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A database was assembled from data collected on all people served by the Developmental Disabilities divisions of Nebraska, South Dakota, and Wyoming, including state institutions and state-funded programs (n=5,928). Information included provider expenditures associated with each individual, allocations made by individual reimbursement rates, services/supports received, funding sources, and individual characteristics as measured by the Inventory for Client and Agency Planning. Results from the analysis found institutions had the highest costs. Although Home and Community-Based Service recipients experienced lower levels of independence than people funded with state money, their costs were higher. South Dakota's people had the highest independence scores. This was attributed to their relatively high utilization of supervised apartments and supported living. Wyoming's costs and rates were higher than those for the other two states, presumably a result of the "Weston v. Wyoming" lawsuit. Supported employment was less expensive than community facility-based daytime programs but this finding was not consistently found in all states. South Dakota, which had a relatively higher utilization of supported employment, also had significantly higher supported employment costs. Evidence substantiated a diseconomy of scale function, as costs increased steadily with agency size. (Contains 23 references.) (CR)

The changes in what people with developmental disabilities wanted and got for living and daytime settings in South Dakota and Wyoming during 1988 were compared to what they wanted and received in 2000. Although the percentage of people in their desired setting rose, there were substantial changes in the types of settings recommended over the years. The numbers of people for whom large residential facilities were recommended generally declined. Conversely, the recommendations for supported employment and supported living rose sharply. The barriers to people getting social and leisure activities were also analyzed. Data from Nebraska were added to the analyses. The Home and Community-Based Services expansion of services reduced some of the social barriers to community integration and independence and increased positive social activities for many of the 7,034 people served in Nebraska, South Dakota, and Wyoming. South Dakota hit a high point in 1987, with 87 percent of its people getting the program they wanted, and is approaching that high with the current 83 percent rate. Wyoming reached a new all time high of 83-90 percent of its people getting the programs they wanted in 2000, while Nebraska's rate was 77-82 percent. (Contains 46 references.) (Author/CR)