Federal order formally diminishes reliance on state hospitals for disabled people

Aug. 25--A Richmond federal judge who conducted unannounced visits to state facilities for the disabled to learn firsthand about their operations and residents has agreed to implement a $2 billion settlement that will gradually diminish the state's reliance on the facilities and return hundreds of residents to neighborhood communities.

In addition, approval of the settlement agreement between the state and the U.S. Department of Justice will fund care for some 4,000 people who have waited years for assistance slowed by funding lapses and competing priorities.

The landmark order, entered Thursday in U.S. District Court in Richmond by Judge John A. Gibney Jr., was hailed Friday by key participants in a decades-long effort to diminish the state's reliance on warehousing intellectually and physically disabled residents.

The order "helps thousands of people with intellectual and developmental disabilities have the chance to have a home, a job and a life in the community," said Jamie Liban, executive director of the Arc of Virginia, a statewide support group for families and the disabled.

Gibney's compassion was evident throughout the case, and in unannounced inspections of state facilities that have been denigrated for years by some parties the judge concluded that he found them, as well as community homes, "clean, healthful and managed by caring staff members."

And the order also seeks to soothe families who opposed the agreement, fearful that severely disabled loved ones who've lived their lives in state facilities would be disrupted and tormented by forced moves.

"The intervenors ignore a provision of state law that forbids the horrible outcomes they conjure up," the judge wrote, adding that "the agreement compels Virginia to offer Medicaid waivers and associated services; it does not compel the shutdown of any Training Center."

A federal investigation begun of the Central Virginia Training Center in Lynchburg in 2008 led to findings by the U.S. Department of Justice of systemic violations of the Americans with Disabilities Act. In January, the state and Justice Department reached a proposed settlement agreement that would extend waivers to thousands of disabled people for community care and gradually disperse the populations of hospitalized residents into the community.

Gibney said that the state and federal government shared a common objective long before the settlement proposal, one that depleted the populations of institutionalized patients from some 6,000 people to less than 1,000 today.

Gibney's approval of the settlement agreement "is a significant step forward for all Virginians with developmental disabilities," Gov. Bob McDonnell said.

"Building on the developmental services system foundation that is now in place, the settlement agreement increases community waiver slots to provide community services for many of the thousands of individuals who have been on the waiver waiting lists.

"The agreement will also improve the discharge planning process at the training centers and enhance the quality and oversight of community-based services."

Lawyers for dozens of intervening parties in the case -- most of them families deeply opposed to the removal of their loved ones from the care afforded in the state hospitals -- declined comment yesterday, saying they needed to discuss with families what course to take.

Four of five training centers would be closed: Southside Virginia Training Center in Petersburg, in 2014; Northern Virginia Training Center in Fairfax, in 2015; Southwest Virginia Training Center in Hillsville, in 2018; and Central Virginia Training Center in Lynchburg, in 2020.

The Southeastern Virginia Training Center in Chesapeake would remain open.

The Justice Department also welcomed the judge's order describing it as providing relief to more than 5,000 people by expanding community services and supports, including Medicaid-funded home and community-based waivers, crisis services, housing and employment supports.

"We are committed to ensuring that the agreement is implemented fairly on behalf of all Virginians with intellectual and developmental disabilities," said Neil H. MacBride, U.S. attorney for the Eastern District of Virginia.

Gibney went to great lengths to praise the state-federal cooperation in reaching an agreement "to fund a broad range of services for disabled Virginians," and while he concluded the agreement intends no harm or diminishment of services, the "ultimate decision whether to close any Training Center lies not with the (Department of Behavioral Health and Developmental Services) but with the legislature."

Legislators already have illustrated a willingness to plow more money, some $60 million, into a so-called agreement trust fund that will fund new waiver slots even beyond those envisioned to meet terms of the agreement.

Gibney noted that some 2,900 people are on the urgent wait list for services and "must fend for themselves in dealing with disability." But many will receive new help through the agreement, thus balancing both the mandate to reduce institutionalization but also address the needs of people already in the community.

The settlement incorporates training programs for caregivers, an independent oversight office, new licensing standards and quality service reviews.

The settlement agreement became effective Thursday with the entry of the court's approval order.

bmckelway@timesdispatch.com (804) 649-6601

Copyright 2012 - Richmond Times-Dispatch, Va.