The Department of Behavioral Health and Developmental Services (DBHDS) has developed this closure plan for Hiram Davis Medical Center (HDMC) under Va. Code § 37.2-316. The plan reflects extensive input from a State and Community Consensus and Planning Team and its three subgroups: Supporting Patients, Supporting Staff, and Community Services. The closure plan will be submitted to the Governor and to the Joint Commission on Health Care (JCHC) for review prior to consideration by the General Assembly. The plan’s objectives are to (1) safeguard the health, safety, and choice of every person served at HDMC; (2) ensure a stable transition for the workforce; (3) sustain essential clinical services now anchored at HDMC; and (4) reposition resources to more integrated, community-based settings while maintaining a training-center option for eligible individuals.

HDMC opened in 1974 and now faces multiple end-of-life building systems (HVAC, plumbing, electrical) and design limitations that preclude phased renovations. Major repairs would require vacating the building for up to 24 months and trigger recertification under current Codes. Recent incidents, including persistent Legionella mitigation and a sewage line failure, underscore the risk of an unplanned evacuation. Engineering estimates place renovation costs at approximately $94 million and full replacement at approximately $145 million. Given these conditions, DBHDS proposes an orderly, person-centered closure by December 2027, rather than waiting for an emergency that would force rapid, disruptive placements.

Consistent with Va. Code § 37.2-316, DBHDS led an open and collaborative planning process through the State and Community Planning and Consensus Team and its three subgroups, actively engaging individuals, families, staff, community partners, and elected officials. The resulting closure plan helps ensure successful transitions for both patients and staff, and protects continuity of care.

The plan is organized around three execution pillars. Patient transitions will be individualized and choice-driven. For individuals with intellectual/developmental disability (ID/DD) who prefer a state-operated option, DBHDS is preparing up to 10 skilled nursing beds at Southeastern Virginia Training Center (SEVTC), licensed by the Virginia Department of Health (VDH) and certified by the Centers for Medicare and Medicaid Services (CMS). Renovations at SEVTC (bathrooms, nurse call, oxygen delivery, lifts, ventilation) are scheduled for November 2025 - May 2026, while staff are being upskilled. DBHDS recognizes that SEVTC’s location is far from many families and commits to working continuously with any interested family to identify willing, qualified providers closer to home, investing in the complex-care supports those providers need to successfully serve individuals with significant medical and/or behavioral issues. For individuals with serious mental illness or dementia/neurocognitive disorders, the plan strengthens pathways to specialized mental-health residential programs, memory care, and nursing facilities with embedded behavioral supports. Short-term “special stay" needs from other state facilities will be met through contracted sub-acute hospital and nursing-facility partners, with standard referral protocols and holding agreements to prevent delays.

Continuity of clinical services is preserved by moving HDMC-anchored departments to the new Central State Hospital (CSH) where feasible (e.g. dental, lab, radiology, pharmacy, therapies), further supplemented by contracted community providers, mobile services, and telehealth. A Community Services Build & Continuity strategy funds start-up and equipment for complex-care providers, establishes nursing-facility behavioral-health consultation teams, and creates navigation, transportation, and data infrastructure to sustain post-transition stability. Workforce transition prioritizes no layoffs by transferring staff to CSH, Piedmont Geriatric Hospital, SEVTC, the Virginia Center for Behavioral Rehabilitation, and other DBHDS sites. A retention program stabilizes staffing through final transitions, training, certification pathways, and supervisor-to-supervisor handoffs support successful onboarding at receiving sites.

The plan acknowledges that not all subgroup recommendations can be adopted. For example, the HDMC Parent Group urged rebuilding a smaller facility on or near the current campus, but that was not put forward as the recommendation because it would require significant capital and workforce to a duplicative bricks-and-mortar program, delays relief by several years, and risks conflict with national policy direction toward integrated, community-based care. Instead, this plan fulfills the core aims voiced by families – safety, quality, and real choice – through SEVTC for eligible individuals and through strengthened community options closer to home for others.

The closure plan identifies specific community capacity-building investments and provider supports necessary to ensure that specialized medical and behavioral health needs currently met at HDMC can be met in alternative settings across the Commonwealth. The fiscal comparison required by Va. Code § 37.2-316 projects a six-year cost of $285.34 million to continue HDMC operations (including renovation downtime and recertification) versus $115.05 million to close HDMC and build out the replacement service model, yielding estimated savings of $170.30 million (exclusive of any property sale proceeds; a 2017 valuation was $13 million). These savings are redeployed, not removed: funds follow the person to SEVTC and community services and sustain shared services at CSH.

Implementation proceeds in four phases: Preparation and Policy Alignment; Initial Transition Wave; Complex Transitions and Service Re-anchoring; and Final Census Draw-down and Building Closure. These phases would occur under a DBHDS project governance structure with clear milestones, risk management, and monthly public reporting. Across all phases, DBHDS maintains life-safety vigilance at HDMC, preserves patient choice (including Va. Code § 37.2-837(A)(3) training-center rights), and partners closely with families to secure qualified, closer-to-home options whenever possible. This approach delivers safer, faster, and more sustainable access to high-quality care while strengthening the Commonwealth’s developmental and behavioral health system for the long term.

While full agreement among a broad array of stakeholders is rare, DBHDS ensured a focus on openness, accessibility, and ensuring voices are heard. The process was designed to create a thoughtful plan that supports safe, person-centered discharges, workforce stability, and system sustainability.

Finally, this closure plan, created with broad stakeholder input, will be submitted to the Governor and to the Joint Commission on Health Care for review and recommendations. The final determination on whether the plan proceeds rests with the General Assembly and the Governor. If the General Assembly and Governor approve the plan, DBHDS is prepared to implement under the phased schedule and governance model described herein, with monthly reporting on placements, safety, service continuity, and staff transitions.