 Surprisingly, except for very small sizes, the larger, medicalized facilities bill the highest costs per individual (e.g., intermediate care facilities over 16 in the state of New York).In relationship to the individual or family, residential services are expensive for low or middle-class families, and federal, state and local government often contribute to these costs.Medicaid-funded options may require use of assets, and Social Security Disability or Social Security are also part of payment plans.