Virginia’s long-delayed efforts to transition people with mental illness and developmental disabilities out of state institutions are being hobbled by state regulations that limit the use of important housing grants to group homes and assisted-living facilities, advocates say.
In a complaint filed with a federal civil-rights office, advocacy groups for the mentally ill are seeking to broaden the use of state money available for housing, shifting the focus from group home settings to include truly independent options such as apartments and individual housing units.
“The commonwealth is essentially requiring people to go from one type of institution to another,” said Jonathan Martinis, legal director with the advocacy group Quality Trust, which is bringing the complaint in conjunction with the Virginia chapter of the National Alliance on Mental Illness.
Filed with the civil-rights office of the U.S. Department of Health and Human Services, the complaint alleges the state policy violates the American with Disabilities Act and other federal laws obligating states to provide minimally restrictive environments to qualified people with mental illness and developmental disabilities.
The complaint argues that the state’s auxiliary grant program serves about 6,000 mentally ill people across Virginia, supplementing other federal and state money, but that current regulations illegally force people into group homes and assisted-living facilities, denying a broad range of alternative housing opportunities, true independence and geographic freedom.
A spokesman for the state Attorney General’s Office said the complaint, filed Friday, has not yet been reviewed.
The complaint argues that Virginia law does not limit the use of the grant money but that the conflict arises in regulations adopted by the state’s Department of Social Services.
“All that is needed for the auxiliary grant program to comply with the ADA is for the program to be implemented consistently with the language of the statute creating it,” the complaint says.
“The complaint does not seek a fundamental alteration of the auxiliary grant program. It only asks that current and future program participants be permitted to use the program funds in integrated, community-based housing, consistent with the letter and spirit of the ADA and Virginia law.”
Martinis argues that the advocacy groups are not seeking an increase in the number of people authorized to receive the grants, 6,000, but the right of those individuals to use the grants toward true community-based housing opportunities.
“Virginia’s auxiliary grant program, plain and simple, is outdated,” said Mira Signer, NAMI-Virginia’s executive director. “Having access to community-based housing close to family and friends and close to work opportunities is critical for achieving recovery from mental illness.
“Institutionalizing people does nothing to support someone’s recovery from mental illness,” Signer said. “We would like to see the program structured in a more flexible way so that people with disabilities can use auxiliary grants in environments that are more conducive to long-term recovery and integration into the community.”
The grant program, operated by the state Department of Social Services and funded by state and local money, is a crucial element of community-based care but one relegated for use in assisted-living facilities and group homes.
Martinis said the limitation on the grants also may affect the state’s landmark $60 million settlement with the U.S. Justice Department last year that will gradually close four of five training centers in Virginia and transition some 1,000 developmentally disabled people into community settings. There are already 3,000 people with developmental disabilities on waiting lists to receive services, and they are all to be cared for through the settlement.
Annual costs of care per training center client are estimated to drop from about $215,000 in institutional settings to about $75,000 a year.
Broadening housing opportunities under the auxiliary grants could reduce abuses and cases of neglect in assisted-living facilities but also would ramp up the need to monitor the condition of people living by themselves in apartments and other private settings.
The complaint cites the case of an unidentified person with a long history of “maladaptive behavior” repeatedly denied care by assisted-living facilities because of behavioral issues.
“In the last year, (the client) has been evicted from or refused admission to assisted-living facilities and could only afford to live in an unsupported boarding home,” the complaint filed last week says.
Now the individual has been forced back into an institution because the auxiliary grants can’t be used for an apartment where the person could be closely monitored by outreach workers.
A state study in 2008 revealed that 41 localities in Virginia don’t have assisted-living facilities, which tend to be in metropolitan areas, further denying clear opportunities for disabled people to reside in their own communities.
“Virginia’s own study found that the auxiliary grant program can in fact be structured so that people can live in community-based settings, not only in segregated, isolated institutions as is currently the case,” Signer said.
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