Gov. Mark R. Warner announced a sweeping $460 million spending proposal Tuesday that would replace several aging hospitals and training facilities for the mentally ill and retarded in Virginia while allocating more to community-based services for the mentally disabled.
The proposal, which Warner (D) will include in his upcoming budget and which will require approval by the General Assembly, calls for building four replacements for some of the state's oldest facilities for the mentally disabled: Western State Hospital in Staunton, Eastern State Hospital in Williamsburg, the Central Virginia Training Center in Lynchburg and the Southeastern Virginia Training Center in Chesapeake. The cost would be $290 million.
The plan also includes nearly $170 million in state and federal funds to help move hundreds of the nearly 3,000 people in the state's 15 institutions to smaller group homes in their communities and increasing outpatient services for those who live in group homes across the state.
Warner's initiative would be the largest investment in a generation in Virginia's underfunded mental health system, several lawmakers and advocates for the disabled said Tuesday.
For years, the state has been slow to move people with mental disabilities out of institutions when they are eligible to leave, largely because money was never made available for the task.
In addition, more than 2,900 people with mental disabilities are on waiting lists for community services, such as therapy and job training. Now that Virginia is on sound financial footing, Warner said, it is time to address a problem that has beset state officials for years.
"It might be another decade before we have a chance to do what we are proposing today . . . unless we can step up and bite the bullet on some of our aging institutions now when we have some financial resources," Warner told dozens of lawmakers, state officials and advocates during the morning announcement at the state Capitol.
G. Paul Nardo, chief aide to House Speaker William J. Howell (R-Stafford), said House Republicans generally agree that Warner's approach is the right one. But they have discussed a slower pace than Warner has proposed for moving mentally ill and disabled patients to community care.
"Having people live in the community certainly makes more sense," he said. About Warner's plan, he added: "To say it's good or bad . . . we can't do that at this point."
State officials said money for community-based care would probably help reduce waiting lists for small group homes and increase money for caregivers who have received only incremental pay raises in recent years. Virginia has some of the lowest reimbursement rates in the country for agencies and employees who take care of the disabled in group homes and other community centers.
The proposal is the fulfillment of a promise the state repeatedly has made to residents with mental disabilities. In 2004, the legislature added $40 million to help provide places for people to live in their home towns. But in many cases, those with disabilities couldn't return to their communities or receive the local services because staffing and other resources were not available. Advocates and family members who were on hand Tuesday said they hoped this initiative would begin to fill long-standing gaps in the system.
"This gives us hope," said Trudy Rinear-Tharp of Montpelier, whose 23-year-old son is on a waiting list for community-based services. "We've been waiting a long time for these opportunities."
Warner would help pay for the initiative with budget surpluses that totaled nearly $550 million in the fiscal year that ended June 30 and which are expected to increase to about $1 billion over the coming year.
Warner also assured those whose family members need to remain institutionalized that resources will be available to care for them. Eleven facilities for the mentally ill and disabled in the state will receive funding for improvements.
"Let me offer this assurance to advocates and family members: We believe everyone who needs a bed in a state facility will have one. But whenever possible, we will serve people in the community as our first option," he said. He added that the state is attempting to move from the current ratio of one patient in community-based care for every institutionalized one to at least two patients in community care for each one who is hospitalized.
"This is a historic shift for Virginia," said Sen. Janet D. Howell (D-Fairfax), who has long supported more money for community care.
"We're going to give the appropriate care in the appropriate setting, and it's humane and compassionate," Howell added.