Study recommends institution closure by 2019
Last year, the Governor proposed the closure of the state’s developmental disabilities institution at Yakima Valley. The result was a pitched battle between community and institution advocates. As the session closed, the legislature commissioned a Feasibility Study of the Closing of Institutions.
The Legislature allocated $500,000 for the task, and the state hired the firm of Davis Deshaies to do the study. The study also looked at possible closure of juvenile and prison facilities and other institutions.
Obviously, we don’t need another study to determine that closing institutions is “feasible”. We know that closure is feasible, because over 130 developmental disabilities institutions have closed around the country since 1980. The institutions have been fully closed in 10 states – including our neighbor to the south, Oregon. Meanwhile, Washington is much more reliant on state institutions then most states. Not surprisingly, the report confirms that we can close our institutions, and maps out a path for doing so.
The study has five major recommendations:
One - Reduce the number and size of the state institutions by 250 beds. The report recommends closure 13 cottages in institutions around the state, and the closure of Francis Hadden Morgan in Bremerton.
Two – Immediately place children currently living at the institutions into the community. The report warns against creating a “new generation” of institiution residents. Because community supports have not been provided, more than 30 children have been placed in state institutions.
The report suggests opening state-run intensive care homes in the community. This is preferable to institution placement. However, adequate funding and implementation for the recently-created Children’s Intensive In-Home Behavioral Support (CIIBS) program could help families avoid out-of-home placement.
There are currently no “state-operated children’s intensive care homes”, referred to in the recommendation.
Three - By 2019, close institution beds and convert Lakeland, Fircrest, and Yakima Valley into three small community support centers. The report recommends closure of all institution beds – but allows ten years to complete the process. The report recommends maintenance of some nursing beds for those with complex medical needs. The community centers would provide emergency crisis support and ambulatory care/clinical outreach.
Four - Create a “zero-reject” state-operated residential option for people with complex health needs or who present significant community risks. “Zero-reject” means that the program cannot reject – or eject – former institution residents. This ensures stable community placement.
Five - Refinancing and increased capacity of community services. The report recognizes that supported living programs serving people leaving RHCs must be adequately funded to ensure that they can provide stable placements that maintain experienced, professional staff.
In addition to these five recommendations, the legislature should make a commitment that all moving RHC residents will be assured of stable, quality community support. Last session the Senate budget proposal to close Yakima Valley School, the Senate budget included language that would have required services in place “to assure the individual's health, safety, personal well-being, and continued growth and development on an ongoing basis”.
The study provides much detail about the costs, cost savings and process of closing the institutions. There is much less discussion about what must be done to assure that the residents are enjoy stable placements in the community.
This assurance should be founded upon a guarantee that each resident will have the services of the Home and Community Based Waiver that meets their needs. Each resident should have the guarantees of procedural rights necessary to make sure their needs are met. The quality of services provided to former RHC residents should be carefully monitored. The Quality Assurance system should collect data for use by policy makers and planners, and should continue to be in place long-term.
People with developmental disabilities should live in ordinary neighborhoods in the community. Children should attend their local schools. Former institution residents around the country – and in Washington – are living well in the community. We have a responsibility that all who move are at least as well supported in the community as in the institution.
The Feasibility Study for the Closure of State Institutional Facilities can be accessed on the Office of Financial Management website at: http://www.ofm.wa.gov/facilities/report/part3_rh.pdf