Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), formerly known as Intermediate Care Facilities for Mental Retardation (ICF/MR), is an American Medicaid-funded institutional long-term support and service (LTSS) for people with intellectual disabilities or related conditions. Section 1905(d) of the Social Security Act[1] enacted benefits and made funding available for "institutions" (which consisted of 4 or more beds) for individuals with intellectual or related conditions. According to federal law 42 CFR § 440.150 the purpose of ICD/IIDs is to "furnish health or rehabilitative services to persons with Intellectual Disability or persons with related conditions."[2]
The number of individuals living in ICD/IID facilities peaked in 1993 at 147,729 people. In 1981, Congress enacted legislation allowing Medicaid funding for LTSS through programs such as the Home-and Community-Based Services (HCBS) waiver program that provides supports for people to live in their communities and that promotes increased opportunities for choice and control (42 U.S.C. Ch. 7, § 1396n §§.) States have refocused their efforts on providing community-based LTSS leading to a reduction in the use of ICD/IID LTSS. Add As of FY 2107, 74,614 individuals resided in these facilities.
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