On April 11, 2007, the U.S. Department of Justice's Civil Rights Division ("DOJ") sent its "findings letter" to Missouri's governor, advising him of the results of the November 2005, DOJ investigation of conditions and practices at the Bellefontaine Habilitation Center ("Bellefontaine"), which ...
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On April 11, 2007, the U.S. Department of Justice's Civil Rights Division ("DOJ") sent its "findings letter" to Missouri's governor, advising him of the results of the November 2005, DOJ investigation of conditions and practices at the Bellefontaine Habilitation Center ("Bellefontaine"), which houses developmentally disabled persons, including patients with mental retardation, cerebral palsy, and autism. The investigation occurred under the authority of the Civil Rights of Institutionalized Persons Act ("CRIPA"), 42 U.S.C. § 1997 et seq. DOJ lawyers and expert consultants visited the facility and reviewed a wide array of documents there. The investigators also conducted interviews with personnel and visited residents in an array of settings at Bellefontaine.
Just before DOJ made its on-site visit, it met with state personnel who advised that the troubling death of a Bellefontaine resident in August 2004, and other allegations of abuse and neglect at Bellefontaine had led the state's Department of Mental Health ("DMH") to conduct its own review of conditions at the facility. DMH found that there were deficiencies at Bellefontaine in the following areas: (1) administration; (2) quality assurance; (3) training;(4) documentation; (5) notification of significant incidents; (6) staffing coverage; (7) use of the grievance process; and (8) the quality of clinical services. The state informed the DOJ that it had retained a consulting group, the Columbus Organization, to assist the state in taking remedial measures to improve conditions at Bellefontaine. Corrective actions were just beginning to be implemented and a decision to close the facility had recently been modified, so that a portion of the facility would be reconstructed and kept operational.
Nevertheless, despite the state's recent efforts, the DOJ advised that its investigation found continuing deficiencies in resident care at Bellefontaine, in that conditions and services at Bellefontaine substantially departed from generally accepted standards of care. Constitutional and federal statutory rights of residents at Bellefontaine were violated in several respects, according to the DOJ.
The DOJ concluded that deficiencies in conditions of resident care and treatment at Bellefontaine existed as to three topic areas causing residents significant harm or risk of harm through Bellefontaine's failure to: (1) keep residents safe (e.g., residents subjected to neglect and physical abuse; disproportionate number of unexplained injuries; lack of resident and staff supervision due to inadequate staffing); (2) provide residents with adequate behavioral support planning and mental health services (e.g., inadequate, non-individualized behavior programs and functional analyses of problem behaviors, including a failure to incorporate positive reinforcement in plans; poor program implementation, monitoring, and follow-up; poor staff training and plan revision; inadequate communications services due to unavailability of augmentative and alternative communication devices); and (3) provide services to Bellefontaine residents in the most integrated setting appropriate to the residents' needs, as required by the Americans with Disabilities Act ("ADA"), 42 U.S.C. § 12131 et seq.; 28 C.F.R § 35.130(d). The letter provided details of deficiencies for all three of these categories. As to the latter of the three, the DOJ observed that (A) residents who desired to reside in the community, and who could appropriately be served in the community, remained institutionalized, and (B) Bellefontaine failed to provide adequate training to prepare residents for transition to integrated settings.
Minimally acceptable remedial measures for each of the three categories were outlined in the letter, which concluded by inviting continued further collaboration in implementing the remediation. The letter also provided notice that, absent a resolution of federal concerns, the DOJ would file a CRIPA lawsuit to compel correction of the identified deficiencies at Bellefontaine.
We have no information indicating post-findings activity in this case.Mike Fagan - 05/30/2008