On May 4, 1990, the United States Department of Justice Civil Rights Division announced, in a letter to the Governor of Virginia, its intent to launch an investigation, pursuant to the Civil Rights of Institutionalized Persons Act (CRIPA), 42 U.S.C. § 1997 et seq., into conditions at the Northern Virginia Training Center (NVTC), an institution for individuals with developmental disabilities in Fairfax, Virginia. Five experts from the Department of Justice toured the facility, reviewed policies and procedures, interviewed NVTC staff, and audited reporting and investigation practices.
On April 9, 1991, the Department of Justice announced its findings. The Department of Justice reported that the health and safety of people living at NVTC was at risk for a number of reasons. NVTC employed too few people and inadequately trained those it did employ, which placed residents in danger of unnecessary chemical and physical restraint. Often mechanical restraints were accompanied by seclusion, which was a fire hazard. Individualized programming for residents was inadequate and recordkeeping deficiencies made it impossible to monitor an individual's progress. In addition, NVTC's medical care, physical therapy, occupational therapy, and medication and side effect monitoring we all inadequate. In addition, NVTC provided insufficient medical care, including medication monitoring and occupational therapy. Recordkeeping made it difficult to track the efficacy of individualized programming and medical care. In closing, the Department of Justice expressed the desire to negotiate a resolution.
Negotiations did not make enough progress and, on May 31, 1994, the Department of Justice threatened to file a CRIPA lawsuit to challenge the constitutionality of conditions at NVTC. In addition to its earlier concerns, the Department of Justice chronicled systematic abuse and neglect at NVTC. For instance, individualized training programs were so inadequate that individuals became seriously sick or died as the result of aggressive, pica, and other self-injurious behaviors. One resident asphyxiated on a rubber glove, while another ate a reported seven cigarettes and one feminine hygiene pad in the span of two days. Similarly, inappropriate feeding techniques and poor nutrition endangered residents' health.
Virginia may have made an effort engage in productive negotiations, but the Department of Justice was not satisfied. On February 8, 1995, the Department of Justice notified the Governor of Virginia that, in addition to being unconstitutional, the conditions at NVTC violated the Americans With Disabilities Act, 42 U.S.C. §§ 12101 et seq., Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. §§ 794, the Social Security Act ("Medicaid"), 42 U.S.C. §§ 1396 et seq., and Virginia law.
On March 4, 1996, the Department of Justice filed a CRIPA lawsuit in the United States District Court for the Eastern District of Virginia, challenging conditions at NVTC. The plaintiffs sought injunctive relief to address (1) individualized programming, (2) undue physical restraint and isolation, (3) facility safety, (4) medical care, (5) physical and occupational therapy, (6) medication monitoring, especially for tardive dyskenesia, and (7) staff numbers and training.
On May 21, 1996, the court (Judge Leonie M. Brinkema) refused to consolidate this lawsuit with United States v. Virginia, No. 96-284, MH-VA-0002, an action challenging the constitutionality of conditions at a Virginia psychiatric hospital. On May 21, 1996, the court also granted the defendants' motion to dismiss, but stayed its ruling to allow for settlement. On July 18, 1996, the court approved a settlement agreement.
The settlement agreement itself was mostly concerned with procedural elements, such as development of a plan for improvement, compliance deadlines, evaluation, and dismissal. The NVTC plan describes the required compliance. The plan emphasizes the importance of trained staff in the provision of developmental disability services. The plan stated detailed training requirements for direct care staff and incorporated training into almost every solution. For instance, the plan mandated the dismissal of employees who neglected or abused residents. Similarly, the plan sought to reduce the need for restraints by both improving staff development and requiring the interdisciplinary treatment teams' advance approval for the type of restraints to be used for each individual. Thus, both chemical restraints and draconian physical restraint techniques, such as papoose boards, were eliminated. Similar clauses addressed medical care, medication administration and tracking, physical and occupational therapy, abuse and injury reporting and investigations, recordkeeping, functional planning, community placement, and quality assurance.
The parties modified the settlement on May 30, 1997. On August 29, 1997, the Department of Justice inspected NVTC and found it was in compliance with the plan. On June 3, 1998, the court dismissed the lawsuit.Elizabeth Chilcoat - 07/07/2006