Barriers to Assistive Technology Access in the Virginia Medicaid Program

Assistive technology (AT) serves as a crucial tool for enabling people with intellectual and developmental disabilities (IDDs) to perform everyday tasks and participate fully in community life. The high cost of many assistive devices, however, is often prohibitive to the individuals who need them the most. To help cover these costs, individuals with IDDs in Virginia can apply for funding through the Virginia Medicaid Developmental Disabilities (DD) Waiver program. Even so, accessing funding for AT in Virginia through this program has been a historically difficult process. While many studies have aimed to identify barriers to AT access on a national scale, little has previously been done to better understand the issue at the state level in Virginia. In this paper, I argue that invisible administrative work and conflicting narratives in the professional evaluation and service authorization processes, stemming largely from institutional and medical biases embedded in the federal Medicaid program, serve as the primary factors limiting access to AT funding through the DD Waiver program in Virginia. First, I demonstrate how institutional and medical biases embedded in the federal Medicaid system’s IDD services from the program’s inception created barriers to accessing AT services across the country. Then, I examine how federal efforts to address these barriers failed to facilitate AT adoption through the Virginia DD Waiver system. Finally, I show how unrecognized administrative work and conflicting narratives in the Virginia DD Waiver program restrict public funding for AT today.

School of Engineering and Applied Science

Bachelor of Science in Systems Engineering

STS Advisor: MC Forelle