The implementation of policies associated with deinstitutionalisation has dominated the development of services for people with intellectual disabilities in most, although not all, of the world's richer countries (Braddock, Emerson, Felce & Stancliffe, 2001; Hatton, Emerson & Kiernan, 1995). In England, traditional large-scale institutional care…

Statistics are analyzed from 1990 to 1996 concerning the fading of Medicaid's bias toward institutionalization of individuals with mental retardation rather than use of Home and Community-Based (HCB) waivers for alternative community services and support. A major shift toward increased use of HCB waivers is noted and documented state by state. (PB)