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UCP Releases Annual Report on States Serving Americans with Disabilities

April 18, 2014
Source: United Cerebral Palsy (UCP)

Eighth Annual Case for Inclusion Report Ranks, Compares States on Medicaid Outcomes

United Cerebral Palsy (UCP) released the 2014 Case for Inclusion today, an annual report that tracks the progress of community living standards for Americans living with intellectual and developmental disabilities (ID/DD).

The Case for Inclusion is a valuable tool for understanding how Americans with intellectual and developmental disabilities (ID/DD) are faring across the country. The report examines data and outcomes for all 50 states and the District of Columbia (DC), ranking each on a set of key indicators, including how people with disabilities live and participate in their communities, if they are satisfied with their lives, and how easily the services and supports they need are accessed. By taking these factors into account, UCP is able to develop a comprehensive analysis of each states progress or failures in providing critical services to individuals living with disabilities.

Since 2006, these rankings have helped enable families, advocates, the media and policymakers to fully understand each states progress or lack of improvement, learn about how the highest-ranking states are achieving their success, and ultimately, to promote inclusion and enhance the quality of life for all Americans. This years Case for Inclusion report includes several major enhancements to the rankings system, made as a direct result of the feedback received from policymakers and advocates, including more person-centered metrics. These changes will help to better understand and highlight how individuals and their families are faring as active parts of their communities. These changes lets us look at not just which states have closed institutions and are enabling people to live independently in their own home or apartment, but gets at what full opportunity and inclusion really mean.

“The Case for Inclusion report examines the supports and services that enable people with disabilities to lead a fulfilling, productive life—and make up the backbone of United Cerebral Palsys work. By providing insight into states progress in serving individuals with intellectual and developmental disabilities as well as a national context, this report is a valuable tool for comparison and improvement,” said Stephen Bennett, President and CEO of United Cerebral Palsy. “We are proud to provide this resource to states, advocates and policymakers and hope that it will continue to be utilized to help advance the independence, productivity and full citizenship of people with disabilities.”


Promoting Independence

All states still have room for improvement, but some states have consistently remained at the bottom since 2007, including Arkansas (#47), Illinois (#46), Mississippi (#51) and Texas (#50).

38 states now meet the 80/80 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 community support. Those that do NOT meet the 80/80 standard are Arkansas, Illinois, Iowa, Kentucky, Louisiana, Mississippi, Nebraska, New Jersey, North Carolina, Oklahoma, Texas, Utah and Virginia, although Nebraska, North Carolina, Oklahoma, Utah and Virginia are very close.

As of 2011, 14 states have no state institutions to seclude those with ID/DD, including Alabama, Alaska, Hawaii, Indiana (new this year), Maine, Michigan, Minnesota, New Hampshire, New Mexico, Oregon, Rhode Island, Vermont, West Virginia and Washington, D.C. Another 11 states have only one institution each. Since 1960, 219 (10 more in the past year alone) of 354 state institutions have been closed, according to the University of Minnesotas Research and Training Center on Community Living. Another 16 more are projected to close through 2015.

18 states now meet 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 three residents. The U.S. average for this standard is 77 percent. Just eight states meet a top-performing 90 percent Home-like Setting Standard: Alaska, Arizona, California, Kentucky, Nevada, New Hampshire, New Mexico and Vermont.

Six states report at least 10 percent of individuals using self-directed services, according to the National Core Indicators survey in 19 states. These states include Connecticut, Georgia, Hawaii, Illinois, Kentucky, Michigan and Ohio.

Tracking Health, Safety and Quality of Life

39 states participate in the National Core Indicators (NCI) model, a comprehensive quality-assurance program that includes standard measures to assess outcomes of services but only 19 states reported data outcomes in 2012. In January 2012, the Obama Administration made available grant funding so that even more states could participate and ensure their quality assurance efforts were benchmarked and comprehensive.

Keeping Families Together

Only 15 states were supporting a large share of families through family support (at least 200 families per 100,000 of population). This is important, because those 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 Alabama, Arizona, California, Delaware, Louisiana, Minnesota, Montana, New Hampshire, New Mexico, New York, Pennsylvania, South Carolina, South Dakota, Vermont and Wisconsin.

Promoting Productivity

Just 10 states have at least one-third (33 percent) of individuals with ID/DD working in competitive employment. These states include Connecticut, Louisiana, Maryland, Nebraska, New Mexico, Oklahoma, Oregon, Vermont, Virginia and Washington State. Washington, D.C. and Pennsylvania were very close.

13 states report successfully placing at least 60 percent of individuals in vocational rehabilitation in jobs. With six states reporting the average number of hours worked for those individuals placed being at least 25 hours and five states reporting at least half of those placed remaining in their job for at least one year. Only Nebraska and South Dakota meet the standard on all three success measures.

Serving Those in Need

Waiting lists for residential and community services are high and show the unmet need. Almost 317,000 people are on a waiting list for Home and Community Based Services. This would require a daunting 46 percent increase in states HCBS programs! However, 22 states report no waiting list or a small waiting list (requiring less than 10 percent program growth).

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