v

Dear Chairman Mendelson,

test

Dear Ms. Lee,

The disAbility Law Center of Virginia (dLCV) appreciates this opportunity to comment on the Draft Mental Health Services Provider Manual, Appendix H. We recognize that the changes to Appendix H reflected in the draft manual are largely structural, with few substantive changes, and we have no position on the proposed changes to the structure and format of the Appendix. We do, however, recommend striking the following language that appears both on page 5 of the Appendix, addressing Intensive In-Home (IIH) services; and on page 10 of the Appendix, addressing Therapeutic Day Treatment (TDT) services:

These services are rehabilitative and are intended to improve the youth’s functioning. It is unlikely that youth with severe cognitive and developmental delays/impairments would clinically benefit and meet the service eligibility criteria.

Virginians dually diagnosed with both an intellectual or developmental disability (ID/DD), and mental illness (MI) face significant obstacles to accessing mental health services in the community. There are many reasons that these obstacles exist. One reason is that harmful stereotypes about people with ID/DD and their capacity to benefit from mental health services are pervasive.

dLCV frequently works with and on behalf of Virginians who are dually diagnosed with ID/DD and MI. In our advocacy work, we have heard of mental health providers who use the existence of ID/DD as a de facto exclusionary criterion for the services that they provide. This discriminatory practice of denying services to an individual solely because that individual has an ID/DD diagnosis should not be tolerated. The language quoted above in the Draft Appendix H perpetuates the very stereotypes that result in this discrimination. We propose that this language be stricken from Appendix H, and that the following be incorporated in its place:

These services are rehabilitative and are intended to improve the youth’s functioning. A youth may not be denied these services solely because that youth is diagnosed with an intellectual or developmental disability. Determinations as to whether a particular youth is likely to clinically benefit from these services and meet the service eligibility criteria must be based on individualized consideration of that particular youth’s needs, challenges, and strengths.

Thank you for this opportunity to comment on this proposed emergency regulatory action. If you have any questions about these comments or otherwise wish to discuss this matter further, please contact Robert Gray, dLCV Director for Compliance and Quality Assurance, at robert.gray@dlcv.org or 804-662-7188.

Sincerely,

Colleen Miller

Executive Director