A continuing trend in services to persons with intellectual disabilities and developmental disabilities (ID/DD) through the past 15 years has been the downsizing, and in some cases closure, of large state institutions. Between 1987 and 2001, 9 states closed all (22) of their large state residential facilities for persons with ID/DD, thereby reducing the total national population of such facilities by 2,414 residents. During the same period, 13 states that had never closed any large state residential facilities for persons with ID/DD downsized their 39 facilities by 5,440 residents. Reduction in the number of residents with ID/DD in large state facilities has been dependent not only on the 163 facility closures between 1960 and 2001 but also on downsizing of those remaining open.
Closures of large state residential facilities for persons with ID/DD peaked in the dozen years from 1988 through 1999, averaging 9.7 closures annually. The 116 closures during that period were more than 70% of all 163 closures between 1960 and 2001. More recently, such closures have averaged less than 3 per year. Downsizing of existing facilities appears the likely means of near term reduction in resident populations.
Table 1 displays reductions in total populations, by state, of large state residential facilities for persons with ID/DD from 1987 through 2001. During this 14-year period, the resident population of large state facilities declined at an average annual rate of 3.69%, whereas large nonstate facilities population was reduced by only 1.8%. More recently, in the period 1997 through 2001, annual rate of reduction in nonstate large facility populations (-4.2%) has approached that of large state facility population declines (-4.4%). In 1987, residents of large state facilities made up 74.6% of all residents of large facilities; in 2001, they represented only 59.5% of that population.
As shown in Figure 1, all states have had a decline in the population of their state residential facilities for persons with ID/DD since 1987. Of the 42 states that have not achieved 100% reduction through closure of all their large state facilities, 23 reduced these populations by more than 50% since 1987.
Over time, the proportion of residents from large residential state facilities and nonstate facilities moving to smaller residential settings has become generally more balanced, with a relative increase in the nonstate share of such large facility depopulation. Figure 1 presents the annual average number of persons leaving large state and nonstate residential facilities for the period 1987 through 2001.
In summary, two trends noted here may be of interest: (a) focus on downsizing of large institutional populations may be of more significance than tracking of facility closures and (b) greater attention to movement of residents out of large nonstate facilities in tracking deinstitutionalization.