The Saga of One Home’s Experience with the ICF/MR (Small) Program
This is a re-print with some updating of an article originally written in the summer of 1985 by John R. Shea, Ph.D., a few days after a licensing and certification visit from California Health Services Licensing. At the time, John was executive director of Bayberry, Inc. He sent the earlier paper to a few friends and associates. Many who read it enjoyed its comic-tragic anecdotes and the more serious points that he tried to make. He learned later that many resource developers in various regional centers passed out copies to people contemplating going into the ICF/DD-H business. He was told that they wanted potential service providers “to know what they would be getting into.” It was John’s hope that readers would: form a much clearer view of some of the things that go on under the rubric of quality assurance; and, assist efforts to reform the ICF/MR (Small) program (if feasible) or to replace it with a much more progressive Medicaid Home and Community-Based Waiver program.
It’s been almost 40 years since the original article was written. We think you’ll agree that things have changed significantly since that time both in quality assurance efforts and in Home and Community Based Services. Our question to readers: What should the next iteration of services and supports for people with developmental disabilities and quality assurance practices look like?