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Virginia expects scathing U.S. critique of system for caring for developmentally disabled

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Washington Post Staff Writer
Sunday, January 23, 2011; 7:06 PM

In coming weeks, civil rights lawyers from the U.S. Department of Justice are expected to deliver a searing critique of Virginia's system for caring for people with profound developmental disabilities.

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The commonwealth has been slower than most states in moving hundreds of developmentally disabled people out of large institutions such as the Northern Virginia Training Center on Braddock Road in Fairfax County, and state officials expect that to be one of many problems cited by the Justice Department.

Originally launched as an investigation of the Central Virginia Training Center in Lynchburg, the federal probe widened after the Obama administration took office and the Justice Department began taking a harder look at states that continue to rely heavily on large institutions to care for people with profound developmental disabilities.

For decades, states have been closing such facilities. Ten states and the District no longer have any. Under court order, the District closed Forest Haven in 1991. And Maryland, which had faced its own federal probe, closed the controversial Rosewood Center in Owings Mills in 2009.

Most states still operate some large institutions, but a handful have lagged especially far behind, among them Arkansas and Virginia, which have been the focus of federal civil rights investigations.

Arkansas was sued by the Justice Department last spring, accused of illegally segregating hundreds of disabled people.

Now Virginia, which cares for 1,100 people at its five training centers, faces its own reckoning with the Justice Department's Civil Rights Division, which expanded its inquiry to examine not only how people are being treated at the training centers but also whether they should be in the institutions in the first place.

The state's top mental health official, James W. Stewart III, told the General Assembly this month that he expects the Justice Department to find that the training centers provide inadequate care, that people are not served in the most integrated settings and that the state doesn't spend enough money to serve everyone eligible for community services.

More than 60 years after the first of several state legislative reports that urged a shift toward community care, Virginia retains a system rooted in large institutions. The number of people in community care has increased, and the number of people in institutional care has decreased. But all five training centers - in Chesapeake, Fairfax, Hillsville, Lynchburg and Petersburg - remain open, making Virginia one of only 10 states that have not closed any of their large institutions for the developmentally disabled.

About 36,000 people with developmental disabilities in Virginia receive services through local and state programs. About 1,100 of them are in the training centers, and 8,000 are receiving intensive community services intended to avoid institutional placement. But more than 5,000 people eligible for the same sort of intensive services, including more than 1,000 in Northern Virginia, are stuck on slow-moving wait lists.

In a sign of how halting and conflicted Virginia's transition has been, the state broke ground last year on a $23 million project to replace its training center in Chesapeake with a smaller facility. It was a decision that left almost no one happy - neither the families who placed loved ones at the Southeastern Virginia Training Center decades ago and have fought to preserve it, nor the families who have struggled to obtain community-based services, only to see millions of dollars pumped into the large facilities.

In his presentation to the General Assembly this month, Stewart said the state's system for caring for people with developmental disabilities has evolved too slowly. Considerable resources continue to be invested in institutions, even as demand for them declines, and too little money is spent on building a system that can provide quality community-based care.

"As we look to the future, we will need to rethink Virginia's model," said Stewart, head of the Department of Behavioral Health and Developmental Services.

Hoping to jump-start that effort - and to begin addressing the Justice Department's criticisms even before they are official - Gov. Robert F. McDonnell (R) and his administration have been laying out what the governor calls a $30 million "down payment" on the future.

The proposed spending package envisions a number of improvements. It would add almost 300 slots to the program that funds individualized community services, bolster oversight of community providers, and create crisis intervention programs across the state for people with developmental disabilities who might otherwise be returned to an institution.

Jamie Liban, executive director of the Arc of Virginia, which advocates for the developmentally disabled, said the proposal marks a significant step forward. But, she said, the fiscal challenges facing the state will make the effort that much more challenging.

"The down payment is an excellent start, but we've got to keep it going," Liban said. "We have to address the waiting lists, restore funding that was cut and come up with a solid plan to move to a community system."


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