08/12/2026
Individuals with IDD were Entitled to Services According to Federal Law, but the State Did Not Provide Them
Families were entitled to residential habilitation under federal law because intermediate care facilities for individuals with intellectual disability (ICF/IID) services are a federally defined Medicaid benefit under 42 U.S.C. § 1396d(d). And because Massachusetts includes ICF/IID in its State Medicaid Plan, individuals who meet the level‑of‑care criteria are entitled either to the ICF/IID service itself or to its home‑ and community‑based (HCBS) equivalent, provided with “reasonable promptness” under 42 U.S.C. § 1396a(a)(8).
Once a person meets the ICF/IID level of care, the state must provide either institutional habilitation or an HCBS waiver slot that substitutes for it. The HCBS waiver does not replace the ICF/IID entitlement; it exists because of it, and individuals who qualify for ICF/IID care have a federal right to receive either the institutional service or its community‑based equivalent.
The claim that “there are no entitlements” is simply false-- but families needed to initiate a lawsuit to exercise their rights.
https://savingwrenthamandhogan.org/boulet-v-cellucci-when-community-living-meant-waiting-without-services/
