Because people with developmental disabilities met the income guidelines to qualify for skilled nursing facilities, there was a rapid rise in the number of people admitted to them.

Intermediate Care Facilities (ICFs) were "intermediate" to hospitals and skilled nursing facilities.

In 1971, under P.L. 92-223, states were allowed to cover services in ICFs for elderly people and in ICFs/MR for people with developmental disabilities.  The ICFs/MR program was established through Medicaid.

It allowed states to receive federal matching funds for institutional services that had been funded by state or local government. To qualify for cost sharing, ICFs/MR had to comply with federal standards.

Today, those standards include eight areas: management, client protection, facility staffing, active treatment services, client behavior and facility practices, health care services, physical environment and dietetic services. Institutions were also called developmental centers.

Dining Room
Photo courtesy William Bronston, M.D.