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The 1990s also saw a growing number of class action lawsuits involving self advocacy (especially People First) groups as plaintiffs, co-plaintiffs, and plaintiff-intervenors.

These suits focused on the same issues as those dating back to the 1970s – abuse and neglect, inhumane living conditions and civil rights violations. The continued outcomes of lawsuits since the 1970s made it clear that even after decades of "improving the institutions" they continued to violate the basic rights of people.

In the 1990s, a new phenomenon occurred – a growing list of states operated no large state institutions for people with developmental disabilities.
  • 1991: New Hampshire becomes the first state
    to close all of its large institutions.
  • 1993: Vermont
  • 1994: Rhode Island and D.C.
  • 1997: New Mexico and Alaska
  • 1998: Maine and West Virginia
  • 1999: Hawaii
Book: Closing the Doors of Institutions