People with severe disabilities or complex needs are one of the most excluded groups of citizens in the European Union. Due to the lack of adequate inclusive service systems, they often spend their lives in institutions. For them, access to services is important during their whole life, but the need of special care should not lead to their social isolation.

The UN Convention on the Rights of Persons with Disabilities in May 2008 obliges us to develop community living that will replace institutional care. The implementation of home care services instead of institutional care is a long-lasting debate, especially when it comes to people with severe or complex disabilities. In countries like EEUU or Australia the provision of support within the community is well advanced, while in many European countries institutional care has traditionally been the mainstream solution.

According to an article submitted to the National Disability Authority in Dublin on the cost-effectiveness of community living for people with intellectual disabilities, 'there is no evidence that community-based models of care are inherently more costly than institutions, once the comparison is made on the basis of comparable needs of residents and comparable quality of care. Community-based systems of independent and supported living, when properly set up and managed, should deliver better outcomes than institutions'. 

Community-based services should meet individual needs and wishes of people with severe disabilities and be continually monitored and adjusted. In many cases, civil society organisations take the lead to implement support services where and for whom those are needed.

Some years ago, the Heart of a Child Foundation launched a project to promote deinstitutionalisation of children and youth with severe disabilities in Galati, Romania. The initiative prevented 10 youth with severe disabilities to live in special institutions, where they had been abandoned, by keeping them in apartments operated by the foundation.

Two years after, the foundation also created a kindergarten and day centre for these children with a view to help individuals develop their skills and capacities according to their particular situation. Their integration in the community is also promoted through the organisation of social and leisure activities.

The services provided by the foundation are extremely valuable, since the local government alone would not be able to provide the support these children and young people are in need of. According to Heart of a Child, comparing the outputs from institutional and community care, superior progress at a lower cost was achieved by the support methods provided within the community.