ADA Rights: Access to Intermediate Care Facilities (ICF/IID) for Individuals with Intellectual Disabilities – Is This a Right?
✅ 1. Right to Appropriate Placement
Individuals have the right to receive services in a setting that meets their medical, behavioral, and developmental needs—even if that setting is an ICF/IID.
✅ 2. Right to Informed Choice
States must respect the individual’s or guardian’s choice of care setting, especially when supported by clinical recommendations.
✅ 3. Right to Avoid Forced Relocation
The ADA prohibits unjustified institutionalization—but it also protects against forced deinstitutionalization when it compromises care.
✅ 4. Right to Equal Access
States cannot create policies that make ICF/IID care effectively unavailable—such as requiring community placement “exhaustion” before considering ICF admission.
🚫 Common Violations of ADA Rights
• Denying ICF/IID admission unless all HCBS waiver options are tried
• Closing facilities without ensuring alternative access to equivalent care
• Pressuring families to accept community placements that are unsafe or inadequate
• Failing to provide individualized assessments for care level decisions
🛡️ Legal Backing for ICF/IID Access
• Olmstead v. L.C. (1999): Integration must be appropriate to the individual
• 28 CFR § 35.130(d): Services must be provided in the most integrated setting appropriate
• CMS ICF/IID Regulations (42 CFR Part 483): Define standards for active treatment and rights of residents
📢 The Americans with Disabilities Act
Legal Resources: ADA Title II Guidance – ADA.gov
Olmstead Decision Text: Justia Supreme Court Summary
ICF/IID Regulations: CMS ICF/IID Provider Guidance