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June 22, 2011

The State of the States in Developmental Disability (It's Not Good)

Harold Pollack

I posted an item on the New Republic website about state policy trends in intellectual/developmental disability (I/DD) services. I draw on the recently-released compendium The State of the States in Developmental Disabilities 2011, which includes data up to 2009. (Thanks to David Braddock of the University of Colorado, who provided additional data for the piece.)

Between 2008 and 2009, 23 states reduced their inflation-adjusted I/DD spending. If one excludes the federal portion of such spending, forty-seven states reduced their spending on such services. (See the chart below the fold). State budgetary retrenchment is the deepest anyone has seen since the late 1970s when records were first kept. These trends are really concerning--not least because things are likely to be even worse today than they were two years ago, given the sunsetting of federal subsidies and enhanced Medicaid matching rates provided within the 2009 federal stimulus bill.

 

Non_fed_expenses 
These patterns are also revealing when one examines which states are cutting most deeply into these programs. As I discuss in TNR, bright red states such as Texas, Alabama, Idaho, and South Carolina are implementing deep cuts, although many started from a low base of service delivery in the first place. State policy choices are quite correlated with political ideology, as measured by then-candidate Obama's share of the two-party vote in the 2008 election.

Intellectually disabled people and their families are a highly valued and vulnerable constituency, perhaps the paradigmatic example of the worthy poor. But times are hard. Budgets are tight. I/DD services are expensive. Both policymakers and citizens face a gut-check moment regarding what they really believe about the size and scope of government. In much of America, the answers are not reassuring.

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