Policy: Health Care

Disabled community split over future of mental health facilities

Local,Virginia,Steve Contorno,Health Care,Mental Health

When Virginia Gov. Bob McDonnell announced last January plans to close four of the state's five mental health facilities and shift the resources to community-based care, advocates celebrated it as a major victory for the disabled.

But Judith Korf, of Reston, feels like the state is kicking her son, Adam Bertman, out of his home of 14 years. Bertman, a resident of the Northern Virginia Training Center in Fairfax, is 41 years old and autistic. On a good day, he enjoys a puzzle. On a bad day, he can be difficult, even physical.

"Adam's had his ups and downs," Korf said. "He knows about this closing plan and has been refusing meals and had a very serious move of aggression -- he ran into another home and bit someone."

Plans to close the Northern Virginia center in 2014 and three others by 2020 are part of a settlement between Virginia and the Justice Department, which claimed Virginia violated the Americans with Disabilities Act by indefinitely institutionalizing residents who could function in the community.

Korf and other parents will go to the General Assembly next month to make the case that the centers are the only place their children can survive.

"I sympathize with both sides of the argument," said Sen. Barbara Favola, D-Arlington. "There are those who say we don't want anybody in an institution. But as a parent, I understand the view of, 'Where is my child going to go?' I'm trying to find a compromise position."

Mental health advocates insist, though, that the centers must close. Studies show the disabled improve when living independently, they said. And parents now worried about meeting their disabled child's needs will get help once money now spent on institutions is shifted to provide nurses and medical care in a community setting.

"The process is scary, and that's not unusual," said Jamie Liban, executive director for the Arc of Virginia. "Our legislators have a responsibility to talk about what infrastructure is needed to create meaningful alternatives, and that's the place where we should be starting."

About 900 people now live in Virginia's training centers. An additional 9,900 are in community-based care, and Virginia agreed as part of its settlement to provide the Medicaid benefits needed for an additional 4,100 people to get community-based care.

Still, apprehension remains.

Korf's son, Adam, was in community care until 1998, when during a walk with a caregiver he started throwing rocks at cars, busting a window and attracting police with their weapons drawn. In 1999, he moved into the training center.

"I wanted community care for him before it didn't work," Korf said.

Community-based care costs about half as much as institutional care -- $106,000 compared with $224,000 -- and Virginia can't afford to provide both, McDonnell spokesman Paul Logan said.

"We see far more individuals choosing to live in their own communities instead of institutional settings," Logan said. "Virginia can't afford to operate two systems simultaneously."

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