The State Community Integration Index (SCII) measures how well each state supports community integration for people with disabilities — or how deeply it remains invested in institutional systems. Scores range from 0 to 100 across six domains: Institutional Population Burden, HCBS Infrastructure, Olmstead Compliance & Legal Posture, Criminal Justice Diversion, Housing & Economic Self-Determination, and Voice, Oversight & Civil Rights. States are classified into four tiers: Tier 1 Leading (80–100), Tier 2 Progressing (60–79), Tier 3 Lagging (40–59), and Tier 4 Critical (below 40). Judicial posture modifiers (+2 Protected, 0 Neutral, −2 Active Enforcement, −5 Judicially Narrowed) reflect circuit court treatment of Olmstead claims.
National Summary
| Tier | Score Range | State Count | Description |
|---|---|---|---|
| Tier 1 — Leading | 80–100 | 3 | Structural integration leaders with elimination of key institutional practices |
| Tier 2 — Progressing | 60–79 | 15 | Meaningful HCBS investment with ongoing institutional gaps |
| Tier 3 — Lagging | 40–59 | 24 | Institutional dependence exceeds community investment |
| Tier 4 — Critical | Below 40 | 8 | Severe institutionalization; community system capacity inadequate |
Complete 50-State Rankings
| Rank | State | Score | Tier | Judicial Modifier | Profile |
|---|---|---|---|---|---|
| 1 | Oregon | 84 | Tier 1 — Leading | +2 (9th Circuit) | View Profile |
| 2 | Vermont | 82 | Tier 1 — Leading | +2 (2nd Circuit) | View Profile |
| 3 | Minnesota | 80 | Tier 1 — Leading | +2 (8th Circuit) | View Profile |
| 4 | Washington | 78 | Tier 2 — Progressing | +2 (9th Circuit) | View Profile |
| 5 | Colorado | 77 | Tier 2 — Progressing | +2 (10th Circuit) | View Profile |
| 6 | California | 76 | Tier 2 — Progressing | +2 (9th Circuit) | View Profile |
| 7 | Maryland | 75 | Tier 2 — Progressing | +2 (4th Circuit) | View Profile |
| 8 | Connecticut | 74 | Tier 2 — Progressing | +2 (2nd Circuit) | View Profile |
| 9 | New Jersey | 73 | Tier 2 — Progressing | +2 (3rd Circuit) | View Profile |
| 10 | Rhode Island | 72 | Tier 2 — Progressing | +2 (1st Circuit) | View Profile |
| 11 | Massachusetts | 71 | Tier 2 — Progressing | +2 (1st Circuit) | View Profile |
| 12 | New Hampshire | 69 | Tier 2 — Progressing | +2 (1st Circuit) | View Profile |
| 13 | Delaware | 68 | Tier 2 — Progressing | +2 (3rd Circuit) | View Profile |
| 14 | Hawaii | 67 | Tier 2 — Progressing | +2 (9th Circuit) | View Profile |
| 15 | Virginia | 66 | Tier 2 — Progressing | 0 (4th Circuit) | View Profile |
| 16 | Maine | 65 | Tier 2 — Progressing | +2 (1st Circuit) | View Profile |
| 17 | Iowa | 64 | Tier 2 — Progressing | 0 (8th Circuit) | View Profile |
| 18 | Illinois | 64 | Tier 2 — Progressing | 0 (7th Circuit) | View Profile |
| 19 | Pennsylvania | 63 | Tier 2 — Progressing | +2 (3rd Circuit) | View Profile |
| 20 | New York | 63 | Tier 2 — Progressing | +2 (2nd Circuit) | View Profile |
| 21 | Michigan | 64 | Tier 2 — Progressing | 0 (6th Circuit) | View Profile |
| 22 | Wisconsin | 63 | Tier 2 — Progressing | 0 (7th Circuit) | View Profile |
| 23 | Kentucky | 62 | Tier 2 — Progressing | 0 (6th Circuit) | View Profile |
| 24 | Ohio | 61 | Tier 2 — Progressing | 0 (6th Circuit) | View Profile |
| 25 | North Carolina | 58 | Tier 3 — Lagging | 0 (4th Circuit) | View Profile |
| 26 | Nebraska | 57 | Tier 3 — Lagging | 0 (8th Circuit) | View Profile |
| 26 | Utah | 57 | Tier 3 — Lagging | 0 (10th Circuit) | View Profile |
| 26 | North Dakota | 56 | Tier 3 — Lagging | 0 (8th Circuit) | View Profile |
| 27 | New Mexico | 56 | Tier 3 — Lagging | 0 (10th Circuit) | View Profile |
| 28 | Montana | 55 | Tier 3 — Lagging | 0 (9th Circuit) | View Profile |
| 29 | Indiana | 54 | Tier 3 — Lagging | 0 (7th Circuit) | View Profile |
| 30 | Kansas | 53 | Tier 3 — Lagging | 0 (10th Circuit) | View Profile |
| 31 | Nevada | 52 | Tier 3 — Lagging | +2 (9th Circuit) | View Profile |
| 32 | Wyoming | 50 | Tier 3 — Lagging | 0 (10th Circuit) | View Profile |
| 33 | Idaho | 49 | Tier 3 — Lagging | +2 (9th Circuit) | View Profile |
| 34 | Missouri | 48 | Tier 3 — Lagging | 0 (8th Circuit) | View Profile |
| 35 | Tennessee | 48 | Tier 3 — Lagging | −2 (6th Circuit) | View Profile |
| 36 | South Dakota | 47 | Tier 3 — Lagging | 0 (8th Circuit) | View Profile |
| 37 | Arizona | 46 | Tier 3 — Lagging | +2 (9th Circuit) | View Profile |
| 38 | Georgia | 45 | Tier 3 — Lagging | 0 (11th Circuit) | View Profile |
| 39 | Florida | 44 | Tier 3 — Lagging | 0 (11th Circuit) | View Profile |
| 40 | Oklahoma | 42 | Tier 3 — Lagging | 0 (10th Circuit) | View Profile |
| 41 | Arkansas | 41 | Tier 3 — Lagging | −5 (8th Circuit, Fifth Circuit reversal impact) | View Profile |
| 42 | Alaska | 40 | Tier 3 — Lagging | +2 (9th Circuit) | View Profile |
| 43 | West Virginia | 39 | Tier 4 — Critical | 0 (4th Circuit) | View Profile |
| 44 | South Carolina | 38 | Tier 4 — Critical | 0 (4th Circuit) | View Profile |
| 45 | Louisiana | 36 | Tier 4 — Critical | −5 (5th Circuit) | View Profile |
| 46 | Alabama | 35 | Tier 4 — Critical | 0 (11th Circuit) | View Profile |
| 47 | Texas | 34 | Tier 4 — Critical | −5 (5th Circuit) | View Profile |
| 48 | Mississippi | 31 | Tier 4 — Critical | −5 (5th Circuit) | View Profile |
| 49 | Nevada | 29 | Tier 4 — Critical | −5 (5th Circuit) | View Profile |
| 50 | South Carolina | 27 | Tier 4 — Critical | −5 (5th Circuit) | View Profile |
Tier 1: Leading States (80–100)
Three states achieve Tier 1 status: Oregon (84), Vermont (82), and Minnesota (80). All three have eliminated or substantially phased out subminimum wages, maintain strong HCBS spending ratios above 70 percent, have active Olmstead enforcement plans, and benefit from Protected judicial circuit modifiers. These states demonstrate that the full community integration framework is achievable — and serve as proof-of-concept for states in lower tiers.
Tier 4: Critical States (Below 40)
Eight states score below 40, all sharing a cluster of structural failures: high institutional population burden, low HCBS spending ratios, no subminimum wage legislation, inadequate Olmstead planning, and — for the five Fifth Circuit states — a −5 judicial posture modifier reflecting the 2023 reversal of federal Olmstead enforcement capacity in United States v. Mississippi. Texas (34), Mississippi (31), and Louisiana (36) face the combined burden of high institutionalization rates and eliminated federal enforcement. Alabama (35) and South Carolina (38) face similar conditions without the circuit court penalty, but with equally underdeveloped community systems. West Virginia (39) is notable as the state with the highest disability prevalence nationally combined with the lowest HCBS investment.
Methodology Notes
SCII scores reflect conditions as of early 2026. Domain scores are based on: (1) CMS Medicaid LTSS spending data, (2) state ICF/IID and nursing facility census data, (3) DD waiver waitlist figures from state developmental disability agencies, (4) DOJ Olmstead enforcement actions and consent decrees, (5) Section 14(c) certificate holder counts from USDOL, (6) state Olmstead plan status, (7) housing cost and SSI income ratio calculations, and (8) P&A organization capacity assessments. Judicial posture modifiers reflect circuit court treatment of federal Olmstead enforcement as of January 2026. Individual state profiles contain detailed domain breakdowns, population counts, policy analysis, and citations. All scores are composite figures — the sum of six domain scores plus the judicial posture modifier — and should be interpreted in conjunction with individual state profiles rather than as standalone rankings.
Access all individual state profiles at: rehabilitationreform.com/category/scii-state-profiles/