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SCII 2026 State Profile: California
California scores 62/100 (Tier 2, Progressing) in the 2026 SCII: full elimination of subminimum wage and civil rights protections beyond the ADA floor, set against a dormant general Olmstead Plan and the nation’s largest chronically homeless population with disabilities.
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SCII 2026 State Profile: Louisiana
Louisiana scores 35/100 (Tier 4, Critical) in the 2026 SCII: a full state psychiatric hospital, a decade of frozen HCBS rebalancing, and the Fifth Circuit’s 2023 reversal of Olmstead protections — the same ruling that lowered Texas and Mississippi’s scores.
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SCII 2026 State Profile: Idaho
Idaho scores 56/100 (Tier 3, Lagging) in the 2026 SCII: a top-quartile HCBS spending ratio undercut by a live January 2025 DOJ finding that the state is violating the ADA, and jails that ProPublica found likely hold more people with serious mental illness than its entire state hospital system.
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SCII 2026 State Profile: Hawaii
Hawaii scores 67/100 (Tier 2, Progressing) in the 2026 SCII: a zero-waitlist HCBS system and full elimination of subminimum wage, offset by one of the nation’s highest chronic homelessness burdens and a state psychiatric hospital that admits only forensic patients.
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SCII 2026 State Profile: Iowa
Iowa scores 54/100 (Tier 3, Lagging) in the 2026 SCII: dead last nationally in state psychiatric beds per capita, yet one of the only states in this dataset to have actually closed an institution — Glenwood Resource Center — under a DOJ consent decree.
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SCII 2026 State Profile: Alaska
Alaska scores 56/100 (Tier 3, Lagging) in the 2026 State Community Integration Index: one of the most HCBS-oriented long-term-care systems in the country, an early (2018) elimination of subminimum wage, and a 14-year wait on its only rationed waiver.
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Introducing Pathways Pro: A Case Management Platform Built for Rehabilitation Services
App in Development by Candace Metcalf, CRC, LPC A Case Management System Built for the Rehabilitation Field Pathways Pro is a case management platform I’m building specifically for the people who deliver rehabilitation services — not a generic practice-management tool adapted after the fact. It’s designed for individual private-practice therapists…
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From Classroom to Caseload: Rethinking Rehabilitation in the Age of AI
In her recent session, Rethinking the Purpose of Education in the Age of AI, Rebecca Winthrop presented a vision for the future of learning that goes far beyond simply dropping new technology into old classrooms. Winthrop, the director of the Center for Universal Education at the Brookings Institution, argues that…
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The Invisibility Problem in Vocational Rehabilitation Systems
Fragmented Disability Systems, Lost Work Futures 1. Abstract Current sociological and health policy research on vocational rehabilitation (VR) and disability systems increasingly centers on cross-system integration, the psychosocial impacts of administrative burden, digital service delivery, and employment outcomes for people with complex, co-occurring disabilities. Across recent peer-reviewed literature and 2024–2026…
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Vocational Rehabilitation
Fractured Systems, Lost Work: Why System Fragmentation Is the Most Urgent Crisis Facing Vocational Rehabilitation Contemporary disability and vocational rehabilitation systems face numerous challenges, including workforce shortages, growing service demand, increasing complexity of disability, and rapidly changing labor markets. Yet beneath these challenges lies a deeper structural problem: fragmentation. Recent…