RD86 - Plan to Transform the System of Care for Individuals with Intellectual Disability in the Commonwealth of Virginia


Executive Summary:
This document outlines the Secretary of Health and Human Resources' plan to transform the system of care for individuals with intellectual disability in the Commonwealth of Virginia, in accordance with amended § 37.2-319 of the Code of Virginia relating to the administration of the Behavioral Health and Developmental Services Trust Fund. (*1) The Trust Fund plan lays out a roadmap to accelerate Virginia's move away from reliance on five large training centers to provide care for individuals with intellectual disability and toward a more fully-integrated community-based system of services and supports for both individuals with intellectual and other developmental disabilities. The plan was developed after careful consideration of the following factors: the declining census in training centers, aging facility infrastructure, nationwide best practices, an improving community-based services infrastructure, and Virginia's recent settlement agreement with the US Department of Justice. Collectively, these factors support decisions outlined in this Trust Fund plan. Specifics include:

• With a declining training center census, Virginia operates more training centers than it needs. Census among the training centers has decreased 42 percent since FY2000;

• All but one of Virginia's training centers is more than 35 years old and have significant infrastructure needs in order to maintain the facilities;

• Nationally, Virginia ranks fourth in the number of individuals with intellectual disability in large settings like training centers (37%) and ranks 48th in the number of individuals served in smaller, community-based settings with fewer than 15 people (63.4%); and,

• Virginia recently entered into a ten year court-enforced settlement agreement with the US Department of Justice requiring the Commonwealth to make significant changes to its system of care for individuals with intellectual and other developmental disabilities.

The plan requires Virginia to:

• Continue downsizing Southeastern Virginia Training Center (SEVTC) to 75 beds;

• Cease admissions and close Southside Virginia Training Center (SVTC), Northern Virginia Training Center (NVTC), Southwestern Virginia Training Center (SWVTC), and Central Virginia Training Center (CVTC) over a 10 year period;

• Improve discharge processes and family education to ensure a smooth and safe discharge process for every individual transitioning from a training center to the community;

• Ensure community-based crisis intervention and stabilization programs are firmly in place;

• Increase the number of waiver slots available to transition individuals and prevent unnecessary institutionalization of those on the wait list for services;

• Significantly improve oversight and quality of community-based services; and,

• Develop specialized medical and dental services in the community for individuals with intellectual disability.
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(*1) Chapter 724, Acts of Assembly, 2011