Sexual Health and Parenting Supports for People with Intellectual and Developmental Disabilities

Introduction Historically, people with intellectual and developmental disabilities (IDD) have lacked supports when it comes to sexual health and parenting. The aim of this study was to examine if, and how, Medicaid Home- and Community-Based Services (HCBS) 1915(c) waivers provided sexual health and parenting supports to people with IDD. Methods We analyzed 107 fiscal year (FY) 2021 HCBS waivers for people with IDD from across the USA to examine trends in service provision. These data were collected between December 2021 and January 2022. Results Approximately 10% of HCBS waivers provided sexual health services to people with IDD and 8% provided parenting services for people with IDD. Most sexual health services took a reactive, sex-negative approach to people with IDD's sexuality, rather than a proactive sex-positive approach. In terms of spending, $282,492 was projected for stand-alone sexual health services and $475,213 for stand-alone parenting services. However, less than 0.05% of people with IDD who received HCBS in FY 2021 were projected to receive stand-alone sexual health or parenting services via the waiver. Conclusions HCBS are a useful vehicle to expand sexual health and parenting supports for people with IDD; however, most states have failed to utilize this funding mechanism to promote the sexual and reproductive rights of people with IDD. Policy Implications There should be an expansion of sexual health and parenting supports offered to people with IDD in HCBS.