by James C. Sherlock

DD/ID (Intellectual and Developmental Disabilities) refers to services, supports, and classifications for individuals with cognitive, physical, or emotional impairments.  The author’s first three articles on this subject provided background on Virginia’s broken system of services to that population. In many instances, it doesn’t work well due to combinations of oversight failures and unethical or incompetent providers. But overall, the system struggles due to its design. The Commonwealth has shared and devolved authority and responsibility for oversight of services for the DD/ID population beyond any reasonable expectation of effectiveness.  

When everyone is in charge, no one is.  

This series has focused on the Virginia Departments of Behavioral Health and Disability Services and of Medical Assistance Services. But there is also local responsibility across 40 Community Services Boards (CSBs) and a single Behavioral Health Authority. See a first-person account from a veteran of a citizens’ advisory board to one of those CSBs, Lefty 665. He speaks more eloquently about the problems in CSBs than anyone this author has read.

Portsmouth

Portsmouth has made its community services board (CSB) a department of the city government.  Its mission statement:

The mission of the Portsmouth Department of Behavioral Healthcare Services is to promote independence, recovery, and positive outcomes for those we serve, through excellence in the delivery of integrated Mental Health, Intellectual Disability, and Substance Abuse, and Co-Occurring services.

It has all gone horribly wrong there.

The City of Portsmouth sends “clients” screened by its Behavioral Healthcare Services department to local providers of incredibly dangerous “services” to developmentally and intellectually disabled children, adolescents, and adults.  The dangers are catalogued in heartbreaking state and federal inspection records.  

Government officials need only read them.   They will get an opportunity in this series.

Community Services Boards

Virginia Community Services Boards (CSBs) are established by local governments under Title 37.2, Chapter 5 of the Code of Virginia.

From § 37.2-500. Purpose; community services board; services to be provided

A. The Department, for the purposes of establishing, maintaining, and promoting the development of mental health, developmental, and substance abuse services in the Commonwealth, may provide funds to assist any city or county or any combinations of cities or counties or cities and counties in the provision of these services. Every city or county shall establish a community services board by itself or in any combination with other cities and counties, unless it establishes a behavioral health authority pursuant to Chapter 6 (§ 37.2-600 et seq.). In order to provide comprehensive mental health, developmental, and substance abuse services within a continuum of care, the community services board shall function as the single point of entry into publicly funded mental health, developmental, and substance abuse services.

B. The core of services provided by community services boards within the cities and counties that they serve shall include:

1. Emergency services;

2. Same-day mental health screening services;

3. Outpatient primary care screening and monitoring services for physical health indicators and health risks and follow-up services for individuals identified as being in need of assistance with overcoming barriers to accessing primary health services, including developing linkages to primary health care providers; and

4. Subject to the availability of funds appropriated for them, case management services.

C. Subject to the availability of funds appropriated for them, the core of services may include a comprehensive system of inpatient, outpatient, day support, residential, prevention, early intervention, and other appropriate mental health, developmental, and substance abuse services necessary to provide individualized services and supports to persons with mental illness, developmental disabilities, or substance abuse. Community services boards may establish crisis stabilization units that provide residential crisis stabilization services.

The Portsmouth Department of Behavioral Healthcare Services

To fund the Portsmouth CSB, which has been established there as the city Department of Behavioral Healthcare Services:

• the Virginia Department of Behavioral Health and Disability Services (DBHDS) provides state and federal funding (ex-Medicaid).
• The Department of Medical Assistance Services (DMAS) provides Medicaid funding.  
• Portsmouth contributes a small amount of city money.  

Providers are paid directly by Medicaid.   See the Portsmouth CSB funding from the DBHDS CSB Dashboard.

Above we see that only a small fraction of the Portsmouth CSB money is spent on Developmental Disabilities, and some of that balance has carried over at year’s end.  

Hardly a surprise, but the Portsmouth Behavioral Healthcare Advisory Board has not met since May of 2022.

Portsmouth City Council

In the Portsmouth City Council meeting minutes, we see how some of the Behavioral Healthcare Service Fund money is spent.  In the meeting on November 25, 2025, the Council unanimously approved:

Adoption of an ordinance appropriating $3,460,000 from the Fund Balance of the Behavioral Healthcare Service Fund to the FY 2026 Behavioral Healthcare Service Fund Budget and transferring said funds to the Municipal Facilities section of the FY 2026 Capital Improvement Fund Budget for the purpose of performing remodeling and roof repairs at the BHS offices located at 1811 King Street and 2011 Queen Street.

Below is a photo of the 1811 King Street office.

So the Portsmouth City Council is using $3.5 million from the Behavioral Healthcare Service Fund to repair city buildings.  Probably legal, but a bad look under the circumstances.

Portsmouth Providers

Two Portsmouth providers of services to the developmentally and intellectually disabled will be cited in detail in the next two articles. 

Holiday House

One is Holiday House, a non-profit Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID).  It has been paid by Medicaid for 50+ years to provide specialized, Medicaid-certified residential settings and 24/7 active treatment, health services, and rehabilitative care to children and adolescents.

Lucas Lodge

The other is a for-profit Medicaid waiver provider of community-based services, Lucas Lodge, which has been in business since 2005.  It has recently offered three specific service types:

• Developmentally disabled (DD) center-based day support services for adults license 341-02-006;
• DD residential group home services for adults license 341-01-001; and
• DD residential supervised living service for adults license 340-01-011.

Lucas Lodge DD Residential Supervised Living Service for Adults (license 340-01-011) began operations in 2023.  Suddenly, this morning, March 18, 2025, that service is no longer listed on the DBHDS investigations and inspections website with the other two service licenses of Lucas Lodge.  The author refuses to believe that it was done to hide anything.  DBHDS has been asked for comment.  The author will post the response here when received.

Bottom Line

The Portsmouth victims are all poor, mostly minorities, and many are helpless to speak for themselves.  The author will share the inspection reports and Death and Serious Incident Reports for both Holiday House and Lucas Lodge.  

Readers will find them quite literally unimaginable.