Report: Care of Virginia's disabled under fire

In a 20-page assessment of Virginia's care for the disabled released Feb. 11, federal investigators detail hundreds of mentally and physically challenged people languishing in state facilities, subject to harm and neglect.
"Virtually no one who has been institutionalized long-term… ever leaves," one section of the report states, referring to residents at the sprawling Central Virginia Training Center in Lynchburg.
"Some individuals have been ready for discharge for a decade or more," the report states, noting a rate of release to community-based care so low that "the vast majority" of center residents "will not move into the community in their lifetime."
Sent to Gov. Bob McDonnell late Feb. 10, the long-anticipated report gives the state 49 days to respond favorably to a litany of adverse findings affecting five state institutions housing 1,100 individuals; but it also draws attention to the condition of 8,600 other persons in the community served by money from federal care waivers and to 6,400 others waiting for help, 3,000 of whom are regarded as critically in need.
Department of Justice officials with the office's civil rights division said their investigation, which began in 2008, could result in litigation if the state does not react appropriately to the findings.
The report cites glaring gaps in complying with the federal Americans with Disabilities Act and, while acknowledging as "commendable" proposed budget increases toward care by the governor, says the current effort "is far from adequate."
McDonnell sponsored legislation as a state delegate that intensified efforts to transition disabled people into the community and he has proposed $30 million in funds to create community-based care slots.
Disability advocates hailed the report and McDonnell's response as "a significant step" that will focus increased attention on a festering problem in the state; Virginia ranks near the bottom among other states in terms of money allocated for the care of intellectually and behaviorally disabled people.
"We feel like the state now is not fighting this so much as marching in line with it," said Dr. Fred Orelove, executive director of Partnership for People with Disabilities at Virginia Commonwealth University.
Orelove said the report's focus on the Central Virginia Training Center is a real but also symbolic assessment of ills within the state's system of care. Central Virginia Training Center was at one time called the State Colony for the Epileptic and Feebleminded; thousands of children were sterilized there in the 1930s in a misguided effort to rid Virginia of mental illness and genetic behavioral problems under the guise of the eugenics movement.
Howard Cullum, president of the advocacy group The Arc of Virginia, said the report validates 40 years of pleas for increased community care voiced by the disabled, their families and concerned citizens.
The report made public Friday focuses on decades of funding insufficiencies, even as investigators turned up case after case of institutionalized people perfectly capable of living independently within relatively less costly systems of home- and community-based care.  
The investigation found that the center spends "almost $120,000 more per year to serve a person confined" there than the money needed to serve the same person in the community.
In Norfolk, the 40-year-old Hope House project has established a system of care for the disabled that utilizes federal and state funds and local donations to provide housing, training and jobs for some 130 disabled people at $6.6 million a year.
Hope House Director of Development Elena Montello said Friday, "We began because a group of families didn't want their loved one to be institutionalized."
But statewide the numbers in need are staggering, the Department of Justice found. Virginia's own studies estimate that funding for between 400 and 1,000 new slots for community care (paid by state and federal funds) is needed annually simply to reduce waiting lists.
The governor's budget proposal creates only 275 new slots.
The report is laced with examples of people living successfully and independently in the community, free of the routines of institutional life that harm self-image and stifle learning.
But failures are more abundant.
A 34-year patient cited in the report who entered the Lynchburg center at age 12 was ready for discharge in 2006. But investigators could find no record that staff members were ever able to locate an available placement.
Bill McKelway is a staff writer for the Richmond Times-Dispatch.