Handicapped funding falls short, group says

The $3.5 million that Gov. James S. Gilmore III approved Oct. 10 for 150 additional positions for home- or community-based care for the mentally handicapped falls well short of the commonwealth’s needs, a regional advocacy group for mentally retarded people asserts.

“It’s pretty much a Band-Aid on a very systemic problem,” said Jeannie Cummins, spokeswoman for the Association for Retarded Citizens of Northern Virginia mental retardation advocacy group. “It’s sort of a salvo that was done that I think was done to try and quell the rising tide of the social agencies community.”

Prince William has 26 mentally handicapped persons in urgent situations, three for which emergency requests have been sent to the commonwealth and three more that will be submitted for funding as emergencies, said Brian Miller, the county community service board’s program manager for mental retardation cases.

Virginia’s waiver program was started in 1991 to give families an alternative to state institutional care with community-based options such as group homes or adult day care, care that is roughly 50 percent less expensive than state institutions, which Virginia is cutting back and overhauling. Since 1997, the waiver program has grown dramatically from $66 million for 1,800 persons in 1997 to $172.4 million for 5,000 persons in 2001. Across Virginia, there are 1,350 persons on waiting lists for a waiver, said Cummins.

“We recognize there is a need … Those are significant increases, but there will always probably be needs that will not be met,” said Martha Mead, director of legislation and public relations for the Department of Mental Health, Mental Retardation and Substance Abuse Services, which retook control of administering waivers this month. “We are doing our best to meet the needs of people who want to live in the community.”

The Virginia Department of Medical Assistance Services had administered the program before this month and had been criticized by social advocates for inaccurate patient assessments and was sued by a Fairfax family that had been unable to receive additional waiver services.

The Department of Mental Health, Mental Retardation and Substance Abuse Services is more suited to managing the program, Cummins said. The lawsuit against the former administrator was settled in August. Enhancement of waiver benefits cannot be denied by the commonwealth for reasons of lack of funding or that the person is not in an emergency situation any longer, she said, such as if a family that receives day care should apply for night care.

But the problem for families seeking additional care does not dissolve.

The settlement allows for Medicaid funding now, but many families have a difficult time finding providers willing to be paid reimbursement rates that haven’t changed in 10 years, Cummins said. Nursing care providers are going out of business and group homes are consolidating or closing, she said.

“What we’re finding, you win the first battle and then there’s the rest of the war,” she said.

Gilmore’s announcement this month does give families more flexibility in finding providers: they can choose persons like an uncle or well-liked teacher to care for their mentally handicapped loved ones and have them paid under the waiver program, Cummins said.

Mead said the commonwealth’s review of its comprehensive plan for providing for mental issues is trying to address such problems cited by mental-retardation advocates.

The 150 slots provided by new funding this month are divided to go to: 39 to people who are ready to be discharged from state institutions, 40 for emergency situations, and 71 controlled by local community services boards.

Staff writer Chris Newman can be reached at (703) 878-8062.

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