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An Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) is a Medicaid-funded residential facility that provides ongoing health and habilitative services to individuals with intellectual disabilities or related conditions who need a level of care comparable to a hospital or nursing home. ICFs/IID range from large state-operated institutions to small community-based group homes with 6 to 8 residents. They provide 24-hour supervision, active treatment programs, health services, and daily living support. While the Olmstead decision and HCBS waiver expansion have shifted the national trend toward community-based services, ICFs/IID remain an option for individuals with the most intensive support needs. Federal regulations require ICFs/IID to provide active treatment — not just custodial care.
Understanding ICF/IID is important because HCBS waivers were created as an alternative to institutional placement. Your child's level of care assessment for waiver eligibility is measured against the ICF/IID standard — documenting that your child needs this level of care is what qualifies them.