Voluntary transformation from an institutionally based to a community-based service system

Area of Science:

• Healthcare Management
• Social Services
• Disability Services

Background:

• Large institutions for individuals with intellectual and developmental disabilities (IDD) face increasing pressure to deinstitutionalize.
• Transitioning from institutional to community-based care requires careful planning and execution.

Purpose of the Study:

• To describe the transformation process of a large, church-affiliated residential service provider from an institutional to a community-based system.
• To discuss the closure of a 200-person Intermediate Care Facility for the Mentally Retarded (ICF/MR).

Main Methods:

• Descriptive analysis of the transformation process.
• Examination of factors influencing institutional closure.
• Review of guidelines for service system transformation.
• Presentation of data on consumer and staff satisfaction and program quality.

Main Results:

• The closure of a 200-person ICF/MR facility was successfully managed.
• Factors influencing the decision to close the institution were identified.
• Guidelines for effecting the transformation were established.
• Consumer and staff satisfaction remained high.
• Judgments of program quality remained high during the transformation period.

Conclusions:

• The transition from institutional to community-based services can be achieved while maintaining high levels of satisfaction and quality.
• Deinstitutionalization is feasible for large residential providers with strategic planning.
• Successful transformation requires addressing institutional closure factors and implementing clear guidelines.