A change occurred in the University of Rochester faculty by 1974. Dr. Haggerty moved first to Harvard, and then assumed the presidency of the W. T. Grant Foundation. Dr. Friedman moved to the University of Maryland's College of Medicine. Drs. Scheiner and McNabb remained in Rochester but left private practice to expand the Monroe Developmental Service into the Monroe Developmental Center (MDC). Their vision was to use the newly constructed building on Westfall Road as a resource for dayhabilitation services rather than fill the over-500 beds the building was designed to accommodate. The New York State Office of Mental Retardation and Developmental Disabilities or OMRDD (known now as The Office for People with Developmental Disabilities, or OPWDD) disagreed and exerted great pressure on MDC leadership and eventually prevailed. MDC's first resident was an adult who moved from Newark State School and was admitted in 1975. Dr. Scheiner worked to obtain federal funding to support a community- university collaborative center addressing service, education, and research on IDD; but this vision did not gain momentum locally and funding was not sought to establish a comprehensive center for IDD at the University of Rochester at that time. Dr. Scheiner's commitment to following the principles of Normalization (Wolfensberger et al., 1972) fit very well with the Community Pediatrics model and formed the basis for what was to come next.

In 1976, Dr. Scheiner moved to the University of Massachusetts Medical School in Worcester at the invitation of J. Barry Hanshaw, MD, a Rochester colleague who had become chairperson of Pediatrics there. Dr. McNabb stayed on at MDC and provided leadership as the new residential facility on Westfall Road opened its doors and accepted many people who had been placed in communal care facilities in other parts of New York State. Dr. McNabb left MDC in 1978 but remained in Rochester to head the Pediatric Service at the Genesee Hospital and establish the Genesee Developmental Unit. This clinical entity provided diagnostic evaluations to children and adolescents with suspected IDD. Dr. Kenney also moved to MDC but remained active at the DCDD as well. Drs. Chamberlin, Nader, Charney, and Heriot also left Rochester; Dr. Roghmann remained.