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Case Name DOJ CRIPA Investigation of North Carolina’s Public Mental Health Hospitals, Dorothea Dix Hospital in Raleigh, Broughton Hospital in Morganton, Cherry Hospital in Goldsboro, and John Umstead Hospital in Butner MH-NC-0001
Docket / Court No Court Case ( No Court )
State/Territory North Carolina
Case Type(s) Mental Health (Facility)
Attorney Organization U.S. Dept. of Justice Civil Rights Division
Case Summary
On March 17, 2004, the U.S. Department of Justice's Civil Rights Division ("DOJ") sent its "findings letter" to North Carolina's governor, advising him of the results of the spring and summer 2002, DOJ investigation of conditions and practices at the four North Carolina public mental health ... read more >
On March 17, 2004, the U.S. Department of Justice's Civil Rights Division ("DOJ") sent its "findings letter" to North Carolina's governor, advising him of the results of the spring and summer 2002, DOJ investigation of conditions and practices at the four North Carolina public mental health hospitals. Each facility served one of four regions in the state and provided services to a wide variety of patients, including adults with acute and long term care needs, children, adolescents, the elderly, and individuals with substance abuse problems.

The investigation occurred under the authority of the Civil Rights of Institutionalized Persons Act ("CRIPA"), 42 U.S.C. § 1997. DOJ and expert consultants visited the facilities, reviewed a wide array of documents there, and conducted interviews with personnel and residents. The letter commended the state's staff for providing a high level of cooperation during the investigation, as well as the dedication many showed for patient well-being. Nevertheless, the investigation found a number of constitutional and federal statutory violations deficiencies in conditions and patient care at the state's public mental health hospitals.

The DOJ investigation identified multiple substantial departures from generally accepted professional standards of care. The findings letter set out that these deficiencies in conditions of patient care and treatment existed at all four facilities in six topic areas, including (1) inadequate mental health treatment; (2) inappropriate use of restraints and seclusion; (3) inadequate nursing and medical care; (4) failure to ensure the reasonable safety of patients; (5) unsafe physical plant conditions; and (6) inadequate discharge planning, as evidenced by the failure to provide services to discharged patients in the most integrated setting. For all six of these categories, the letter provided examples of deficiencies that usually existed at each of the state's four facilities.

Minimally-acceptable remedial measures for each of these categories were outlined in the letter, which observed that improvements had already been made in some respects at the various facilities since the DOJ inspections occurred. The letter invited further collaborative steps toward remediation, but also notified the state that, absent prompt agreement to alleviate the DOJ's concerns, the federal government could seek to compel the state, via a CRIPA lawsuit, to correct the deficiencies and protect these four hospitals' patients' rights.

It appears the matter settled out of court, bcause according to the Department of Justice Annual Reports to Congress, compliance monitoring continued for several years. The last report listing such monitoring is for Fiscal Year 2009, see so apparently the matter was closed some time thereafter.

Mike Fagan - 05/23/2008


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Issues and Causes of Action
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Issues
Constitutional Clause
Due Process
Defendant-type
Hospital/Health Department
Jurisdiction-wide
Disability
Integrated setting
Mental impairment
General
Confinement/isolation
Fire safety
Individualized planning
Informed consent/involuntary medication
Restraints : chemical
Restraints : physical
Staff (number, training, qualifications, wages)
Medical/Mental Health
Intellectual disability/mental illness dual diagnosis
Medical care, general
Medication, administration of
Mental health care, general
Suicide prevention
Mental Disability
Mental Illness, Unspecified
Plaintiff Type
U.S. Dept of Justice plaintiff
Type of Facility
Government-run
Causes of Action Civil Rights of Institutionalized Persons Act (CRIPA), 42 U.S.C. § 1997 et seq.
Defendant(s) Broughton Hospital
Cherry Hospital
Dorothea Dix Hospital
John Umstead Hospital
North Carolina Department of Health and Human Services
Plaintiff Description U.S. Department of Justice, on behalf of people with mental illness confined to state public mental health facilities in North Carolina.
Indexed Lawyer Organizations U.S. Dept. of Justice Civil Rights Division
Class action status sought No
Class action status granted No
Prevailing Party Plaintiff
Public Int. Lawyer Yes
Nature of Relief Injunction / Injunctive-like Settlement
Source of Relief Settlement
Form of Settlement Private Settlement Agreement
Order Duration not on record
Case Closing Year 2009
Case Ongoing No
Docket(s)
No docket sheet currently in the collection
General Documents
Re: North Carolina’s Public Mental Health Hospitals, Dorothea Dix Hospital in Raleigh, Broughton Hospital in Morganton, Cherry Hospital in Goldsboro, and John Umstead Hospital in Butner 03/17/2004
MH-NC-0001-0001.pdf | Detail
Judges None on record
Monitors/Masters None on record
Plaintiff's Lawyers Acosta, R. Alexander (District of Columbia)
MH-NC-0001-0001
Defendant's Lawyers None on record
Other Lawyers None on record

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