The use of Title XIX funds for community residences has generated considerable controversy. Several states have developed small ICF/MRs. Michigan—with its Macomb-Oakland Regional Center—is a national leader in developing model residences with ICF/MR funds. However, few states have limited ICF/MR funds to small living arrangements with six or less residents. Statistics show that some states are using ICF/MR funds to develop mini-institutions. This article discusses the feasibility of developing small living alternatives with ICF/MR funds. It concludes that the success or failure of community ICF/MRs in meeting the needs of disabled persons will depend on the degree to which states are committed to serving people in the least restrictive and most normalized settings possible.
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