People with disabilities did not always live in institutions. In the mid 1800's, some of the first services for people with disabilities were in school settings. But in the late 19th century, the medical model view of the time forced institutionalized care. Little changed for almost 100 years and only recently have we come full circle in our view of how best to serve and support our citizens with disabilities.

In the 1990's, supporters of people with disabilities helped to create a movement to relocate people with disabilities and the elderly, out of institutionalized care and into residences in the community. Hawai`i led the way in making these changes. The state officially closed its institutions for people with developmental disabilities in the year 2000.

Deinstitutionalization

"Deinstitutionalization" means to remove from an institution or to enable someone to live away from an institution. Although transferring people from institutions into community settings has created new opportunities for people with disabilities, it has also become clear that a change of address is not enough for someone to become part of a community. Fortunately, communities have adapted quickly and have responded to the needs of their new neighbors.

There are more services in the community for those with disabilities and the elderly. More and more community businesses are reaching out to meet their needs and they are now able to participate more fully in everyday life activities.

Community-based living services support individuals by encouraging them to interact with their community. Services range from offering neighborhood classes to providing personal shopping or driving assistance. More intensive services are also offered. These may include providing a personal attendant or finding a special daytime program.

Executive Order Community-based Alternatives for Individuals with Disabilities
The White House issued an Executive Order on June 19, 2001. It stated that whenever appropriate, communities must place qualified individuals in community settings.

CMS and Related Laws and Regulations
The Centers on Medicare & Medicaid Services (CMS) lists rules on serving persons with disabilities. Medicaid provides states with billions of dollars to help people with disabilities obtain long-term care services.

Medicaid Reform Information Page
The Association of University Centers on Disabilities (AUCD) sponsors this website to help its members and the public learn about new proposals to change (reform) Medicaid.

Disability Community Events Calendar (National)

a running list of events of general disability community events.  If you have an event you would like considered for this page, contact info is on the linked website.

Current Legislative Agendas for the Disability Population
Read information on Federal policies. Federal public policy is critical to ensuring that people with I/DD can live fully inclusive and productive lives in the community. 

Work Matters Report

What can states do to help their citizens with disabilities enter the workforce and advance their careers?

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OLMSTEAD Decision

In 1999, the U.S. Supreme Court concluded that under Title II of the American Disabilities Act (ADA), all states are required to place persons with mental disabilities in community settings rather than in institutions when:

• The state's treatment professionals have determined that community placement is appropriate.
• The affected individual does not oppose transfer from institutional care to a less restrictive setting.
• Placement can be reasonably accommodated, taking into account the resources available to the state and the needs of others with mental disabilities.
• The implications of this decision are far reaching and states have been encouraged to develop plans for implementing this decision. They must also report on how this will impact their unique needs and circumstances.

State Plan 2015-2017 
The State Council on Developmental Disabilities has developed a plan for Hawai`i through 2017. This plan covers all aspects of the lives of people with disabilities. It also focuses on a life free from institutionalized and restrictive settings.

Progress Report - Hawai`i
2015-2017 Plan: Progress Report Sept 2016 

Hawai`i State DDD Administrative Rules
This site lists the State of Hawai`i statutes related to people with developmental disabilities, community-based services, and the establishment of the Developmental Disabilities Council.

Olmstead decision
On this site you will find the complete text of the Olmstead decision.

Assuring Access to Community Living for the Disabled
The Centers for Medicare & Medicaid Services (CMS) address how the Olmstead decision affects Medicaid funding and services.

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