PETITION AGAINST CLOSURE OF SEVTC
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PETITION AGAINST CLOSURE OF SEVTC
Southeastern Virginia Training Center (SEVTC) is a partner in the community-based system of supports for persons with intellectual and related developmental disabilities and their families. SEVTC provides education, habilitation, and health services; promotes dignity, self-determination, and empowerment; and supports the work, relationships, and lives of individual Virginia citizens.
In Governor Kaines address to the General Assembly on December 17th, he stated,
In the area of mental health care and services to intellectually disabled individuals, I've attempted to preserve care for our most vulnerable citizens. In the wake of the Virginia Tech tragedy, we made significant investments last session in community-based mental health care. My proposed budget recommends no cuts in those community programs, except for some administrative savings within the community service boards that would match similar administrative efficiencies required of state agencies.
In fact, my budget recommendations are designed to further our mutual, long-term goal of increasing community investments while reducing dependence upon institutional care. I am proposing to close one of the state's five large training centers for intellectually disabled individuals, close the last state-operated mental health hospital for children, and restructure other state facilities. Community and private providers are actively serving these populations, and I propose to reinvest $47.6 million from the closure of institutions to expand community care options. And let me assure you, no individual currently residing in these closed facilities will be discharged without an appropriate plan of care and full funding to receive that care in a more appropriate setting.
Kaine said...
"...cutting deeper would mean real harm to real people..."
"...no reason to carve deeper into core services to vulnerable people..."
without compromising core services
focuses in areas that do not affect essential services
our expenditures are truly needed for the public good
will not displace persons currently being served
$5 million increase in Governors Opportunity Fund
Given these statements and this closure, we find Kaine's words empty, false and without merit.
HERE ARE THE FACTS
Approximately 170 people currently live at Southeastern Virginia Training Center (SEVTC)
55 Medicaid certified beds are currently available at the other 4 training centers in the state (this number may vary by 5-10 over the next several months); however, if all of those beds are utilized by people currently living at SEVTC, the other training centers will then be at 100\% capacity, unable to accept admissions from people in their region in need of emergency placement, respite, or regular admission; 3 of the 4 other training centers in the state are older that Southeastern (one built in 1904) and have larger wards or wings, not individual cottages like Southeastern
Of the remaining 120 people (approximation), it is proposed that 20 people would take MR Waiver slots in the community; 100 people would utilize Money Follows the Person funds use of these funds mandates that the person live in a home with four or fewer people; this equates to at least 25 group homes; these group homes do not currently exist and building community capacity (purchase and renovation of existing homes in neighborhoods or building new homes) is not feasible in less than 6 months time; sponsored placements are also an option but licensing of new providers will take more time than is available
Downsizing of SEVTC
In 2005 a plan was developed by the TACID group to downsize SEVTC from 200 beds to 100 beds, thus meeting the needs of the 100 people or so for whom either the community lacks the ability to meet their complex medical needs (need ICF/MR care) or those who are behaviorally challenging and have experienced multiple failed placements in the community; maintaining 100 beds also allows a safety net for the nine Community Services Boards in Region V in regards to providing a safe, secure environment for those requiring emergency admission or respite care (Region V is the second largest catchment area in the state consisting of 10 cities and 16 counties spanning from the Eastern Shore through the Southside and Peninsula up to the Middle Peninsula and Northern Neck; if Southeastern closes, people in future need of the level of care provided by Southeastern will have to look elsewhere in the state, moving the person out of their community)
Since 2005, as part of the downsizing plan, SEVTC has successfully discharged 25 people
However; during that same time frame SEVTC has continued to accept admissions (17 admissions from July 2006 through August 2008); 14 of these were emergency admissions and 3 of these emergency admissions became regular admissions because the community could not provide an appropriate placement; the vast majority of emergency admissions were people who could not be stabilized in the community and who had either lost their placement or were in jeopardy of losing their placement if not stabilized
In a presentation to the Virginia House Appropriations Committee on January 26, 2007, Marilyn Tavenner, Secretary of Health and Human Resources stated that: Downsizing of both CVTC (Central Virginia Training Center) and SEVTC has not progressed as quickly as initially projected for a variety of reasons including:
o Lack of appropriate community alternatives
o Family discomfort with moving from state facilities
o Severity of disabilities of persons considering community placement/difficulty in finding appropriate community services
o Relatively late start in beginning initiative
Demographics of people living at Southeastern
Over the past several years the admissions to SEVTC have consisted of more people with mild to moderate levels of intellectual disabilities who exhibit aggression and/or severe challenging behaviors; these people have typically exhausted the resources and the tolerance of community programs; in community settings, these people experience frequent psychiatric hospitalizations (or trips to the emergency room) or contact with local law enforcement personnel
Southeastern has the ability, through physical capacity (staffing ratios, small cottages, and a large campus that is somewhat isolated from the surrounding neighborhoods) and the ability to implement restrictive procedures, to prevent the behaviorally challenged person from running away, inappropriately having contact with law enforcement, or requiring psychiatric hospitalization
The inability of community programs to implement restrictive procedures often enables the person with severe challenging behaviors to endanger the safety of staff or other consumers in the home; if Southeastern closes, public safety concerns will require that these individuals be placed in correctional facilities in greater numbers
The profoundly disabled and medically fragile individuals living at Southeastern (approximately 50 people) are most appropriately served by long-term placement in a training center where medical expertise, a vast array of professional services (occupation therapy, physical therapy, speech therapy, specialized nutritional and dietary services, respiratory therapy, nurses with expertise in wound care and preventing skin breakdown), and equipment resources that are beyond the capacities of most community programs; in community settings, these people are placed in nursing home with elderly individuals most nursing homes are unprepared to address the complex medical needs of these developmentally disabled individuals; the quality of life of a profoundly disabled individual in an appropriate staffed training center is vastly superior to that of a similar individual in a community nursing care facility; many of our admissions of this type of individual are either due to aging out of a facility for children (up to age 18) or parents being unable to continue providing care at home as they and their child have aged
REASONS TO OPPOSE CLOSURE OF SEVTC
SOCIAL
No appropriate plan is provided by the governor.
The Virginia Alliance for Community, who supports closure, is doing so to privatize the system.
A continuum of care needs to be provided, ranging from facilities like Southeastern to private care in a persons own home with their family, just as people with intellectual and developmental disabilities represent a large spectrum of needs.
Privatizing social services leads to bottom line over quality of care and cannot be properly managed or policed. Certainly not cheaper, if proper care is given.
A 1993 report by Congressman Ron Wyden (California) noted that "the private sector residential facilities for the mentally retarded have become an $11 billion-a-year business.. Millions of Americans with these life-long handicaps are at risk for poor quality care, questionable and even criminal management practices by service providers, and lackluster monitoring by public health and welfare agencies.
Sending some of the people living at SEVTC to Central Virginia Training Center that has life/safety code violations is, in fact, worse. SEVTC has NO violations.
There are NO more appropriate settings as Kaine suggests. It would be nice if these adults could be at home with their parents. But for most, their parents are elderly (70's or 80's) and are unable to take care of their children's needs. They certainly won't be able to drive 100-200 miles to see them, as Kaine has suggested.
A study by David Strauss and Theodore Kastner, based on 18,000 adults who were "clients" of the Department of Developmental Services in California from 1980 to 1992, found the death rate to be 72\% higher in group homes than in institutions. A more recent study of nearly 1,900 California patients transferred to group homes from institutions in 1993-1994 showed an 82\% higher death rate in group homes. Updated studies show that when unavoidable cancer deaths are separated from the statistics, the excess mortality in the community versus institutions is 96\%.
On December 14, 1996, the ARC of California, which has strongly supported the movement of the mentally handicapped from the "Developmental Centers" into the so-called "community," petitioned the state for a two-year moratorium on further closings of institutions, and for discontinuation of its "deflection" program, which largely prevented any new patients from being admitted to these institutions. (ARC is the organization that was initially-and informatively-called the Association for Retarded Children.) Their change of heart was due to mortality statistics and horror stories about what happened to people once discharged from institutions and placed in the community.
Some advocates have tried to convince us that a "one size fits all" residential program-the group home-is optimum for all people with intellectual and developmental disabilities, regardless of their medical needs, behavioral problems, and skill levels-and regardless of their families' wishes. But one size doesn't fit all. If the rest of us can thrive in a wide variety of settings, ranging from apartments to school dorms to military barracks, single-family homes, and farms-why can't people with intellectual and developmental disabilities? In their case, it's not just a matter of personal preference. As the statistics of Strauss and Kastner show, it can be a matter of life or death.
Above all, it is my understanding that not one of the parents of these 170 people wants this closure to occur.
ECONOMIC
Of 1500 reduction in state employees, 496 (463 full-time and 33 part-time staff) will come from Hampton Roads when closing SEVTC. Kaine said through attrition, but layoffs are not attrition.
Virginia invests $13.5 million to match $13 million in federal dollars. This is a good investment. And it will have to be done regardless of where these patients end up.
Kaines savings are false.
SEVTC requires NO capital improvements for the next 20 years.
It is rumored that certain local entities that seek to expand have sought to secure the property.
LEGAL
In the Olmstead v. L.C. Supreme Court decision, the Court emphasized that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings. Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it.
Our duty as citizens is to take care of these unfortunate individuals who cannot defend themselves. It is the last place we can afford to cut funding. Kaine is misinformed and wrong. Please sign this petition to express your opposition to the closure of Southeastern Virginia Training Center.
Thank you,
Tim Early
President, Hampton Roads Technology Council
President, Virginia Venture Capital Forum
Southeastern Virginia Training Center (SEVTC) is a partner in the community-based system of supports for persons with intellectual and related developmental disabilities and their families. SEVTC provides education, habilitation, and health services; promotes dignity, self-determination, and empowerment; and supports the work, relationships, and lives of individual Virginia citizens.
In Governor Kaines address to the General Assembly on December 17th, he stated,
In the area of mental health care and services to intellectually disabled individuals, I've attempted to preserve care for our most vulnerable citizens. In the wake of the Virginia Tech tragedy, we made significant investments last session in community-based mental health care. My proposed budget recommends no cuts in those community programs, except for some administrative savings within the community service boards that would match similar administrative efficiencies required of state agencies.
In fact, my budget recommendations are designed to further our mutual, long-term goal of increasing community investments while reducing dependence upon institutional care. I am proposing to close one of the state's five large training centers for intellectually disabled individuals, close the last state-operated mental health hospital for children, and restructure other state facilities. Community and private providers are actively serving these populations, and I propose to reinvest $47.6 million from the closure of institutions to expand community care options. And let me assure you, no individual currently residing in these closed facilities will be discharged without an appropriate plan of care and full funding to receive that care in a more appropriate setting.
Kaine said...
"...cutting deeper would mean real harm to real people..."
"...no reason to carve deeper into core services to vulnerable people..."
without compromising core services
focuses in areas that do not affect essential services
our expenditures are truly needed for the public good
will not displace persons currently being served
$5 million increase in Governors Opportunity Fund
Given these statements and this closure, we find Kaine's words empty, false and without merit.
HERE ARE THE FACTS
Approximately 170 people currently live at Southeastern Virginia Training Center (SEVTC)
55 Medicaid certified beds are currently available at the other 4 training centers in the state (this number may vary by 5-10 over the next several months); however, if all of those beds are utilized by people currently living at SEVTC, the other training centers will then be at 100\% capacity, unable to accept admissions from people in their region in need of emergency placement, respite, or regular admission; 3 of the 4 other training centers in the state are older that Southeastern (one built in 1904) and have larger wards or wings, not individual cottages like Southeastern
Of the remaining 120 people (approximation), it is proposed that 20 people would take MR Waiver slots in the community; 100 people would utilize Money Follows the Person funds use of these funds mandates that the person live in a home with four or fewer people; this equates to at least 25 group homes; these group homes do not currently exist and building community capacity (purchase and renovation of existing homes in neighborhoods or building new homes) is not feasible in less than 6 months time; sponsored placements are also an option but licensing of new providers will take more time than is available
Downsizing of SEVTC
In 2005 a plan was developed by the TACID group to downsize SEVTC from 200 beds to 100 beds, thus meeting the needs of the 100 people or so for whom either the community lacks the ability to meet their complex medical needs (need ICF/MR care) or those who are behaviorally challenging and have experienced multiple failed placements in the community; maintaining 100 beds also allows a safety net for the nine Community Services Boards in Region V in regards to providing a safe, secure environment for those requiring emergency admission or respite care (Region V is the second largest catchment area in the state consisting of 10 cities and 16 counties spanning from the Eastern Shore through the Southside and Peninsula up to the Middle Peninsula and Northern Neck; if Southeastern closes, people in future need of the level of care provided by Southeastern will have to look elsewhere in the state, moving the person out of their community)
Since 2005, as part of the downsizing plan, SEVTC has successfully discharged 25 people
However; during that same time frame SEVTC has continued to accept admissions (17 admissions from July 2006 through August 2008); 14 of these were emergency admissions and 3 of these emergency admissions became regular admissions because the community could not provide an appropriate placement; the vast majority of emergency admissions were people who could not be stabilized in the community and who had either lost their placement or were in jeopardy of losing their placement if not stabilized
In a presentation to the Virginia House Appropriations Committee on January 26, 2007, Marilyn Tavenner, Secretary of Health and Human Resources stated that: Downsizing of both CVTC (Central Virginia Training Center) and SEVTC has not progressed as quickly as initially projected for a variety of reasons including:
o Lack of appropriate community alternatives
o Family discomfort with moving from state facilities
o Severity of disabilities of persons considering community placement/difficulty in finding appropriate community services
o Relatively late start in beginning initiative
Demographics of people living at Southeastern
Over the past several years the admissions to SEVTC have consisted of more people with mild to moderate levels of intellectual disabilities who exhibit aggression and/or severe challenging behaviors; these people have typically exhausted the resources and the tolerance of community programs; in community settings, these people experience frequent psychiatric hospitalizations (or trips to the emergency room) or contact with local law enforcement personnel
Southeastern has the ability, through physical capacity (staffing ratios, small cottages, and a large campus that is somewhat isolated from the surrounding neighborhoods) and the ability to implement restrictive procedures, to prevent the behaviorally challenged person from running away, inappropriately having contact with law enforcement, or requiring psychiatric hospitalization
The inability of community programs to implement restrictive procedures often enables the person with severe challenging behaviors to endanger the safety of staff or other consumers in the home; if Southeastern closes, public safety concerns will require that these individuals be placed in correctional facilities in greater numbers
The profoundly disabled and medically fragile individuals living at Southeastern (approximately 50 people) are most appropriately served by long-term placement in a training center where medical expertise, a vast array of professional services (occupation therapy, physical therapy, speech therapy, specialized nutritional and dietary services, respiratory therapy, nurses with expertise in wound care and preventing skin breakdown), and equipment resources that are beyond the capacities of most community programs; in community settings, these people are placed in nursing home with elderly individuals most nursing homes are unprepared to address the complex medical needs of these developmentally disabled individuals; the quality of life of a profoundly disabled individual in an appropriate staffed training center is vastly superior to that of a similar individual in a community nursing care facility; many of our admissions of this type of individual are either due to aging out of a facility for children (up to age 18) or parents being unable to continue providing care at home as they and their child have aged
REASONS TO OPPOSE CLOSURE OF SEVTC
SOCIAL
No appropriate plan is provided by the governor.
The Virginia Alliance for Community, who supports closure, is doing so to privatize the system.
A continuum of care needs to be provided, ranging from facilities like Southeastern to private care in a persons own home with their family, just as people with intellectual and developmental disabilities represent a large spectrum of needs.
Privatizing social services leads to bottom line over quality of care and cannot be properly managed or policed. Certainly not cheaper, if proper care is given.
A 1993 report by Congressman Ron Wyden (California) noted that "the private sector residential facilities for the mentally retarded have become an $11 billion-a-year business.. Millions of Americans with these life-long handicaps are at risk for poor quality care, questionable and even criminal management practices by service providers, and lackluster monitoring by public health and welfare agencies.
Sending some of the people living at SEVTC to Central Virginia Training Center that has life/safety code violations is, in fact, worse. SEVTC has NO violations.
There are NO more appropriate settings as Kaine suggests. It would be nice if these adults could be at home with their parents. But for most, their parents are elderly (70's or 80's) and are unable to take care of their children's needs. They certainly won't be able to drive 100-200 miles to see them, as Kaine has suggested.
A study by David Strauss and Theodore Kastner, based on 18,000 adults who were "clients" of the Department of Developmental Services in California from 1980 to 1992, found the death rate to be 72\% higher in group homes than in institutions. A more recent study of nearly 1,900 California patients transferred to group homes from institutions in 1993-1994 showed an 82\% higher death rate in group homes. Updated studies show that when unavoidable cancer deaths are separated from the statistics, the excess mortality in the community versus institutions is 96\%.
On December 14, 1996, the ARC of California, which has strongly supported the movement of the mentally handicapped from the "Developmental Centers" into the so-called "community," petitioned the state for a two-year moratorium on further closings of institutions, and for discontinuation of its "deflection" program, which largely prevented any new patients from being admitted to these institutions. (ARC is the organization that was initially-and informatively-called the Association for Retarded Children.) Their change of heart was due to mortality statistics and horror stories about what happened to people once discharged from institutions and placed in the community.
Some advocates have tried to convince us that a "one size fits all" residential program-the group home-is optimum for all people with intellectual and developmental disabilities, regardless of their medical needs, behavioral problems, and skill levels-and regardless of their families' wishes. But one size doesn't fit all. If the rest of us can thrive in a wide variety of settings, ranging from apartments to school dorms to military barracks, single-family homes, and farms-why can't people with intellectual and developmental disabilities? In their case, it's not just a matter of personal preference. As the statistics of Strauss and Kastner show, it can be a matter of life or death.
Above all, it is my understanding that not one of the parents of these 170 people wants this closure to occur.
ECONOMIC
Of 1500 reduction in state employees, 496 (463 full-time and 33 part-time staff) will come from Hampton Roads when closing SEVTC. Kaine said through attrition, but layoffs are not attrition.
Virginia invests $13.5 million to match $13 million in federal dollars. This is a good investment. And it will have to be done regardless of where these patients end up.
Kaines savings are false.
SEVTC requires NO capital improvements for the next 20 years.
It is rumored that certain local entities that seek to expand have sought to secure the property.
LEGAL
In the Olmstead v. L.C. Supreme Court decision, the Court emphasized that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings. Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it.
Our duty as citizens is to take care of these unfortunate individuals who cannot defend themselves. It is the last place we can afford to cut funding. Kaine is misinformed and wrong. Please sign this petition to express your opposition to the closure of Southeastern Virginia Training Center.
Thank you,
Tim Early
President, Hampton Roads Technology Council
President, Virginia Venture Capital Forum
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