Category: SCII State Profiles Tags: Vermont, Disability Policy, Community Integration, Olmstead, HCBS, Vocational Rehabilitation, Disability Rights, SCII 2026, State Profile, Independent Living, Disability Services, Policy Analysis
Introduction
Vermont ranks first among all states assessed in the 2026 State Community Integration Index — not because it is a perfect system, but because it has made the most consistent, structurally embedded commitment to the principle that people with disabilities belong in their communities. What distinguishes Vermont is not a single landmark policy or a court-ordered transformation, but a decades-long accumulation of legislative decisions, administrative investments, and service design choices that have collectively produced a system oriented toward community living as its operational default. Vermont closed its sole state Intermediate Care Facility for Individuals with Intellectual Disabilities — the Brandon Training School — in 1993, and has not rebuilt comparable congregate capacity since. Understanding Vermont’s ranking requires understanding not just what the state has built, but what it has chosen not to rebuild (Vermont Division of Disability and Aging Services, 2024) [1].
2026 SCII Score Card
| Composite Score | 84 / 100 |
| National Rank | #1 of 15 (Pilot Phase) |
| Tier | 🟢 Tier 1 — Leading |
| Active DOJ Olmstead Action | No |
| Olmstead Plan Status | Embedded in §1115 Demonstration Framework |
| Judicial Posture | Neutral (+0) |
| Data Current As Of | May 2026 |
Domain Scores
| Domain | Score | Notes |
|---|---|---|
| Institutional Population Burden | 17 / 20 | Low rates across all five institutional settings |
| HCBS Infrastructure | 16 / 20 | No traditional DD waiver waitlist; §1115 demonstration architecture |
| Olmstead Compliance | 13 / 15 | Strong substantive compliance; formal plan structure less defined |
| Criminal Justice Diversion | 11 / 15 | Strong mobile crisis infrastructure; small jail population |
| Housing & Economic Self-Determination | 13 / 15 | State SSI supplement active; strong supportive housing investment |
| Voice, Oversight & Civil Rights | 14 / 15 | Disability Rights Vermont; robust ILC network; state Human Rights Act |
Critical Population Counts
| Setting | Count | Source |
|---|---|---|
| Nursing facility residents under 65 | Below national median per capita | CMS Nursing Home Compare, 2024 [2] |
| State psychiatric hospital census | Small; community mental health primary | SAMHSA URS, 2024 [3] |
| ICF/IID residents | None — Brandon Training School closed 1993 | Vermont DDAS, 2024 [1] |
| Estimated incarcerated adults with serious mental illness | Below national median | Bureau of Justice Statistics, 2024 [4] |
| Chronically homeless adults with disabilities | Below national median per capita | HUD AHAR, 2024 [5] |
Three Strengths
1. No Traditional DD Waiver Waitlist Vermont is one of a small number of states in the country that does not maintain a traditional waitlist for developmental disability services. Rather than operating standard 1915(c) waivers with capped enrollment, Vermont delivers HCBS through a Section 1115 demonstration framework that integrates disability services into a broader system of care. While this architecture requires careful interpretation — the absence of a formal waitlist does not mean the absence of all access delays — it reflects a fundamentally different policy orientation toward HCBS capacity (Kaiser Family Foundation, 2025) [6].
2. Sustained Deinstitutionalization Since 1993 Vermont’s closure of the Brandon Training School over three decades ago represents one of the earliest and most complete acts of deinstitutionalization in the country. The state has not reopened comparable institutional capacity in the years since, meaning that the community service infrastructure built to replace Brandon has had decades to mature, expand, and become the system’s operational foundation rather than its supplement (Vermont DDAS, 2024) [1].
3. Strong Civil Rights Infrastructure Disability Rights Vermont — the state’s federally designated Protection and Advocacy organization — operates with per-capita funding above the national median, providing legal representation, systemic advocacy, and individual rights protection across disability populations. Vermont’s Human Rights Act explicitly covers disability, providing a state-level enforcement mechanism beyond the federal ADA floor (Administration for Community Living, 2024) [7].
Three Critical Gaps
1. Rural HCBS Workforce Capacity Vermont’s geography creates a persistent challenge that its policy framework does not fully resolve. Rural areas face significant HCBS provider shortages driven by workforce recruitment and retention difficulties that are structural rather than policy-driven. Individuals living outside Vermont’s population centers may experience access delays that the absence of a formal waitlist does not capture (Vermont Agency of Human Services, 2024) [8].
2. Aging-Related Institutional Drift As Vermont’s population ages — the state has one of the oldest median ages in the country — the risk of institutional drift into nursing facilities increases. The systems built for working-age adults with disabilities do not always translate seamlessly into supports for older adults with acquired disabilities, creating a potential gap in the community integration continuum (Centers for Disease Control and Prevention, 2025) [9].
3. Subminimum Wage Not Yet Eliminated Vermont has not enacted statutory elimination of Section 14(c) subminimum wage employment, placing it behind Oregon, Maryland, Washington, and Colorado on this indicator. Strong Employment First policies exist at the administrative level, but without statutory elimination the protection is policy-dependent rather than legally embedded (Association of People Supporting Employment First, 2025) [10].
Key Insight
Vermont’s first-place ranking reflects a principle that has important implications for every state in the Index: community integration is an investment that compounds over time. The decision to close Brandon Training School in 1993 did not immediately produce a perfect community service system. It produced three decades of accumulated investment, institutional learning, and service infrastructure development that now enables Vermont to operate without a DD waitlist, without active DOJ enforcement, and without the systemic crises visible in Tier 3 and Tier 4 states. The lesson is not that Vermont has no problems — rural workforce gaps and aging-related drift are real. The lesson is that states which make structural commitments to community integration early, and sustain them consistently, build systems that are qualitatively different from those that pursue compliance under pressure. Vermont is what Olmstead looks like when it becomes operational culture rather than legal obligation (Olmstead Decision 25 Years Later, Center for Health Care Strategies, 2024) [11].
References
[1] Vermont Division of Disability and Aging Services. (2024). Home and community-based services in Vermont. Vermont Agency of Human Services. https://ddas.vermont.gov
[2] Centers for Medicare & Medicaid Services. (2024). Nursing home compare. U.S. Department of Health and Human Services. https://www.medicare.gov/care-compare
[3] Substance Abuse and Mental Health Services Administration. (2024). Uniform reporting system. U.S. Department of Health and Human Services. https://www.samhsa.gov/data/report/uniform-reporting-system-urs-table
[4] Bureau of Justice Statistics. (2024). Prisoners in 2023. U.S. Department of Justice. https://bjs.ojp.gov/library/publications/prisoners-2023
[5] U.S. Department of Housing and Urban Development. (2024). The 2024 annual homeless assessment report (AHAR) to Congress. HUD USER. https://www.huduser.gov/portal/sites/default/files/pdf/2024-AHAR-Part-1.pdf
[6] Kaiser Family Foundation. (2025). A look at waiting lists for Medicaid home- and community-based services from 2016 to 2025. KFF. https://www.kff.org/medicaid/a-look-at-waiting-lists-for-medicaid-home-and-community-based-services-from-2016-to-2025/
[7] Administration for Community Living. (2024). Protection and advocacy systems. U.S. Department of Health and Human Services. https://acl.gov/programs/aging-and-disability-networks/legal-assistance
[8] Vermont Agency of Human Services. (2024). Vermont home and community based services workforce report. https://humanservices.vermont.gov
[9] Centers for Disease Control and Prevention. (2025). Disability and health data now. https://www.cdc.gov/disability-and-health/articles-documents/disability-and-health-data-now.html
[10] Association of People Supporting Employment First. (2025). State legislative watch: Subminimum wage elimination. APSE. https://apse.org/state-legislation/
[11] Center for Health Care Strategies. (2024). The Olmstead decision 25 years later. CHCS. https://www.chcs.org/the-olmstead-decision-25-years-later/
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