A/HRC/28/37
replaced with families, extended families or foster-care systems. Specific steps should be
taken to avoid further institutionalization in the transition from care to aftercare.22
26.
Deinstitutionalization should include public and private institutions to avoid transfer
from one to the other, and target all persons with disabilities, without exception. Real
options need to be made available to persons moving out of an institution: community
living arrangements should not be established and monitored by the institution itself. The
Government of Finland is currently implementing programmes providing individual
housing and community services for persons with intellectual disabilities, with a deadline of
2020 for full deinstitutionalization. Support is particularly important in the transition from
institutional to community living and should include individualized assessment,
information, counselling, housing and income assistance. Such support should be based on
effective coordination among health-care and social-service providers, and the housing
sector. The programme “I, just like you” implemented in Croatia has provided persons with
intellectual and psychosocial disabilities in institutions with individual planning and skills
development as a preparation for life in the community. Continued support is provided even
after the project’s beneficiaries move to community-based arrangements. In the Republic of
Korea, some local governments provide resettlement benefits to help persons with
disabilities discharged from institutions to live independently in local communities.
27.
The cost of deinstitutionalization should be addressed by a reallocation of resources,
which may require targeted investments, particularly in the initial phase, effective
partnerships and prioritization. Adequate resources need to be available to build the new
support infrastructure — both accessible mainstream community services and specific
support services — prior to altering the balance of service provision. Funding opportunities
should be directed to sustaining systemic reforms. For instance, in the new European Union
structural funds regulations for 2014–2020, the availability of funding is closely linked to
deinstitutionalization through a number of ex ante conditionalities. Community-based
services should exist alongside institutions during the transition phase, necessitating double
funding. Studies have demonstrated that after the initial phase, community-based services
are not necessarily more expensive than institutional services; on the contrary, they are
more cost-effective and provide higher quality services.23 The comparison of the costs of
institutional care and those of community-based services should also take into account the
long-term impact of deinstitutionalization, including the fiscal implications of a higher
number of persons with disabilities being part of the workforce and household income.24
B.
Support
1.
Community support services
28.
Support services are essential for enabling persons with disabilities to live
independently and be included in the community; they are also an indispensable element of
deinstitutionalization. Article 19 (b) of the Convention on the Rights of Persons with
Disabilities requires States parties to ensure that persons with disabilities have access to a
22
23
24
See Committee on the Rights of the Child, general comment No. 9, paras. 47–49, and the Guidelines
for the Alternative Care of Children, in particular paras. 3, 14, 22, 34 and 132.
See WHO and World Bank, World Report, p. 149, and Council of Europe Commissioner for Human
Rights, “The right of people with disabilities to live independently”, p. 32.
On the impact of employment of persons with disabilities on the gross domestic product, see, for
instance, Sebastian Buckup, “The price of exclusion: the economic consequences of excluding people
with disabilities from the world of work”, Employment Working Paper No. 43 (International Labour
Office, 2009).
9
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