Fifteen years after a landmark Supreme Court ruling on giving people with disabilities a choice to live outside institutions, South Carolina has shown little progress.
But state officials say they're working to change that.
Since 1999, the percentage of Medicaid funds spent to help people live independently has nearly doubled. But progress varies widely, with states devoting anywhere from 27 percent to 78 percent on non-institutional spending.
South Carolina ranks behind 40 other states and the District of Columbia by spending 41 percent of Medicaid long-term care funding on home and community services in 2012. That's up from 35 percent a decade earlier, when the state ranked 22nd, according to the Centers for Medicare and Medicaid Services.
"We do have a long way to go" in funding more cost-effective, humane care, said Sue Berkowitz of the Appleseed Legal Justice Center.