To qualify for care in a licensed intermediate care facility for the developmentally disabled, or ICF/DD, a person must have one of the health conditions recognized by state law:
- Intellectual disability: Generally, an IQ of 70 or less and inability to live without help or supervision
- Cerebral palsy: Caused by damage to parts of the brain that control movement or posture, resulting in paralysis, spasticity, poor coordination and balance, or other significant motor dysfunction
- Epilepsy: A brain condition causing seizures
- Autism: A disorder of brain development causing impairments to social interactions and communication, with common symptoms of repetitive behavior and poor motor skills
- Other conditions: Such as degenerative brain disease or damage that are closely related or that require treatment similar to intellectual disability
The condition must also be a “substantial disability” — meaning that the person lacks at least three of the following abilities to:
- Care for himself or herself
- Understand and express language
- Move around
- Be self-directed
- Live independently
- Be economically self-sufficient
California licenses facilities providing 24-hour care and housing for those who qualify as developmentally disabled. There are five large Developmental Centers in the state that house residents, but most accommodate 4 to 15 people in homes converted for this purpose. Residents who are able to also attend day programs offsite, which provide some of the support services and camaraderie needed to thrive.
Although counties define ICF/DDs differently, and availability is often limited, an individual’s medical needs largely determine what facilities may be considered. The Regional Center team, responsible for providing services to Californians with developmental disabilities, usually initiate a medical assessment to evaluate the level of care needed. Medical consultants from the facility also assess potential residents before admission to ensure that all care needs can be met there.
Types of ICF/DDs
The state licenses several types of facilities to care for people with developmental disabilities.
ICF/DD General. Fewer than 20 facilities in California have 16 or more residents who primarily require developmental services, such as training in socialization, recreation, and meal planning, and who sometimes need skilled nursing.
The best fit for residents who have some behavioral challenges or physical limitations in vision, hearing, or movement but who can function independently if properly encouraged. They may prefer the stimulation in a larger facility and require little help with personal care, but take medications that must be monitored by medical professionals.
ICF/DD Habilitative. Approximately 760 facilities accommodate 15 or fewer residents who need personal care and occasional nursing services but not continuous skilled care, as certified by a physician and surgeon. Most care focuses on enhancing emotional well-being and intellectual and functional skills.
The best fit for those who prefer a small, intimate setting and who need skilled care that can be predictably scheduled, or occasional medical monitoring in addition to help with personal care.
ICF/DD Nursing. About 400 facilities house 15 or fewer residents whose conditions require constant monitoring but do not need continuous skilled care, as certified by a physician and surgeon. Residents may attend a day care program, but these facilities put less emphasis on improving social skills.
The best fit for those who need full-time personal care and supervision and up to eight hours of nursing care daily. Most residents use wheelchairs, and many are considered “medically fragile.”