HHS Office for Civil Rights and U.S. Attorney’s Office for the District of Rhode Island Reach Agreement with the State of Rhode Island to Resolve Violations of Federal Disability Laws for Children with Disabilities in State Care

Agreement ensures that children who are hospitalized are transitioned to family settings with services and prevents children from experiencing unnecessary psychiatric hospitalizations.

Today, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), in partnership with the U.S. Attorney’s Office for the District of Rhode Island, entered into a proposed consent decree with the State of Rhode Island to resolve the joint OCR and U.S. Attorney May 2024 findings that Rhode Island’s unnecessary placement of children with behavioral health disabilities in a psychiatric hospital violates federal civil rights laws. The proposed consent decree filed in U.S. District Court, alongside a civil complaint, requires that the State provide these children with community-based services that will allow them to stay in their own homes and communities while they receive the services they need. Compliance with the decree will be overseen by a court-appointed monitor and a federal judge.

“Every child – and every person – deserves to access critically needed care, free from discrimination: it’s fair, just, and a legally protected right. Twenty-five years after the Olmstead decision, today’s consent decree follows the HHS Office for Civil Rights’ continued efforts to ensure that people with disabilities have opportunities to live and receive needed services in their communities rather than institutions,” said OCR Director Melanie Fontes Rainer. “We are encouraged by the State of Rhode Island’s commitment to stand with the communities we serve in resolving these issues. OCR will continue to protect and enforce the essential civil rights of every person to live in their homes and communities across the nation.”

“No child deserves to be isolated indefinitely in a locked psychiatric facility when their condition can be treated at home or in a community setting,” remarked U.S. Attorney Zachary A. Cunha.  “Our kids, our families, and our communities deserve – and the law demands - better than that.  While today’s consent decree will not transform a broken system that has all too often failed children with behavioral disabilities, it marks an important, and an enforceable, step toward getting these kids care, rather than confinement.  I commend the state of Rhode Island for doing the right thing by stepping up to resolve this matter, and hope that this reflects an ongoing commitment to meeting the state’s civil rights obligations towards our most vulnerable fellow citizens.”

“A child should grow up surrounded by family and loved ones, not in an institution,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “This consent decree will provide children with disabilities the services they need to live and grow at home with the love and support of their families. The American with Disabilities Act’s integration mandate lies at the core of the department’s efforts to safeguard the rights of people with disabilities across the country and we will continue our critical work in this area.”

The filing of the proposed consent decree in federal court follows a public letter of findings issued by the HHS Office for Civil Rights and United States Attorney’s Office in May 2024 notifying the State of violations of civil rights laws. The complaint filed today alleges that the State failed to ensure that children with disabilities were able to access the intensive in-home and community-based services they need, and failed to facilitate prompt discharges from Bradley Hospital to family homes, resulting in extended and unnecessary hospitalization, or risk of future hospitalization, all in violation of Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973. In Olmstead v. L.C., the U.S. Supreme Court held that Title II of the Americans with Disabilities Act (ADA) requires public entities, in providing services to persons with disabilities, to do so in their homes and communities when appropriate services can reasonably be provided in those settings to individuals who want them.

Under the proposed consent decree, which is subject to court approval, the State has agreed to do the following:

• Help children who are currently hospitalized at Bradley Hospital to transition to family settings and receive services at home with needed supports;
• Provide children and families with service planning and care coordination to improve the likelihood that children recently hospitalized, who have experienced multiple visits to emergency departments, can remain living at home;
• Improve access to intensive in-home services, including in-home individual and family therapy, behavioral services, and therapeutic mentoring;
• Address current or future shortages of therapeutic foster care families and community-service providers, including providing payment rates and support, to enable children they serve to return to or remain in family settings;
• Provide prompt mobile crisis interventions to help children avoid entering hospitals; and
• Monitor outcomes and timeliness of services.

The parties have agreed that a court-appointed monitor will monitor the state’s compliance with this five-year consent decree. The State worked cooperatively with the United States to resolve and remedy the federal civil rights violations that were identified and agreed to settle this matter without contested litigation.

This case was negotiated by Assistant United States Attorney Amy R. Romero, with assistance from HHS Equal Opportunity Specialist Erin Walker.

The consent decree may be found at: https://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/agreements/ri-dcyf/index.html

Additional information about the ADA can be found at www.ada.gov, or by calling the Department of Justice’s toll-free ADA information line at 800-514-0301 or 800-514-0383 (TDD).

This action is the latest in a series of efforts OCR has made to advance and protect the civil rights of people with disabilities. This includes the announcement of the Section 504 of the Rehabilitation Act of 1973 final rule and the Section 1557 of the Affordable Care Act final rule.

For more information on nondiscrimination on the basis of disability, including Section 504 of the Rehabilitation Act and the Americans with Disabilities Act, visit: https://www.hhs.gov/civil-rights/for-individuals/disability/index.html.

For more information about OCR’s Olmstead activities, visit: https://www.hhs.gov/civil-rights/for-individuals/special-topics/community-living-and-olmstead/index.html. 

If you believe that you or someone else has been discriminated against because of race, color, national origin, disability, age, sex, or religion in programs or activities that HHS directly operates or to which HHS provides federal financial assistance, you may file a complaint with the HHS Office for Civil Rights at: https://www.hhs.gov/civil-rights/filing-a-complaint/index.html.

Anyone in Rhode Island 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.