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Published Online: 15 April 2024

A Patient-Centered Multidisciplinary Medical HOME for Persons With Intellectual and Developmental Disabilities

Abstract

Innovative models of medical and psychiatric care are necessary to address the complex needs of individuals with intellectual and developmental disabilities (IDD), including autism. This article describes a subspecialty medical home program that has provided accessible, comprehensive, coordinated, patient- and family-centered care for this high-needs, underserved patient population. For more than two decades, the University of Utah Huntsman Mental Health Institute Neurobehavior HOME Program (HOME) has provided primary and behavioral health care for individuals with IDD across their lifespan. Program highlights include integrated medical and behavioral health, a unique funding structure, innovative care delivery, and case management. HOME is a clinical setting as well as a Medicaid managed care plan that has blended medical and psychiatric funding streams. This unique funding structure has demonstrated the fiscal sustainability of focusing care on preventive and proactive management of health concerns and responding to crises using a coordinated and comprehensive approach. Rethinking health care delivery and adopting models that are both financially sustainable and provide quality care to this vulnerable population is greatly needed.

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Information

Published In

History

Published in print: Spring 2024
Published online: 15 April 2024

Keywords

  1. Intellectual and developmental disabilities
  2. Medical Homes
  3. Autism Spectrum Disorder
  4. Neurodevelopmental Disorders
  5. Mental Health Care/Service Delivery Systems

Authors

Affiliations

Patricia Aguayo, M.D., M.P.H. [email protected]
Department of Psychiatry (Aguayo, Lin, Stevens, Bilder, Rapaport), and Department of Pediatrics (Carbone, Bilder), University of Utah, Salt Lake City.
Anne G. Lin, M.D.
Department of Psychiatry (Aguayo, Lin, Stevens, Bilder, Rapaport), and Department of Pediatrics (Carbone, Bilder), University of Utah, Salt Lake City.
Paul T. Stevens, M.D.
Department of Psychiatry (Aguayo, Lin, Stevens, Bilder, Rapaport), and Department of Pediatrics (Carbone, Bilder), University of Utah, Salt Lake City.
Paul S. Carbone, M.D.
Department of Psychiatry (Aguayo, Lin, Stevens, Bilder, Rapaport), and Department of Pediatrics (Carbone, Bilder), University of Utah, Salt Lake City.
Deborah A. Bilder, M.D.
Department of Psychiatry (Aguayo, Lin, Stevens, Bilder, Rapaport), and Department of Pediatrics (Carbone, Bilder), University of Utah, Salt Lake City.
Mark H. Rapaport, M.D.
Department of Psychiatry (Aguayo, Lin, Stevens, Bilder, Rapaport), and Department of Pediatrics (Carbone, Bilder), University of Utah, Salt Lake City.

Notes

Send correspondence to Dr. Aguayo ([email protected]).

Competing Interests

Dr. Bilder reports her work as a consultant and advisory board member for BioMarin Pharmaceutical, Taysha Gene Therapies, Encoded Therapeutics, Synlogic Therapeutics, and as an advisory board member for Sanofi. The other authors report no financial relationships with commercial interests.

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