A Painful Choice Over the Mentally Disabled

Peggy Kube of Spotsylvania had to place brother Terry Leatch in a group home outside of Lynchburg because there were no spots available near her.
Peggy Kube of Spotsylvania had to place brother Terry Leatch in a group home outside of Lynchburg because there were no spots available near her. (Photos By Jahi Chikwendiu -- The Washington Post)
By Chris L. Jenkins
Washington Post Staff Writer
Tuesday, December 19, 2006

It was a decision that Peggy Kube thought she would never have to make: Her brother, Terry Leatch, a 50-year-old with severe mental retardation, needed a new group home with more supervision. He wanted to stay near his sister because their parents, who doted on him for years, were dead.

But there was no place for him near her Spotsylvania County home -- not in Fairfax, not in Loudoun, not in Prince William. So she did the once unthinkable and had him moved 200 miles from his sister "Peg" to a group home outside Lynchburg, Va.

"I can't imagine that this is what my parents ever wanted for him . . . being so far away from family after we tried for so long to have him near us," said Kube, 61. "They were focused on family, keeping our family together the best way they could."

Like Kube, several dozen Northern Virginia families have sent mentally disabled relatives to facilities hundreds of miles away over the past few years because there is no space for them at the area's few homes. Escalating land, labor and other costs have prevented enough homes from opening at a time when the region's population and health-care needs are rising.

Virginia has long had a poor reputation for caring for the mentally disabled, and the problem is particularly acute in its suburbs outside Washington, local officials said.

Nearly 1,400 Northern Virginians with mental disabilities get a Medicaid-funded waiver to receive services -- largely group home beds -- in the community in lieu of being placed in institutions. But because of funding shortages, nearly as many are on years-long waiting lists to receive this community care, which is cheaper than placing the mentally disabled in the large facilities downstate.

A 2004 University of Colorado report found that Virginia was 47th in the nation in funding for the mentally disabled.

As a result, the rare instance of a new Northern Virginia group home opening often follows one closing, advocates and local officials said. In addition, several agencies have scaled back operations to cut costs and stay open.

Gov. Timothy M. Kaine (D) included money for 170 more group home beds throughout the state in the budget he proposed Friday. But he did not include a $5.5 million annual increase that Northern Virginia providers had sought to help defray the higher costs of doing business in the area.

For families, the lack of facilities creates heartbreaking decisions and strained relations as visits become less frequent.

To health-care advocates, the situation makes no sense. For years, they have tried to move the mentally disabled out of large, distant facilities into smaller, community-based ones near family.

"It's been like we've taken two steps forward and are now taking four steps back," said Nancy Mercer, executive director of the Arc of Northern Virginia, an advocacy group for the mentally disabled. "We're undercutting the ultimate point of our system, which is to provide community care for people to live in their communities."

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