Designating People with Intellectual and Developmental Disabilities as a Medically Underserved Population: Putting Health in Policy

Congress created the designation “medically underserved population” (MUP) to improve public health using a formula that weighs populations’ lack of primary care providers, its experience with poverty and increased infant mortality, and its percentage of people 65+. More than 25 federal government programs require an MUP designation to participate in, or benefit from billions of federal resources. These programs fund health centers and public health infrastructure, such as federally qualified health centers (FQHCs). State agencies, and some private foundations use the designation to award grants, scholarships, and research funding.

The federal government defines MUP in terms of groups that occupies the same neighborhood, census tract or geographic area.  This puts people with intellectual and developmental disabilities (I/DD) in a Catch-22. Though as a population, people with I/DD experience a lack of primary care providers, significant rates of poverty, increased infant mortality, and an aging population, the I/DD population can never meet the MUP designation standard because they do not live in segregated communities. This means people with I/DD, now woven into the fabric of our communities, cannot benefit from what other medically underserved populations receive to remedy their health disparities and lack of access to health care.

This paper identifies a critical opportunity for law change to improve the public health of people with I/DD, for people with some familiarity with law. It presents a little known exception under the law, and possible law changes to include people with I/DD as an MUP and improve their health as a population.