U.S. v. NORTH CAROLINA
Local advocates began calling attention to the declining state of North Carolina’s public mental health system in the early-to-mid-2000s, when the state began downsizing and privatizing psychiatric hospitals without implementing sufficient community-based mental health services.
The Civil Rights Division of the Department of Justice (DOJ) conducted an eight-month investigation and concluded that North Carolina is violating the Americans with Disabilities Act (ADA) and the Supreme Court’s 1999 Olmstead decision, by failing to afford many people with mental illnesses the opportunity to live in integrated settings. According to the DOJ’s letter of findings, published in July 2011, thousands of North Carolinians with mental illnesses remain in large, segregated adult care homes because the state has failed to make supportive housing, assertive community treatment (ACT), and other services available to enable these individuals to live in their own homes.
DOJ then negotiated with the state to resolve these findings. DOJ told North Carolina that in order to comply with Olmstead, it must provide integrated supportive housing for individuals with mental illnesses who are currently in adult care homes or are at risk of being placed in one; ensure that people with mental illnesses who move to supported housing are connected to the services they need; and develop a comprehensive plan for transitioning people with mental illnesses from adult care homes to supportive housing.
The Bazelon Center represents a diverse group of stakeholders, including some of the state’s largest providers of community services for people with disabilities, as well as national and state mental health consumer and family organizations, and a former North Carolina mental health commissioner. These stakeholders support the Justice Department’s position, and wrote to the state to demand that the state comply with Olmstead by developing scattered-site supportive housing, ensuring that individuals living in supportive housing are connected with necessary services, and ensuring that individuals with mental illnesses who are living in or being considered for admission to adult care homes have the necessary information to make an informed choice about where they receive services.
On August 23, 2012, the U.S. Department of Justice and the state of North Carolina reached an agreement to end the state’s reliance on large, segregated adult care homes for people with mental illnesses. Some of the requirements of the agreement include:
- The state must develop 3,000 new units of supported housing over 7 years for people with serious mental illnesses living in large adult care homes with significant numbers of residents with mental illnesses, coming out of state hospitals, or diverted from admission to adult care homes.
- The housing units must be permanent, afford tenancy rights, and enable people with disabilities to interact with people without disabilities to the fullest extent possible and must not limit access to the community.
- Virtually all of these housing units must be scattered throughout the community.
- The state must provide the array and intensity of services and supports necessary for these individuals to live in integrated settings.