Surveys of state intellectual disabilities and developmental disabilities (ID/DD) agencies and the 186 state institutions (16 or more residents) for persons with ID/DD for fiscal year (FY) 2004 indicate continuing, but slow decreases in state institution populations. As shown in Table 1, during FY 2004, populations of state institutions decreased by 1,324 residents (3.1%). This rate of decline was slightly greater than the previous year (2.7%) but was essentially equal to the average 3.2% decrease in the previous 3 years. State institution populations decreased in 40 of the 43 states operating such settings, with 3 states (Minnesota, Oregon, and South Dakota) reporting a combined increase of 14 residents. Rates of decrease by state ranged from less than 1.0% in Mississippi, Oklahoma, and Texas to 40.9% in Alabama.

Admissions in FY 2004 (2,497) equaled 6.0% of average daily residents. This represents a slight increase in number and percentage from the previous year (2,117 and 6.2%, respectively). Discharges in FY 2004 (2,938) equaled 7.0% of average daily residents, somewhat greater in number and proportion than the previous year (2,674 and 6.2%, respectively). Resident deaths (904) were 2.2% of average daily residents in FY 2004, a slight increase in number and percent from the previous year (873 and 2.0%, respectively). The national average cost per day per state institution resident in FY 2004 was $363.92, a slight increase (1.3%) from FY 2003. State average per resident per day expenditures ranged from $239.54 (Arkansas) to $853.59 (Minnesota).

Table 2 presents national summaries of these same statistics for FYs 1974, 1984, 1994, and 2004. It shows that during the 3 decades, the national average daily residents of state institutions decreased from 168,214 in FY 1974 to 41,792 in FY 2004 (75.2%), while state institution residents per 100,00 of total U.S. residents decreased from 78.8 in FY 1974 to 14.3 in FY 2004 (81.9%). Persons admitted to state institutions in FY 2004 were actually greater in 2004 (2,497) than in FY 1994 (2,243), but many fewer than in FY 1984 and FY 1974 (6,123 and 18,075, respectively). Persons discharged in FY 2004 (2,938) were many fewer than in FY 1994 (5,490), FY 1984 (8,484) and FY 1974 (16,807). Deaths among state institutions residents as a percentage of average daily residents were slightly higher in FY 2004 than in FY 1974 (1.7%), 1984 (1.4%), and 1995 (1.5%). In inflation-controlled dollars ($=2004), the per person average daily expenditures in state institutions increased from $100.57 in FY 1974 to $363.92 in FY 2004, with the average daily per person cost increase each decade in the range of $84 to $95.