Raleigh, NC: Today the North Carolina House of Representatives Committee on Appropriations released its budget. Faced with the possibility of legal action from the U.S. Department of Justice (US DOJ) for the state’s institutionalization of adults with mental illness in adult care homes, the House has taken steps to move toward community placements for adults with mental illness. These steps will help make it possible for the state to reach a settlement with the US DOJ, avoiding major litigation. The House budget provides ten million dollars to support adults with mental illness as they transition from Adult Care Homes (ACHs) to community-integrated placements. “While ten million dollars is certainly not enough to solve the crisis of institutionalization identified by the Department of Justice, it is a step in the right direction,” said Vicki Smith, Executive Director of Disability Rights North Carolina.

The bill allocates another 40 million dollars to assist ACHs to transition into a key component of the State’s Transitions to Community Living Initiative. Disability Rights North Carolina urges lawmakers to improve the balance of this allocation by devoting more funds directly to assisting individuals with mental illness as they move to more integrated settings. “Spending tens of millions in taxpayer dollars to make institutions less institutional is an inefficient way to solve our state’s problems,” said Smith.

The Committee also proposes a short-term commission to study and recommend improvements to the State’s system of care for adults with mental illness and developmental disabilities. “While we applaud the attention given to these underserved populations, we are disappointed that the commission membership includes representatives from the adult care home industry, which does not provide mental health services. Any providers included in the commission should be those experienced with the delivery of community-based services, including mental health care. The inclusion of the ACH industry in the required membership is inappropriate and will only slow efforts at deinstitutionalization,” said Smith.

Background on North Carolinians with Mental Illness Housed in Adult Care Homes

In July 2010, Disability Rights NC filed a complaint with the US DOJ alleging that the State of North Carolina is in violation of the Americans with Disabilities Act (ADA) because the State has a bias towards placing people with mental illness in Adult Care Homes (ACHs) rather than supporting them in more integrated settings in their home communities. ACHs are institutional settings that do not provide appropriate services to support recovery and meaningful community integration. Disability Rights NC alleged that the State, in relying on placements in these types of Adult Care Homes, is violating the ADA. Please see the Report: Trapped in a Fractured System – People with Mental Illness in Adult Care Homes. Under the ADA the unjustified segregation of persons with disabilities is an illegal form of discrimination. The integration mandate allows individuals to interact with non-disabled persons to the fullest extent possible so people with disabilities are not isolated from their communities.

The US DOJ, Civil Rights Division, issued a letter of findings on July 28, 2011, concluding that North Carolina “fails to provide services to individuals with mental illness in the most integrated setting appropriate to their needs in violation of the ADA,” and that “[r]eliance on unnecessary institutional settings violates the civil rights of people with disabilities.” The central finding of the US DOJ is that North Carolina lacks an adequate community support system for people with mental illness. As a result, individuals are institutionalized in more expensive and more restrictive settings in Adult Care Homes. “Most people with mental illness receiving services in adult care homes could be served in more integrated settings, but are relegated indefinitely and unnecessarily to adult care homes because of systemic State actions and policies,” wrote U.S. Assistant Attorney General Thomas Perez.