Justice Department report blasts Central Virginia Training Center

RICHMOND – Virginia has harmed residents of Central Virginia Training Center and other state training centers by keeping people in large institutions instead of providing smaller, community-based homes where the could integrate into mainstream life, the U.S. Department of Justice says in a scathing report released Friday.

The DOJ said its three-year investigation of CVTC found physical restraints were used on residents and that some people were overmedicated or sedated.

The report does not say that CVTC or any of the state’s other four training centers must close.

But it does say their total population of 1,100 should be reduced as quickly as possible, which would make it impossible to keep all the centers open, said state Sen. Steve Newman, R-Lynchburg.

Newman said he disliked federal officials telling the state what it must do, and he also said, “CVTC holds the most challenged individuals in the entire state.”

Parents and families who want their relatives to remain in CVTC’s care “are right, and this is the proper location for those that are most challenged,” Newman said.

Negotiations with the federal agency are the next step, said Bill Hazel, Virginia’s secretary of health and human resources. “That’s the way these things normally are handled,” Hazel said.

“The big issues, I think, are probably two things,” Hazel said.

“First, they believe we have not worked adequately to move people from institutional settings to what they call ‘more integrated settings,’ and that means, I believe, into the community,” Hazel said.

Also, DOJ objected to Virginia’s erecting new buildings at CVTC and a training center in Chesapeake instead of providing smaller group homes where residents could be closer to everyday living conditions, Hazel said.

“We have done some of that,” providing community homes, “but they particularly cite that we have spent money rebuilding institutions and they specifically reference the new building at Central Virginia and the new building at Southeastern Virginia Training Center as opposed to building community settings,” Hazel said.

“That was fully expected,” he added, because state officials have been working alongside federal investigators who compiled the report.

Virginia officials have taken an “amicable and cooperative” posture in addressing federal investigators’ concerns, the report said.

The federal officials liked Gov. Bob McDonnell’s state budget plan to provide 275 new waiver slots with Medicaid funding so people with disabilities could live in community-based housing.

The General Assembly’s House of Delegates proposed to provide another 100 waiver slots, while the Senate’s budget proposal does not add money for those waivers. Another budget difference to be resolved by the assembly’s conferees involves crisis teams and crisis centers for people with disabilities. The DOJ said it wanted more funding for those services, which intervene when a disabled resident has an emotional or behavioral crisis.

The report’s immediate effect on CVTC’s operations in Madison Heights was not clear. The training center has about 1,400 employees.

The DOJ investigation began at CVTC in 2008 and later was expanded to the state’s other training centers.  It is seeking compliance with a 1999 U.S. Supreme Court decision known as the Oldstead ruling, which held that people with disabilities have the right to live in community-based homes rather than institutions.

The General Assembly already has set a goal of taking CVTC, which has about 400 residents, down to 300 people. The DOJ wants that process to move faster.

Hazel and other top state officials said they didn’t know Friday whether CVTC or the state’s other four training centers would continue in operation.

He said he didn’t expect to have an answer until negotiations begin.

The DOJ said it intended to file a lawsuit accusing Virginia of violating the Americans With Disabilities Act if problems could not be resolved within 49 days, but it also said it hoped to “resolve this matter by working cooperatively with the Commonwealth.”

Hazel said the federal officials know that Virginia doesn’t have enough community-based housing to move residents out of training centers immediately, and expected them to be flexible on timing.

Hazel also said that he expects Virginia may have to build some of those community-based homes, and also to find other ways of providing community-based housing.

The federal agency’s concerns about use of restraints on residents and about medication problems have been mostly resolved, Hazel said.

“They did raise a question about whether we were over-medicating or improperly sedating patients,” Hazel said. “That is something we have dealt with as we have gone along.

“With restraints, there was evidence of that before and we believe we have worked through that in the last couple of years,” Hazel said, adding that he became the state’s top health official in January 2009.

“A good portion of this had gone on before I got there,” Hazel said.

“We changed the administrator there” at CVTC, he said, and “a number of things have happened that were intended to improve the care of residents at Central Virginia.”

Former CVTC administrator Denise Micheletti was replaced by Dale Woods last fall.

Martha Bryant, a spokeswoman for a parents’ group at CVTC, said morale of employees has improved since Woods took over management of the facility.

“We know things have improved under the new leadership,” Bryant said. “There is less mandatory overtime, and Dale is very hands-on in getting out of the office and visiting living areas,” Bryant said.

She also said the DOJ complaints about CVTC sounded like a common theme in its investigations of other states’ training centers.

“They cite the same types of things,” Bryant said.

She defended CVTC’s efforts to help residents be part of the Lynchburg community.

“We attend ball games, church worship, and Special Olympics, we go to fall festivals,” Bryant said.

“There is a lot of community interaction.”