INTRODUCTION AND OVERVIEW OF CRIPA ACTIVITIES
The Civil Rights of Institutionalized Persons Act (CRIPA), 42 U.S.C. ï½§ 1997 et seq., gives the Attorney General the 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. (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 1998, the Department investigated conditions in 327 jails, prisons, juvenile correctional facilities, mental retardation and mental health facilities, and nursing homes. As a result of the Department's CRIPA efforts, 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 1998, the Section was active in CRIPA matters and cases involving more than 200 facilities in 34 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 15 facilities, continued its investigations of 77 additional facilities, and monitored the implementation of consent decrees, settlement agreements, and other court orders involving 119 facilities. The Attorney General filed four CRIPA suits that were settled during the fiscal year. The federal district court for the Middle District of Florida approved the United States' intervention in a fifth case, that remains in litigation. In addition, with regard to CRIPA cases filed in prior fiscal years, the Section continued litigation in two cases, involving six facilities, and settled two other cases, involving 21 facilities. During fiscal year 1998, the Section closed investigations of 12 facilities and joined with defendants to dismiss cases involving another six 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. By focusing on statewide investigations and relief where warranted, the Section maximized its impact and increased its efficiency.
SPECIFIC ACTIONS UNDER CRIPA
Filing of CRIPA Complaints/ Resolution of Lawsuits
In four CRIPA cases filed during fiscal year 1998, involving thirty-eight facilities, the parties filed a settlement agreement at the same time the complaint was filed. Discovery is proceeding in a fifth case, involving one facility and community services in a five district region surrounding the facility. In addition, the Section continued discovery in two CRIPA cases, involving six facilities, that were filed in prior fiscal years and settled two other outstanding CRIPA cases, involving 21 facilities.
On October 31, 1997, the Department filed a complaint and settlement agreement in United States v. Maricopa County (D. Ariz.) concerning conditions of confinement in five county jails in Phoenix, Arizona. The complaint alleged that the defendants used excessive physical force and restraints in violation of the constitutional rights of individuals detained in the jails. The settlement agreement provided for adequate staffing; staff training, particularly in use of force issues; prohibition of "hogtying" procedures; revised policies on pepper spray and stun guns that prohibit their use where hands-on control can be used; proactive measures to prevent excessive use of force and restraints; and procedures to receive and investigate inmate grievances. Pursuant to the parties' joint motion, the federal district court conditionally dismissed the complaint, subject to the County's compliance with the settlement agreement, on November 9 , 1997. When the County complied with the agreement, the court franted the parties' joint motion for dismissal of the complaint on July 6, 1998. The Special Litigation Section is continuing its CRIPA investigation of medical care and mental health treatment at the five jails.
On January 5, 1998, the Department filed United States v. Dooly County, Georgia (S.D. Ga.) to protect the constitutional rights of persons confined in the Dooly County Jail in Vienna, Georgia. The federal district court for the Southern District of Georgia approved a consent decree on January 12, 1998 to remedy inadequate medical, dental and mental health care; unsanitary, unhealthy and unsafe conditions; failure to protect detainees from undue risk of harm from fires, and overcrowding; security concerns stemming from inadequate staffing and staff training; and inadequate access to courts. In addition, the County agreed to build a new jail or move all detainees to another facility by September 1, 1999.
On March 18, 1998, the Department filed a complaint and settlement agreement in United States v. State of Georgia (N.D. Ga.) to resolve its investigation of Georgia's juvenile correctional facilities pursuant to CRIPA and the pattern or practice provision of the Violent Crime Control and Law Enforcement Act of 1994, 42 U.S. C. ï½§ 14141. The federal district court conditionally dismissed the complaint on March 31, 1998, subject to Georgia's compliance with a comprehensive settlement agreement. The agreement, which applies to all juveniles at 31 juvenile correctional facilities in the State, sets forth improvements that the State will take in a number of areas, including protection from harm, educational services, mental health and medical care, staffing and staff training, and supervision. As part of the agreement, Georgia agreed to create an Office of Quality Assurance within the Department of Juvenile Justice to ensure safe and appropriate conditions at Georgia's juvenile facilities.
On August 13, 1998, a complaint and settlement agreement were filed in United States v. City of Philadelphia (E.D. Pa.) concerning the conditions of care in the Philadelphia Nursing Home, which is operated by Episcopal Long Term Care under a contract with the City of Philadelphia. The Court approved the settlement on August 14, 1999. This settlement represents the first case stemming from a joint investigation under CRIPA and the False Claims Act, 31 U.S.C .ï½§ 3729 et seq.. The settlement, which was a cooperative effort by the Special Litigation Section, the U.S. Attorney for the Eastern District of Pennsylvania, the Civil Division, and the Office of the Inspector General of the U.S. Department of Health and Human Services, covers both the injunctive relief necessary to remedy deficiencies in the nursing home as well as monetary penalties to reimburse the federal government for fraudulent Medicare billings for inadequate care . The settlement requires improvements in conditions at the Philadelphia Nursing Home to ensure that its elderly and disabled residents are free from abuse and neglect and that they receive adequate care and treatment. As a result of alleged false billing practices, the Defendants agreed to pay civil monetary penalties to the federal government under the False Claims Act and also to pay restitution to the residents by establishing a fund for a special project, authorized by the United States, that will improve the quality of life for residents at the nursing home. In addition, the settlement provides for a federal monitor who will oversee compliance with the terms of the agreement.
The Court approved intervention by the United States in Johnson v. Sellers (M.D. Fla.) on March 23, 1998. The Attorney General filed a complaint in intervention on April 2, 1998, alleging violations of the constitutional and federal statutory rights of the residents of G. Pierce Wood Memorial Hospital, a psychiatric hospital in Arcadia, Florida. The complaint seeks injunctive relief to protect residents from harm, neglect, and abuse. It also seeks adequate mental health treatment and psychosocial rehabilitation during hospitalization and adequate discharge planning and aftercare services following hospitalization. Discovery is proceeding in this case and the Court has scheduled a trial for February 2000.
The Special Litigation Section continued its discovery in two CRIPA cases filed during fiscal year 1997: United States v. Michigan (E.D. Mich.), involving two women's prisons and United States v. Arizona (D. Ariz.), involving four women's prisons.
The Department also settled two cases filed during prior fiscal years. On December 11, 1997, the federal district court in Puerto Rico approved and ordered a settlement agreement in United States v. Commonwealth of Puerto Rico (D. P. R.). The agreement, which covers 20 juvenile correctional facilities in Puerto Rico, replaces an earlier agreement that was entered on an interim basis to remedy emergency conditions at the facilities while the parties negotiated more comprehensive relief. The 1997 agreement, which was filed with an amended complaint, requires Puerto Rico to remedy environmental and fire safety hazards in the facilities and to provide adequate mental health and substance abuse treatment and educational and vocational services, including special education for juveniles with disabilities. The agreement also requires Puerto Rico to hire sufficient staff, provide staff training, and develop and implement adequate systems for classification, discipline, and protective custody. A court monitor will assist with monitoring the Commonwealth's compliance with the agreement.
On September 24, 1998, the parties in Williams and United States v. Stalder (E.D. La.) entered into a settlement agreement to address the remaining concerns about medical care at the Louisiana State Penitentiary at Angola.
Compliance Evaluations and Enforcement Activities
During fiscal year 1998, the Special Litigation Section monitored defendants' compliance with CRIPA consent decrees, settlement agreements, and other court orders designed to remedy unlawful conditions in 119 publicly operated facilities throughout the United States. (4) These facilities are:
1. Mental retardation facilities: Southbury Training School (United States v. Connecticut (D. Conn.)); Boswell Regional Center (United States v. Mississippi (S.D. Miss.)); 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.)); Northern Virginia Training Center (United States v. Virginia (E.D. Va.)); and Southern Wisconsin Developmental Center and Central Developmental Center (United States v. Wisconsin (W.D. Wis.)).
2. Mental health facilities: Hawaii State Hospital and children and adolescent residential services at Castle Medial 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.)); Eastern State Hospital (United States v. Virginia (E.D. Va.)); and Northern Virginia Mental Health Institute (United States v. Virginia (E.D. Va.)).
3. Nursing homes: Philadelphia Nursing Home (United States v. City of Philadelphia (E.D. Pa.)); and Hancock Geriatric Facility (United States v. Virginia (E.D. Va.)).
4. Juvenile Correctional Facilities: Thirty-one juvenile correctional facilities in Georgia (United States v. State of Georgia (N.D. Ga.)); thirteen Kentucky correctional facilities (United States v. Kentucky (W.D. Ky.)); Essex County Youth House (United States v. Essex County (D. N. J.)); and twenty Puerto Rican juvenile correctional facilities (United States v. Puerto Rico (D. P. R.)).
5. Jails: Five Maricopa County Jails (United States v. Maricopa County (D. Ariz.); 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 (S.D. Ga.)); Rosario Detention Center (United States v. Guam (D. Guam)); Alcorn County Jail (United States v. Alcorn County (N.D. Miss.)); Corinth City Jail (United States v. Corinth City (N.D. Miss.)); Grenada County Jail (United States v. Grenada County (N.D. Miss.)); Grenada City Jail (United States v. Grenada City (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.)); Forrest County Jail (United States v. Forrest County (S.D. Miss.)); Harrison County Jail (United States v. Harrison County (S.D. Miss.)); Neshoba County Jail (United States v. Neshoba 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.)); and Sunflower County Jail (United States v. Sunflower County (S.D. Miss.)).
6. Prisons: Guam Adult Correctional Facility (United States v. Guam (D. Guam)); Louisiana State Penitentiary at Angola (Williams and United States v. Stalder (E. D. La.)); Michigan Reformatory, Marquette Branch Prison, State Prison of Southern Michigan, Engler Correctional Facility, Riverside Psychiatric Center, Huron Valley Mental Health, Huron Valley Men's Facility, and Western Wayne Correctional Facility (United States v. Michigan (W.D. Mich.)); Montana State Prison (United States v. Montana (D. Mont.)); and Golden Grove Adult Correctional Institution (United States v. Virgin Islands (D. V. I.)).
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. For example:
On January 20, 1998, the Department filed a contempt motion in United States v. Territory of Guam regarding fire safety and sanitation issues at the adult correctional facility and jail. On April 22, 1998, the parties agreed to a stipulation whereby Guam will build a new 80-bed prison unit as well as improve fire safety, ventilation and sanitation procedures.
On February 2, 1998, the federal district court for the Southern District of Mississippi approved and ordered a stipulation for further relief in United States v. Mississippi that requires Mississippi to secure adequate technical assistance to achieve compliance with the consent decree involving Boswell Regional Center, a State mental retardation facility.
On February 13, 1998, the federal district court in Hawaii approved and ordered the State to comply with a comprehensive remedial plan covering protection from harm, restraint usage, treatment plans, psychosocial rehabilitation, discharge plans, and staffing at the Hawaii State Hospital, a psychiatric hospital in Honolulu, and two residential facilities for children and adolescents with mental illness in Hawaii. The plan remedies the State's non-compliance with existing orders in United States v. Hawaii (D. Haw.).
On April 13, 1998, the federal district court for the Western District of Wisconsin ordered Wisconsin officials to permit the Department and a monitoring panel to visit community placements of former residents of the Southern Wisconsin and Central Wisconsin Centers for the Developmentally Disabled to ensure that conditions in the community placements are safe and adequate to meet residents' needs, as required by the consent decree in United States v. Wisconsin (W.D. Wisc.).
On September 21, 1998, the federal district court for the Western District of Tennessee approved and ordered a stipulation for further relief in United States v. Tennessee. The stipulation requires Tennessee to take additional remedial measures to achieve compliance with consent decree requirements in treatment planning and staffing at Memphis Mental Health Institute.
During fiscal year 1998, the Department supported plaintiff's contempt motion and participated in several enforcement hearings before the Special Master in Evans and United States v. Barry (D.D.C.), to address the District's continuing failure to comply with court orders designed to provide adequate services to former residents of Forest Haven (a mental retardation facility operated by the District), who now live in community settings. (6)
Prison Litigation Reform Act
The Prison Litigation Reform Act (PLRA), 18 U.S.C. ï½§ 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 its CRIPA activities. The Special Litigation Section has applied the PLRA requirements to the new remedies it seeks. In addition, the Section evaluated all on-going CRIPA investigations, as well as all consent decrees and litigated orders in its active cases, in light of the statute.
Termination of CRIPA Consent Decrees and Partial Dismissals of Complaints
When jurisdictions comply with settlement requirements settlements and correct unlawful conditions in the institution, the Section joins defendants in a motion to dismiss the underlying action. During fiscal year 1998, the Department joined with defendants to seek dismissal of two cases covering six facilities. As noted earlier, on July 6, 1998, the federal district court in Arizona granted the joint motion to dismiss United States v. Maricopa County, involving five county jails. On June 3, 1998, the federal district court for the Eastern District of Virginia granted the joint dismissal motion in United States v. Commonwealth of Virginia (E.D. Va.), involving Northern Virginia Training Center, a mental retardation facility in Fairfax, Virginia.
Finally, the federal district court for the Eastern District of Michigan granted a joint motion for partial dismissal of the complaint in United States v. Michigan, involving two women's prisons. On April 27, 1998, the court dismissed the mental health issues from the case and on August 24, 1998, it dismissed the medical issues.
Responsiveness to Allegations of Illegal Conditions
During fiscal year 1998, 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 3200 incoming citizen letters and 400 incoming telephone complaints during the fiscal year. In addition, the Division responded to 84 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 restraint 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§ 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.
New CRIPA Investigations
The Department initiated CRIPA investigations of 15 institutions during the fiscal year. These new investigations involved the following facilities:
* Fort Wayne Developmental Center in Fort Wayne, Indiana;
* Muscatatuck Developmental Center in Butlerville, Indiana.;
* Black Hawk County Jail in Waterloo, Iowa;
* Clark County Detention Center, in Las Vegas, Nevada;
* Six facilities operated by the Commonwealth of the Northern Mariana Islands (Saipan, Tinian, Rota and INS jails, Kagman Juvenile Facility, Saipan Correctional Complex);
* Morgan County Jail in Wartburg, Tennessee;
* Western State Hospital in Staunton, Virginia;
* Rainier Residential Habilitation Center, a mental retardation facility in Buckley, Washington;
* Francis Haddon Morgan Center, a mental retardation center in Bremerton, Washington; and
* Wyoming State Penitentiary in Rawlins, Wyoming.
Findings Letters and Investigation Closures
The Department issued written findings of the results of its investigations, pursuant to Section 4 of CRIPA, 42 U.S.C. ï½§ 1997b, in 58 facilities:
* Gila County Jail in Globe, Arizona;
* Two Yavapai County jails in Prescott and Camp Verde, Arizona;
* Laguna Honda Hospital and Rehabilitation Center in San Francisco, California;
* 31 juvenile facilities in Georgia;
* New Castle Developmental Center in Indiana;
* Daviess County Detention Center, Harold N. Taylor Restricted Custody Facility, E. Robert Goebel Secure Juvenile Detention Facility, and Louis Johnson Youth Alternative Center in Daviess County, Kentucky;
* Holly Center for mentally retarded persons in Salisbury, Maryland;
* New Mexico School for the Visually Handicapped in Alamogordo, New Mexico;
* Orleans County Jail in Albion, New York;
* A prison, two detention facilities, and a juvenile facility in Saipan, a detention facility in Tinian, and a detention facility in Rota, all operated by the Commonwealth of the Northern Mariana Islands;
* Six mental retardation facilities in Puerto Rico;
* Greenville County Detention Center, in Greenville, South Carolina;
* Morgan County Jail in Wartburg in Tennessee; and
* Dickens County Corrections Center in Spur, Texas.
During the fiscal year, the Section closed investigations involving 12 facilities. The Section closed its CRIPA investigations of the following facilities based on their voluntary correction of unlawful conditions: Central Alabama Youth Services in Selma, Alabama; Gila County Jail in Payson, Arizona; Turner County Jail in Ashburn, Georgia; Harris County Jail in Hamilton, Georgia; Maryland Corrections Adjustment Center in Baltimore, Maryland; Montana Youth Alternatives in Helena, Montana; Pine Hill School for Boys in Miles City, Montana; Hampton City Jail in Hampton City, Virginia; Newport News City Jail in Newport News, Virginia; and Fircrest Residential Rehabilitation Center in Seattle, Washington. The Section closed its investigation of Lee-Arendale Correctional Institute in Alto, Georgia during its overall investigation of Georgia juvenile correctional facilities because the Institute housed only a few juveniles. In addition, the Section closed its investigation of the Davisboro Regional Youth Detention Center in Davisboro, Georgia because State officials closed the facility during the course of the Department's investigation.
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. For example, the Department provided assistance to officials operating all of Georgia's secure juvenile correctional facilities through the Office of Juvenile Justice and Delinquency Prevention by providing $200,000 in technical assistance grants to the State to hire consultants to be used to develop plans to implement the settlement agreement in our CRIPA litigation. In our investigation of Lee County Jail, also in Georgia, the United States provided the expertise of its consultants to evaluate facility space, safety and sanitation issues as county officials developed plans for a new jail. The County incorporated several of the consultants' recommendations in the plan for the proposed jail design. As part of the investigation of Louisiana's secure juvenile correctional facilities, the United States provided technical assistance from nationally known experts in the area of abuse prevention, education, psychiatry and juvenile medicine. The Department also provided technical assistance to the state of Louisiana and the Wackenhut Corporation by reviewing plans for opening a new secure juvenile facility. As part of the settlements involving two psychiatric hospitals in Virginia, Departmental experts provided technical assistance to the facilities to assist them in achieving compliance with the remedial requirements. In addition, Departmental consultants have continued to provide technical information and consultation to institutional directors and their counsel regarding necessary improvements in a number of other CRIPA investigations and cases.
1. Institutions covered by CRIPA include nursing homes, psychiatric hospitals, 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. 3/ Fiscal year 1998 began on October 1, 1997 and ended on September 30, 1998. This report is submitted to Congress to supplement the Attorney General's report on Fiscal Year 1998 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 10, supra, the Department joined with defendants to seek full or partial dismissal of three cases covering eight facilities.
5. Embreeville Center closed during the fiscal year but , under the terms of the settlement, the Section continues to monitor conditions in community placements from the facility.
6. 5/ The Department is plaintiff-intervenor in this case, which was filed before CRIPA was enacted.>