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How To Use This Toolkit

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The Deinstitutionalization Toolkit was developed by the National Council on Disability (NCD). Its companion piece is a paper, “Deinstitutionalization: Unfinished Business,” which can be found at:

NCD’s Deinstitutionalization Toolkit is designed to provide all those interested in institutional closures and expanded community living opportunities for people with intellectual disabilities and developmental disabilities (ID/DD) with information, strategies, state data, and case studies that can facilitate closure and build community capacity to serve more people with ID/DD in the community.

Specifically, this toolkit is designed to:

  • Help develop and support a closure strategy
  • Provide facts to combat misinformation
  • Share lessons learned from states that have recently closed institutions
  • Help effectively support community capacity building to ensure that needed supports are available to everyone who wants to live in the community
  • Identify strategies that communities have used to ensure quality of care

Although this toolkit is focused on closing large state institutions, people with ID/DD live in a variety of institutional settings, including large non-state intermediate care facilities for the developmentally disabled (ICFs/DD), nursing homes, and smaller institution-like settings. Much of the information presented here is relevant to these institutions as well.

NCD’s Deinstitutionalization Toolkit is divided into eight topic areas, each of which represents a valuable consideration in developing a successful Deinstitutionalization Plan:

  1. Strategy
  2. Legal
  3. Institutions
  4. Community
  5. Finance
  6. Costs
  7. Closures
  8. Case Studies

Within each topic area are three levels of information, which can be viewed or printed as reference material:

  1. In Brief – A one- to three-page quick synopsis of the topic area
  2. In Detail – Greater specifics and supporting information behind the In Brief synopsis of each topic area, gleaned from literature reviews and interviews
  3. In Depth – Resources and external documents intended to provide relevant additional information