Transportation is an all-important piece of the puzzle for people with developmental disabilities looking to access the community, yet new research shows that options remain limited.

In a review of 99 Medicaid waiver programs serving people with autism or other developmental disabilities across the country in 2013, a new study finds that most offered transportation services, but such rides were often only available for specific purposes like getting to and from work.

Overall, 58 of the waivers reviewed provided transportation services and 71 included rides within other offerings like supported employment, residential or day services, according to findings published in the December issue of the Journal of Disability Policy Studies.

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Meanwhile, 13 of the waivers offered no assistance in getting from one place to another.

Those with developmental disabilities face a host of barriers accessing public transportation, researchers said, meaning that rides provided through Medicaid waivers are often the only options for this population short of depending on friends and family.

“People with (intellectual and developmental disabilities) may have particular trouble navigating the public transportation system compared with non-disabled people or people with other disabilities because they are often impaired in the very areas public transit most often requires,” wrote researchers from the University of Illinois and The Council on Quality and Leadership in the study. “Navigating the public transportation system may require comprehension, memory, attention, time management, literacy, multitasking and problem solving.”

Moreover, they said many with disabilities simply lack the training to take public buses or trains and concerns about safety and stigma are often at play.

Nonetheless, nonemergency medical transportation is the only type of ride that Medicaid programs must offer, the researchers noted.

“Transportation is a critical need for all people with disabilities,” the authors wrote. “Although transportation for services like supported employment and residential habilitation is very important, transportation for community purposes is crucial for people with (intellectual and developmental disabilities) to have equal access to opportunities.”