Virginia wastes millions of dollars providing deeply flawed services to the state’s mentally handicapped residents, according to a scathing critique issued by the U.S. Department of Justice. The state’s insufficient services put it in violation of the Americans With Disabilities Act, the report said. Virginia has about 50 days to show signs of reform, or it could face a federal lawsuit. Some 1,100 people with mental disabilities live in state-run institutions at the cost of nearly $200,000 per person per year. Virginia is one of only five states that still operate such facilities.
About 8,600 people in the state receive support in their home communities — the preferred setting under law — using Medicaid waivers worth an average of $76,400 each. An additional 6,400 people are on a waiting list for aid.
“The Commonwealth continues to spend far more proportionally on institutional than community care … [and] continues to invest millions of dollars in new construction and remodeling of its training centers instead of seriously investing in the community services necessary to transition people,” the report said.
It added that hundreds of people are “unnecessarily institutionalized,” and many more are at risk of institutionalization because of too little money allocated for Medicaid waivers, and too few community-based services.
The largest of the institutions, Central Virginia Training Center just outside of Lynchburg, was reprimanded for excessive use of restraints on patients, for “day rooms [that] are bare and impersonal, with minimal decorations and little home-like furniture,” and for failing to discharge patients even after they’ve been deemed eligible.
About 140 of the institution’s 170 patients eligible for discharge have been on the list since 2007 or earlier, including some who’ve been eligible for more than a decade.
The findings are in line with a 2010 report by the state’s inspector general, and Gov. Bob McDonnell announced in his State of the Commonwealth address a $30 million proposal “that will strengthen our system of care for persons with disabilities,” in part by removing them from institutional settings.
However, in its recommendations the report said the 275 additional Medicaid waivers currently proposed are far too few. The 2010 state report recommended up to 1,000 more to address the wait list alone.
Del. Patrick Hope, D-Arlington, called Friday for additional waivers and more dollars directed at community-based services.
“I recognize this will require a significant investment of resources, but we have been underfunding these services for decades and it is high time we met our obligation to our most vulnerable citizens,” he said.
