The state Department of Health and Human Services announced Thursday a $67 million plan to improve the treatment and services for people with mental illnesses by relocating them from assisted living centers.
The plan is an attempt by the state to avoid being sued by the U.S. Department of Justice, which is now negotiating with the department over its failure to comply with the Americans with Disabilities Act. Reaction to the plan was tempered by the announcement that the program includes no agreement to make sure the state follows federal guidelines about care for people with mental illness.
Vicki Smith, executive director of Disability Rights North Carolina, said a binding agreement is necessary to ensure the promises made will be kept.
The state has been promising these services for over a decade, and the state has consistently failed to deliver, said Smith, whose group filed the complaint in 2010 that brought the problem to the attention of the Department of Justice. Without any enforcement, without a binding agreement, this seems like it could just be another empty promise.
The plan would give some people with a mental illness now living in adult-care homes the option of relocating to community-based housing that provides personalized care. Many North Carolinians with mental illnesses are housed in adult-care homes, also known as assisted-living facilities, which are licensed by the state. The facilities are less medically intensive than nursing homes.
Over the state programs eight years, the goal is to help at least 3,000 people move out of adult-care homes. At least 100 people will be moved by the end of the year. There are an estimated 5,800 people with a mental illness in adult-care homes around the state, though exact numbers are difficult to track. Chrissy Pearson, a spokeswoman for DHHS, said there are several ways an agreement with the feds could be structured.
There are several options of how we could move forward, and we believe discussion will continue to be productive, Pearson said. Regardless of the outcome, were moving ahead with the plan to change the way we deliver services in adult care homes because its whats best for the people of North Carolina, she said.
The overhaul comes in response to an investigation last year by the Department of Justice that found the state lacked community-based alternatives for people with mental illnesses. The states approach has confined thousands of people with mental illness unnecessarily and indefinitely in adult care homes and puts many others at risk of unnecessary institutionalization, according to a report summarizing the departments investigation.
The confidential negotiations between the state and the Department of Justice have already spanned more than a year. It is unclear whether the plan announced Thursday will pre-empt costly and time-consuming litigation.
Advocates who brought the problem to light, state and federal government leaders and state lawmakers agree that the dollar amount set aside is a good start and possibly enough to enact worthwhile comprehensive reform.
But they disagree over whether an agreement between the state and the feds should be legally binding and force the state to cede control of some decision making. Sen. Nelson Dollar, R-Wake, said he believes the state is apprehensive of entering into a binding agreement because of past experiences. Dollar said previous federal consent orders have been difficult to implement and left many state officials with a negative view of the process. Dollar is against the states entering into one in this case and said the plan announced Thursday would put North Carolina on a path to fixing the problems.
Smith said she hopes it is possible to avoid litigation so that attention and resources will not be diverted from people with mental illness who are now living in substandard conditions.
The Department of Justices investigation characterized the day-to-day life of people with a mental illness living in North Carolina adult-care homes as void of most basic freedoms, confined to small rooms in sterile buildings, and shaped by rigid structure that rarely attempts to improve an individuals quality of life.