Deinstitutionalization in two states: The impact of advocacy, policy, and other social forces on services for people with developmental disabilities

This paper presents a comparative case study of diverse approaches to deinstitutionalization of developmental disabilities residential services in two Midwestern states. During the 1970s and 1980s, the convergence of leadership by advocates, legislators, and bureaucrats led to Michigan's rapid transformation from an institutional to a community-based system, which was further facilitated by a political culture open to innovation. In contrast, during the same period in Illinois, fragmented leadership by advocates of community services, and the power held by unions, parents of institutionalized children, and private service providers worked for retention of institutions and against development of community residential services. Illinois' political culture, state governmental structure and bureaucracy also actively impeded innovation and further hindered the development of community homes. Implications for today's advocates are drawn from a comparative historical review.