Two More State Centers Close in Pennsylvania
Today, the Pennsylvania Department of Human Services (DHS), and DHS Secretary Teresa Miller announced that DHS plans to close the Polk and White Haven State Centers. These closures represent great opportunities for increased choice and community integration for many people with intellectual and developmental disabilities in Pennsylvania.
The Institute on Disabilities at Temple University, College of Education applauds these announced closures, and looks forward to assisting individuals with intellectual disabilities and their family members with the transition to community living. Throughout the years our research has shown unequivocally that people who move from state centers to the communities of their choosing are better off having moved, in every way in which we can measure it. Further, our research shows that people with the most significant disabilities benefit the most from the move to community living.
The Institute, founded in 1973, is one of 67 centers throughout the country, funded by the Federal Developmental Disabilities Assistance and Bill of Rights Act. We are Pennsylvania's only University Center for Excellence in Developmental Disabilities, and although our primary location is on Temple's main campus in north Philadelphia, we are a statewide program with a satellite office just north of Pittsburgh.
Our charge through the Developmental Disabilities Act is to provide community training and technical assistance, interdisciplinary training in order to prepare the next generation of professionals, research and dissemination, all on behalf of people with intellectual and developmental disabilities and their families.
What are Polk and White Haven?
Polk and White Haven are two of the four remaining state-run public intermediate care facilities for people with intellectual disabilities in Pennsylvania, with the other two being Ebensburg, and Sellinsgrove. Over the last 22 years, the resident population of these institutions has seen a more than 70 percent decrease. Currently, fewer than 720 people reside in the remaining four Pennsylvania state centers. At one point, Pennsylvania operated 20 state centers for people with intellectual disabilities. Between the mid-1980s and 1999, nine of these centers (or intellectual disability units associated with state mental health facilities) were closed. Between 1999 and 2017, three additional state centers closed. Now, according to DHS, Polk and Whitehaven will be the next to close, with the closures taking place over the next three years. This transition period will allow residents an adequate opportunity to transition into the community with necessary home and community-based services and supports. Polk currently has 194 residents who will be transitioning from the 2,000 acre campus in Venango County. White Haven currently houses 112 individuals on a 192 acre campus in Luzerne County Pennsylvania.
Home and Community-Based Services
Home and community-based services (HCBS) are available to Pennsylvanians with intellectual disabilities through a variety of Medicaid "waiver" programs. Medicaid waivers allow states access to Federal Medicaid funds to provide home and community-based services to people with disabilities as an alternative to Medicaid funded nursing homes or other institutional settings. HCBS waivers allow states to fund services that might not otherwise be compensated under Medicaid, including long-term services and supports for activities such as meal preparation, eating, bathing, dressing, personal care, medication management and participation in community and employment activities.
The people who transition from Polk and White Haven will benefit from these services, integral for offering personal choice in where and how long-term services and supports are provided. They allow people with intellectual disabilities the choice to live in their own home instead of an institutional setting, and they are cost-effective. Statistically, at least two people with disabilities can be supported with services in the community, for every one person who is served in an institution such as Polk or White Haven.
The Shift to Community Integration
The closure of Polk and White Haven State Centers is the result of decades of movement away from institutional living toward community living, for Pennsylvanians with disabilities. Most recently, in 2018, Pennsylvania successfully closed the Hamburg State Center.
In 2014, the Centers for Medicare and Medicaid Services (CMS) issued the "HCBS Final Rule." The Final Rule requires that services funded by Medicaid dollars be provided in integrated, community-based settings. Pennsylvania, like other states, is currently developing a required plan to successfully implement this Final Rule. The announced closure of Polk and White Haven represents a positive step toward Final Rule compliance and implementation in Pennsylvania.
For more than 28 years, the Americans with Disabilities Act (ADA) has sought to end discrimination against people with disabilities, including unnecessary segregation and isolation away from family members, friends and the community. The leading case on this issue is the U.S. Supreme Court's decision in Olmstead v. L.C., 527 U.S. 581 (1999). Olmstead involved two women with intellectual and other disabilities who had been voluntarily committed to a state-run psychiatric institution. Following completion of treatment, professionals at the facility determined that these women were ready to transition into the community. Despite this recommendation, the women remained in the institution for many years because the state of Georgia claimed they did not have a community program for them. The plaintiffs in Olmstead sued for the right to home and community-based programs and services. Ruling in favor of the plaintiffs, the Court ruled that the ADA requires the state to provide community-based services as an appropriate option. Olmstead is still the law of the land. The announced closure of Polk and White Haven illustrates the continued trend away from institutionalization and toward a community life.
Celia S. Feinstein, Executive Director
Jamie Ray-Leonetti, Policy Director
Institute on Disabilities at Temple University, College of Education
Pennsylvania's University Center for Excellence in Developmental Disabilities Education, Research and Service