Reduction

 

Traditionally, healthcare systems have spent most of their resources reacting to crises. The HRST flips that model. As one of the essential tools developed for risk reduction, the HRST gives agencies clear, objective insights, enabling proactive planning that prevents emergencies before they happen. Continuous oversight of health risks is crucial for effective risk reduction and operational stability.

For providers and payers, this shift is powerful. It means the HRST enables a range of solutions and actions that organizations can implement to start proactive planning, including:

  • More accurate, individualized health plans.
  • Reduced waste on avoidable care.
  • Better outcomes for people supported.
  • A more sustainable system overall.
  • Support for field teams in their on-site work to assess and address risks.

These changes help teams respond appropriately to health risks and achieve effective risk reduction. The HRST enables organizations to expand their services and better protect the people they support. It also supports the work of healthcare professionals in the field, helping them deliver practical, on-site solutions.

 

The Bottom Line

 

The Ohio evaluation confirms what we’ve long known: investing in prevention is both the ethical and financially sound choice, and aligns with our mission to provide quality care.

With the HRST, organizations don’t have to choose between quality care and cost savings. They can achieve both while enhancing their service offerings and demonstrating a commitment to serving people with IDD. It is tested and trusted to deliver reliable results.

To read the full report, click here. For more resources, visit IntellectAbility’s website.

Health & Safety Training That Meets the Real Risks Facing People with IDD

Intellectability Academy: Health & Safety Training That Meets the Real Risks Facing People with IDD

Intellectability Academy: Health & Safety Training That Meets the Real Risks Facing People with IDD

 

Health and safety for people with intellectual and developmental disabilities (IDD) is rarely about a single crisis moment. More often, it is shaped by everyday decisions — how meals are prepared, how pain is noticed or missed, how equipment is maintained, how medications accumulate over time, and how communication either builds trust or creates confusion, while challenging behaviors and mental health concerns can also signal underlying risks. These are not abstract concerns. They are the moments where risk quietly grows, or where prevention can truly take root.

For provider agencies and support teams in community-based support environments, the challenge is clear: traditional training often focuses on compliance or isolated topics, while real-world risk is layered, ongoing, and deeply human. Recognizing this gap, IntellectAbility developed a new Health & Safety eLearn course series designed to address the realities of day-to-day IDD support.

 

Why Everyday Health & Safety Training Matters for People with IDD

 

Many of the most serious health outcomes for people with IDD are linked to issues that begin quietly: unsafe mealtime practices, unrecognized pain, poorly fitting or neglected medical equipment, communication barriers, or the cumulative effects of multiple medications. These risks often unfold gradually and can be overlooked in busy support environments.

Direct Support Professionals (DSPs), house managers, support coordinators, supporters, and families are on the front lines of these moments. Yet they are frequently expected to identify, document, and respond to complex health concerns, including recognizing symptoms that may indicate underlying issues, without training that reflects the nuances of their role. Effective health and safety education must therefore do more than deliver information — it must build observation skills, confidence, and practical decision-making that translates into safer outcomes.

 

A Practical, Layered Approach to Learning

 

The Health & Safety eLearn Courses were intentionally designed as a flexible yet cohesive training series. The courses form a structured curriculum specifically developed for professionals working in IDD support services — such as adult day programs and residential care centers — ensuring practical application and immediate relevance to daily needs. Each course can be taken individually to address a specific training need, allowing organizations to respond quickly to identified gaps or priority areas. At the same time, the courses were developed to build upon one another, reinforcing shared concepts such as observation, documentation, communication, and risk awareness across multiple health and safety domains.

When licensed together as a complete package, the six courses create a more comprehensive learning pathway — one that mirrors how risk actually presents in real life. Mealtime safety connects to communication. Pain recognition intersects with polypharmacy. Equipment maintenance influences mobility, comfort, and overall health. Taken as a whole, the series strengthens teams’ ability to recognize patterns, not just isolated issues, and respond earlier and more effectively. The delivery of these courses is designed to support different learning needs, offering flexible online access and self-paced modules.

These courses are intended for provider agencies, clinicians, and support staff who work with people with intellectual and developmental disabilities, equipping them with practical skills to improve health and safety outcomes.

 

What the Six Courses Cover

 

Diet & Meal Planning for Provider Agency Staff

Mealtime is one of the most routine — and riskiest — parts of daily support. This course helps staff interpret diet orders, plan meals that respect both nutritional needs and personal dignity, and consider the unique needs of children with IDD, as well as shop and prepare food safely for people with allergies, texture modifications, or special dietary requirements. Improper diet or unsafe mealtime practices can contribute to illness in people with IDD.

 

Plate It Safe: Avoiding Mealtime Risks

 

Unsafe mealtime practices remain a leading cause of preventable health emergencies. This course addresses the “Dangerous Dozen” mealtime risks, silent aspiration, and the importance of observing and supporting DSPs in maintaining safe, respectful eating environments, as well as the need to report any incidents or concerns promptly. Tailored learning tracks ensure relevance for both provider staff and support coordination roles.

Techniques in Proper Maintenance of Durable Medical Equipment

 

Durable medical equipment, particularly wheelchairs, plays a crucial role in enhancing comfort, mobility, and safety, with employees responsible for regular checks to ensure proper function and a proper fit.

Learners gain practical guidance on routine maintenance, recognizing poor fit or discomfort, and understanding when issues require reporting or professional intervention, as certain equipment problems may point to broader health or safety concerns.

 

Effective Communication for Direct Support Professionals

 

Communication is foundational to health, safety, and trust; applying key principles of effective communication is essential for achieving positive outcomes. This course explores expressive and receptive communication, presuming competence, recognizing emotional and psychological discomfort, and using person-centered strategies to de-escalate challenging situations and strengthen relationships, incorporating trauma-informed care approaches.

 

Understanding Polypharmacy

 

Medication management can become increasingly complex over time, especially when addressing the mental health needs of individuals with IDD. This course introduces the concept of polypharmacy and helps learners recognize potential concerns, monitor medication use, and understand how medication-related risks can occur gradually, as well as when additional oversight or review may be necessary.

 

Understanding and Recognizing Pain in People with IDD

 

Pain is often underrecognized in people with IDD, particularly when communication barriers exist. This course builds skills in identifying physical, behavioral, and emotional indicators and symptoms of pain, as well as documenting and reporting concerns effectively to healthcare professionals and collaborating with nurses for comprehensive pain assessment.

 

Built for Individual Learning — Stronger as a Series

 

Organizations may choose to assign individual courses based on role, experience level, or immediate needs. However, when implemented as a full series, the Health & Safety eLearn Courses offer a more integrated training experience. These programs are designed to enhance staff skills, support employee retention, and foster leadership development within IDD service providers. Concepts introduced in earlier courses are reinforced and expanded upon in later ones, supporting deeper understanding and more consistent application across teams.

This approach allows agencies to scale training strategically, starting where it makes sense, while working toward a shared foundation of health and safety knowledge that supports consistency, oversight, and quality across services.

 

Who These Courses Are Designed For

 

The Health & Safety eLearn series supports a wide range of roles across the IDD system, including DSPs, house managers, support coordinators, intensive support coordinators, planning list administrators, state support staff, frontline supervisors, and providers. Each course is intentionally structured to align with the responsibilities these professionals carry every day, making the learning immediately applicable whether taken alone or as part of the full package.

Completing these trainings can also enhance employment opportunities for participants by equipping them with specialized skills valued in the IDD field.

 

Flexible Learning That Fits Real Work Environments

 

All six courses are available 24/7 through IntellectAbility’s eLearning Platform (eLP), allowing learners to progress at their own pace. The platform automatically tracks progress, monitors completion, and generates certificates to support oversight and regulatory requirements. Many modules also offer continuing education credits for professionals, supporting licensing and certification needs.

No additional downloads are needed — everything is accessible directly through the platform, with course development managed by our dedicated Productions department.

IntellectAbility develops training courses in partnership with recognized organizations to ensure high-quality, specialized content for the IDD community.

Accessibility Features That Empower Every Learner

 

Ensuring that every learner can access and benefit from training is fundamental to quality support for people with intellectual and developmental disabilities. IntellectAbility’s Health & Safety eLearn Courses are designed with accessibility at their core, recognizing that both individuals with disabilities and the direct support professionals who serve them deserve inclusive, barrier-free education.

By prioritizing accessibility, IntellectAbility empowers direct support professionals and direct support staff to gain the knowledge and skills needed to provide high-quality, person-centered support. This commitment extends to all individuals—whether they are learning to better serve people with intellectual disabilities, developmental disabilities, or other complex needs. Accessible training materials help ensure that no one is left behind, supporting the development of a more skilled, confident, and inclusive workforce.

Ultimately, accessible education is about more than compliance—it’s about equity, dignity, and the ability for every person to learn, grow, and contribute. With these features in place, organizations can be confident that their teams are equipped to provide direct support that truly meets the needs of people with IDD, fostering safer, healthier, and more inclusive communities.

 

Strengthening Safety, Dignity, and Quality of Life

 

Health and safety training should never feel disconnected from the people it is meant to protect. By offering both individual courses and a comprehensive, integrated series, the Health & Safety eLearn Courses provide organizations with the flexibility they need, allowing centers, such as state-supported living centers, to implement the training and improve the safety and quality of life for people with IDD. When staff are equipped to recognize early warning signs, communicate effectively, and respond thoughtfully across multiple domains, the result is not just reduced risk. It is safer systems, stronger teams, and a better quality of life for the people they support.

 

Additional Resources:

–          Learn more and enroll in these courses

–          Explore the IntellectAbility Academy and browse full course offering

–          Download the Health and Safety Course Overview

The Rural Health Transformation Program: The Imperative Role of State Developmental Disability Agencies

The Rural Health Transformation Program: The Imperative Role of State Developmental Disability Agencies

Across the country, states are receiving new federal funding through the Rural Health Transformation Program (RHTP), an initiative designed to strengthen health care access and outcomes in rural and underserved communities. With award amounts now announced, states are moving quickly to design and implement their plans.

For state developmental disabilities agencies, this presents a critical opportunity to help ensure people with intellectual and developmental disabilities (IDD) are included in these efforts from the outset.

What Is the Rural Health Transformation Program?
Authorized under the One Big Beautiful Bill Act (Section 71401 of Public Law 119-21), RHTP provides states with significant funding and flexibility to improve rural health systems. While approaches will vary, common priorities include:

  • Expanding access to care
  • Improving care coordination and quality
  • Strengthening the health workforce
  • Addressing health disparities
  • Advancing technology and innovation

States now have important decisions to make about priority populations, partnerships, and performance measures.

Why This Matters for State DD Systems
People with IDD in rural communities often experience compounded challenges, including limited access to clinicians with IDD expertise, long travel distances, and fragmentation between health care and home and community-based services (HCBS).

State DD agencies play a key role in bridging these systems. Without intentional collaboration, there is a risk that RHTP investments will move forward without fully addressing the needs of people receiving HCBS and other disability services.

Opportunities for State Leadership
As RHTP plans are developed, state DD agencies can help ensure alignment by:

  • Partnering with Medicaid and public health agencies involved in RHTP planning
  • Elevating people with IDD as a priority population within state strategies
  • Bringing HCBS and disability service providers into cross-system discussions
  • Sharing data and insights on health disparities and service gaps in rural IDD populations
  • Encouraging integration between health care delivery and long-term services and supports

Early engagement can help shape not only funding decisions, but also long-term system design.

How IntellectAbility is Supporting IDD Inclusion in RHTP Efforts
IntellectAbility is working to support states and providers in advancing more inclusive health systems. Through tools, training, and data-driven approaches, IntellectAbility helps identify health risks, strengthen quality improvement efforts, and build workforce capacity to better support people with IDD.

These resources can complement state RHTP initiatives by helping ensure that people with IDD are meaningfully included in care models, quality strategies, and outcome measurement. Learn more here.

Looking Ahead
RHTP represents one of the most significant recent investments in rural health. With thoughtful collaboration, it can also serve as a catalyst for better integration between health care and disability services.

State DD agencies have an important role to play in ensuring these efforts lead to meaningful improvements in health outcomes for people with IDD. Prioritizing inclusion now can help build more responsive, equitable systems for the future.

Together, let’s get #IDDinRHTP.

Case Study: Discovery Living Strengthens Staff Preparedness with Fatal Five Fundamentals Training

Case Study: Discovery Living Strengthens Staff Preparedness with Fatal Five Fundamentals Training

 

Executive Summary

 

After implementing IntellectAbility’s Fatal Five Fundamentals training program, Discovery Living Inc., an Iowa provider supporting 150 people with intellectual and developmental disabilities (IDD), achieved significant improvements in health outcomes, staff preparedness, and operational efficiency.

A one-year outcome analysis found a 37% reduction in emergency department and urgent care visits, decreasing from 254 visits in 2024 to 159 in 2025. This reduction translated into estimated annual medical cost savings of $274,410 and staffing overtime savings of $15,237. In addition, 97% of staff reported feeling better prepared to recognize preventable health risks, while 85% were able to apply their training immediately in daily practice.

These results demonstrate how proactive health surveillance training can reduce avoidable medical crises, strengthen early intervention, improve the quality of care, and support long-term financial sustainability for organizations that support people with IDD.

 

Background

 

Supporting people with intellectual and developmental disabilities (IDD) requires consistent vigilance, strong clinical awareness, and systems that empower staff to recognize risk early.

Discovery Living Inc. is committed to helping people with IDD live healthy, meaningful lives through proactive, person-centered support. To strengthen staff capacity and reduce preventable medical crises, the organization pursued training focused on the “Fatal Five” — constipation, aspiration, dehydration, seizures, and sepsis.

These five conditions are the leading preventable causes of illness and premature death among people with IDD. In fact, people with IDD are more than twice as likely to die prematurely as the general population (The Center for Inclusive Health).

By investing in targeted health surveillance education, Discovery Living aimed to move beyond reactive crisis response and toward a culture of early intervention, shared responsibility, and long-term wellness.

 

Funding the Initiative

 

This project was made possible by a $5,000 mini-grant awarded by Iowa’s University Center for Excellence in Developmental Disabilities (UCEDD). The UCEDD offered up to ten mini-grants to community agencies, healthcare organizations, community-based services, and centers to promote high-quality healthcare for people with IDD.

Discovery Living’s successful application focused on educating its employees through IntellectAbility’s Fatal Five Fundamentals eLearn program. The grant enabled all staff to access the training via IntellectAbility’s Electronic Learning Platform (eLP). The course comprises seven individual modules, along with associated resources and downloadable materials designed specifically for frontline supporters.

 

Implementation

 

To build awareness, Discovery Living introduced the Fatal Five concepts during an all-agency training on March 27, 2024, highlighting why this training would be central to the organization’s mission moving forward. The session began with an overview of the Fatal Five presented by Dr. Craig Escudé. Staff were encouraged to actively participate, ask questions, and were informed of the expectation to complete the eLearning course.

Following the training, staff completed the Fatal Five Fundamentals eLearn course, which:

  • Identifies the top five preventable causes of death in people with IDD
  • Guides learners through real-world scenarios for spotting and responding to changes in health status
  • Incorporates visual aids, interactive questions, and downloadable reference materials
  • Emphasizes practical skills that staff can apply immediately in their daily work

 

What the Data Shows: Measurable Impact of Fatal Five Training

 

A one-year outcome analysis at Discovery Living found that Fatal Five Fundamentals training led to significant improvements in both health outcomes and operational efficiency. The training helped staff work proactively to mitigate health risks, resulting in improved outcomes for people with IDD.

After implementing the training, the organization experienced a 37% reduction in combined emergency department and urgent care visits, from 254 in 2024 to 159 in 2025. Even after excluding individuals with the highest medical utilization, visits still declined by 33%, demonstrating that the improvements were not driven by chance or population changes.

This reduction in emergency care translated into meaningful cost savings. Based on national healthcare estimates and IDD-specific utilization data, Discovery Living achieved:

  • $255,210 in reduced emergency department costs
  • $19,200 in urgent care savings
  • $274,410 in total estimated annual medical savings

In addition, fewer emergency visits resulted in staffing efficiencies. The study estimated approximately $15,237 in annual overtime savings, along with indirect savings related to transportation, scheduling, documentation, and follow-up care. These efforts are aimed at continually improving health and wellness for the people served.

 

Staff Confidence and Early Intervention

 

Survey data from 60 staff members revealed that the training strengthened frontline clinical awareness and decision-making. The training also increased staff understanding of health risks and the importance of making decisions based on early warning signs.

After completing the course:

  • 97% felt better prepared to recognize Fatal Five conditions
  • 92% felt better prepared to prevent them
  • 85% could apply what they learned immediately
  • 83% would recommend the training
  • The overall experience was rated 4.15 out of 5 stars

Staff reported increased communication with supervisors, guardians, and healthcare providers, often leading to earlier evaluations and treatment.

As one participant shared:

“Learners felt empowered to observe, make informed decisions, and act when necessary.”

The training also emphasized positive control, empowering staff to support autonomy and safety.

These changes reflect a shift from reactive crisis management to proactive health monitoring and early intervention.

 

Cultural and Practice Transformation

 

Beyond measurable outcomes, Discovery Living Inc. observed a cultural shift across the organization. Staff began discussing health concerns more openly and collaboratively, leading to earlier intervention and improved support coordination.

This approach reflects a move from traditional risk management to “replacing risk” with proactive health and wellness strategies. By focusing on prevention and person-centered support, staff are helping improve stability, engagement, and quality of life for the people they support. The organization is also promoting positive control by implementing person-centered approaches that empower people and preserve their autonomy.

 

Why These Results Matter for Providers

 

For organizations supporting people with IDD, emergency department visits carry significant clinical, operational, and emotional consequences. Each visit disrupts staffing, strains budgets, and reduces continuity of care.

This case study demonstrates that targeted health surveillance training can:

  • Reduce avoidable medical emergencies
  • Improve staff confidence and consistency
  • Lower healthcare and staffing costs
  • Strengthen collaboration with medical providers
  • Improve the quality of life for people with IDD

Rather than relying on crisis response, trained teams are better equipped to identify early warning signs and intervene before emergencies occur.

 

About IntellectAbility’s Academy Courses

 

IntellectAbility’s Academy offers comprehensive healthcare and person-centered support training for providers serving people with IDD. Courses support clinical and non-clinical staff and are designed to complement organizational policies and quality initiatives.

Many courses are NADSP-accredited and offer CME or CEU credits, providing accessible, high-quality education that empowers learners to take informed action.

Each eLearn course includes:

  • Illustrations
  • Knowledge checks
  • Real-world scenarios
  • Retention-focused learning tools

 

Conclusion

 

Through UCEDD grant support and IntellectAbility’s Fatal Five Fundamentals training, Discovery Living significantly improved staff awareness, confidence, and collaboration around critical health concerns.

By strengthening early detection, communication, and preventive healthcare, the organization created a safer, more responsive environment for people with IDD. When paired with validated health risk screening tools such as the Health Risk Screening Tool (HRST®), these efforts further support early intervention and targeted support planning.

This case study demonstrates how evidence-based training can directly improve outcomes, reduce costs, and strengthen support systems for people with IDD.

 

Additional Resources:

 

  • Visit our training page to explore how Fatal Five Fundamentals can benefit your organization.
  • Download our free brochure to learn more about IntellectAbility’s Academy courses.
  • Download the IntellectAbility and Discovery Living Inc. case study and infographic to learn more about the impact of the Fatal Five Fundamentals eLearn.

 

What Is Virtual Person-Centered Thinking Training (vPCTT)? A Practical Guide for Providers and Support Professionals

What Is Virtual Person-Centered Thinking Training (vPCTT)? A Practical Guide for Providers and Support Professionals

 

In today’s healthcare and human services landscape, being person-centered is no longer optional. Person centeredness is a foundational approach that empowers individuals to maintain control over their own lives by focusing on their preferences, strengths, and personal goals, regardless of disabilities or life circumstances. For organizations supporting people with intellectual and developmental disabilities (IDD), person-centered thinking is at the core of ethical, effective, and compliant care.

The philosophy of person-centered thinking serves as the foundation for this approach, guiding the values, skills, and tools that promote individual autonomy and meaningful support.

That’s where Virtual Person-Centered Thinking Training (vPCTT) comes in. Understanding the core concept of person-centered thinking, such as the importance of ‘Important To and For,’ is essential for effective support.

This online, instructor-led training helps professionals build the mindset, skills, and tools needed to truly place people with IDD at the center of planning, services, and decision-making—no matter where staff are located.

But what exactly is vPCTT? And how does it work in practice?

Let’s break it down.

 

Understanding Person-Centered Thinking

 

Person-centered thinking is a framework that focuses on understanding what truly matters to a person beyond what’s important for them.

Rather than designing services around systems, schedules, or convenience, this approach emphasizes:

  • Individual strengths, preferences, and goals
  • The importance of knowledge about the person’s preferences, strengths, routines, and needs to inform personalized support
  • Meaningful relationships and community inclusion
  • Choice, autonomy, and self-direction
  • Respect for personal history, culture, and identity
  • Collaborative decision-making

Person-centered supports are support approaches that prioritize an individual’s preferences, strengths, and needs, empowering people with intellectual and developmental disabilities by focusing on individualized strategies that put the person at the center of planning and decision-making to enhance their quality of life.

Person-centered thinking involves a process of discovery and collaboration to ensure supports are truly individualized.

In short, it shifts care from “doing for” to “working with.”

Person-centered thinking is also closely connected to federal and state regulations, including CMS Access Rule requirements and HCBS standards, making it both a best practice and a compliance priority.

 

What Is Virtual Person-Centered Thinking Training (vPCTT)?

 

Virtual Person-Centered Thinking Training (vPCTT) is a live, interactive, online course designed to teach person-centered practices through real-world application. This class offers an engaging learning experience, featuring interactive activities and resource-rich materials that help participants build essential person-centered skills.

Unlike self-paced modules or recorded videos, vPCTT is delivered in real time by certified instructors. Participants engage directly with trainers and peers through discussion, activities, and case examples.

Most programs follow a multi-day format—often three full days like IntellectAbility—allowing learners to develop a deep, practical understanding rather than surface-level familiarity. Participants must complete the full course to receive certification and ensure a comprehensive understanding of person-centered practices.

 

How IntellectAbility’s vPCTT Works

 

1. Live Online Instruction

vPCTT takes place via video conferencing platforms like Zoom. Participants join scheduled sessions from their workplace or home, eliminating travel costs and time barriers.

Sessions typically include:

  • Guided instruction
  • Small-group breakouts
  • Interactive exercises
  • Reflection activities
  • Real-life scenario analysis

This structure keeps learners actively involved rather than passively watching.

To enroll in vPCTT sessions, participants are required to complete an online registration form.

 

2. Certified, Experienced Trainers

High-quality vPCTT programs are led by instructors who are formally certified in person-centered thinking methodologies and have hands-on experience in IDD and human services. The training curriculum was developed in collaboration with key partners in the field to ensure it meets current standards and best practices.

This ensures that training goes beyond theory and addresses:

  • Day-to-day support challenges
  • Documentation requirements
  • Team communication issues
  • Leadership and culture change

Participants learn not just what to do, but how to do it in real environments.

 

3. Applied Learning Tools

A major strength of vPCTT is its focus on practical tools that can be used immediately, such as:

  • Communication and listening strategies
  • Person-centered profiles
  • Decision-making supports
  • Relationship mapping, which helps foster supportive relationships and environments that promote trust and independence
  • Support planning frameworks
  • Risk and safety balance tools
  • Tools to help participants identify individual strengths, preferences, and support needs

These resources help teams turn values into action.

 

4. Accreditation and Continuing Education

Many virtual person-centered thinking programs are accredited and offer continuing education credits, with many programs being approved by relevant accrediting bodies. This makes vPCTT valuable for:

  • Direct support professionals
  • Case managers
  • Nurses and clinicians
  • Supervisors and administrators
  • Quality and compliance staff

It supports both professional development and regulatory expectations.

Note: Please check specific course details for prerequisites, approved accrediting bodies, and eligibility for continuing education credits.

 

Who Should Take vPCTT?

 

Virtual Person-Centered Thinking Training is beneficial for professionals across the entire support system, including:

  • Community-based providers
  • Residential and day program staff
  • Care coordinators and service planners
  • State and county administrators
  • Healthcare providers working with IDD populations to deliver person-centered care
  • Leadership and management teams
  • Agency staff and agencies seeking organization-wide implementation

Effective communication between healthcare providers and patients with intellectual and developmental disabilities is essential to ensure tailored, person-centered care.

Supporters—including direct support professionals, caregivers, and agency staff—play a crucial role in facilitating person-centered practices, promoting autonomy, and helping individuals with disabilities live independently and with dignity across various settings.

Because person-centered practices affect every level of service delivery, organizations often train multidisciplinary teams together.

 

Key Benefits of Virtual Person-Centered Thinking Training

 

1. Improved Quality of Support

When staff understand what matters most to the people they support, services become more responsive, respectful, and effective. Person-centered practices empower individuals to achieve their personal goals and maintain positive control over their lives, ensuring that support strategies promote autonomy and person-led decision-making.

This leads to:

  • Better engagement
  • Increased satisfaction
  • Stronger trust
  • More meaningful outcomes

 

2. Stronger Compliance and Documentation

Person-centered approaches support compliance with CMS and state regulations by aligning care plans with individual preferences and needs.

Training helps staff document services in ways that reflect genuine person-centered practice—reducing audit risk and improving quality reviews. Conducting a review of key person-centered thinking concepts at the end of training is essential to reinforce understanding and retention, ensuring staff consistently apply these principles in their documentation and daily practice.

 

3. Workforce Development and Retention

Staff who feel equipped, valued, and confident are more likely to stay in their roles.

vPCTT supports workforce stability by:

  • Reducing burnout
  • Improving communication
  • Strengthening team culture
  • Clarifying expectations

 

4. Accessible, Scalable Learning

Because it is virtual, vPCTT makes high-quality training accessible to:

  • Rural providers
  • Multi-site organizations
  • Remote employees
  • Smaller agencies with limited travel budgets

Organizations can train more staff without sacrificing instructional quality.

 

How vPCTT Supports Organizational Culture Change

 

One of the most powerful outcomes of virtual person-centered thinking training is its impact on organizational culture.

When implemented effectively, vPCTT helps organizations move toward:

  • Shared language around support and dignity
  • Consistent decision-making practices
  • Collaborative leadership models
  • Stronger accountability systems
  • Promotion of self-determination by empowering individuals and staff to make choices, exercise independence, and have greater control over their lives

Rather than being “one more training,” it becomes part of how the organization operates.

 

What to Look for in a Quality vPCTT Program

 

Not all virtual trainings are equal. When evaluating a vPCTT program, look for:

✔ Live, instructor-led sessions (not just recordings)
✔ Certified and experienced trainers
✔ Interactive learning components
✔ Practical tools and resources
✔ Accreditation or CE options
✔ Ongoing support or follow-up resources
✔ Connection to a recognized learning community, such as The Learning Community for Person Centered Practices, for ongoing support, resources, and professional development

Some participants may prefer a classroom-based course format, depending on availability or organizational requirements.

A strong program should feel engaging, relevant, and immediately applicable.

 

Why Virtual Person-Centered Thinking Matters More Than Ever

 

As healthcare and disability services continue to evolve, systems are under pressure to improve outcomes, reduce risk, and demonstrate value. Person-centered thinking is especially important for individuals with mental illness, as it ensures that planning and treatment strategies are tailored to each person’s unique needs, supporting more effective recovery and individualized care.

Person-centered thinking provides a foundation for:

  • Ethical service delivery
  • Preventative support models
  • Equity-focused care
  • Sustainable workforce development

Virtual training makes these principles accessible to more organizations than ever before.

 

Is vPCTT Right for Your Organization?

 

If your organization is seeking to:

  • Strengthen person-centered planning
  • Improve compliance
  • Develop staff skills
  • Enhance service quality
  • Build long-term sustainability

…then Virtual Person-Centered Thinking Training is a strategic investment, not just a learning opportunity. Pursue the journey of person-centered transformation with vPCTT and empower your team to deliver truly individualized, compassionate support.

 

Why Choose IntellectAbility for Virtual Person-Centered Thinking Training?

 

When it comes to person-centered thinking, who delivers the training matters.

At IntellectAbility, person-centered practice is not treated as a checkbox or compliance exercise. It is embedded in everything we do—from clinical education to workforce development to quality improvement.

As a nationally recognized leader in IDD health and support systems, IntellectAbility brings a unique depth of experience to Virtual Person-Centered Thinking Training.

 

A Trusted National Leader in IDD Education

For more than two decades, IntellectAbility has partnered with providers, state agencies, and healthcare systems to improve outcomes for people with IDD.

Our work spans:

  • Health risk management and prevention
  • Workforce training and certification
  • Quality assurance and compliance
  • System-wide improvement initiatives

This national perspective allows us to design training that reflects real-world challenges—not just ideal scenarios.

 

Certified Trainers With Real-World Experience

 

IntellectAbility’s vPCTT courses are led by certified person-centered thinking instructors who bring extensive field experience in disability services, healthcare, and human services.

Our trainers understand:

  • Regulatory expectations
  • Staffing and workforce pressures
  • Documentation realities
  • Leadership and culture change

Participants learn from professionals who actively work within the systems they serve.

 

Integrated With Evidence-Based Tools and Resources

Unlike standalone training providers, IntellectAbility integrates person-centered thinking into a broader ecosystem of evidence-based solutions, including:

  • Health Risk Screening Tool (HRST®)
  • IntellectAbility Academy eLearning
  • Curriculum in IDD Healthcare®

This allows organizations to connect person-centered values directly to health, safety, and quality outcomes.

 

Focused on Long-Term Impact

Our approach goes beyond “checking the training box.”

IntellectAbility designs vPCTT programs to support:

  • Sustainable practice change
  • Leadership development
  • Team alignment
  • Continuous quality improvement

Organizations leave with tools and strategies they can apply long after the training ends.

 

Proven Track Record With Providers and States Nationwide

IntellectAbility works with organizations in all 50 states, supporting thousands of professionals each year.

This nationwide reach ensures our training reflects:

  • Regional regulatory differences
  • Diverse service models
  • Urban and rural system needs
  • Varying organizational capacities

Your team benefits from best practices gathered across the country.

 

Final Thoughts

Virtual Person-Centered Thinking Training bridges the gap between values and practice. Through live instruction, certified trainers, and applied tools, it helps professionals create support systems that truly reflect the voices, goals, and dignity of people with IDD.

In an increasingly digital and distributed workforce, vPCTT ensures that person-centered care remains personal, intentional, and impactful.

 

Additional Resources:

Improving Healthcare for People with IDD: IntellectAbility Launches New Quality Improvement Program Recognized by ABMS

Improving Healthcare for People with IDD: IntellectAbility Launches New Quality Improvement Program Recognized by ABMS

 

People with intellectual and developmental disabilities (IDD) experience some of the highest rates of preventable health complications and premature death in the U.S., often due to gaps in healthcare training, limited provider confidence, and a lack of person-centered approaches in clinical settings.

Intellectual disability typically begins before the age of 18 and is often present at birth, affecting an individual’s physical, intellectual, and emotional development. Developmental disabilities are characterized by chronic conditions that affect multiple body parts and systems of the body, and can include syndromes such as Down syndrome, autism, cerebral palsy, and other disabilities, all of which can affect the well-being and quality of life of individuals and their families. Various organizations are dedicated to supporting people with intellectual or developmental disabilities and advancing their care.

IntellectAbility, a leader in healthcare software and education for people with IDD, is taking a major step toward changing that narrative.

IntellectAbility has announced a new quality improvement (QI) program, Improving Care for Patients with Intellectual and Developmental Disabilities (IDD), now recognized through the American Board of Medical Specialties Portfolio Program™ (ABMS Portfolio Program).

 

Elevating Standards in IDD Healthcare Education

 

The ABMS Portfolio Program is a nationally recognized initiative that rewards physicians and physician assistants (PAs) who engage in meaningful QI activities as part of their continuing certification. Through this collaboration, ABMS members can now fulfill Maintenance of Certification (MOC) requirements while enhancing their ability to deliver high-quality, person-centered care to people with IDD.

The new QI program leverages IntellectAbility’s evidence-based Curriculum in IDD Healthcare, a six-module eLearning course designed to close the knowledge gap in medical training.

Each module provides practical, actionable guidance for diagnosing and managing common yet often misinterpreted conditions in people with IDD — including the Fatal Five, aspiration, bowel obstruction, dehydration, seizures, and infection/sepsis. The curriculum also addresses deficits in intellectual functioning, adaptive behavior, intelligence, and other essential skills, including life skills, problem-solving, and general mental abilities, all of which are crucial for people with IDD to function independently.

Clinicians are encouraged to learn more about these areas to enhance their understanding and improve care for individuals with intellectual and developmental disabilities.

 

Supported by Elevance Health

 

This initiative was made possible through the generous support of Elevance Health, whose commitment to health equity aligns closely with IntellectAbility’s mission to improve outcomes and quality of life for people with disabilities.

Elevance Health is committed to supporting the well-being of children and families through its efforts to expand access to support services and resources related to IDD.

The organization offers a range of services, including specialized services for people with IDD, to meet the needs of children and families.

“Most healthcare providers are not adequately trained to meet the unique healthcare needs of people with intellectual and developmental disabilities,” explains Dr. Craig Escudé, President of IntellectAbility. “The Curriculum in IDD Healthcare enhances clinicians’ confidence and clinical skills while helping them meet Maintenance of Certification requirements and earn CME credits. With one course, clinicians can meet professional requirements and improve care for an underserved population.”

Dr. Escudé adds, “Our partnership with Elevance Health represents a groundbreaking collaboration that combines clinical expertise, data-driven insights, and person-centered tools to help address the often-complex healthcare needs of people with IDD.”

 

Joining a Community of National Leaders

 

As the newest ABMS Portfolio Program Sponsor, IntellectAbility joins a distinguished network of hospitals, academic medical centers, specialty societies, and government agencies—all dedicated to advancing healthcare quality through education and continuous improvement.

These organizations, including facilities and centers, support a broader category of intellectual and developmental disabilities, ensuring comprehensive care and regulatory compliance across multiple conditions.

 

Take the Next Step: Strengthen Your Clinical Skills in IDD Care

 

For clinicians, educators, and healthcare systems seeking to develop lasting competence in this area, IntellectAbility’s Curriculum in IDD Healthcare (CIDDH) provides flexible, evidence-based online learning that bridges the gap between clinical knowledge and real-world practice.

The course equips clinicians to utilize health risk screening tools to detect health risks, such as the Health Risk Screening Tool (HRST®), which assigns scores to behaviorally related rating items to identify health risks and determine healthcare levels.

The HRST assigns total points to each individual, and the total points determine the associated degree of health risk, ranging from the lowest risk (Level 1) to the highest risk (Level 6). This process helps detect health concerns and risks early, enabling intervention before they become destabilizing.

In addition, the course prepares clinicians to describe situations, initiate early intervention, and address the development and overall health of people with IDD and other disabilities across all ages, thereby improving their lives and outcomes.

Developed by Dr. Craig Escudé, a physician specializing in IDD healthcare, this six-module course helps healthcare professionals:

  • Improve diagnostic accuracy and reduce preventable complications
  • Deliver more person-centered, equitable care
  • Earn continuing medical education (CME) credits
  • Now, fulfill QI and MOC requirements through the ABMS Portfolio Program

Whether you’re a physician, nurse, or healthcare educator, the CIDDH program is a powerful step toward advancing health equity for people with IDD.

 

Additional Resources

Explore the course and register today: Curriculum in IDD Healthcare