Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs): Community Residential Living

Centers for LivingRight to Placement

The Agency for Persons with Disabilities is required to ensure that all individuals requesting ICF/IID placement are authorized for admission within 90 days (Policy Directive #00-06).  Individuals who meet ICF/IID eligibility criteria have the right to be placed in an ICF/IID while remaining on the state’s Home and Community-Based Services Waiver waitlist.

 

Florida’s ICF/IID Community Residential Program

ICFDD LoopICF/IIDs 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/IIDs feature “active treatment” which means consistent, specialized and generic training, treatment, and health services.  Individuals served in ICF/IIDs tend to be the most severely disabled, including those on respirators and feeding tubes.  ICF/IIDs are designed to provide the highest level of intervention and supports funded by the federal government for people with developmental disabilities.

 

Types of ICF/IIDs in Florida (87 total - 2,071 licensed beds) 

  • Six-Bed (38) - Six-bed homes operate similarly to group homes.  They are located within residential neighborhoods and residents are involved in community activities.

  • Clusters (27) - 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.

  • 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.

  • Other (16) - Other ICF/IIDs 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/IIDs Are Different than Other Long-term Care Programs

  • ICF/IID care is 100% Medicaid funded, there is no ability to serve individuals through other funding sources.

  • All ICF/IID placements are approved by the Agency for Persons with Disabilities (APD).

  • Over the last 20 years, Florida transitioned thousands of residents to waiver services; however, the waiver has a waitlist of over 20,000 individuals. 

  • ICF/IID residents typically have no other place to live, and many have no family, or their family members are unable to care for them.

  • Many ICF/IID 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.

  • ICF/IID 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.

  • The occupancy rate for ICF/IIDs is about 95%.  The number of beds is frozen per a licensure moratorium.

  • The ICF/IID program is highly regulated by the federal government with the Agency for Health Care Administration (AHCA) providing licensure approval and compliance oversight.

 

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