United Cerebral Palsy has released its annual Case for Inclusion, which ranks all 50 states
and the District of Columbia (DC) on outcomes for Americans with intellectual and
This year’s report shows that:
All states have room for some improvement, but some have consistently remained
at the bottom of the rankings since 2007;
Waiting lists for residential and community services remain high, demonstrating the
unmet need of people with disabilities and their families;
Just 8 states, down from 10 last year, have at least one-third (33 percent) of
individuals with ID/DD working in competitive employment— showing significant
opportunity for improvement in employing people with disabilities;
14 states report successfully placing at least 60 percent of individuals in vocational
rehabilitation in jobs. Only California met the standard on all three success
measures this year.
A very useful document for advocates. The highlights of the full report are below.
Significant Takeaways from the 2015 Rankings
All States still have room for improvement, but some States have consistently remained at
the bottom since 2007, including Arkansas (#49), Illinois (#47), Mississippi (#51) and
Texas (#50) primarily due to the small portion of people and resources dedicated to those
in small or home-like settings in these four states. Mississippi and Texas also do not
participate in NCI.
32 States, down from 38, meet the 80/80 Home and Community Standard, which means
that at least 80 percent of all individuals with ID/DD are served in the community and 80
percent of all resources spent on those with ID/DD are for home (less than 7 residents
per setting) and community support. Those that do not meet the 80/80 standard are
Arkansas, Delaware, Florida, Illinois, Indiana, Iowa, Kentucky, Louisiana, Mississippi,
New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South
Dakota, Texas, Utah and Virginia.
As of 2013, 14 States report having no state institutions to seclude those with ID/DD,
including Alabama, Alaska, Hawaii, Indiana, Maine, Michigan, Minnesota, New Hampshire,
New Mexico, Oregon, Rhode Island, Vermont, West Virginia and Washington, D.C.
Another 10 States have only one institution each (Arizona, Delaware, Idaho, Montana,
Nebraska, Nevada, North Dakota, South Dakota, Utah and Wyoming). Since 1960, 220 of
354 state institutions have been closed (5 more in the past year alone), according to the
University of Minnesota’s Research and Training Center on Community Living. Another
13 more are projected to close by 2016 in California, Massachusetts, New Jersey (3),
New York (2), Oklahoma (2), Tennessee (2) and Virginia (2)
26 States, up from 18, now report meeting the 80 percent Home-Like Setting Standard,
which means that at least 80 percent of all individuals with ID/DD are served in settings
such as their own home, a family home, family foster care or small group settings like
shared apartments with fewer than four residents. The U.S. average for this standard is
79 percent. Just eight States meet a top-performing 90 percent Home-like Setting
Standard: Arizona, California, Colorado, D.C., Hawaii, Nevada, New Hampshire, and
Ten States, up from seven last year, report at least 10 percent of individuals using self-
directed services, according to the National Core Indicators survey in 29 States. These
States include Arkansas, Connecticut, Florida, Hawaii, Illinois, Indiana, Kansas,
Kentucky, Utah and Virginia.
Tracking Health, Safety and Quality of Life
42 States, up from 39 last year, participate in the National Core Indicators (NCI) survey,
a comprehensive quality-assurance program that includes standard measurements to
assess outcomes of services. A total of 29 States, a 50% increase from last year,
reported data outcomes in 2014.
Keeping Families Together
Only 14 States report that they are supporting a large share of families through family
support (at least 200 families per 100,000 of population). These support services
provide assistance to families that are caring for children with disabilities at home,
which helps keep families together, and people with disabilities living in a community
setting. These family-focused state programs were in Arizona, California, Delaware,
Louisiana, Minnesota, Montana, New Hampshire, New Mexico, New York, South
Carolina, South Dakota, Vermont, Wisconsin, and Wyoming. Alabama and
Pennsylvania reported that they were providing higher levels of family support in last
Just 8 States, down from 10 last year, report having at least 33 percent of individuals
with ID/DD working in competitive employment.These States include Connecticut,
Maryland, New Hampshire (newly added), New Mexico, Oklahoma, Vermont,
Washington, and West Virginia (newly added). Louisiana, Nebraska, Oregon and
Virginia reported that they met this threshold in last year’s ranking, but reported a
decrease in competitive employment this year.
14 States report successfully placing at least 60 percent of individuals in vocational
rehabilitation in jobs, with fifteen States reporting the average number of hours worked
for those individuals placed being at least 25 hours and three States reporting at least
half of those served getting a job within one year. Only California met the standard on
all three success measures this year compared to last year’s ranking, when Nebraska
and South Dakota were the only two States to report meeting all three thresholds.
Serving Those in Need
Waiting lists for residential and community services are high and show the unmet
need. More than 322,000 people, 5,000 more than last year, are on a waiting list for
Home and Community-Based Services. This requires a daunting 44 percent increase
in States’ HCBS programs. 16 States, a decrease from 22 last year, report no waiting
list or a small waiting list (requiring less than 10 percent program growth).
Tony Paulauski Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423