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And Then There Was One

In the early 1990’s, the state of Tennessee operated four large public institutions for persons with intellectual disabilities.  Ultimately, two federal lawsuits were filed against the state alleging widespread mistreatment and other violations of civil rights.  Plaintiffs in the litigation included the U.S. Department of Justice and People First.  After over 20 years of litigation, it was announced last week that Clover Bottom Developmental Center will be closing at the end of November.  Clover Bottom had been in operation for over 90 years and at one time housed over 1,500 residents.  Now, Clover Bottom joins Arlington and Nat T. Winston Developmental Centers in closing its doors leaving only Greene Valley Developmental Center in east Tennessee as the only remaining state institution for persons with developmental and intellectual disabilities.  Greene Valley’s closure has also been announced with the expectation that it will close by the end of June, 2016.  Greene Valley still houses about 75 individuals and most of the remaining people there will transition to community providers and receive services under the Medicaid Waiver.  Once Greene Valley closes, the state will ultimately exit the litigation that has dictated public policy and planning efforts for almost 25 years.

When the lawsuits were first filed in the early 1990’S Tennessee seriously lagged national trends in providing funding and support for community services.  It was an institution-driven system and the dollars and policy making were dominated by state officials who had those interests at heart. There were still almost 2000 Tennessee citizens living in the four state institutions as of 1991, and it has taken now over two decades for that number to move to less than 100 and perhaps even zero within the next eight months.  Tennessee’s delays in closing the state institutions have cost taxpayers millions of dollars and unnecessarily kept people far too long in these settings.

Tennessee will soon join fourteen other states which no longer operate large public facilities.  However, Tennessee has decided to continue operating small ICF homes and a number have been built across the state as a part of the overall phasedown of the state institutions.  This was in part a decision reached by the state as part of an agreement with families and guardians who favor state-run facilities over privately operated community homes.  However, once the exit plan for the lawsuits has been fulfilled and the Clover Bottom litigation officially ended, one would hope that the State would initiate plans to transition the state-run homes to private providers.  There is considerable evidence that this is a better long range option for persons (from both an economic and quality point of view) who live in these homes.

Join me in congratulating the current DIDD leadership, Commissioner Debbie Payne and her team, in leading efforts to close this chapter in Tennessee’s history.  Keep watching for the next headline—THEN THERE WAS ONE will finally read THEN THERE WAS NONE!

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