The Impact of Support Intensity Needs on Person-Centred Case Management

Area of Science:

• Disability Studies
• Health Services Research
• Social Policy

Background:

• International policies advocate for person-centred disability services, but resource allocation based on support intensity needs for individuals with intellectual and developmental disabilities (IDDs) is under-researched.
• Italy's integrated socio-health system, operating within a human rights framework, provides a unique context for studying resource allocation in individualized support planning for adults with IDDs.

Purpose of the Study:

• To investigate how individual and contextual factors influence resource allocation in individualized support planning for adults with IDDs in Italy.
• To identify potential systemic inequities in resource distribution despite the implementation of person-centred planning frameworks.

Main Methods:

• Quantitative analysis of data from 1152 adults with IDDs across 23 service centres in Italy.
• Individualized Support Plans (ISPs) informed by the Supports Intensity Scale and socio-ecological variables were used to measure resource use (adaptive skills training, community participation, habilitation, assistive technologies).
• Multivariate count models (Sarmanov-Lee) were applied to analyze resource allocation patterns and interdependencies.

Main Results:

• Gender and intellectual functioning level did not significantly impact resource allocation.
• Individuals with the highest support intensity needs received fewer supports, particularly in adaptive skills and community participation.
• Residential settings, assistive technologies, and prosthetics were associated with higher levels of support provision.

Conclusions:

• Despite person-centred planning, systemic inequities persist, potentially disadvantaging individuals with the greatest support needs.
• Multivariate modeling is a valuable tool for understanding resource use and promoting equity-focused planning in disability services.
• Findings support policy and practice reforms aligned with human rights principles and the UN Convention on the Rights of Persons with Disabilities (UNCRPD) for more inclusive support systems.