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Assistant Attorney General Thomas E. Perez Holds
a Press Conference Regarding Delaware’s Mental Health System


New Castle, DE
United States

Good morning. Thank you for joining us today to discuss an agreement that will change the lives of thousands of Delaware residents who have mental illness.

This is an exciting and groundbreaking day for the people of Delaware, especially those living with mental illness and their loved ones. The agreement we are announcing today will dramatically improve their lives. Monday was Independence Day for America. This week we mark independence day for people in Delaware with mental illness, and I want to thank Governor Markell, Attorney General Biden, Commissioner Kevin Huckshorn, Secretary Rita Landgraf and Mike Barlow for your leadership in crafting this landmark agreement.

More than a decade ago, in its landmark ruling in the case Olmstead v. L.C., the Supreme Court ruled that, under the Americans with Disabilities Act, states must serve individuals with disabilities in the most integrated setting appropriate to their needs. The decision, which has been called the Brown v. the Board of Education of the disability rights movement, recognized that segregating individuals with disabilities in institutions deprives them of the freedom to live their day to day lives as they choose.

Today’s agreement will bring Delaware into compliance with the ADA and the Olmstead decision by building a comprehensive, community-based mental health system.

This agreement is a win-win-win for the state and the people of Delaware. First, it fulfills the state’s legal obligation to comply with the ADA. Second it fulfills your fiscal obligation to your taxpayers by moving from expensive, state-financed, institutional care to more cost-effective community-based services that allow the state to leverage federal dollars most effectively. It currently costs an average of $220,000 to treat a person at the Delaware Psychiatric Center, and the state foots 100 percent of the bill. That same person can be treated in the community for less than $50,000, a significant portion of which can be paid for by the federal government. Finally, the agreement will serve the state’s moral interest in serving people with mental illness in the way most conducive to recovery and independence.

The fundamental goals of the agreement are straightforward:

·                      To ensure that people who are unnecessarily institutionalized—at the Delaware Psychiatric Center or other inpatient psychiatric facilities—can receive the treatment they need in the community.

·                      To ensure that when individuals go into mental health crisis, sufficient resources are available in the community so that they do not need to go unnecessarily to mental hospitals or jails.

·                      And to ensure that people with mental illness who are living in the community are not forced to enter institutions because of the lack of stable housing and intensive treatment options in the community.

The agreement will provide relief for more than 3,000 individuals with mental illness in Delaware.  It will create a comprehensive community crisis system to serve as the front door to the state’s mental health system and divert individuals from unnecessary hospitalization and jailing.  It will provide intensive, community-based treatment to nearly 3,000 people through Assertive Community Treatment (ACT) teams, intensive case management teams, and targeted case management.  It will provide integrated supported housing to at least 650 people.  It will guarantee evidence-based supported employment services to 1,100 people, rehabilitation services (including education and substance abuse services) to 1,100 people, and family and peer supports to 1,000 people. 

It is a landmark agreement, a blueprint for sustainable reform, and it will serve as a model for our enforcement of the ADA going forward. 

Today’s agreement is part of a broad, nationwide effort to enforce the Olmstead decision.  In the last two years, the Civil Rights Division has joined or initiated litigation to ensure community-based services in more than 25 cases in 17 states.  And we have investigations pending in a number of other states. Last October, we reached a comprehensive agreement with the State of Georgia that, like the agreement with Delaware, provides broad relief for thousands of individuals with disabilities.

These matters involve a wide range of settings.  Some, like the matter we resolve today, involve people with mental illness who seek to avoid unnecessary institutionalization in state hospitals.  Some involve people with developmental disabilities who seek to avoid unnecessary institutionalization in state facilities.   Some, like the case we have been litigating for the last two years in New York, and a case in Texas in which we sought to intervene two weeks ago, involve people with mental illness or developmental disabilities who wish to leave unnecessary placements in state-funded private institutions, like adult care homes or nursing homes.  And still others involve people with physical disabilities who are trapped in nursing homes even though they could flourish in the community with appropriate services.

Today’s agreement will allow Delaware to avoid costly litigation and move directly to the matter of providing the services that people with mental illness in the state need to live independent lives and avoid unnecessary institutionalization.  Across the country during the deinstitutionalization movement of the 1970s and 1980s, doors were opened.  But the community infrastructure was lacking, and the promise of independence for people with mental illness remained elusive. We can and must do better as a nation, and this agreement will serve as a national model for efforts moving forward.

The state and its leadership are to be commended for their leadership in tackling this problem, and I thank them for their cooperation.  The problems that we address in today’s agreement certainly did not begin with this governor or this administration.  But Governor Markell and his outstanding team, including Secretary Landgraf, really took the bull by the horns.  I look forward to continuing to work collaboratively with them as we move toward implementing this agreement.

Updated September 17, 2014