All states still have room for improvement, but some states have consistently remained at the bottom since 2007, including Arkansas (#49), Illinois (#48), Mississippi (#51) and Texas (#50);

36 states now meet the 80/80 Community standard, which means that at least 80% of all individuals with ID/DD are served in the community, and 80% of all resources spent on those with ID/DD are for community support;

As of 2010, 11 states have no state institutions to seclude those with ID/DD, including Alaska, Hawaii, Maine, Michigan, New Hampshire, New Mexico, Oregon (new this year), Rhode Island, Vermont, West Virginia and D.C. In addition, Minnesota closed its last remaining institution in June 2011, and another 12 states have only one institution each;

22 states now meet the 80% Home-like Setting standard, which means that at least 80% of all individuals with ID/DD are served in their own home, a family home, family foster care, shared apartments, or in other small group settings with fewer than three residents;

29 states participate in the National Core Indicators (NCI) model, a comprehensive quality assurance program that includes standard measures to asses outcomes of services (nationalcoreindicators.org);

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;

Just nine states have at least one-third (33%) of individuals with ID/DD working in competitive employment, which best recognize and support work as key to a meaningful life. These states include Alaska, Connecticut, Delaware, Maryland, Michigan, Oklahoma, Pennsylvania, Vermont and Washington; and

Waiting lists for critical services continue to climb and show the unmet need of individuals living with ID/DD and their families. More than a quarter of a million people (268,000) are on a waiting list for Home and Community Based Services (HCBS). To address this need, states' HCBS programs would need to collectively increase by 46%.

Alaska – dropped 28 places since 2007 – fell so dramatically because the number of people being served in a family home was previously estimated (by the state) at 3,700 for the 2007 ranking. Beginning with the 2010 ranking, it was reported accurately at around 200 people served. It is also important to note that Alaska does not participate in NCI.

Colorado – dropped 20 places since 2007 – fell so dramatically because of a significant decline in competitive employment participation (from 53% to 17%), and the state does not participate in NCI.

Idaho – improved 13 places since 2007 – significantly increased the share of individuals (from 75% to 85%) and resources (from 51% to 91%) dedicated to the community. It also more than doubled the number of people with ID/DD in competitive employment (from 14% to 30%).

Kansas – dropped 14 places since 2007 – does not participate in the NCI.

Louisiana – improved 19 places since 2007 – had huge improvement in the portion of individuals (from 49% to 63%) and resources (from 41% to 77%) dedicated to community services over institutions, and it had large drop in the portion of individuals served in large institutions (from 18% to 8%).

Maryland – improved 22 places since 2007 – closed a state institution and reduced the population at state institutions by 60%. The state also began participating in NCI and added a Medicaid Buy-in Program to support individuals as they go to work, increase their productivity and raise their incomes.

Missouri – improved 18 places since 2007 – dramatically increased the portion of resources dedicated to people in the community (from 59% to 81%) and started participating in NCI.

Nevada – improved 10 places since 2007 - dramatically increased the portion of resources dedicated to people in the community (from 68% to 93%), closed a state institution and reduced the number of people at state institutions by 47%.

New Jersey – dropped 14 places since 2007 – primarily did poorly because the state did not report whether it has a waiting list and how many people are on it.

North Carolina – dropped 10 places since 2007 - primarily did poorly because the state did not report whether it has a waiting list and how many people are on it.

Ohio – improved 14 places since 2007 – dramatically increased the share of individuals (to 82% from 63%) and resources (from 50% to 82%) dedicated to the community, closed a state institution, reduced by half the portion of individuals served in large institutions (from 18% to 9%), started participating in NCI and reported on its waiting list which was of average size.

Pennsylvania – improved 19 places since 2007 – substantially increased the portion of resources dedicated to people in the community (from 70% to 82%), dramatically increased the portion of people served in home-like settings (from 58% to 83%), reduced by almost half the portion of people served in large institutions (from 11% to 6%) and closed a state institution.

South Dakota – improved 11 places since 2007 – steadily improved in the share of individuals served in the community and added a Medicaid Buy-in Program.

Washington – improved 12 places since 2007 – mostly a result of the state accurately reporting on its waiting list, which is relatively small.

West Virginia – dropped 13 places since 2007 – dramatically increased the share of resources going to the community (from 77% to 99%) but does not participate in NCI.

Wyoming – dropped 18 places since 2007 – primarily due to the fact that it does not participate in NCI and resulting from a large drop in competitive employment (from 25% to 14%).