Individuals living with certain kinds of intellectual, developmental, or other disabilities may experience multiple impairments with their vision, hearing, communication, mobility, or cognition. As such, their needs are typically complex, and they require a range of medical and social support services. In the past, individuals with certain kinds of disabilities were often institutionalized. However, recent movement of care away from large state inpatient institutions to community-based settings is an important trend in care for individuals living with certain disabilities. In the United States, the average daily census of individuals living with developmental or intellectual disabilities residing in large state institutions (i.e., those with 16 or more residents and staffed by state employees) decreased by 69% from