Surveys of state intellectual disabilities and developmental disabilities (ID/DD) program agencies and 173 individual state institutions (16 or more residents) for persons with ID/DD for Fiscal Year (FY) 2006 indicate continuing decreases in state institution populations. As shown in Table 1, during FY 2006 (July 1, 2005–June 30, 2006), populations of state institutions decreased by 1,344 residents (3.4%). This annual rate of decline was equal to the average 3.4% decrease of the previous 3 years. State institution populations decreased in 35 of the 42 states operating such settings, with 7 states (Arkansas, Colorado, Idaho, Minnesota, Mississippi, Utah, and Wyoming) reporting a combined increase of 45 residents. Rates of decrease among other states ranged from less than 1.0% in Maryland and New Hampshire to 20.7% in Delaware.

Table 1

Average Daily Residents (ADR), Resident Movement, and Expenditures in State Institutions in FY 2006

Admissions in 2006 (2,094) equaled 5.4% of average daily residents. This was very similar to 2005 (2,106, 5.2%). Discharges in 2006 (2,608) equaled 6.8% of average daily residents, slightly greater than in 2005 (2,561, 6.3%, respectively). Resident deaths in 2006 (916) were 2.3% of average daily residents, a slight increase in number of residents and percentage from the previous year (905 and 2.2%, respectively). The national average daily cost of state institution care in FY 2006 was $453.59, an increase of 11.3% from FY 2005. State average per resident per day expenditures ranged from$245.83 in Texas to $917.04 in New York. Table 2 represents national summaries of these same statistics at 10-year intervals from 1966 to 2006. It shows that during the 4 decades, the average daily population of state institutions decreased from 191,584 in 1976 to 38,137 in 2006 (80.1%). Although the raw numbers of residents decreased more slowly between 1996 and 2006 (21,208) than between 1986 and 1996 (40,244) and 1976 and 1986 (53,404), the rates of decrease in resident populations were relatively similar in each of the three most recent decades (between 34.8% and 40.2%). State institution residents per 100,000 of the population of the United States decreased from 98.8 in 1966 to 13.1 in 2006. Persons admitted to state institutions in 2006 (2,094) were fewer than in 1996 (2,537), 1986 (6,535), 1976 (17,053), and 1966 (15,153). Persons discharged from state institutions in 2006 (2,608) were fewer than in 1996 (4,652), 1986 (9,399), 1976 (16,433), and 1966 (9,268). Deaths among state institution residents as a percentage of average daily residents in 2006 (2.3%) was greater than in 1996 (1.7%), 1986 (1.3), 1976 (1.7%), and 1966 (1.9 %). In inflation-controlled dollars ($ = 2006), the average daily expenditures in state institutions increased more than 10-fold from $43.32 per person in 1966 to$453.59 in 2006. By far, the largest proportional increase came in the decade between 1966 and 1976, when per person daily expenditures increased (in 2006 dollars) from $43.32 to$127.19 (194%). Between 1976 and 1986, per person costs increased 88%. In the 1986– 1996 and 1996–2006 decades, cost increases were in the range of 35% to 40%.

Table 2

Forty-Year Trends in Residents, Resident Movement, and Costs in State Institutions for Persons With ID/DD Trends by Decade

Table 1

Continued