The state of community-based support Medicaid services to people with intellectual and developmental disabilities shows continued mixed results according to the 2011 Case for Inclusion report. This year‘s report, based largely on data for most states‘ fiscal year ending June 2008, is a look back at where states stood before the current recession and before states received significant boosts in federal stimulus funding.

6^th Annual Report Finds Progress in Medicaid Services but Nearly 33,000 Americans with ID/DD Still Live in 162 Large, State-run Institutions

UCP's 6th Annual The Case for Inclusion Ranks 50 States & DC on Medicaid Services for Individuals with Disabilities

United Cerebral Palsy (UCP), a leading service provider and advocate for children and adults with a spectrum of disabilities, released The Case for Inclusion, an annual ranking of all 50 states and the District of Columbia (DC) for Medicaid services provided to intellectual and developmental disability (ID/DD) populations.

The sixth annual rankings reveal:

1. All states have room to improve outcomes and services for individuals with intellectual and developmental disabilities and must be particularly vigilant in the current economic climate;
2. Too many Americans with intellectual and developmental disabilities still do not live in the community (57,982 people with ID/DD live in facilities with 16 or more beds), although real and notable progress have been made over the last year;
3. Certain states are making substantial progress toward inclusion;
4. Too much money is still spent isolating people in large institutions (nearly 33,000 people at an average cost of $539 per person per day), with nominal change from last year; and
5. Waiting lists have increased dramatically overall (up 56% from 2005 to 2009), but performance is quite mixed by state. Most states are not serving all those in need.

Top ten states in terms of quality of Medicaid service provided:

1. Vermont
2. Arizona
3. Michigan
4. New Hampshire
5. California
6. Washington
7. Delaware
8. Nevada
9. Massachusetts
10. Connecticut

Bottom ten states in terms of qualityof Medicaid service provided:

1. Indiana
2. North Carolina
3. Utah
4. Oklahoma
5. Nebraska
6. District of Columbia
7. Illinois
8. Texas
9. Arkansas
10. Mississippi

Thirteen states shifted by at least eight places in the rankings from 2007 to 2011.

Highlights include:

• An impressive 21 states - down one since last year, but up two from 2009 and an increase from 16 states in 2007 - have more than 80 percent of those served living in home-like settings.
• From 2005 to 2009, an impressive 18 states - up six from last year - reduced the number of Americans living in large institutions by 20 percent or more.
• Nationally, the 14.4 percent (down from 19 percent in four years) of those living in institutions consume 33.7 percent (down from 41.4 percent in four years) of all Medicaid funding on those with intellectual and developmental disabilities.
• Although nearly 60 points separate the top performing state from the poorest performing state, eight points separate the top 10 states, 15 points separate the top 25 states and only 15 points separate the middle 25 states. Therefore, minor changes in state policy or outcomes could significantly affect how a state ranks on future or past The Case for Inclusion reports.

"It is very encouraging that The 2011 Case for Inclusion reveals notable progress since the 2010 report. However each of the states and DC have room for improvement, because too many Americans with intellectual and developmental disabilities still do not live in the community. UCP commends those making substantial progress toward inclusion and will continue using this report as a resource in the civil rights movement for people with disabilities, a movement that is far from over. Advocates, including leaders in each state, can use the 2011 report to advocate for all people with disabilities," said Stephen Bennett, United Cerebral Palsy President & Chief Executive Officer.

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