A landmark settlement between the U.S. Department of Justice and the Commonwealth of Virginia marks the beginning of the end of a shameful era of warehousing severely disabled persons. After a two-year federal investigation found multiple violations of the Americans with Disabilities Act, Virginia has agreed to phase out four of its five “training centers,” including one in Fairfax County, and spend $2.1 billion over the next decade to expand its system of community-based care with the goal of increasing options for independent living.
A February 2011 “findings” letter by DOJ outlined the damage done by Virginia’s “needless and prolonged institutionalization” of its disabled population. Assigned to “units” of eight to 12 people, training center residents are afforded “very limited privacy,” spending most of their waking hours in depressing, prison-like day rooms with “minimal decorations and little home-like furniture.” They are not even allowed to choose what they’d like to eat or which programs to watch on the group TV. The resulting “learned helplessness” inevitably leads to “regressive consequences” — such as repeated accidents and injuries, behavioral problems, and the use of “planned restraints … as an intervention of first, rather than last, resort.”
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Since their establishment in 1911, very little training has been done in these so-called “training centers,” so virtually no long-term residents are ever able to leave. For unfortunates institutionalized at the tender age of 5 or 6, their disability became a life sentence in more ways than one. As one of just five states still operating such outdated institutions, Virginia was also found to be in violation of the U.S. Supreme Court’s 1999 Olmstead decision, which requires serving the disabled in the most integrated settings possible.
According to state figures, substandard care in training centers cost $216,000 per resident annually — more than twice the statewide average of $138,000 for community-based care. The centers absorb 63.8 percent of all statewide appropriations for individuals with intellectual disabilities, but support only 15.6 percent of this population, so moving the centers’ remaining 1,000 residents into community-based programs will actually save taxpayers a substantial amount.
The savings will be used to whittle down a long waiting list for Medicaid waivers, including about 3,000 cases currently considered “urgent,” as well as fund unannounced licensing inspections of group homes and create 24/7 mobile crisis teams statewide. After a century of keeping disabled citizens in Virginia out of sight and out of mind by consigning them to dreary, soul-killing institutions, it’s about time.
