To keep costs down, close nursing homes/training centers for people with disabilities and support services providers such as the Independent Living Center so people with disabilities can live in their home-based community.

It is cheaper for a person with a disability to live in the community.

Please support pay increases for attendant pay. A well provided for attendant is essential to a person with a disability living in the community.

**09 state rankings for community-based home care Medicaid support**

The ongoing national debate about Medicaid must involve more than budget appropriations. Untied Cerebral Palsy has issued a case for inclusion to spotlight how states serve people with disabilities.

For a more extensive report go to: http://www.ucp.org/medicaid/stateranks.cfm

§ Virginia is ranked 41^st. Vermont is ranked #1.

§ Now three states, up from two the previous year Vermont, Nevada and Alaska – have more than 95 percent of individuals served living in home-like settings

§ Too much money is still spent isolating people in large institutions, with nominal change from last year:

Nationally, 16.5 percent (down from 19 percent in two years) of those living in institutions consume over a third of all Medicaid funding spent on those with intellectual and developmental disabilities.

The Virginia Alliance for Community today calls on all candidates for statewide office and House of Delegates to adopt a “Community for All” platform that reforms Virginia’s system of supports for persons with intellectual and other developmental disabilities.

§ Virginia continues to inappropriately segregate persons with intellectual and other disabilities in expensive state institutions (Training Centers).

§ Virginia is one of only 10 states that have not closed any state operated institutions for persons with intellectual and other developmental disabilities. Eleven states have already closed all of their state-operated institutions.

§ The potential costs to rebuild or renovate all five state Training Centers would well exceed $100 million dollars, which is unjustifiable, particularly in a period of limited state revenues.

§ Spending scarce state dollars to rebuild and operate state institutions means fewer dollars available in the future to address the state’s growing waiting lists for the ID and DD waivers -- well over 5,000 persons are already waiting to live in the community.

(During its 2009 session, the Virginia General Assembly expressed its intent to eliminate the waiting lists for the Medicaid Intellectual Disabilities (formerly “Mental Retardation”) Waiver and the Individual and Family Developmental Disabilities Supports Waiver. The Governor was directed to develop a plan to eliminate the waiting lists for these waivers by the 2018-2020 Biennium.)

§ It is NOT reasonable to continue to invest scarce public dollars operating large, inefficient state institutions when there is a better way. It is NOT reasonable to deny persons with disabilities the right to live among us in the community if needed supports are provided.

What is the solution?

§ Halt future plans to rebuild state Training Centers. Virginians with the most significant disabilities can -- and do -- live in their own community homes when appropriate supports are available to them. Capital outlays can be leveraged with community housing money to significantly expand available, limited state dollars.

§ Consider the fiscal reality. Is it the best use of limited resources to spend $194,000 to support an individual in a state operated institution when individuals with like needs are being supported in the community for half that cost?

§ Make a true long-term commitment to eliminating waiting lists for waivers and other supports by developing and adopting a reform plan that transitions Virginia from its inefficient institutions to innovative, person-centered supports in the community.