Maine Gov. Janet Mills and the U.S. Department of Justice announced a settlement agreement has been reached in the DOJ’s lawsuit against Maine, in which the state was accused of unnecessarily segregating children with behavioral health disabilities in psychiatric hospitals, residential facilities and a state-operated juvenile detention facility.The Justice Department filed a lawsuit on Sept. 9 that claimed Maine was in violation of the Americans with Disabilities Act and the Supreme Court’s decision in Olmstead v. L.C., which require state and local governments to ensure the services they provide for children with disabilities are available in the most integrated setting appropriate to each child’s needs. The DOJ said it had previously notified Maine of its findings of civil rights violations in a June 2022 letter, which identified the steps the state should take to remedy those violations.In its lawsuit, the Justice Department accused Maine of limiting families’ access to needed behavioral health services that would allow their children to live in the community. These services can include assistance with daily activities, behavior management and individual or family counseling. Community-based behavioral health services also include crisis services that can help prevent a child from being institutionalized during a mental health crisis.The DOJ claimed that as a result of how Maine administers its system, children in the state must enter in- and out-of-state facilities, or even the Long Creek Youth Development Center, in order to receive those services. The Justice Department had also said Maine children with disabilities enter emergency rooms, come into contact with law enforcement and remain in institutions when they could remain with their families if the state provided them with sufficient community-based services.According to the DOJ, the settlement resolves the department’s allegations and requires Maine to make significant improvements to ensure children with behavioral health disabilities can receive the services they need in the community, including:Help hundreds of children remain with their families or foster families with the services they need to avoid emergency department stays and institutions;Help children move out of institutions, including the Long Creek juvenile detention facility, and instead receive services at home if their needs can be met there and they and their families want them to be at home;Identify children with behavioral health disabilities and timely furnish them the full range of services they are eligible for at home;Provide children with care coordination designed so that children with the most intense behavioral health disabilities can be successful at home;Address any current or future workforce shortages of community-service providers. This includes providing payment rates and support for community providers to enable children they serve to return to or remain at home long-term;Improve oversight of community providers and monitor desired outcomes and timeliness of services; andProvide prompt mobile crisis interventions to help children avoid entering emergency departments or law enforcement contact.”This agreement reflects the Civil Rights Division’s commitment to ensuring that children with disabilities can live at home surrounded by the love and support of their families rather than isolated away in facilities,” Assistant Attorney General Kristen Clarke of the DOJ’s Civil Rights Division said in a statement.Mills said the agreement with the Justice Department follows years of work and robust investments by her administration and the Maine Legislature to strengthen children’s behavioral services across the state, citing an investment of $260 million to increase accessibility, availability, quality and consistency of those services in recent years.According to the governor, the total number of Maine children in residential treatment has been lowered from 540 to 261. She also said that since June 2022, the state has reduced the waitlist for home and community-based services by 42% and the waitlist for rehabilitative and community support services by 21.8%.”For more than two years, my administration negotiated in good faith with the U.S. Department of Justice to address its concerns about children’s behavioral health services in Maine,” Mills said in a statement. “I shared many of the U.S. DOJ’s concerns, many of which preceded my Administration, and we have worked closely with the Legislature to invest hundreds of millions of dollars to strengthen the system – important reforms which we believe in and we that we continue to implement.”While I am confident that the State of Maine would have prevailed if we pressed forward with a defense, I asked myself, ‘At what cost?’ Protracted, expensive litigation would only have detracted from what’s most important – continuing to improve our children’s behavioral health system,” the governor added.Maine officials said the settlement with the DOJ recognizes the initiatives undertaken by the state, assuring Maine is in compliance with Title II of the ADA and fully resolving and settling the claims that gave rise to the lawsuit.The Justice Department said the parties have agreed the federal district court will retain jurisdiction to enforce the settlement agreement and that an independent reviewer will evaluate the state’s compliance.Previous coverage:
Maine Gov. Janet Mills and the U.S. Department of Justice announced a settlement agreement has been reached in the DOJ’s lawsuit against Maine, in which the state was accused of unnecessarily segregating children with behavioral health disabilities in psychiatric hospitals, residential facilities and a state-operated juvenile detention facility.
The Justice Department filed a lawsuit on Sept. 9 that claimed Maine was in violation of the Americans with Disabilities Act and the Supreme Court’s decision in Olmstead v. L.C., which require state and local governments to ensure the services they provide for children with disabilities are available in the most integrated setting appropriate to each child’s needs. The DOJ said it had previously notified Maine of its findings of civil rights violations in a June 2022 letter, which identified the steps the state should take to remedy those violations.
In its lawsuit, the Justice Department accused Maine of limiting families’ access to needed behavioral health services that would allow their children to live in the community. These services can include assistance with daily activities, behavior management and individual or family counseling. Community-based behavioral health services also include crisis services that can help prevent a child from being institutionalized during a mental health crisis.
The DOJ claimed that as a result of how Maine administers its system, children in the state must enter in- and out-of-state facilities, or even the Long Creek Youth Development Center, in order to receive those services. The Justice Department had also said Maine children with disabilities enter emergency rooms, come into contact with law enforcement and remain in institutions when they could remain with their families if the state provided them with sufficient community-based services.
According to the DOJ, the settlement resolves the department’s allegations and requires Maine to make significant improvements to ensure children with behavioral health disabilities can receive the services they need in the community, including:
- Help hundreds of children remain with their families or foster families with the services they need to avoid emergency department stays and institutions;
- Help children move out of institutions, including the Long Creek juvenile detention facility, and instead receive services at home if their needs can be met there and they and their families want them to be at home;
- Identify children with behavioral health disabilities and timely furnish them the full range of services they are eligible for at home;
- Provide children with care coordination designed so that children with the most intense behavioral health disabilities can be successful at home;
- Address any current or future workforce shortages of community-service providers. This includes providing payment rates and support for community providers to enable children they serve to return to or remain at home long-term;
- Improve oversight of community providers and monitor desired outcomes and timeliness of services; and
- Provide prompt mobile crisis interventions to help children avoid entering emergency departments or law enforcement contact.
“This agreement reflects the Civil Rights Division’s commitment to ensuring that children with disabilities can live at home surrounded by the love and support of their families rather than isolated away in facilities,” Assistant Attorney General Kristen Clarke of the DOJ’s Civil Rights Division said in a statement.
Mills said the agreement with the Justice Department follows years of work and robust investments by her administration and the Maine Legislature to strengthen children’s behavioral services across the state, citing an investment of $260 million to increase accessibility, availability, quality and consistency of those services in recent years.
According to the governor, the total number of Maine children in residential treatment has been lowered from 540 to 261. She also said that since June 2022, the state has reduced the waitlist for home and community-based services by 42% and the waitlist for rehabilitative and community support services by 21.8%.
“For more than two years, my administration negotiated in good faith with the U.S. Department of Justice to address its concerns about children’s behavioral health services in Maine,” Mills said in a statement. “I shared many of the U.S. DOJ’s concerns, many of which preceded my Administration, and we have worked closely with the Legislature to invest hundreds of millions of dollars to strengthen the system – important reforms which we believe in and we that we continue to implement.
“While I am confident that the State of Maine would have prevailed if we pressed forward with a defense, I asked myself, ‘At what cost?’ Protracted, expensive litigation would only have detracted from what’s most important – continuing to improve our children’s behavioral health system,” the governor added.
Maine officials said the settlement with the DOJ recognizes the initiatives undertaken by the state, assuring Maine is in compliance with Title II of the ADA and fully resolving and settling the claims that gave rise to the lawsuit.
The Justice Department said the parties have agreed the federal district court will retain jurisdiction to enforce the settlement agreement and that an independent reviewer will evaluate the state’s compliance.
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