Justice Department Finds Louisiana Unnecessarily Relies on Nursing Facilities to Provide Services to People with Serious Mental Illness

Following a comprehensive investigation, today, the Justice Department released its findings that Louisiana unnecessarily relies on nursing facilities to provide services to people with mental health disabilities, in violation of the community integration mandate of the Americans with Disabilities Act (ADA) and the Supreme Court’s decision in Olmstead v. L.C.

The ADA and the Olmstead ruling require states to make services available to people with disabilities in the most integrated setting appropriate to their needs, regardless of the type of disability.  However, many Louisianans with serious mental illness do not have a meaningful choice to receive the services they need in their own homes and communities. 

The department’s findings, detailed in a letter to Louisiana Governor John Bel Edwards, follow an investigation into the state’s system of care for people with serious mental illness who receive services and supports in nursing facilities.  The department found that people with serious mental illness who rely on Louisiana for needed services must live in nursing facilities, isolated from their communities, to receive those services.  With access to adequate, evidence-based community services, these individuals could instead live in integrated settings.

“Louisiana residents with mental illness who can and want to live in their own homes and communities deserve the chance to do so,” said Principal Deputy Assistant Attorney General Vanita Gupta, head of the Justice Department’s Civil Rights Division.  “We appreciate Louisiana’s cooperation with our investigation and hope to continue working with state officials to ensure that residents with serious mental illness who qualify for state services can live successfully in their communities with appropriate supports.”

Louisiana houses approximately 4,000 people with serious mental illness in nursing facilities each year.  On average, these residents tend to be younger, live in nursing facilities for longer periods of time and have low-care nursing needs compared to typical nursing facility residents.  Louisiana likely could serve these people more effectively and for less money by using its home- and community-based service system. 

The findings letter examines the widespread impact of the state’s nursing facility system on people with serious mental illness.  For example, the Justice Department interviewed a man in his sixties who experienced a mental health crisis a few years ago and repeatedly called 911 about his blood pressure.  Instead of connecting him to community treatment services, he was charged with abusing 911, sent briefly to jail and then admitted to a state psychiatric hospital.  The hospital eventually discharged him to a nursing facility that primarily houses people with serious mental illness.  Six years later, the man remains in the same nursing facility, even though he desires to return to the community and could do so with proper physical and psychiatric supports.

The department’s findings letter includes the following key conclusions:

• People with serious mental illness who need physical and mental health supports live in nursing facilities because Louisiana does not adequately arrange for community-based services or identify residents who can benefit from such services. 
• Many people who rely on state services do not know that they could choose community-based services instead of nursing facilities because the state has not told them about these services.
• Many nursing facility residents with serious mental illness can live successfully in community-based settings rather than in institutions.
• People with serious mental illness who have similar needs to those living in Louisiana’s nursing facilities successfully receive community-based services in other states, and even in Louisiana.  The state already offers many of the services that people need to live in their own homes and can increase community capacity to ensure that all qualified people with serious mental illness can choose these services instead of nursing facility placement.   

The investigation was conducted by the Civil Rights Division.  The full letter can be found at www.ada.gov.  Please visit www.ada.gov/olmstead to learn more about the Civil Rights Division’s ADA Olmstead enforcement efforts and www.justice.gov/crt to learn more about the laws enforced by the Justice Department’s Civil Rights Division.