An investigation by the U.S. Department of Health and Human Services Office for Civil Rights (HHS OCR) and the U.S. Attorney’s Office for the District of Rhode Island has found that the state of Rhode Island violated federal civil rights laws by routinely and unnecessarily isolating children with mental illnesses and developmental disabilities at Bradley Hospital, an acute care psychiatric facility. HHS OCR Regional Manager Susan Rose and U.S. Attorney Zachary A. Cunha made the announcement in Rhode Island today and issued a joint letter of findings, which was sent to the Governor of Rhode Island and the Commissioner of the Rhode Island Department of Children, Youth and Families (DCYF).
A comprehensive, multiyear federal investigation found that the state kept children in DCYF custody at Bradley longer than necessary. While Bradley admissions are intended for one to two weeks of acute care, federal investigators concluded that children with mental illnesses and developmental disabilities in DCYF custody were often hospitalized for weeks, months, and in some cases more than a year. In these cases, the children remained at Bradley even though they were ready to be discharged and could have been better cared for in less restrictive community-based care settings, according to the investigation. The investigation also marks the first Olmsted case from OCR’s new HHS Olmsted Initiative.
“Today’s ruling continues the Office for Civil Rights’ efforts to strengthen access to care for people with disabilities like these Rhode Island children,” said HHS OCR Director Melanie Fontes Reiner. “We must do better for the children and the communities we serve, and states and other agencies must uphold federal civil rights laws to ensure all children have access to care without discrimination. As we approach the 25th anniversary of the Olmstead decision, today’s action also underscores our commitment to continue to protect individuals’ important rights to live in their own homes and communities.”
“Children with disabilities should be able to return home to the love and support of their families, not be confined to institutions for months on end,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “We will continue to vigorously enforce the ADA to ensure that children with disabilities have access to the community-based services they need to live with their families and participate in their communities.”
“It is simply astonishing that the state has chosen to commit children to psychiatric hospitals rather than proactively working to provide the care, support and services in the community that these children need and are required by law,” said U.S. Attorney Zachary A. Cunha. “We hope that the findings we release today will prompt the state to act swiftly to meet its obligations under federal law and, more importantly, to ensure that the civil rights of these children are protected.”
Title II of the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973 (Section 504), and the Supreme Court’s Olmstead v. LC decision require state and local governments to provide services to individuals with disabilities in integrated settings that best meet their needs. Enforcement of the integration requirements of Title II of the ADA, Section 504, and the Olmstead decision is a priority for the Department of Justice and the Department of Health and Human Services. A federal investigation found that DCYF violated Title II and Section 504 of the ADA by failing to ensure that children with disabilities receive the care they need in the most appropriate integrated setting.
As detailed in the government’s findings, between January 1, 2017 and September 30, 2022, 527 children in DCYF custody or voluntarily receiving services through DCYF were admitted to Bradley Hospital. Although Bradley Hospital’s short-term services are intended solely to stabilize children in crisis, of the 527 children admitted to Bradley during the period, 116 were admitted for more than 100 consecutive days in a single admission, 42 were admitted for more than 180 days, and seven were admitted for more than a year. The findings found that prolonged hospitalizations are often traumatic for children as well as their families, exacerbating the impact of non-compliance with federal civil rights laws.
For additional information about the ADA, visit www.ada.gov or call the Department of Justice’s toll-free ADA Information Line at 800-514-0301 or 800-514-0383 (TDD). For more information about Section 504 of the Rehabilitation Act and protections for people with disabilities, visit https://www.hhs.gov/civil-rights/for-individuals/disability/index.html.
Individuals who believe their civil rights have been violated may file a complaint with the HHS Office for Civil Rights at www.hhs.gov/civil-rights/filing-a-complaint/index.html. Rhode Island residents may also report civil rights violations directly to the U.S. Attorney’s Office for the District of Rhode Island at https://www.justice.gov/usao-ri/civil-rights-enforcement or 401-709-5000.