exclude_category option was never intended to simply hide categories from the drop down, it was meant to complete exclude them and their entries. Basically, it was buggy.
What you can do is create a “Specialty” category and move categories ‘1,2,3,4,5,57’ to be children categories and then Create a “Countries” category and move the countries to be children categories. You can safely make these changes. It will no affect how the entries are assigned or the parent child relationship you already have, ie, the states as children categories of the United States.
After made those changes, you can use the method outlined in this FAQ. The FAQ is for cMap, but it works with Tile Plus too.
Your shortcode would be something like:
X would be the category ID of the “Regions” category.
Now that I think about it more…
You do not even need the “Specialty” category or move the specialties. you just need the “Regions” category with all the regions under it for the shortcode to work.
Hope that helps!