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What is Intellectual Disability Care?
Intellectual disability care refers to a range of health care and support services for people with intellectual disabilities*.
Intermediate care facilities for individuals with intellectual disability (ICF/ID) are one option for this type of care. These Medicaid-certified residences provide health care and training to help people live with as much independence as possible. Some ICFs are small residential homes, with as few as six beds, while others are large facilities with more than 150 residents.
*An intellectual disability is defined by two broad markers: limitations in intellectual functioning (e.g. low IQ), and in limitations in adaptive functioning (e.g. independent living).
What services are provided at intermediate care facilities for people with intellectual disabilities?
All intermediate care facilities for people with intellectual disabilities provide what are known as active treatment (AT) services. Medicaid defines this as an “aggressive, consistent implementation of a program of specialized and generic training, treatment and health services.”
Each resident is treated according to an Individual Program Plan (IPP), which is developed and monitored by a qualified intellectual disability professional.
The services provided at intermediate care facilities vary, but typically include:
- Shared or private rooms in a home-like environment
- Help and training in daily activities (e.g. grooming, shopping, personal finances)
- Direct care staff available 24/7
- Licensed nurse on staff
- Meals and dietary/nutrition planning
- Medication management
- Day programs
- Vocational training and employment
- Sports and recreational activities
- Engagement with the community
Other services that are provided at some intermediate care facilities include:
- Occupational, physical and speech therapy
- On-site dental care and doctor’s visits
- On-site amenities and services (e.g. hairdresser, gym, general store)
What services are not provided at intermediate care facilities for people with intellectual disabilities?
Intermediate care facilities do not provide care for individuals who are able to live well with little supervision and support. They are solely designed for people who require continuous care, training and assistance in order to perform the functions of daily living.
Although some intermediate care facilities may be affiliated with a nursing home, they are not skilled nursing facilities. They are not designed to provide ongoing medical care for individuals with complex, urgent or severe physical healthcare needs.
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/ID) vs Skilled Nursing Facilities (Nursing Homes)
| ICF/ID Care | Nursing Homes | |
|---|---|---|
| Living Space | Private or shared rooms in a home-like setting, either a residential home or larger facility. | Semi-private or private rooms with shared bathrooms in an outpatient facility. |
| ADLs Assistance (help with dressing, bathing, eating, etc.) | Yes | Yes |
| Medication Management | Yes | Yes |
| Meals and Dietary/Nutrition Support | Yes | Yes |
| Recreational Activities and Community Engagement | Yes | Limited |
| Medical Care | - Limited / varies - Not equipped to manage complex and acute physical health care needs |
- Registered nurse on site 24/7 -Equipped to manage complex and acute physical health care needs |
| Costs | $150 to $400 per day, on average | $3,750/month on average* |
| Payment options | - Medicaid (if eligible) - Parent’s Medicare/Social Security (if eligible) - Personal funds (if required) |
- Medicare (if eligible) - Medicaid (if eligible) - Personal funds (if required) - Long-term care insurance (if you have it) |
How much do intermediate care facilities cost and who pays for it?
Costs for intellectual disability care at intermediate care facilities varies depending on the provider and the level of care required, but generally ranges from $150 to $400 per day.
People use the following methods, or most often a combination of the following methods, to pay for intermediate care facility care:
Medicaid covers most of the costs associated with intellectual disability care at an intermediate care facility. Coverage varies from state to state.
In some cases, children with intellectual disabilities are able to receive coverage through their parents’ Medicare and Social Security benefits.
Families are required to pay out of pocket for any extra services that are not covered under Medicaid or other government programs.
How to find the best intellectual disability care for your loved ones.
Visit the facility on multiple occasions. Arrange for a tour of the facility and ask to spend time with residents during mealtimes and day excursions. Observe the way staff interact with residents to ensure they’re treated with dignity and respect. If possible, visit the facility again without providing prior notice to make sure standards are maintained even when they aren’t expecting you.
Find an intermediate care facility near you. This will allow you to visit with your loved one regularly. Not only is this beneficial to their quality of life, but it also allows you to monitor the care they’re receiving and make sure it meets your standards.
Assess the range of services and programs offered. Ask about the frequency of day excursions and recreational activities outside the residence. If your loved one would benefit from vocational training or employment, make sure the facility provides it.
Review staffing policies. Ask the facility manager about background checks, training procedures, required qualifications and staff-to-resident ratios.
Make sure the facility is certified by the Centers for Medicare & Medicaid Services (CMS). Not only is this necessary to ensure you can pay for services using Medicaid benefits, but it also ensures the facility meets federal quality requirements.
View state inspection reports. Intermediate care facilities are also licensed and regulated by the state. Enquire with your state’s Department of Health about viewing inspection reports, which are often available to the public online.
