Day 7 of 15 | Investigations and Monitoring

In 1973, national television news reports shocked the country with horrifying video that captured disabled children and adults in a filthy New York state-operated institution called Willowbrook. People were naked, emaciated, rocking and moaning on filthy floors. All were clearly neglected, sitting unattended in large rooms with no support or services or anything to do, day in and day out – invisible to people outside the institution. 

Two years later, the US Congress created the Protection and Advocacy system, mandating that every state and all US territories have a “P&A,” and giving the P&As federal “access authority” to monitor conditions in facilities, speak with residents and staff, and conduct investigations where necessary. The P&As were created to end the inhumane mistreatment of people with disabilities in institutions such as was documented at the Willowbrook State School in Staten Island. 

The P&A in North Carolina is Disability Rights North Carolina (DRNC), and we take this mandate seriously. Since DRNC opened 15 years ago, our staff have monitored hundreds of facilities throughout NC, speaking with thousands of residents and patients to make sure they are safe and know their rights. Where we have significant concerns, we investigate. 

These facilities include schools, jails, prisons, group homes for children or adults, hospitals, nursing homes, day programs, psychiatric resident treatment facilities for children and adolescents (PRTFs), and intermediate care facilities (ICFs) for people with intellectual/developmental disabilities. We monitor these places regardless of whether they are state-run or privately owned. In short, anywhere disabled people receive services. 

We can speak with children and adults, regardless of whether they have guardians. 

DRNC monitors to: 

• Prevent, detect, and address instances of abuse, neglect, or exploitation 
• Ensure the environment is safe, and that people receive appropriate services, and opportunities to participate in activities and work that is important to them 
• Identify people who want to live or work in the community with the proper supports 

DRNC’s Investigations and Monitoring (I&M) team goes into institutions across NC to check the health and safety of people with disabilities. Every week, we are on the road ensuring disabled people in facilities are safe and know their rights.  

DRNC’s investigations and monitoring work extends to other teams. Our Criminal Legal team monitors prisons and advocates against abusive solitary confinement. The Community Inclusion team monitors institutions like adult care homes and sheltered workshops and has learned that disabled people in these places prefer to live or work in the community, and we work to help them to get them the support they need. The Education team monitors the education services provided in Youth Detention Centers. 

DRNC speaks to facility administrators, regulators, and policy makers to share our findings and eliminate abuse. Depending on the nature of what we find, we may make reports to regulators, law enforcement, a local fire department, or health departments.  

Sometimes what we find prompts us to launch an investigation. We investigate when we believe serious abuse or neglect may have occurred, or when we receive a complaint. Importantly, federal law requires that we keep confidential the names of people who submit complaints to us. 

Investigations require significant time and resources, so we pursue those that have the potential to create systemic change and improve the lives of large numbers of people with disabilities.  

Some examples of systemic outcomes from DRNC’s I&M work: 

• A landmark agreement with the NC Department of Health and Human Services, that will phase out segregated employment services that rely heavily on paying workers with disabilities less than minimum wage 
• Elimination of solitary confinement for incarcerated people in NC prisons who are 17 or younger 
• Closure of a behavioral health program that resulted in abuse and neglect of students at the NC School for the Deaf in Morganton 
• Multiple investigations in the Cumberland County School System that caused the school system to remove all restraint chairs from its classrooms and adopt a policy prohibiting the use of dangerous prone (face-down) restraint 
• Closure of two large locked psychiatric treatment facilities for children, after years of DRNC monitoring and investigations, including intensive advocacy with state regulators about conditions in these institutions 
• Critical staffing changes in the management of Cherry Hospital that greatly improved treatment outcomes and patient safety after DRNC investigations uncovered dangerous overmedication of patients