Compliance and quality in residential life. From standards to compliance, to good services, to quality lives: is this how it works?

Licensing and certification of ICFs/MR can adversely affect individuals, distort the allocation of (and waste) scarce resources, and encourage community residences to become small institutions. At a home in Northern California, used as a case study, recent interest in active treatment has emphasized good paper rather than good service or quality lives. Several recommendations were offered to encourage responsive services in line with progressive values and the wants and needs of individuals with developmental disabilities.