This Research to Practice brief examines how state Medicaid HCBS waiver design affects access to integrated employment for people with IDD by analyzing state funding policies, identifying predictors of better employment participation, and gathering expert input through a Delphi panel. Findings indicate that strong funding incentives and staff capacity are most critical for improving employment outcomes, while transportation remains a major barrier—best addressed through stand-alone supports—and emerging tools like remote services and assistive technology show promise when directly tied to employment goals.
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