CRIPA ACTIVITIES IN FY 2001
I. Introduction and Overview
The Attorney General has authority to investigate conditions in public residential
facilities (1) and to take appropriate action if a pattern or practice of unlawful conditions
deprive persons confined in the facilities of their constitutional or federal statutory rights
pursuant to the Civil Rights of Institutionalized Persons Act (CRIPA), 42 U.S.C.§§ 1997- 1997j (2). Protecting the rights of institutionalized persons is an important part
of the Department's civil rights law enforcement effort. From May 1980, when CRIPA
was enacted, through September 2001, the Department investigated conditions in 355
jails, prisons, juvenile correctional facilities, mental retardation and mental health
facilities, and nursing homes. As a result of the Department's CRIPA enforcement,
thousands of persons residing in public institutions across our country emerged from
living in dire, often life-threatening, conditions to now enjoying adequate care and
The Attorney General has delegated day-to-day responsibility for CRIPA
activities to the Special Litigation Section of the Civil Rights Division. During fiscal year
2001, the Section was active in CRIPA matters and cases involving more than 187
facilities in 33 states and the District of Columbia, as well as the Commonwealths of
Puerto Rico and the Northern Mariana Islands, and the Territories of Guam and the
Virgin Islands. (3) The Section initiated investigations of eleven facilities, continued its
investigations of 53 additional facilities, and monitored the implementation of consent
decrees, settlement agreements, and other court orders involving 105 facilities. The
Attorney General filed two CRIPA suits involving a total of three facilities during the
fiscal year. Both of these suits were settled during the fiscal year. During fiscal year
2001, the Section closed two investigations of two facilities and joined with defendants
to dismiss four cases involving 20 facilities.
In keeping with the statutory requirements of CRIPA and the Attorney General's
initiative, the Section engaged in negotiations and conciliation efforts to resolve a
number of CRIPA matters both before and after filing CRIPA cases. The Section
maximized its impact and increased its efficiency by continuing to focus on multi-facility
investigations and cases, obtaining widespread relief whenever possible.
II. Filing of CRIPA Complaints/Resolution of Lawsuits
A. Cases Filed
1. On December 29, 2000, we filed a complaint and settlement agreement in
United States v. Indiana (S.D. Ind.), concerning two state operated facilities serving
approximately 560 persons with developmental disabilities, Muscatatuck State
Developmental Center in Butlerville, Indiana, and at Fort Wayne State Developmental
Center in Fort Wayne, Indiana. The settlement agreement was entered by the court.
The agreement requires defendants to take steps to ensure not only the safety of
persons at the two facilities, but also the safety of those persons placed in alternative
community settings. Within the facilities, the state is required to improve training,
clinical and medication practices, ensure that use of restraints is appropriate, and
increase efforts to place individuals with developmental disabilities from these facilities
in the most integrated setting possible which is appropriate to their individual needs.
The Department will continue to monitor progress toward full implementation of the
2. On January 19, 2001, the Department filed a complaint and settlement
agreement in United States v. McCracken County, Kentucky (W.D. Ky.) concerning
conditions of confinement at the McCracken County Jail, a 350-bed facility. The
agreement requires numerous improvements to inmate health and psychiatric care,
including intake procedures, medication management, infection control and crisis
intervention, as well as improvements regarding inmate housing, safety, protection from
harm and environmental practices. The Department will continue to monitor progress
toward full implementation of the agreement.
B. Settlements in Cases Filed in Prior Fiscal Years
1. On October 3, 2000, the court approved our settlement agreement in United
States v. Louisiana (M.D. La.), which involved conditions of confinement in four of
Louisiana's secure juvenile facilities. As a result of the agreement, Louisiana State
University School of Medicine will assume responsibility for the provision of medical,
dental, and mental health services in the facilities. The state also will take steps to
improve conditions for incarcerated youth in Louisiana relating to abuse and excessive
force as well as to provide better protection from harm while they are confined. This
agreement culminated almost five years of investigation and discovery in this matter.
2. On April 21, 2001, the court in United States v. Commonwealth of Virginia
(E.D. Va.) approved a modification of the consent decree pertaining to Central State
Hospital in Dinwiddie County, Virginia. This agreement reset the dates for compliance
monitoring and resolution of any disputes.
3. On September 20, 2001, the court in United States v. Hawaii (D. Haw.)
entered a stipulated order regarding space utilization. This order establishes a
procedure to address overcrowding issues at Hawaii State Hospital, the mental health
facility which is the main subject of this case. Defendants will evaluate current space
availability, short term repair projects, discharge planning, transfer criteria and the
feasibility of purchasing modular buildings to provide space for patient residential and
program needs. The order establishes patient census ranges by month and requires
defendants to seek contracts for additional space if those ranges cannot be met for
three consecutive months. The United States will continue to monitor compliance with
III. Compliance Evaluations
During fiscal year 2001, the Special Litigation Section monitored defendants'
compliance with CRIPA consent decrees, settlement agreements, and other court orders
designed to remedy unlawful conditions in publicly operated facilities throughout the
United States. (4) These facilities are:
1. Mental retardation facilities: Southbury Training School (United States v.
Connecticut (D. Conn.)); Embreeville Center (United States v. Pennsylvania (E.D.
Pa.)); (5) Arlington Developmental Center (United States v. Tennessee (W.D. Tenn.));
Clover Bottom Developmental Center, Greene Valley Developmental Center, and Harold
Jordan Center (United States v. Tennessee (M.D. Tenn.)); Southern Wisconsin
Developmental Center and Central Wisconsin Developmental Center (United States v.
Wisconsin (W.D. Wis.)); and Center for Integral Services, Centro de Servicios Multiples
de Camaseyes, Hogar de Grupo Las Mesas, Facilidad de Cuidado Intermedio, Centro
de Reeducacion para Adultos, and Centro de Servicios Multiples Rosario Bellber (United
States v. Commonwealth of Puerto Rico (D. P. R.)).
2. Mental health facilities: Hawaii State Hospital and children and adolescent
residential services at Castle Medical Center and Kahi Mohala (United States v. Hawaii
(D. Haw.)); Guam Adult Mental Health Unit (United States v. Guam (D. Guam)); Pilgrim
Psychiatric Center (United States v. New York (E.D. N.Y.)); Memphis Mental Health
Institute (United States v. Tennessee (W.D. Tenn.)); and Central State Hospital (United
States v. Commonwealth of Virginia (E.D. Va.)).
3. Nursing homes: Philadelphia Nursing Home (United States v. City of
Philadelphia (E.D. Pa.)).
4. Juvenile Correctional Facilities: thirty-two juvenile correctional facilities in
Georgia (United States v. State of Georgia (N.D. Ga.)); Essex County Youth House
(United States v. Essex County (D. N. J.)); 19 Puerto Rican juvenile correctional facilities
(United States v. Puerto Rico (D. P. R.)); Kagman Youth Facility (United States v.
Commonwealth of the Northern Mariana Islands (D. N.Mar.I.)); and educational services
in four facilities in United Stated v. Louisiana (M.D. La.).
5. Jails: Crittenden County Jail (United States v. Crittenden County (E.D. Ark.));
Hagatna Detention Center and Fibrebond Detention Facility (United States v. Guam
(D. Guam)); Grenada County Jail (United States v. Grenada County (N.D. Miss.));
Tupelo City Jail (United States v. Tupelo City (N.D. Miss.)); Forest City Jail (United
States v. Forest City (S.D. Miss.)); Harrison County Jail (United States v. Harrison
County (S.D. Miss.)); Simpson County Jail (Rainier and United States v. Jones (S.D.
Miss.)); Sunflower County Jail (United States v. Sunflower County (S.D. Miss.)); Gila
County Jail (United States v. Gila County, Arizona (D. Ariz.)), four jails in Northern
Mariana Islands (United States v. Commonwealth of the Northern Mariana Islands
(D. N.Mar.I.)); Muscogee County Jail (United States v. Columbus Consolidated
City/County Government (M.D. Ga.)); and Morgan County Jail and Sheriff's Department
(United States v. Morgan County, Tenn. (E.D. Tenn.)).
6. Prisons: Guam Adult Correctional Facility (United States v. Guam
(D. Guam)); Montana State Prison (United States v. Montana (D. Mont.)); Golden Grove
Adult Correctional Institution (United States v. Virgin Islands (D. V. I.)); and
Saipan Prison Complex (United States v. Commonwealth of the Northern Mariana
Islands (D. N.Mar.I.)).
7. Other Facilities: New Mexico School for the Visually Handicapped (United
States v. New Mexico (D. N. Mex.)).
IV. Enforcement Activities
The Department took enforcement action during the fiscal year where state and
local officials failed to meet their legal obligations under consent decrees and other court
orders in CRIPA cases to improve conditions of confinement.
On May 17, 2001, in United States v. Hawaii (D. Ha.), following agreement by the
parties, the court appointed a federal magistrate as Special Master as a vehicle to bring
the State into compliance with previous court orders. The Special Master ordered the
State to develop a comprehensive plan for the delivery of both hospital and community-based mental health services. The Special Master also chairs monthly status
conferences during which the parties update the court on progress being made in
developing the comprehensive plan as well as addressing immediate concerns in the
case. One such immediate concern involves the remedial plan to correct patient
overcrowding issues at the Hawaii State Hospital. On September 20, 2001, the parties
filed a stipulation and proposed order which calls for a reduction in the hospital census
as well as the transfer of patients to private hospitals.
On June 28, 2001, in Johnson and United States v. Murphy ( M.D. Fla.), after a
two month trial in August and September 2000, the court decided the case in favor of
defendants. However, largely as a result of this litigation, the state made substantial
changes to the services it provides to persons with mental illness in central Florida. On
the first day of the trial, defendants announced that the G. Pierce Woods Memorial
Hospital (GPW), the subject facility in the case, would close on January 1, 2002.
Further, the state allocated $37 million in new money for community mental health
services to former patients of GPW.
V. Prison Litigation Reform Act
The Prison Litigation Reform Act (PLRA), 18 U.S.C. § 3626, which was enacted
on April 26, 1996, covers prospective relief in prisons, jails, and juvenile correctional
facilities. The Department has defended the constitutionality of the PLRA and has
incorporated the PLRA's requirements in the new remedies it seeks regarding
improvements in correctional facilities.
VI. Termination of CRIPA Consent Decrees and Partial Dismissals of Complaints
When jurisdictions comply with settlement agreements or court orders and correct
unlawful conditions in the institution, the Section joins defendants in a motion to dismiss
the underlying action. During fiscal year 2001, the Department joined with defendants to
seek dismissal of four cases covering twenty facilities. On November 27, 2000, the
court granted a joint motion for dismissal of United States v. Maricopa County (D. Ariz.)
which ended litigation involving medical and mental health services in five jails in
Phoenix, Arizona. On January 16, 2001, the court granted a joint motion to dismiss
United States v. Kentucky (E.D. Ky.) regarding thirteen state operated juvenile facilities
throughout Kentucky. On June 29, 2001, the court granted the parties' joint motion to
dismiss United States v. Dooly County, Georgia (M.D. Ga.). County officials made
substantial improvements to the jail's physical plant, fire and life safety, medical and
mental health care, and ongoing correctional procedures. Substantial compliance with
the settlement agreement, including the building of a new jail, formed the basis for the
joint motion by the parties. On July 5, 2001, the court approved the joint motion to
dismiss United States v. Commonwealth of Virginia (E.D. Va.), our case involving care
and treatment at the Northern Virginia Mental Health Institute (NVMHI) in Fairfax,
Virginia. Significant remedial measures at NVMHI included development and
implementation of a comprehensive treatment process, increased protection from harm
and discharge planning for community placement.
VII. Responsiveness to Allegations of Illegal Conditions
During fiscal year 2001, the Special Litigation Section reviewed allegations of
unlawful conditions of confinement in public facilities from a number of sources,
including individuals who live at the facilities and their relatives, staff and ex-staff of
facilities, advocates, concerned citizens, media reports, and referrals from within the
Department and other federal agencies. The Section received approximately 7700
incoming citizen letters and 1000 telephone complaints during the fiscal year. The
majority of these citizen contacts related to CRIPA complaints. In addition, the Division
responded to over 17 CRIPA-related inquiries from Congress.
The Section prioritized these allegations by focusing on facilities where
allegations revealed systemic, serious deficiencies. In particular, with regard to mental
health and mental retardation facilities and nursing homes, the Section focused on
allegations of abuse and neglect; adequacy of medical and mental health care; use of
restraints and seclusion; and services to institutionalized persons in the most integrated
setting appropriate to meet their needs as required by Title II of the Americans with
Disabilities Act and its regulations, 42 U.S. C. §§ 12132 et seq.; 28 C.F.R. § 35.130(d).
With regard to juvenile correctional facilities, the Section focused on allegations of
abuse, adequacy of mental health and medical care, and provision of adequate
rehabilitation and education, including special education services. In jails and prisons,
the Section placed emphasis on allegations of abuse, sexual misconduct, adequacy of
medical care and psychiatric services, and grossly unsanitary and other unsafe
VIII. New CRIPA Investigations
The Department initiated CRIPA investigations of eleven institutions during the
fiscal year. These new investigations involved the following facilities:
- Wicomico County Detention Center, Maryland;
- Baltimore City Detention Center, Maryland;
- Los Angeles County, California: Eastlake Juvenile Hall, Los Padrinos Juvenile Hall, and Sylmar Juvenile Hall;
- Banks-Jackson-Commerce Medical Center and Nursing Home, Georgia;
- North Carolina mental health facilities: John Umstead Hospital, Dorothea Dix Hospital, Cherry Hospital, and Broughton Hospital; and
- Oakwood Developmental Center, Kentucky.
IX. Findings Letters
The Department issued written findings of the results of its investigations,
pursuant to Section 4 of CRIPA, 42 U.S.C. § 1997b, regarding two facilities:
- Bergen Regional Medical Center, New Jersey; and
- Shelby County Jail, Tennessee.
X. Investigation Closures
During the fiscal year, the Section closed investigations involving two facilities:
- Scioto/Riverview Joint Juvenile Correctional Center, Ohio; and
- Hamilton County Nursing Home, Tennessee.
XI. Technical Assistance
Where federal financial, technical, or other assistance is available to help
jurisdictions correct deficiencies, the Department advises responsible public officials of
the availability of such aid and arranges for assistance, where appropriate. During
FY2001, the Section provided expert consultants to both Central State Hospital and
Northern Virginia Mental Health Institute in Virginia regarding community placement,
discharge planning, and treatment planning with particular emphasis on planning for
persons with specialized needs. At Central State Hospital, we evaluated policies and
procedures; provided advice on how to improve staffing, nursing plans, and patient
safety; provided feedback on medication practices, and counseled staff and
administrators on ways to improve their participation in treatment plan meetings; and
offered guidance on behavioral data-collection, treatment planning, and staffing issues.
In our mental health case involving Pilgrim Psychiatric Center in New York, we provided
technical assistance on the development of constitutionally adequate restraint and
seclusion policies. In connection with our case involving two mental retardation facilities
in Indiana, we provided technical assistance to state officials regarding community
placement issues involving persons who are medically fragile, available resources to
enhance vocational training, mortality review policy development, biopsychosocial
psychiatry model, assistive technology communication services, psychotropic
medication, residential provider development, behavioral supports, and seizure
management as well as the most effective techniques to investigate allegations of
abuse. As part of our investigation of Los Angeles County juvenile facilities, we offered
technical assistance regarding modern equipment to evaluate the adequacy of
sanitation, the design and reorganization schemes in the medical units; care and
inspection of heating and air conditioning, refrigeration and laundry systems; and
education issues. In our investigation of Jackson County Correctional Center, our
consultants provided technical guidance in the development of new medical policies and
procedures, quality assurance plans, and new correctional policies and procedures.
1. Institutions covered by CRIPA include nursing homes, mental health facilities,
mental retardation facilities, residential schools for children with disabilities, jails,
prisons, and juvenile correctional facilities.
2. CRIPA does not cover the federal statutory rights of inmates in jails or prisons.
3. Fiscal year 2001 began on October 1, 2000, and ended on September 30, 2001.
This report is submitted to Congress to supplement the Attorney General's report on
Fiscal Year 2001 Department activities by providing additional details about CRIPA
actions during the fiscal year pursuant to 42 U.S.C. § 1997f.
4. As noted on page 2, supra, the Department joined with defendants to seek full or
partial dismissal of four cases covering twenty facilities; those facilities are not listed
here, but are discussed infra at pages 8-9.
5. Embreeville Center closed during FY 1998 but, under the terms of the consent
decree, the Section continues to monitor conditions in community placements from the