CHARLESTON, W.Va. — Children in West Virginia’s mental health system are too often sent to institutions rather than given services that would allow them to stay in or near their homes, the U.S. Department of Justice has found.
The report, the result of a year-long investigation begun in April 2014, cites a lack of integrated services and a reliance on “unnecessary institutionalization” as part of the state’s failure to comply with the Americans with Disabilities Act — specifically, the part that requires children and other people with disabilities to “receive supports and services in the most integrated setting appropriate to their needs.”
In an open letter to Gov. Earl Ray Tomblin, U.S. Deputy Assistant Attorney General Vanita Gupta wrote that children who rely on mental health services through the state Department of Health and Human Resources are frequently placed in “segregated facilities,” often in another state, that include group residential care, psychiatric residential treatment facilities and psychiatric hospitals.
Gupta added that the state’s lack of home-based and outpatient resources means that many of the children relegated to segregated treatment do not need it.
“The unnecessary segregation of children with mental health conditions violates their civil rights and wastes the state’s fiscal resources,” Gupta wrote. “Community integration with core services and supports will permit the state to support children in their homes and in their communities in a lawful, effective and cost-efficient manner.”
The state also hasn’t done enough with its existing resources, Gupta wrote, and hasn’t taken full advantage of Medicaid support for community-based services.
“Child-serving agencies in West Virginia fail to collaborate to address the needs of children with mental health conditions involved in multiple systems. As a result, agencies duplicate efforts, waste limited state resources, and provide fractured care delivery, causing confusion and harm to children and families,” Gupta wrote.
The DOJ report also found that state hasn’t implemented what’s called an “Olmstead plan” to keep people with disabilities from being segregated unnecessarily, or to make sure those people get services in the proper setting.
West Virginia’s choice to warehouse children in segregated mental health facilities is also costly, the report notes. The cost to provide in-home and community-based health services to a child ranges from $2,500 to $3,500 a month; in contrast, the cost of placing a child in an in-state treatment facility is between $5,623 and $9,088 a month, according to the DOJ. Placing children in out-of-state facilities cost West Virginia more than $20 million in 2012.
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