For Aging Parents, Help Just in Time

"These families really have nowhere else to turn," said Sen. Janet D. Howell (D-Fairfax), a member of the Senate Finance Committee, which pushed for the expanded program this year. "When we talked of funding core services this year in the Senate, it is these families that we were talking about."

The additional slots also mean that about 200 mentally retarded individuals will be moved from institutions and into their home communities. For years, advocates say, Virginia has also been slow to move people with mental disabilities out of institutions when they are eligible: A state study found several years ago that about one in four people with mental retardation and developmental disabilities lived in institutions in 2002, which was twice the national rate.

Several advocates said that the state has been on the brink of violating federal standards by not moving people out of institutions fast enough.

But there are still hurdles in supplying the necessary services to the mentally disabled. Even though funding for more group home placements will be available this summer, each locality will have to scramble to find manpower -- nurses and health aids -- to serve these patients.

The challenges are greatest in Northern Virginia, where the cost of housing, wages and everything else is higher.

"Finding people to work in the field -- particularly in Northern Virginia, is very, very hard," said Mary Ann Bergeron, executive director of the Virginia Association of Community Service Boards, which supervises the local agencies that help manage the waiver program for cities and counties. "It's going to be a challenge even though we now have the slots."

In addition, advocates and lawmakers point out that still more mentally disabled people are on the waiting list and that the list will continue to grow. The urgent care list grew from about 970 to 1,300 in six months at the end of last year.

"We still have work to do," said Sen. William C. Wampler (R-Bristol), one of the chief advocates for the program in the Senate. This list will continue to grow, and we're probably going to have to play catch-up again."

Like several other lawmakers, he said this year's effort was a start. "We're getting there," he said.