Wide geographical disparities exist when it comes to opportunities for people with intellectual and developmental disabilities to live and work in their communities, according to a new report that ranks states.

The Case for Inclusion 2019 report released by United Cerebral Palsy and the ANCOR Foundation examines how well state programs — particularly Medicaid — are meeting the needs of people with intellectual and developmental disabilities.

The report evaluated how states are promoting independence, including by avoiding placement in institutions. In the top ranked state, Arizona, 99 percent of people with intellectual and developmental disabilities live at home or in a small group setting. In the lowest ranked state, Mississippi, that figure is 51 percent.

Since the last report published in 2016, states have fallen behind in some areas. For instance, only seven states, down from 10 three years ago, reported at least a third of working-age people with intellectual and developmental disabilities are employed at market-driven wages. Waiting lists for home and community-based services have grown by almost 75,000 to nearly 424,000 people nationwide.