Virginia will shut down four facilities that provide services for the intellectually disabled as part of a settlement agreement reached with federal authorities whose investigation concluded that the state was mistreating these vulnerable residents. Under the agreement announced Thursday, the state will spend $1.1 billion, including $580 million in new spending, over the next decade to shift its mentally and developmentally disabled residents to community-based home care. The cost of institutionalization is $216,000 per patient per year, compared with $75,000 in the community, so officials hope the move saves money over the long term.
The settlement stems from a 2008 federal investigation of the Central Virginia Training Center, in which the Justice Department found the state violated the Americans with Disabilities Act by unnecessarily institutionalizing a large number of the state’s disabled population. By 2010, federal officials determined that the problem existed in four other facilities as well.
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Four of the five state centers will close their doors by 2020, including one in Northern Virginia expected to shut down by 2015. Their 800 occupants will transition to community care. An additional 3,000 intellectually disabled and 450 developmentally disabled patients will receive Medicaid waivers to start home and community care.
“We are happy to have this part of the discussion behind us, but know our road ahead has a lot of work,” said Virginia Secretary of Health and Human Resources Bill Hazel.
Advocacy groups are cautiously optimistic that this is Virginia’s first major step toward complying with a 1999 U.S. Supreme Court decision that requires states to integrate their disabled residents into the community.
“If I said, ‘It’s about time,’ that would probably be an understatement,” said Karen Michalski-Karney, president of the Virginia Association of Centers for Independent Living. “It’s been slow, but we’re moving ahead.”
Still, the Medicaid waivers will assist less than half of the 7,000 intellectually disabled and 1,000 developmentally disabled waiting for such help, said Doris Ray with the ENDependence Center of Northern Virginia. And even as Gov. Bob McDonnell’s two-year budget provides an additional $60 million to start funding the settlement, he reduces Medicaid eligibility for long-term care recipients and cuts back the number of hours of at-home care the state will pay for someone to receive.
“This is a landmark agreement, a blueprint for sustainable reforms,” said Assistant U.S. Attorney General Thomas Perez. “[But] it’s important to know this is the floor, it’s not the ceiling.”
