Community-based behavioral health providers are deeply familiar with uncertainty. Funding pressures shift, workforce shortages persist, and community needs continue to deepen, especially for organizations serving people with intellectual and developmental disabilities (I/DD). What distinguishes organizations that simply endure from those that help move the field forward is not fearlessness, but discernment. The ability to stay anchored in mission while thoughtfully engaging with change has become a defining leadership skill in this moment.

At the 2025 Behavioral Health Tech Conference, I/DD leaders shared how they are approaching this work with intention. Their insights offer a vision of a future shaped less by reaction and more by intentional design.

Practicing Productive Awareness

Rich Bobby, CEO of Little City in Chicago, described his leadership posture as being “productively paranoid.” The phrase resonates because it names a familiar tension. Ignoring warning signs does not serve organizations well, but neither does operating in a constant state of alarm.

Productive awareness means scanning the horizon without losing balance. It involves tracking policy signals, reimbursement trends, and workforce realities, then filtering that information through trusted associations and peer networks. Just as important, it requires restraint. Not every headline demands a response.

For frontline teams, this kind of leadership creates steadiness. Staff can sense when leaders are grounded. They are more likely to stay engaged when decisions reflect both realism and care for the people doing the work.

Trust Is Built in Small, Repeated Moments

During periods of change, trust functions as infrastructure. Without it, even the most thoughtful strategies struggle to take hold.

Bobby pointed to a straightforward framework for building trust within organizations and with the communities they serve:

• Speak with respectful honesty, even when the message is difficult
• Show how priorities are set and why
• Hold leadership accountable in visible ways
  
  

These practices do not require new tools or additional funding. They require consistency. In practice, this might look like being transparent with families about staffing challenges or explaining the reasoning behind hard budget decisions. Over time, these moments add up. Trust grows through follow-through, not grand gestures.

Technology as a Tool for Dignity

Conversations about technology in I/DD services often focus on efficiency. Samantha Cutler, regional VP of Community Options, offered a different lens, one centered on independence.

In Community Options homes, technology is used to reduce unnecessary tasks for staff while giving residents greater control over their daily lives. Smart home features allow individuals to manage lighting, temperature, and routines in intuitive ways. The impact extends beyond operational relief for direct support professionals. It creates meaningful opportunities for autonomy and choice.

This perspective matters because workforce challenges are not short-term. Providers who treat technology as a partner in care, rather than a substitute for human connection, are better positioned to sustain quality while honoring dignity.

Questioning the Incentives Beneath the System

Mark Davis, president and CEO of PAR, invited the field to examine the structure of how I/DD services are funded. Fee-for-service models reward volume, not progress toward independence.

When reimbursement is tied to hours delivered rather than outcomes achieved, providers face a quiet tension between financial sustainability and long-term empowerment. Davis called for approaches that align payment with individual goals, rather than service utilization alone.

Moving toward outcome-oriented models will require collaboration with payers, stronger data infrastructure, and continued advocacy. It will also require providers to clearly articulate what success looks like for the people they support.

The Work Ahead Is Shared Work

The challenges facing I/DD providers do not exist apart from the broader behavioral health ecosystem. Many individuals with I/DD also experience mental health conditions, substance use, or complex medical needs. When systems are fragmented, care becomes fragmented as well.

Progress depends on partnership across sectors. It depends on providers sharing lessons and engaging payers and policymakers in open, constructive dialogue.

Resilience, in this context, is collective. Innovation moves faster when trust is present. For leaders in I/DD services, the future is not something to brace against. It is something to help shape, with intention, humility, and a shared commitment to expanding access to high-quality care.