ICF/DD Info Center
Intermediate Care Facilities for Individuals with
Developmentally Disabilities (ICF/DDs): Community Residential Living
Right to Placement
The Agency for Persons with Disabilities is required to ensure that all individuals requesting ICF/DD placement are authorized for admission within 90 days (Policy Directive #00-06). Individuals who meet ICF/DD eligibility criteria have the right to be placed in an ICF/DD while remaining on the state’s Home and Community-Based Services Waiver waitlist.
Florida’s ICF/DD Community Residential Program
ICF/DDs provide health and rehabilitative services to individuals with developmental disabilities in a protected residential setting. Services include ongoing evaluation, service planning, 24-hour supervision, coordination, and integration of health/rehabilitative services to help individuals with severe disabilities function at their greatest ability. ICF/DDs feature “active treatment” which means consistent, specialized and generic training, treatment, and health services. Individuals served in ICF/DDs tend to be the most severely disabled, including those on respirators and feeding tubes. ICF/DDs are designed to provide the highest level of intervention and supports funded by the federal government for people with developmental disabilities.
Types of ICF/DDs in Florida (86 total - 2,068 licensed beds)
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Six-Bed (38) - Six-bed homes operate similarly to group homes. They are located within residential neighborhoods and residents are involved in community activities.
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Clusters (23) - Cluster facilities feature three homes located in close proximity but operate as separate living units. Each home has four semi-private rooms. Clusters specialize in extensive medical care and rehabilitative services provide deep-end care to medically fragile people that will be much more costly in institutional settings.
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64 Bed Campus (6) - The 64-bed model has four separate living units. Each unit has eight semi-private rooms. Residents participate in day activity programs and community activities.
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Other (21) - Other ICF/DDs are variations of the models described above and have more than 12 residents per home. One site has 120 residents housed in multiple buildings/apartments.
ICF/DDs Are Different than Other Long-term Care Programs
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ICF/DD care is 100% Medicaid funded, there is no ability to serve individuals through other funding sources.
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All ICF/DD placements are approved by the Agency for Persons with Disabilities (APD).
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Over the last 20 years, Florida transitioned thousands of residents to waiver services; however, the waiver has a waitlist of 21,000 individuals.
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ICF/DD residents typically have no other place to live, and many have no family, or their family members are unable to care for them.
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Many ICF/DD residents are non-ambulatory and/or have seizure disorders, behavior problems, mental illnesses, visual or hearing impairments, or a combination of these conditions. Almost ¼ (23%) require 24-hour nursing services and a medical care plan in addition to their services plans.
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ICF/DD payment is based on a cost reimbursement model, meaning the state only pays recognized costs. Individuals contribute toward the cost of their care when personal assets are available.
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The occupancy rate for ICF/DDs is about 95%. The number of beds is frozen per a licensure moratorium.
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The ICF/DD program is highly regulated by the federal government with the Agency for Health Care Administration (AHCA) providing licensure approval and compliance oversight.