Petrina Thomas, SOCG371,Section 1, Reaction Paper #3

This timeline illustrates that the Virginia Department of Medical Assistance Services (DMAS), Department of Health and Human Resources, and the Department of Behavioral Health and Developmental Services (DBHDS) continue to operate outside of federal laws and mandates for person centered practices and community integration.
1990—The ADA mandates that public entities provide services in the “most integrated setting.”
1999—“The Supreme Court’s decision in Olmstead v. L.C., a ruling that requires states to eliminate unnecessary segregation of persons with disabilities and to ensure that persons with disabilities receive services in the most integrated setting appropriate to their needs.” (
2006—Virginia awarded federal Systems Transformation Grant to implement Person Centered Practices across the Commonwealth and initiate the Money Follows the Person (MFP) program designed to assist individuals transition from living in institutions to the community (most integrated setting).
2011-2012—The U.S. Department of Justice (DOJ) launches investigation with findings that state “the Commonwealth fails to provide services to individuals with intellectual and developmental disabilities in the most integrated setting appropriate to their needs in violation of the ADA” (Letter of findings from the U.S. DOJ to Gov. McDonnell, Feb. 10, 2011). The DOJ Settlement also includes language mandating Person Centered Practices and shortening of lengthy waitlists for services.
2015—Twenty-five years after the signing of the ADA, thousands of Virginians with disabilities remain on long waitlists for home and community based services while the thousands who have services remain in segregated living, employment and day programs where the paid staff make decisions for the individuals with funds that are intended to be used under the principles of person centered practices and community integration (most integrated setting). Federal funds continue to be misused by the Departments in Virginia listed above under federal regulations. This systemic problem is twofold: It violates human rights to decision making and community inclusion (segregation) and it costs the state much more to support an individual in an institution than to provide services for support in the community. At face value, people living in nursing homes are refused their requests to live in the community 16 years after Olmstead and 25 years after ADA. A young man (now deceased) is refused the opportunity to have lunch with his mother due to the segregated nature of the day program receiving 50% federal funds with “most integrated setting” mandate attached.

From a Pluralist approach, indeed, all positive change came from involvement and strong advocacy.  Amazing grassroots efforts have turned into national organizations that strive to protect human rights to live and work in their communities even 25 years after the ADA indicating a strong example of Resource Mobilization.  Even the DOJ Settlement resulted from a formal complaint.  Advocates have a lot to be proud of but Virginia state bureaucracies echo Regime tendencies in resistance to pressure from both the people (below) and the federal government (above).

Leave a Reply