In the quiet corners of rural America, far from metropolitan health centers and bustling medical campuses, there are people with intellectual and developmental disabilities (I/DD). Their voices too often go unheard, and their lives are often shaped by gaps in care that others may not even see.
People with I/DD experience health disparities compared to the general population, with these inequities often being more pronounced in rural areas where access to quality health care is limited. At IntellectAbility, we believe that everyone—no matter where they live—deserves more than just survival. Addressing health disparities for people with I/DD, especially in rural areas, is essential to ensuring they receive equitable care. They deserve health, wellness, dignity, and the chance to live a life they love.
The Gaps for People with I/DD
Time and again, we’ve seen providers and support teams say, “We knew something wasn’t right, but we didn’t have the right tools or data to act.” Too often a change in condition, an underlying health risk, or a subtle behavioral sign goes unnoticed until it becomes a crisis.
The result? Preventable hospitalizations. Unnecessary suffering. Excessive costs. Lives that could have been different. These issues negatively impact health outcomes and highlight the urgent need to improve quality of care. Emphasizing preventative care and disease prevention for people with I/DD is essential to reduce these avoidable events.
There is a clear need for more resources and research to support better care for people with I/DD.
Why a New Federal Initiative Matters
With rural health receiving a meaningful boost through the Rural Health Transformation (RHT) Program—authorized by the budget legislation signed into law in July 2025 and earmarked to invest $50 billion over the fiscal years 2026 to 2030—the role of technology-enabled tools, training of rural clinicians, and integrated approaches to prevention and population health are at the forefront.
For state Medicaid and Developmental Disabilities Directors, agencies, provider networks, and health care providers who serve people with I/DD, this is a pivotal moment. Medicaid programs and covered services are essential for ensuring access to a full range of services, and changes in federal legislation can significantly impact state budgets and the ability to deliver comprehensive care.
A Call to Action for State & Agency Leaders
If you are a director in a state developmental disabilities agency, in a Medicaid office, or in a provider network, serving rural communities and people with I/DD: this is your moment.
Now is the time to invest in tools and training that will enable your teams to detect risk earlier, plan for long-term care and service needs, reduce ER visits and hospitalizations, and most importantly, support people with I/DD in living lives of purpose, wellness, and connection.
Imagine: a rural case manager equipped not just with experience or intuition, but with validated health-risk data. A provider team that can pull up dashboards, see risk trends, and respond proactively, with resources available to health care providers to support data-driven decision-making. A system where a person with I/DD doesn’t have to wait until their next crisis to get the support they need.
That’s what we’re advocating for, and what we’re offering.
Why We Care
Our story began with a simple but powerful truth: health and wellness flourish when uncertainty, misinformation, and risk are replaced by insight, training, and intentional support. For people with I/DD, this truth is especially pressing because the margins of risk are narrower, the stakes are higher, and systemic failures too often lead to tragedy.
When you’re living in a rural community, the challenges multiply: fewer specialist providers, longer travel distances, limited provider experience in I/DD, and fewer supports. As the recent announcement of the RHT Program highlights, this moment could bring a real shift.
The investment is not only in bricks and mortar but also points to the possibility of change in healthcare access, innovation, and workforce development. The RHT Program aims to improve healthcare delivery and health care access in rural communities, which directly addresses the unique needs of people with I/DD.
For IntellectAbility, this also means ensuring that people with disabilities are not left behind, emphasizing the importance of health equity and the need for the health care system to address disparities for people with disabilities.
Why we’re committed
Our founder, Karen Green McGowan, entered the field because she refused to accept that people with I/DD had to live in conditions of neglect or oversight. Her work formed the backbone of what became the Health Risk Screening Tool (HRST®): a method of early warning that replaces risk with health and wellness. That has remained at the heart of everything we do at IntellectAbility.
When you adopt the HRST, you aren’t just getting another piece of software. You’re embracing a paradigm shift in how health risk is viewed and addressed for people with I/DD. You’re centering their lives, their supports, their voices, and giving your staff the tools they need to act, rather than react.
The benefits of providing access to primary care, specialty care, and behavioral health services for people with I/DD are clear: improved health outcomes, greater independence, and enhanced quality of life.
From opportunity to action
At IntellectAbility, our purpose goes beyond risk reduction. Our mission is clear: We provide tools and training to those who support people with vulnerabilities, helping them replace risk with health and wellness. Education and research are essential to improving outcomes for people with developmental disability and intellectual disability, and we are committed to advancing both.
For too long, the narrative about people with I/DD has been about what they can’t do or the risks they face. We’re flipping that narrative, focusing on what they can do, who they are, and how systems can better support them, including those with intellectual disability and developmental disability.
We believe in possibility. We believe in potential. We believe that when support teams, clinicians, administrators, and leaders are equipped with resources and training, and supported by public health initiatives for people with disabilities, anything is possible for people with I/DD.
If you’d like to explore how the HRST and our learning platform can help your team transform care in rural settings, let’s talk. Because the people we serve, and the support professionals who serve them, deserve nothing less.
IntellectAbility® is the developer and provider of the Health Risk Screening Tool (HRST), which has been used in multiple states and provider agencies across the U.S. for over 20 years. In addition to the HRST, IntellectAbility provides numerous health-related and person-centered thinking trainings for supporters of people with I/DD. Visit ReplacingRisk.com to learn more.
Aliah Farley is a Junior Marketing Associate at IntellectAbility.