Does Virginia Need Training Centers? — Continuing Discussion

In the 2014 session of the Virginia General Assembly, the legislature passed Senate Bill 627, which instructed the Department of Behavioral Health to convene a work group to consider options for expanding the number of training centers that remain open in Virginia.

That work group has now met twice. It is clear that the Commonwealth remains committed to supporting a community based service system. There are many advocates on the workgroup who support that commitment, especially in light of the growing numbers of people who are on the waiting list for services. It is equally clear that a small group of parents are resistant to that service system shift.

Read more about the information being considered by the workgroup at this link: http://www.dbhds.virginia.gov/ODS (Scroll down about half way to the section called “announcements.”)

If you want to comment on the Commonwealth’s commitment to community based services for people with intellectual disabilities and the prospect of keeping more training centers open, you can email to sb627@dbhds.virginia.gov

or send your comments by hard copy to

SB627 Work Group
DBHDS
1220 Bank Street, Room 1323
Richmond, VA 23219

The next meeting of the work group will be on September 5, 2014 at 10 am. The group meets in the capital building in downtown Richmond.

Does Virginia need Training Centers? part 3

First, let me thank all of you who have shared comments about this series, either directly here on this wordpress blog or through our dlcv facebook page. I do intend to try to respond to the comments before I complete this series, but first, let me throw another consideration into the mix:

Virginia, more so than many other states, has a bad case of inertia. Here in the Old Dominion, we are resistant to change. Remember that although women got the right to vote federally in 1920 with the passage of the 19th amendment, Virginia rejected that amendment in 1920. We did not subsequently ratify the 19th amendment until 1952 — thirty two years after women had been voting. So too, with so many other areas of civil rights progress. The Commonwealth’s history of accepting racial civil rights is scarred with one act of defiance after another. We don’t like change.

Likewise with the Integration Mandate. The Integration Mandate was a key component of the Americans with Disabilities Act, passed by Congress in 1990, almost 25 years ago. That law requires that state and local governments must operate all of their programs in the most integrated setting possible. The Supreme Court issued its clarifying decision, LC v Olmstead, in 1999. That decision made clear that states must serve people with disabilities in the most integrated setting possible, and must move towards greater integration at a pace that does not seek to keep institutions open. Now, fifteen years later, Virginia continues to resist that change and seeks ways to keep its institutions open.

Do we really need training centers? Or are we fearful of change? Are we simply resistant to the change in our communities, and our lives, that closing the training centers will mean?

Does Virginia Need Training Centers — part 2

When the question comes up, some argue that we need training centers for individuals with the most complex needs. Some believe that the people who currently live in training centers have a higher level of need than those who live in the community and that the community, at least the community in Virginia, is just not prepared to meet that level of need.

Is it true that the people living in training centers have more complex needs than those living in the community? According to the National Council on Disability, in a report entitled “Unfinished Business,” this claim is a myth. The report states that “More people with extensive support needs are served in the community rather than in institutions, demonstrating that all people with ID/DD can be served effectively in the community. While many people in institutions have very significant impairments and will require extensive supports to live in the community, many people with the same level of impairments are already successfully receiving those supports in the community. Many are living with families, with few paid supports.”

We actually know that, in Virginia, the community can serve people with very complex needs. For example, in 2010 a study was conducted by Human Services Research Institute, looking at the population living at Southeastern Virginia Training Center. The HSRI study compared residents of SEVTC with 521 people with disabilities living in community homes around the state. They found that while the needs of SEVTC residents were on average greater than their non-institution counterparts, the developmentally disabled with the most severe challenges were not living in institutions at all, but instead were living in the community.

The community does know how to serve people with very complex needs, and has been serving those needs for many years, even in Virginia. Yet, the belief runs deep that we need training centers, and only training centers, for those with the most complex disabilities. Where does that belief come from?

Does Virginia need training centers?

Virginia operates five large institutions for people with developmental disabilities, which we call “training centers,” and which have a total population of just under seven hundred people. In a few months, the Commonwealth will close just one of those institutions, Southside Virginia Training Center, in Petersburg. Four other institutions will remain open for a little while.

However, in order to improve services in the community, under an agreement with the United States Department of Justice, the state plans to close three more of the training centers over the next six years. Eventually, just one institution will remain, in Chesapeake, for no more than 75 people.

At least, that is the plan. And that plan has some people worried. Last month, some family members testified before the General Assembly, arguing that the state needs to keep its training centers open. Only in training centers, they argue, will their family members be safe and cared for. These citizens believe that their loved ones have needs that are far too complex to be served in community settings.

Is it true? Does Virginia need training centers? The General Assembly seems unsure. The House and Senate passed legislation, now on its way to the Governor, that calls for a stakeholder group to consider keeping more training centers open. What is happening in Virginia? Is this the right direction for us?

Community Integration matters

Check out this wonderful video about a meaningful life in the community:

This is someone who was once confined to a training center in Virginia. This is what community integration is all about!

Kudos to the Virginia Board for People with Disabilities for this production.

The R word …. again?

We were surprised to read that the Social Security Administration declared its plan to start using the term “intellectual disability” in place of “mental retardation.” After the passage of “Rosa’s Law” two years ago, we thought that federal agencies had already dropped the use of the “r” word. (see “The R Word in Federal Law,” blog entry below, June 2, 2010) But Rosa’s Law applies only to federal health, education and labor policy and Social Security was not required to make this change.

Thankfully, the Social Security Administration has decided to drop the “r” word. Many believe the term “retardation” has a negative meaning. According to Social Security, “Advocates for individuals with intellectual disability have rightfully asserted that the term ‘mental retardation’ has negative connotations, has become offensive to many people, and often results in misunderstandings about the nature of the disorder and those who have it.”

To make this happen, Social Security is proposing a rule change: “Consistent with the concerns expressed by Congress when it enacted Rosa’s Law, and in response to numerous inquiries from advocate organizations, we propose to revise our rules to use the term ‘intellectual disability’ in the name of our current listings and in our other regulations.” The agency stresses that the change in terminology will not affect how disability claims are evaluated.

The proposed change was published on January 28th, so the time left to comment is very short. The 30 day comment period closes on February 27, 2013.

To offer your comments, follow this link: http://www.regulations.gov/#!documentDetail;D=SSA-2012-0066-0001

Landmark agreement for People with DD

Last month,  the Commonwealth of Virginia and the United States Department of Justice  announced a comprehensive plan to resolve widespread violations of the Americans with Disabalities Act as they relate to services for people with intellectual and developmental disabilities.    The plan requires the addition of thousands of Medicaid waiver slots, necessary to enable people with disabilities to transition from training centers and for those already in the community to receive the services they need.  The agreement mandates the creation of crisis response services, enhances case management services for all individuals covered by the agreement, and requires integrated housing.  The agreement calls for the closure of four of the state’s five training centers by 2020.  The parties agreed to an independent reviewer to evaluate the state’s compliance with the terms of the agreement.

This agreement arose from an investigation that began many years ago, starting at the Central Virginia Training Center in Lynchburg.  In February 2011, the Department of Justice found that conditions inVirginia’s state-operated institutions for people with intellectual and developmental disabilities violate constitutional standards.  DOJ also concluded that the inadequate system of community services and supports for persons with disabilities inVirginia violates the Americans with Disabilities Act.   The lack of such services, DOJ concluded, forces people to remain in overly restrictive settings like training centers.

Read the agreement  here:

http://www.vopa.state.va.us/News/Press%20Releases/virginia_settlement.pdf

The agreement must still be approved by a federal judge and the agreement needs sufficient funding from the General Assembly.   People with developmental disabilties have waited for decades for these services.  It is time for the court and the legislature to step up.

Virginia’s Training Centers violate the ADA

On February 10th, the United States Department of Justice sent a letter to Governor McDonnell concluding that Virginia is in violation of the Americans with Disabilities Act in the operation of its developmental disabilities services.  The 21 page letter concludes that Virginia does not serve its residents with intellectual disabilities in the most integrated setting possible and that Virginia further violates the ADA by maintaining a waiting list for community based services that exceeds 3000 people.   DOJ concludes that the discharge process at Central Virginia Training Center and other training centers is inadequate and that staff at CVTC and other training centers are not knowledgeable about the availability of community services.  The letter details conditions at CVTC that are typical of all five of the states training centers — overuse of restraints, inadequate programming, absence of community integration, and isolated and depersonalized living conditions.  The letter finds that even when individuals want to be discharged and all parties agree that they can be discharged from the training centers, the individuals remain stuck in isolation. 

DOJ commends the Governor for cooperation in the investigations and expresses hope that the Commonwealth will continue working towards an amicable and cooperative agreement to resolve the findings.  Indeed, VOPA commends the Governor and his administration for making a strong first step towards remedying the violations found by DOJ.  The Administration needs to develop a clear plan to completely remedy the violations, but most importantly, the Administration needs to share information with the individuals themselves at the training centers, and with their family members.  Planning for such a dramatic shift in services should not — must not — take place without the input of people with intellectual disabilities.  The people who will be most personally affected by this plan must get frequent and accurate information, and must get reliable assurances that this transformation will be done safely and appropriately.