State News

NC mentally ill get help from feds

Posted July 29, 2011

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— North Carolina must find homes for thousands of mentally ill people in communities and stop housing them in adult care centers, where residents say their lives are regimented and boring, the U.S. Department Justice told the state in a letter this week.

"Adult care homes are institutional settings that segregate residents from the community and impede residents' interactions with people who do not have disabilities," Assistant Attorney General Thomas E. Perez says the letter, dated July 28 and sent to Attorney General Roy Cooper.

Keeping the mentally ill in adult care homes violates the Americans with Disabilities Act, Perez said. The state not only places the mentally ill in such homes, but encourages them financially to stay there instead of going to communities by providing about $550 to those who live in adult care centers, the letter said.

DOJ officials toured adult care homes in March and April, talking with residents who said they wanted to return home. "Throughout our investigation, residents emphatically expressed their desire to leave their adult care home and become members of their communities again," the letter said. One resident said he "would do anything to get out; this is a prison" while another said the residents spend their days vegetating and smoking because there's nothing else to do.

The state doesn't disagree with the letter's basic thrust — that the mentally ill shouldn't live only with other mentally ill people or with elderly people who may be frail — and the DOJ relies on the state's own findings to help reach its conclusions.

But about 5,800 people with mental illness live at 288 adult care homes with at least 20 beds where people with mental illness comprise at least 10 percent of the population, the letter says. Many landed in the homes when North Carolina reduced the number of beds available at three state mental hospitals, Dix, Cherry and Broughton, said John Rittelmeyer, litigation director for Disability Rights North Carolina, an advocacy group.

"Even though adult care homes are not appropriate settings for persons with mental illness and state law prohibits the admission of persons to adult care homes for the treatment of mental illness, the facilities have become a major part of the state's mental health service system," the letter says. "Thousands of people with mental illness receive services in adult care homes — although they could be served in more integrated settings — because there are few community-based options available to them."

Disability Rights North Carolina Executive Director Vicki Smith called the DOJ's letter "a critical step towards true recovery for people with mental illness" in the state. 

The DOJ investigation arose from a complaint filed last year by Disability Rights North Carolina, which said the homes are dingy and dangerous, violating the rights of mentally ill residents.

"We couldn't be happier" with the decision, Rittelmeyer said Friday. The decision is proof "that the state of North Carolina can do a lot better in offering people with mental illness the choice of living in the community and not in a large institutional setting like an adult care home," he said.

The state keeps the mentally ill in the adult care homes partially because that's convenient, Rittelmeyer said. When a psychiatrist visits an adult care home, he or she can treat many patients at the same time instead of just a few.

Officials with the state Attorney General's Office and the state Department of Health and Human Services are reviewing the letter.

While some parts of DOJ's ruling may need to be challenged, the state now has to find community-based homes for the mentally ill, said Rep. Nelson Dollar, R-Wake. "We have to find adequate and suitable housing for these individuals," he said. "That has to be our No. 1 concern at this point in time."

In March, DOJ visited adult care homes in Durham, Wake Forest, Cary, Wilson, Fremont, Greensboro and Rocky Mount. In April, the officials went to homes in Louisburg, Kannapolis, Morganton, Wilkesboro, Nebo and Conover.

In the past two years, the DOJ has reached settlements in similar cases in Delaware and Georgia, Rittelmeyer said.

In addition to the DOJ investigation, the state may have problems with the federal government over Medicaid payments, which aren't supposed to go to what's called "institutions of mental disease," which are facilities that predominantly care for people with mental illness. North Carolina has identified as many as 41 adult care homes that house as many as 2,000 people that might qualify as institutions of mental disease, Rittelmeyer said.

14 Comments

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  • scifion Jul 29, 2011

    new rule: if you comment to p_ss and moan about how something is a waste of your tax money, please have the courtesy to offer an alternate solution to the problem. Use your brains, people! Thanks in advance! :-)

  • rickardcv Jul 29, 2011

    Talk to the families of the mentally ill and see if they can continue to take care of them. Talk to the jails that are housing alot of them that are still out in the community because they have no one to help them remember to take their medications or see the doctor. It is a shame that people cannot get the long-term care that is needed. I am all for community-based care but you have to have someone in the community willing and able to do this.

  • whatelseisnew Jul 29, 2011

    I don't see how the DOJ can complain. They need only go to the various Legislature buildings and they will see large groups of mentally ill people all gathered together.

    It should be interesting to see where the money will come from to make these changes. My suggestion, take it out of the education budget.

  • readerman Jul 29, 2011

    About time!

  • ProudBlackSingleMother Jul 29, 2011

    This is a waste of our tax dollars.

  • ProudBlackSingleMother Jul 29, 2011

    Why can't we bring back the mental institutions of the 80s?

  • pappybigtuna1 Jul 29, 2011

    How does one apply for Gov. Paid Housing,

  • keneds Jul 29, 2011

    you know N C is going to mess this up

  • Rebelyell55 Jul 29, 2011

    I really don't know what to think about this. What person would not tell them or anyone else they wanted to go home. Before anything is done, I would say an appeal to the letter should be done 1st. At the same time an investigation and audit of all of these places to see you is abusing the system or flat stealing money from the goverment.
    Last, get our do nothing elected leaders to look into what is needed long term and contact our Rep. in Washington involved in removing the Fed. Power of state intrusion.

  • wildcat Jul 29, 2011

    Living in the communty with mental issues...Who would look after them. People don't care for one another like in the old days. Better rethink on this one.

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