A Guide to Residential Services for Persons with Mental Retardation or Developmental Disabilities (MR/DD)
Read about Carol Stewart, the 2007 MR/DD Hero of the Year
Society
changes. Today, for example, there is greater understanding, acceptance
and a more open environment for people with mental retardation or developmental
disabilities (MR/DD); they have the opportunity to learn and develop throughout
their lifetimes. There have been many agents of this change: the advent
of community Intermediate Care Facilities for the Mentally Retarded (ICFs/MR);
progressive laws such as the Developmental Disabilities Act (1970); the
Individuals with Disabilities Education Act (1975); additions to the Social
Security Act (1981); the Americans with Disabilities Act (1990); and,
educational services such as Special Education that emphasizes mainstreaming
in public schools. Another change agent has been locating small facilities
and group home residences in communities.
Over time, long term care has been redefined to include, with the inception by the federal government of ICFs/MR in 1971, services and supports for persons with MR or DD (referred to as “residents” or “clients”). Today, community ICFs/MR and the Home- and Community-Based (HCB) waiver program provide a progressive and technically advanced care and quality of life environment, with access and choice the hallmarks of these services. Support and training programs provide more opportunities for clients to live in settings they choose with greater access to the full benefits of the community-at-large, jobs, socialization, etc.
The result is that clients in all settings have the opportunity to live their lives characterized by health, happiness, dignity and productivity to the maximum extent possible for the individual.
An important aspect in understanding the environment of this special community is that, according to the federal Centers for Medicare & Medicaid Services (CMS), which regulates facilities, the median number of clients served in an ICF/MRDD facility is 6 clients. Even a seemingly larger ICF/MR, in terms of the total number of beds, may not have every client in one building. Rather the ICF/MR may operate several freestanding community homes with only a few beds each or it may be organized as a series of small residences arrayed in a campus-style setting. Larger facilities may not offer the intimacy of smaller ones yet these facilities tend to serve the most difficult clients and offer a wide array of in-house or contract client support services to meet their needs. However, for ICFs/MR, there is one constant--the licensure and inspection regimes remain the same irrespective of how they are organized. This contrasts with group homes under the HCB waiver program that may only have a few clients in a staffed (or unstaffed) residence with minimal government involvement, supervision or oversight.
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