Rehabilitation Reform

Michigan scores 64/100 (Tier 2, Progressing) in the 2026 SCII: a community mental health system that was nationally innovative at its inception, now strained by county-level variation, a 3,400-person DD waiver waitlist, and no legislative action on subminimum wage elimination.

Arkansas scores 35/100 (Tier 4, Critical) in the 2026 SCII: a pioneering self-direction program dating to the 1990s, undercut by no state SSI supplement, no 14(c) elimination, and the lowest average direct-support-professional wage in the nation.

Kansas scores 45/100 (Tier 3, Lagging) in the 2026 SCII: a favorable Tenth Circuit precedent and a litigation-tested Protection & Advocacy system, offset by an 8-11 year I/DD waiver waitlist and a merely voluntary, non-mandatory approach to subminimum wage.

Kentucky scores 33/100 (Tier 4, Critical) in the 2026 SCII: the lowest measured HCBS-to-institutional rebalancing ratio in the nation, an active DOJ finding on Louisville’s psychiatric hospitals, and a 42-point disability employment gap ranking 48th nationally.

Maine scores 53/100 (Tier 3, Lagging) in the 2026 SCII: a state-law ban on subminimum wage ahead of most of the country, undercut by one of the lowest SSI state supplements nationally ($10/month) and a decades-old adult mental health consent decree that just ended.

Arizona scores 50/100 (Tier 3, Lagging) in the 2026 SCII: a nationally-profiled crisis system and a landmark 1989 community-treatment precedent, undercut by zero SSI state supplement and a civil rights statute that never exceeds the federal ADA floor.

Massachusetts scores 62/100 (Tier 2, Progressing) in the 2026 SCII: a $1 billion DOJ-reinforced nursing-home transition settlement and a 24/7 statewide crisis line, built on a pattern where every major community-integration advance followed a federal lawsuit rather than proactive reform.

Delaware scores 69/100 (Tier 2, Progressing) in the 2026 SCII: the only state in the nation to reach full, court-certified compliance with a DOJ Olmstead settlement, plus dual HCBS waivers with no waitlist — offset by a narrow SSI supplement and thin public data on day-to-day performance.

Indiana scores 43/100 (Tier 3, Lagging) in the 2026 SCII: a top-10 988 answer rate and binding Seventh Circuit precedent constraining the state’s own waiver caps, undercut by an HCBS system that hit capacity and reinstated waitlists in 2024-2025.

Connecticut scores 53/100 (Tier 3, Lagging) in the 2026 SCII: a best-in-class 988 crisis line and psychiatrically-specific pretrial diversion programs, offset by the only capped Katie Beckett waiver in New England and no confirmed current Olmstead Plan.