ICFs are facilities where people with developmental disabilities live and receive the health care services, life skills training, and vocational training they need.^[1]For definitions of different kinds of ICFs, see Health & Safety Code section1250(e)(g)&(h). Because they provide some nursing and medical care on site, ICFs are licensed by the Department of Health Care Services.

There are four different ICFs for people with Developmental Disabilities:

1. ICF/DD^[2]Health & Safety Code Section 1250(g); Title 22 Cal. Code Regs. section 51343.
2. ICF/DD-Habilitation^[3]Health & Safety Code Section 1250(e); Title 22 Cal. Code Regs. section 51343.1.
3. ICF/DD-Nursing^[4]Health & Safety Code Section 1250(h); Title 22 Cal. Code Regs. section 51343.2.
4. ICF/DD-Continuous Nursing Care^[5]Welfare & Institutions Code section 14495.10.

Most ICFs are small, with six or fewer residents. But, ICFs can be larger, sometimes with hundreds of residents.

We only discuss ICF/DD-Habilitation, ICF/DD-Nursing, and ICF/DD-Continuous Nursing Care homes. Larger ICF/DD homes are not considered community living options because they are often large, congregate settings.

ICF/DD-Habilitation homes are mostly small homes for six people, but they can have up to 15 people. They provide 24-hour personal care, habilitation, developmental, and supportive health services. These homes are for people who need some nursing services, but do not need constant nursing care. Residents have also been certified by a physician and surgeon as not needing continuous skilled nursing care.^[6]Health & Safety Code Section 1250(e); Title 17 Cal. Code Regs. section 54302(a)(42); Title 22 Cal. Code Regs. section 51343.1.

ICF/DD-Nursing homes are mostly small homes for six people, but they can have up to 15 people. They provide 24-hour personal care, habilitation, developmental, and supportive health services. These homes are for people who need more nursing services than people in an ICF/DD-Habilitation. Residents of these homes need 24-hour nursing supervision, but their conditions are stable, and they do not require 24-hour nursing care. These homes serve people who require medical attention, or with a serious developmental delay that may lead to a developmental disability if not treated.^[7]Health & Safety Code Section 1250(h); Title 17 Cal. Code Regs. section 54302(a)(43); Title 22 Cal. Code Regs. section 51343.2.

ICF/DD-Continuous Nursing homes are rare. Only 10 homes are allowed by law for California. They serve up to six residents. They provide skilled nursing care 24 hours per day, 7 days per week from (or supervised by) a registered nurse. These homes are funded 100% with federal Medicaid funds.^[8]Welf. & Inst. Code § 14495.10. For more information on DD-CNCs, see California Department of Health Care Services website, http://www.dhcs.ca.gov/services/medi-cal/Pages/ICFDDCN_MC_Waiver.aspx.