RD617 - SFY 2020 Annual Mortality Report

Executive Summary:

This is the sixth Annual Mortality Report of the Virginia Department of Behavioral Health and Development Services (DBHDS). The information contained in this report is based on reviews of the deaths of individuals with a developmental disability that occurred during the timeframe of July 1, 2019 to June 30, 2020 as reported in the DBHDS incident reporting systems. This report compares state fiscal year (SFY) 2020 mortality review data to that in previous years. The interpretation of information presented in this report is not intended to be used for direct comparison with the mortality reviews and reports of other states. Each state utilizes its own specified population, definitions, processes, and different methods or analyzed data which is relevant to their need or state requirements, and generalized findings or comparisons of mortality rates is limited.

As of June 30, 2020, there were 14,834 individuals enrolled on a Virginia Developmental Disability (DD) Home and Community Based Services (HCBS) waiver(*1). DBHDS authorizes approximately ninety services to thousands of residents for the following waivers: Community Living, Family and Individual Supports, and Building Independence.

As a commitment to the Commonwealth of Virginia, DBHDS and the Developmental Disabilities Mortality Review Committee (MRC or Committee) contribute to system of care improvements through integration of clinical evidence, data driven determinations, and evidenced based quality improvement recommendations. Deaths of all individuals who were receiving a service licensed by DBHDS at the time of death and diagnosed with an intellectual disability and/or developmental disability (I/DD) are reviewed and analyzed. Analysis of the mortality trends, patterns, and problems can identify opportunities for system improvements to reduce risks to all individuals with developmental disabilities receiving behavioral health and/or developmental services. On an ongoing basis, DBHDS seeks to prevent instances of abuse, neglect, exploitation, and unexplained or unexpected death by identifying and addressing relevant factors during mortality reviews. Mortality review determinations are then utilized to develop quality improvement initiatives in order to reduce mortality rates to the fullest extent practicable.

In the midst of this state fiscal year, the world was introduced to a novel coronavirus, COVID-19, which has resulted in a global pandemic and declaration of a public health emergency in the Commonwealth. This respiratory illness quickly impacted congregate care settings as public health leaders fought to study and contain the virus. Research has grown indicating that the elderly and those with chronic medical conditions were the most susceptible to severe illness, and thousands across the United States have died from the disease. When the COVID-19 pandemic was declared a state of emergency in March 2020 by Governor Ralph Northam, there was significant concern regarding the impact that the pandemic would have on the DD population. DBHDS licenses a number of congregate settings, which were the settings of many COVID-19 outbreaks across the country. This report does not include the total number of individuals with DD who were infected with COVID-19; however, COVID-19 accounted for approximately ten percent of deaths in quarter four of this study period, rivaling sudden cardiac death, which is the leading cause of death overall in this population. COVID-19 continues to pose a threat in Virginia, and the provider community should be commended for their ongoing dedication to serve individuals with DD in those critical settings despite the multiple workforce, financial, and service delivery challenges that have impacted all healthcare providers as a result of the pandemic.

Finally, one of the most monumental events of this study year for the Commonwealth’s developmental disabilities system of care was the closure of Central Virginia Training Center (CVTC) in the spring of 2020. Only one training center will remain open, Southeastern Virginia Training Center. CVTC opened in 1910 and at its peak in 1972, 3,686 individuals resided there. Its closure signified tremendous effort and commitment toward transitioning individuals from four training centers into the community to live and prosper.
(*1) Virginia Waiver Management System. Accessed by DBHDS on Aug 13, 2020