South Carolina May Violate ADA in Its Treatment of Adults With Mental Illness: DOJ

The Justice Department seal is seen on the lectern during a Hate Crimes Subcommittee summit in Washington, on June 29, 2017. Mark Wilson/Getty Images

The Department of Justice (DOJ) announced on July 6 that there is reasonable cause to believe the state of South Carolina violates the Americans with Disabilities Act (ADA) by unnecessarily segregating adults with mental illness in adult care homes.

The DOJ conducted an extensive investigation in response to a complaint lodged on Jan. 12, 2022. The department wanted to know whether the state unnecessarily segregates adults with serious mental illness in adult care homes—known in the state as “Community Residential Care Facilities” (CRCF).

It concluded that South Carolina violates Title II of the ADA, 42 U.S.C. Section 12132, by failing to give adults with serious mental illness adequate community-based services “in the most integrated setting appropriate to their needs.”

Instead, the state of South Carolina subsidizes their stay in adult care homes, the DOJ said. The department found that in these homes, adults with mental illness have little contact with people without disabilities, and they are often only allowed out of the homes for medical appointments and group visits to grocery and convenience stores.

“It is critically important to ensure that these individuals are afforded the opportunity to live and receive services in their own homes and communities, consistent with the ADA’s integration mandate,” the DOJ stated.

Critical Services Not Sufficiently Available

The critical community-based mental health services lacking by the state include “assertive community treatment, supported employment, permanent supportive housing, intensive case management, and peer support.”

While they are provided in certain parts of the state, they are not sufficiently available throughout South Carolina to give adults with mental illness opportunities to avoid or move out of the adult care homes and live in the community.

There are approximately 2,000 people with a serious mental illness residing in CRCFs in adult care homes. Most of these adults stay for a long time. Among a sample of people there, the DOJ found “lengths of stay up to 35 years, with an average stay of 5 years,” it said in its report (pdf).

“Nearly half of the people in the sample also had at least one other placement in a congregate facility, meaning that the typical amount of time spent in these types of institutions is likely longer than 5 years.”

DOJ Seeks to Resolve Issues With State

In a letter to state officials overseeing the South Carolina Department of Mental Health and South Carolina Department of Health and Human Services, the DOJ said it would like to work with the state to resolve the situation.

“The lawyers assigned to this investigation will contact counsel for the State to arrange those discussions. We anticipate that these negotiations will result in an agreement to resolve these issues,” Clarke wrote in the letter (pdf).

“In the unexpected event we are unable to reach a resolution regarding our concerns, we are obliged to advise you that we may take appropriate action, including initiation of a lawsuit, to ensure the State’s compliance with the ADA.

“In addition, the complainant to our agency maintains the right to file a lawsuit at any time.”

“People with disabilities should not be isolated in institutions for years on end when they can and want to live in their own homes,” Kristen Clarke, the assistant attorney general of the DOJ’s civil rights division, said in a statement. “The Civil Rights Division will safeguard the rights of people with disabilities to ensure that they are able to participate fully in community life.”

“A sacred promise of the ADA includes giving people a meaningful choice for where they wish to live, including in their own private home,” Adair F. Boroughs, U.S. attorney for the District of South Carolina, said in a statement.