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Va. Hits Snag On Services For Retarded

Unused Treatment Slots Tied to Too Few Providers

By Chris L. Jenkins
Washington Post Staff Writer
Saturday, November 27, 2004; Page B01

RICHMOND -- Virginians with mental disabilities have been able to use a little more than half of the guaranteed treatment slots the state made available this year, because many cannot find providers to supply the services, according to a state audit.

In Northern Virginia, about a third of the available slots have been used, the audit found.

As a result, some families taken off five-year waiting lists when the General Assembly expanded the number of treatment slots are still awaiting help. Parents continue to care for adult children with mental disabilities.

"The services are coming very slowly," said C. Lee Price, director of the state's Office of Mental Retardation Services. Price said that once a service is authorized for a person with cerebral palsy or other ailments, it should begin within 90 days.

In the spring, many of those who work with the disabled celebrated the infusion of $40 million -- the most the program has ever received from the state -- and believed that they had won a long battle to extend care to more people.

Payments for services are granted in lieu of placing those with mental disabilities in large institutions. A combination of state and federal financing pays for certain people with mental disabilities to live in group homes or to receive visits at home from health aides and buy specialized equipment.

Organizations that provide home health aides or nurses and operate group homes have been unable to meet the demand, state officials said.

In addition, many said they cannot afford to take on more clients, because Virginia's Medicaid program pays a fraction of the actual cost of services, the audit found. The problem is particularly acute in Northern Virginia, where the cost of doing business is higher.

"We knew that we were going to have a problem with providers, but the money just wasn't there," said Sen. Janet D. Howell (D-Fairfax), who sits on the Senate Finance Committee. "This is something we're going to try to address next session, to make sure that we can follow through with making sure we can provide services for those who truly need it."

Of the 723 slots made available in May, 381 have been used, according to the study, conducted by Mental Retardation Services and released last week. In Northern Virginia, where 149 treatment slots were made available, 51 people have received the guaranteed services, the study found.

"People have been on the waiting list for so long, and now they realize that a [slot] is really not the answer," said Nancy Mercer, executive director of the Arc of Northern Virginia, which works on behalf of the mentally disabled. "That has been very disappointing."

The state reported that 100 slots have gone unfilled because health care organizations could not perform the services or did not have the space available for new clients. In 53 other cases, the state reported, the clients' needs were too complex and they could not be given the help they were entitled to.

"What's going to help," Price said, "is trying to increase the rates that we are able to pay the providers."

The inability to find enough service providers is the latest hurdle for the state's mental retardation program. Another study found that in 2002, about one in four people with mental retardation and developmental disabilities lived in institutions, which was twice the national rate.

Virginia also ranks last among the 50 states in a comparison of what they pay for community care as a percentage of what they pay for institutional care, according to an analysis by the University of Colorado.

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