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. ï½§ï½§ 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 2000, the Department investigated conditions in 344 jails, prisons, juvenile correctional facilities, mental retardation and mental health facilities, and nursing homes. As a result of the Department's CRIPA enforcement, tens of thousands of institutionalized persons who were living in dire, often life-threatening, conditions now receive adequate care and services.
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 2000, 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 nine facilities, continued its investigations of 57 additional facilities, and monitored the implementation of consent decrees, settlement agreements, and other court orders involving 123 facilities. The Attorney General filed three CRIPA suits involving seven facilities during the fiscal year. All of these suits were settled during the fiscal year. One case was litigated in a month long trial in the Middle District of Florida during the fiscal year. In addition, the Section resolved one institutional matter with an out of court settlement. During fiscal year 2000, the Section closed investigations of two facilities and joined with defendants to dismiss five cases involving thirteen 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 7, 1999, the Department filed a complaint in United States v. Maricopa County (D. Ariz.) regarding the provision of medical and mental health services to 7,000 inmates of the Maricopa County Jail which is comprised of five facilities. Simultaneously, the parties filed a settlement agreement that provided for hiring of additional medical and mental health staff; improved medical evaluation services both for intake and routine care; additional space for the provision of medical services; an improved distribution system for medications and monitoring of possible side effects; creation of an Infection Control Committee; and improved quality assurance mechanisms to assess the quality of medical and mental health services provided at the facilities.
2. On February 10, 2000, the Department filed a complaint in United States v. Morgan County, Tennessee (E.D. Tenn.) concerning conditions of confinement at the Morgan County Jail. This action followed unsuccessful attempts to resolve the investigation of this facility. On June 27, 2000, the parties filed a settlement agreement. It provided for renovation or construction of the Jail to eliminate suicide hazards, provide sufficient living space for inmates, and improve fire safety, general safety and sanitation; hiring and training of additional staff; maintenance of contracts to provide adequate medical, dental and mental health services; improvements in inmate access to legal materials, privacy and protections from harassment for female inmates, as well as new policies and procedures to prevent sexual misconduct by staff.
3. In December 1999, the United States was requested by the court expert in Williams v. Stalder (E.D. La.), which involved Louisiana prisons, to evaluate the adequacy of services at the recently-opened Jena Juvenile Justice Center, a juvenile facility run by Wackenhut Corporation on behalf of Louisiana, and report to the court. The United States uncovered life-threatening conditions at the facility for about 240 youth and reported those conditions to the court in February 2000. When the State failed to negotiate an immediate remedy to the unsafe conditions, the Department decided to add Jena to its suit against Louisiana involving the state's four other secure juvenile correctional facilities. On March 30, 2000, the Department moved to amend its complaint in United States v. Louisiana (M.D. La.), to add claims regarding Jena. The Department also moved for preliminary relief to address the life-threatening conditions. The court then ordered day-to-day negotiations regarding conditions at Jena. On April 15, 2000, the parties filed with the court a settlement agreement addressing the life-threatening conditions; days after the agreement was filed, Wackenhut announced its decision to close Jena. Jena was closed in May 2000. Some youth were transferred to Louisiana's other secure juvenile correctional facilities and others were released from secure confinement.
B. Out of Court Settlement
1. On September 15, 2000, the United States and Black Hawk County, Iowa, entered into a settlement agreement pertaining to conditions of confinement at the Black Hawk County Jail in Waterloo, Iowa. This agreement resolved our CRIPA investigation of the facility. The county has agreed to significantly improve medical staffing with physician, psychiatrist and mental health therapist coverage at a minimum of twenty hours per week and on-site nursing coverage seven days per week. Inmates will receive medical care regardless of their economic status. A small co-payment for medical services may be charged under clearly defined and limited circumstances. The settlement also calls for certain architectural modifications at the jail to reduce the possibility of inmate suicides, as well as policies to be implemented regarding suicide watch and suicide prevention equipment to be provided at each officer's post. Policies will also be implemented to assure that the use of restraint, including use of a restraint chair, is appropriate to reduce the possibility of injury to self or others and is non-punitive.
C. Settlements in Cases Filed in Prior Fiscal Years
The Department was successful in obtaining favorable agreements to resolve two additional cases in fiscal year 2000. These matters addressed conditions of confinement in institutions against which complaints had been filed in prior fiscal years.
1. On November 23, 1999, the court in United States v. Tennessee (M.D. Tenn.) unconditionally ordered the implementation of the consent decree filed in this case in 1996. The United States had requested clarification of language in the original order entering the consent decree because there was uncertainty as to the court's intent. This case concerns the institutional and community services provided to developmentally disabled persons who reside in four Tennessee institutions.
2. On April 13, 2000, the Department filed an agreement in United States v. Louisiana (M.D. La.) which addressed the adequacy of educational services provided to incarcerated juveniles in Louisiana. As a result of the agreement, state officials will take steps to improve services in regular, special and vocational education. The agreement provided for the hiring of a State Director of Education to oversee services throughout the juvenile justice system; hiring of new educators with better qualifications; development of new curricula; hiring of related services personnel such as school psychologists, diagnosticians, social workers, speech therapists, and transition coordinators; and the building of more than 30 new classrooms. The agreement contained provisions for enforcement and monitoring to ensure implementation.
On September 7, 2000, also in United States v. Louisiana (M.D. La.), the Department filed a settlement agreement for medical, dental, mental health, rehabilitation and juvenile justice issues. This agreement provided that Louisiana State University School of Medicine will assume responsibility for medical, dental and mental health services to juveniles in the five facilities. In addition, the state will take steps to improve conditions relating to the abuse, excessive force and failure to protect children from harm. Specifically, the agreement called for hiring more than 200 new staff and training staff in the most effective, non-violent methods to employ when dealing with troubled youth; removal of suicide hazards throughout the facilities; development of substance abuse programs; development of systems to investigate allegations of abuse and neglect adequately; development of a quality assurance program to monitor conditions at the secure juvenile facilities; limitations on the use of chemical, mechanical and medical restraints as well as the use of isolation in the facilities; and the creation of six new legal positions to help represent the juveniles in the juvenile justice system.
III. Compliance Evaluations
During fiscal year 2000, 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.)); Fairview Training Center (United States v. Oregon (D. Or.)); 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.)); Northern Virginia Mental Health Institute (United States v. Commonwealth of Virginia (E.D. Va.)); 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.)); 13 Kentucky juvenile correctional facilities (United States v. Kentucky (W.D. Ky.)); Essex County Youth House (United States v. Essex County (D. N. J.)); 20 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 five facilities in United Stated v. Louisiana (M.D. La.).
5. Jails: Crittenden County Jail (United States v. Crittenden County (E.D. Ark.)); Clay County Jail (United States v. Clay County, Georgia)(M.D. Ga.)); Dooly County Jail (United States v. Dooly County, Georgia (S.D. Ga.)); 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.)); Scott County Jail (United States v. Scott 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.)); five Maricopa County Jails (United States v. Maricopa County (D. Ariz.)); 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.)); Saipan Prison Complex (United States v. Commonwealth of the Northern Mariana Islands (D. N.Mar.I.)); four Arizona prisons for women (United States v. Arizona (D. Ariz.)); and Crane Correctional Facility and Scott Correctional Facility (United States v. Michigan (E.D. Mich.)).
7. Other facilities: New Mexico School for the Visually Handicapped (United States v. New Mexico (D. N. Mex.)).
IV. Enforcement Activities
The Section litigated Johnson and United States v. Bradley (M.D. Fla.) in August and September 2000. Our complaint in intervention in this class action involved the conditions at G. Pierce Wood Memorial Hospital (GPW) in Arcadia, Florida and the community mental health services for discharged patients in a five district area surrounding the hospital. Our claims included both constitutional violations and statutory violations under the Americans with Disabilities Act, 42 U.S.C. 12131. We presented the testimony of seven expert witnesses and four lay witnesses. The evidence presented at the trial included facts relating to psychology, psychosocial rehabilitation, protection from harm, nursing care and discharge planning at GPW. During the trial, defendants announced their intention of closing the hospital by 2002. We also provided facts regarding the five districts in the community with respect to residential treatment, vocational services, and day treatment programs. Ultimately, in June, 2001, the court issued judgment for the defendants.
V. Prison Litigation Reform Act
The Prison Litigation Reform Act (PLRA), 18 U.S.C. ï½§ 3626, 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 its CRIPA activities. The Special Litigation Section has applied the PLRA requirements to the new remedies it seeks.
VI. Termination of CRIPA Consent Decrees and Partial Dismissals of Complaints
When jurisdictions comply with settlement requirements and correct unlawful conditions in the institution, the Department joins defendants in a motion to dismiss the underlying action. During fiscal year 2000, the Department joined with defendants to seek dismissal or partial dismissal of 5 cases covering thirteen facilities. On December 17, 1999, the court granted a joint motion for dismissal of United States v. Arizona (D. Ariz.) which ended litigation involving four women's prisons in Arizona. On March 7, 2000, the court granted a joint motion to dismiss United States v. Michigan (E.D. Mich.) regarding two men's prisons in Michigan. On July 7, 2000, the court for the Middle District of Georgia granted the joint motion of parties to dismiss United States v. Clay County, Georgia regarding the Clay County Jail. On August 28, 2000, the court granted the joint motion of parties to dismiss United States v. Oregon (E.D. Ore.) and terminated the case against Fairview Training Center. On September 21, 2000, the court dismissed claims against Sheriff Joseph Arpaio in United States v. Maricopa County, Arizona (D. Ariz.).
VII. Responsiveness to Allegations of Illegal Conditions
During fiscal year 2000, 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 7300 incoming citizen letters and 1000 incoming telephone complaints during the fiscal year. The majority of these citizen contacts related to CRIPA complaints. In addition, the Division responded to 30 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; inadequate medical care, mental health treatment, and habilitation; misuse of restraints and seclusion; and failure to serve 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. ï½§ï½§ 12132 et seq.; 28 C.F.R. ï½§ 35.130(d). With regard to juvenile correctional facilities, the Section focused on allegations of abuse, inadequate mental health and medical care, and failure to provide adequate rehabilitation and education, including special education services. In jails and prisons, the Section placed emphasis on allegations of abuse, inadequate medical care and psychiatric services, and grossly unsanitary and other unsafe conditions.
VIII. New CRIPA Investigations
The Department initiated CRIPA investigations of nine institutions during the fiscal year. These new investigations involved the following facilities:
- Cape Girardeau County Jail, Jackson, Missouri;
- Six South Dakota Juvenile Facilities;
- Shelby County Jail, Memphis, Tennessee;
- Red Onion State Prison, Pound, Virginia.
IX. Findings Letters
The Department issued written findings of the results of its investigations, pursuant to Section 4 of CRIPA, 42 U.S.C. ï½§ 1997b, regarding six facilities:
- Western State Hospital, Staunton, Virginia;
- McCracken County Regional Jail, Paducah, Kentucky;
- Jackson County Correctional Center, Marianna, Florida;
- Bradley Healthcare and Rehabilitation Center, Cleveland, Tennessee;
- Cape Girardeau County Jail, Jackson, Missouri;
- Nassau County Correctional Center, East Meadow, New York.
X. Investigation Closures
During the fiscal year, the Section closed investigations involving two facilities based on their voluntary correction of unlawful conditions:
- Greenville County Detention Center, Greenville, South Carolina;
- Norfolk City Jail, Norfolk, Virginia.
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 FY2000, the Section provided expert consultants to discuss behavioral, quality assurance and risk management issues with Washington state officials regarding Rainier School and Frances Haddon Morgan Center. Similarly, the Department provided a consultant to discuss behavioral, quality assurance and risk management issues to Indiana officials responsible for the operation of Muscatatuck and Fort Wayne Developmental Center. In United States v. Tennessee (M.D. Tenn.), regarding Cloverbottom Developmental, Greene Valley Developmental, and Harold Jordan Centers, the Department provided a behavioral psychologist to work with state officials in developing a plan to reach out to University Affiliated Programs in Tennessee to include in their curricula programs on services for persons who have been dually diagnosed with mental retardation and mental health disorders. In that case, the Department also provided consultants to review the current procedures utilized by Independent Service Coordinators (ISC's) and to offer suggestions to promote increased efficiency for the ISC's. In United States v. Tennessee (W.D. Tenn.), regarding Arlington Developmental Center, the Department provided consultants to assist state officials in drafting a Home/Community Based Medicaid Waiver. We also facilitated interagency discussions between state officials and officials of the Health Care Financing Administration regarding the possibility of expanding the Home/Community Based waivers to improve medical care services. In United States v. Commonwealth of Virginia (E.D. Va.), regarding Central State Hospital, the Department provided expert consultants on behavioral management to assist state officials in improving treatment. In another case, also styled United States v. Commonwealth of Virginia (E.D. Va.), the Department provided expert consultants to assist officials of the Northern Virginia Mental Health Institute in behavioral management, performance of functional analyses and discharge planning.
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 2000 began on October 1, 1999, and ended on September 30, 2000. This report is submitted to Congress to supplement the Attorney General's report on Fiscal Year 2000 Department activities by providing additional details about CRIPA actions during the fiscal year pursuant to 42 U.S.C. ï½§ 1997f.
4. As noted on page 11, supra, the Department joined with defendants to seek full or partial dismissal of five cases covering thirteen facilities.
5. Embreeville Center closed during FY 1998 but, under the terms of the consent decree, the Department continues to monitor conditions in community placements from the facility.