About a week into his role at Makom, CEO David Ervin received a phone call from the mother of a son with autism. The caller was struggling to find consistent, competent health care in the DMV area for her child, she told an astonished Ervin.
This mother is not alone. Access to health care for adults with intellectual and/or developmental disabilities — including autism, Down syndrome and cerebral palsy — is “terrible,” according to Ervin, who’s worked in health care for more than two decades.
He cited a lack of providers trained in IDD (intellectual and developmental disabilities) care, fragmented services scattered across various locations and a system not designed with the needs of disabled people in mind, leading to delayed care, unmet health needs and preventable challenges that interfere with quality of life.
“In a region of profound wealth and healthcare systems seemingly on every street corner … the work of health equity remains a high priority for the [disabled] community,” Ervin wrote in a statement to Washington Jewish Week.
So he set out to create a one-stop shop for disabled adults in the DMV. Makom, formerly the Jewish Foundation for Group Homes, launched a clinical services department and fully-equipped clinic in early October to address barriers to accessing quality health care.
“We feel compelled to address, in some way, these massive inequities,” Ervin said.
The new specialized care clinic in Rockville provides occupational therapy, physical therapy, speech-language pathology, behavioral health, nutrition support and nursing services, all under one roof, according to Makom. It said these comprehensive services will “fold into the larger health care delivery system,” including primary and some specialty care and dentistry.
“The clinic represents a major step forward in creating an integrated, person-centered healthcare delivery model tailored to the unique needs of people with IDD,” a recent Makom blog post read.
Through the new clinic, Makom will serve some of the more than 98,000 disabled people living in Montgomery County and about 92,000 in Fairfax County.
Employing a hybrid model, therapists currently visit Makom’s group homes in Montgomery County and Fairfax County to treat residents in their own spaces. Dr. Aiman Tohid, Makom’s director of clinical services, said this model will apply to those outside of Makom’s living communities: “It’s a mobile clinic. We’ll go and help [people] if they cannot commute … because we don’t want to deny someone care if they cannot come to the clinic.”
Tohid said each of the clinical staff members are specially trained through conferences on IDD and through training by a nonprofit, IntellectAbility. Dr. Craig Escudé, the president of IntellectAbility, instructed Makom’s therapists and nurses, who also completed online courses: “They are specialized to care for this population,” Tohid said of Makom’s clinical staff.
Tohid said the clinic is one of a kind, or at least one of “very few” specialized clinics for people with IDD across the nation. “I can count [them] on my fingers,” she said.
“This is a very common scenario in the U.S. — lots of health care options, but very, very little that is built with or for people with IDD,” Ervin said, adding that he hopes Makom’s clinical structure can serve as a replicable model in other locations.
The clinic is the product of several years of planning. The Makom team first added clinical services to its repertoire as a response to the COVID-19 pandemic. In September 2024, Makom moved into the Jewish Federation of Greater Washington building in Rockville, securing a space that would allow for an ambulatory care clinic. Prior to that move, clinicians worked out of the trunks of their cars, entirely mobile, Ervin said.
The clinical services will remain on the second floor of the Federation building, but Tohid said depending on the client load, Makom may seek to expand in the long term.
“When we cut the ribbon for the clinic and then we moved to the Federation building, tears were about to come out because finally, we were able to provide these services for outside people, not just Makom [clients],” she said.
For Tohid, this work is personal.
“A few loved ones and people close to me have autism,” she explained. “And I just wanted to help this population because I see, firsthand, them suffering, not receiving this care in the outside world.”
Filling this gap in health care is also linked to Makom’s Jewish roots.
“For us, it’s Talmudic: ‘If not us, who? If not now, when?’” Ervin said, citing the disabled community’s disproportionately high morbidity and mortality rates during the pandemic. “They got much sicker and died far more frequently from [COVID-19] infection than virtually any other cohort, including seniors.
“Sitting back and doing nothing is not in Makom’s DNA,” he added. “Ours is not an obligation to finish the task, but neither may we desist from undertaking it,” he said, quoting Pirkei Avot.
Ervin also said Makom’s values reflect tikkun olam, the commitment to repairing the world.
“From the Torah, ‘do not place a barrier in front of the blind person,’ is, for us, a call to action,” he said. “Taken literally, we are precluded from allowing barriers to full participation in community life commonly experienced by people with IDD. For us, it also means eliminating barriers. Barriers to health equity are multitudinous and longstanding. Doing nothing is not an option.”
