Over the past 30 years, a number of social, political, and economic forces have influenced public policy decisions regarding residential services for persons with mental retardation and other developmental disabilities (MR/DD). One of the most striking outcomes of these forces has been a steady decrease of persons with MR/DD residing in state institutions. In this paper we show the changes over the past 30 years in state institutional populations, interstate variability, movement of individuals into and out of state institutions, costs of state institutional care, and state institution closures as a result of social policy.

This paper is based on data gathered and analyzed as part of the National Residential Information Systems Project, supported by Grant No. 90DD0342/01 from the Administration on Developmental Disabilities with supplemental support from the Health Care Financing Administration, both of the U.S. Department of Health and Human Services.

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