Saturday, December 10, 2005

"Dream" scenario for mental health - Virginia

BY MICHAEL HARDY
TIMES-DISPATCH STAFF WRITER
Dec 7, 2005

Gov. Mark R. Warner wants to spend about $460 million to replace four
outdated state mental-health institutions and upgrade community
mental-health services.

The four are Eastern State Hospital in Williamsburg, Western State Hospital
in Staunton, Central Virginia Training Center in Lynchburg and Southeastern
Virginia Training Center in Chesapeake.

New state-of-the art hospitals and training centers for the mentally
retarded, costing $290 million, will be built at or near the existing
facilities over the next four years, the governor said. Employees now on the
job will not lose their positions, he said.

In his final budget, the Democratic governor also wants to use almost $170
million, most of it state cash produced by a booming economy, to upgrade
Virginia's deficient community services for the mentally disabled.

Warner assured that those with severe conditions will be treated in
institutions and that the state will substantially expand local services.

"We believe that everyone who needs a bed in a state facility will have one,
but whenever possible, we will serve people in the community as our first
option," the governor said.

"I believe this is a historic step forward for Virginia today -- a
record-setting investment in the commonwealth's mental-health and
mental-retardation systems, " he said.

About 90 legislators, mental-health advocates and officials attended
Warner's announcement yesterday in the executive office building near
Capitol Square.

Warner leaves office Jan. 14, and his mental-health proposals will be left
for the legislature to decide during its winter session. Initial reaction
was highly positive yesterday from politicians and activists, two groups
that have been at war over the issue for decades.

"The situation in Virginia for years has been shameful, and we were not
living up to our obligations," said Sen. Janet D. Howell, D-Fairfax.

"You're really going out with a bang for a lot of us," said Sen. Benjamin J.
Lambert III, D-Richmond.

"It fulfills what is a dream for many," said Del. Phillip A. Hamilton,
R-Newport News, a health-care leader in the General Assembly.

Nita Grignol, president of the ARC of Virginia, which champions services for
the retarded, said, "I'm happy as long as the state is moving toward"
emphasis on local services.

Mary Ann Bergeron, executive director of the Virginia Association of
Community Service Boards, described herself as "extremely delighted and
gratified."

"There has to be an adequate array of community services if we are to do
anything with" state institutions.

Heidi Lawyer, director of the Virginia Board for People with Disabilities,
said most are awaiting details of the program.

"We're certainly delighted at the infusion of money in communities," she
said.

Although Warner will not be in office to push for the initiative, Gov.-elect
Timothy M. Kaine supports its broad outlines.

The new emphasis, backed by cash, on providing services in localities for
mental patients may in part make a virtue out of necessity.

Virginia's poor record on local treatment and services could invite legal
challenges in the wake of a 1999 U.S. Supreme Court decision. It required
that states must release institutional patients who could be treated in
local communities.

Often, Virginia has responded to calls for improving mental-health services
only when threatened with lawsuits or action by the U.S. Department of
Justice.

Without his proposed investments, Warner predicted, "it might be another
decade before we have a chance to do what we are proposing today."

His plan will provide more services and placements in localities for the
handicapped, he said.

The upgrades will cut the number of beds at the four hospitals by one-third
and nudge the state toward its goal of treating two patients in their home
communities for every one patient in an institution.

The extra dollars -- about $116 million in state funds and an additional $52
million in federal Medicaid dollars -- will result in higher reimbursement
rates for service providers. The cash will shorten the waiting lists for
people seeking services.

In Virginia, 16 public hospitals serve about 3,000 mental-health and
mentally retarded patients.

Rebuilt Eastern State will have a population of about 300, down from 486,
and Western State will have 260 beds, down from 270. Central Virginia will
be reduced from 544 beds to 300, and Southeastern Virginia will be cut from
200 to 100 beds.

Contact staff writer Michael Hardy at (804) 649-681