Vermont provides the highest quality Medicaid services to individuals with intellectual and developmental disabilities, while Mississippi provides the worst, according to a United Cerebral Palsy analysis released Wednesday.

The states with the best services are Vermont, Arizona and Alaska. Meanwhile Texas, Arkansas and Mississippi round out the bottom of the list of the 50 states and the District of Columbia.

The top ten states include states with some of the largest and smallest populations and states with some of the highest and lowest tax levels.

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As compared to last year’s analysis, Pennsylvania improved its ranking most significantly while Wyoming and Maine dropped the greatest number of places.

Across the board, however, the analysis finds every state has room to improve. Too much money is still spent on serving people in large institutional environments and waiting lists continue to grow in almost every state, the annual analysis finds. In fact, 15 states have a waiting list for residential services so long that a 25 percent expansion of the program would be needed to meet the need.

“Too often the goals of independence, productivity and community inclusion are at odds with reality,” said United Cerebral Palsy CEO Stephen Bennett.

Much progress has been made, however, with nine states no longer running any institutions with more than 16 beds and 13 states running just one each. Since last year, the number of Americans living in large institutions has decreased by 1,536, though 36,175 people remain in such facilities. Furthermore, 11,000 more people are now served in their own homes.

The full report titled “The Case for Inclusion 2009” can be found by clicking here.