Integrating OT in Underserved Settings: A Framework for Sustainable Support for Adults with Intellectual Disabilities

Adults with intellectual disabilities (ID) in the United States face persistent challenges in accessing equitable healthcare due to systemic gaps between medical and social services. These barriers, exacerbated by limited employee training, inadequate resources, and fragmented systems, negatively impact health outcomes and community participation. Non-profit community-based (NPCB) programs aim to address these gaps but are often constrained by undertrained staff, insufficient funding, and minimal access to specialized professionals. This paper examines the role of occupational therapy (OT) in enhancing care delivery within NPCB settings and proposes sustainable models for long-term integration. A quality improvement initiative was implemented to integrate OT services into a local NPCB program, with a focus on direct client care, employee training, and leadership support. Key components included staff education on safe client handling and body mechanics, client-centered interventions to promote independence, and systems-level strategies to strengthen organizational capacity. Program evaluation suggested improvements in employee confidence, adoption of safe care practices, and positive progress toward client goal attainment. Three sustainability strategies are proposed to support long-term OT integration in NPCB settings: a consultative model, internal hiring, and community-academic partnerships. These replicable approaches demonstrate how OT can bridge systemic gaps, enhance interdisciplinary collaboration, and improve outcomes for adults with ID in underserved community-based environments.