The successful community placement of 15 medically fragile individuals with profound mental retardation and complex epilepsy was examined. We found that simplification of anticonvulsants, early intervention for seizures, and improved staff education resulted in (a) fewer seizures, (b) decreases in emergency room visits for status seizures and drug-related side effects, and (c) increased levels of functioning as measured by activities of daily living. This program allowed for a medically fragile epileptic population to be transferred from the institution to the community.