Arizona offers the best Medicaid services for people with developmental disabilities while Mississippi comes in dead last in an annual ranking of the states released Tuesday.

In addition to Arizona, the states coming out on top in the analysis from United Cerebral Palsy are Vermont, New Hampshire, Washington and California. Meanwhile, the lowest performing jurisdictions are Washington, DC, Illinois, Texas, Arkansas and Mississippi.

Much like in previous years, the best performing states included those of all population sizes, varying levels of wealth and those with differing tax structures. Further, successful states exhibited differing levels of per person spending on Medicaid home and community-based services waivers.

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Notably, Washington state jumped from a rank of 25 in 2009 to a fourth place ranking this year, largely due to better reporting. Meanwhile, Alaska declined from third place to rank 27 after state estimates of the number of people living in the community were replaced with actual numbers.

Success in the ranking known as the “Case for Inclusion” is largely based on a state’s strides toward serving individuals in the community. On that front, the report finds that the number of states where over 80 percent of individuals are supported in home-like settings continues to rise, reaching 22.

Nonetheless, waiting lists continue to grow — they increased 56 percent between 2005 to 2008 — and the 2010 report finds that state spending on housing people in large institutions remains steady.

The analysis is culled from the most recently available data, much of which is from 2008. With that in mind, the report authors note that the landscape could presently be altered due to the recession and subsequent stimulus dollars states received.