Justice Department Secures Agreement with Maine to Ensure Children with Behavioral Health Disabilities Can Live at Home

Press Release

Settlement Marks New Milestone in Department's Enforcement of the ADA's Integration Mandate

The Justice Department announced today that it secured a settlement agreement to resolve its lawsuit alleging that Maine violates Title II of the Americans with Disabilities Act (ADA) and the Supreme Court's decision in Olmstead v. L.C. by unnecessarily segregating children with behavioral health disabilities in psychiatric hospitals, residential facilities and a state-operated juvenile detention facility.

"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," said Assistant Attorney General Kristen Clarke of the Justice Department's Civil Rights Division. "We know that too many children with behavioral health disabilities end up in juvenile justice settings or in out-of-home placements, often in different states far from their families, disrupting their lives in ways that can cause permanent harm. Under this agreement, more children will have access to community-based services and in-home behavioral health services so that they can grow up surrounded by family and loved ones."

"Mainers with disabilities, particularly children, must be able to access the critical services they need in their homes and within their communities," said U.S. Attorney Darcie N. McElwee for the District of Maine. "Maine's geographical expanse is a treasure, but children with behavioral health disabilities cannot be needlessly limited to accessing necessary services and supports in facilities away from their families. This agreement prioritizes Maine's children and ensures the availability of crucial services to allow them to pursue their greatest potential and ease the emotional toll on their caregivers."

The department sued Maine in September, following a thorough investigation and a public letter of findings notifying Maine of the violation. The lawsuit alleged that Maine limited families' access to needed behavioral health services for 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. Absent these services, Maine children with disabilities would enter emergency rooms, come into contact with law enforcement and remain in institutions.

The agreement 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.

The parties have agreed that the federal district court will retain jurisdiction to enforce the agreement and that an independent reviewer will evaluate the state's compliance.

Enforcement of the ADA's Integration Mandate Nationwide

This agreement is the most recent example of the Civil Rights Division's enforcement of the ADA's "integration mandate"-that is, the right to receive services in the most integrated setting appropriate. The Division has worked to enforce the integration mandate to address the segregation of people with disabilities in all its varied forms. For example, a 2023 agreement with Alameda County, California, provides relief to adults with mental health disabilities facing a similar dearth of services that resulted in their admission to emergency departments and jails. The Division has also won court-ordered relief for children with physical disabilities who were unnecessarily segregated in nursing homes in Florida. Florida is now required to provide those children the services they need to move out of nursing facilities. And last month, the Division secured an agreement with Colorado to ensure adults unnecessarily segregated in its nursing facilities have meaningful opportunities to live at home. The Civil Rights Division's enforcement of the integration mandate has brought change across the country for people with disabilities of all ages and those who have been segregated from their communities.

Additional information about the Civil Rights Division is available on its website at www.justice.gov/crt. Those interested in finding out more about the ADA may visit www.ada.gov.

Members of the public may report possible civil right violations at www.civilrights.justice.gov.

View the settlement agreement here.

Updated November 26, 2024