Current trends in mental retardation services in the Commonwealth of Massachusetts were investigated using the New England region, the state of Michigan, and the United States as comparative frames of reference. Our goal was to analyze recent structural, financial, and programmatic trends in Massachusetts and the New England region to close state institutions and implement community and family support services. Massachusetts in particular illustrates the policy choices and challenges facing many American states engaged in restructuring their service delivery systems. New England is an extremely dynamic and innovative region that is providing significant national leadership in the provision of alternatives to institutional care.

Data Collection for this study was supported in part by the Administration on Development Disabilities, United States Department of Health and Human Services. Manuscript preparation was supported in part by the Commonwealth of Massachusetts, Department of Mental Retardation. The authors especially acknowledge the assistance of Philip Campbell, Commissioner; Mary Cerreto, Assistant Commissioner; and Ron Sanfield, Director of Evaluation, in the Massachusetts Department of Mental Retardation and James Westrich, research associate at The University of Illinois at Chicago.

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