(CN) – After a two-year investigation, the Justice Department found Louisiana’s reliance on nursing homes to provide services to people with serious mental illnesses violates their civil rights.
The U.S. Department of Justice said Wednesday that Louisiana’s reliance on nursing homes to serve the mentally ill violates the Americans with Disabilities Act and the U.S. Supreme Court’s decision in Olmstead v. L.C., which bans states from unnecessarily segregating people with disabilities.
“Louisiana residents with mental illness who can and want to live in their own homes and communities deserve the chance to do so,” Vanita Gupta, head of the Justice Department’s Civil Rights Division, said in a statement.
The Justice Department found Louisiana has one of the highest percentages in the country of nursing facility residents with mental illness.
About 4,000 people with serious mental illnesses are currently institutionalized in Louisiana nursing homes. According to a letter Gupta sent to Louisiana Gov. John Bel Edwards on Wednesday, these people are unnecessarily “isolated and segregated from their families, friends and communities.”
Additionally, the cost to the state of serving the mentally ill in nursing facilities instead of the community can be as high as $7,000 a year per person, Gupta said in the letter.
“On average, these individuals are younger and have fewer physical care needs than the broader nursing facility population,” Gupta said. “They often spend years in nursing facilities that provide minimal mental health services and apart from paid staff, they rarely interact with people who do not have disabilities.”
According to Gupta, most of the people with serious mental illnesses currently living in nursing homes could be more appropriately served in their own homes and communities, “if they had the mental and physical healthcare services that Louisiana already provides to thousands of people who have similar needs,” but the state is not telling them about other available options.
During its investigation, which began in October 2014, the Justice Department interviewed several people unnecessarily living in nursing homes who wanted to return to their own communities.
The department interviewed a man in his 60s who was sent to a nursing home after he repeatedly called 911, concerned about his blood pressure. Instead of connecting him to community treatment services, Gupta said, he was charged with abusing 911, briefly sent to jail and admitted to a state psychiatric hospital before being sent to a nursing home.
“Six years later, the man…remains in the same nursing facility, even though he wants to return to the community and could do so with proper physical and psychiatric supports,” Gupta’s letter states. “This man’s story is not unique.”
Another nursing home resident in his 40s also said he would like to live independently. Although he sometimes experiences symptoms of mental illness, he told Justice Department investigators, “I’m a human, too.”
“I would try to find an apartment to stay in if I could. I’d like to move somewhere so I can take care of my own self,” he said, according to the letter.
The Justice Department is calling for the state to “promptly implement remedial measures to protect the civil rights of individuals with serious mental illness.”
The department said such measures should include identifying and diverting those with serious mental illness from nursing facility placement, implementing “person-centered” transition planning, and providing “quality services in sufficient amount” to ensure that the mentally ill avoid institutionalization and are instead integrated in the community.
“Given the array of mental health services in Louisiana, the existence of funds that could be directed to community-based settings, and the state’s ability to build upon existing processes for diversion and transition, Louisiana can reasonably modify its service system to provide mental health services in the most integrated setting appropriate,” Gupta said.
In her letter, Gupta told Gov. Edwards that the state could be sued if it refuses to enter into negotiations or if negotiations with the Justice Department are unsuccessful.
Kelly Zimmerman, spokesperson for the Louisiana Department of Health, said the department will review the recommendations and “will work with stakeholders and legislators to determine the best path forward.”
“Creating a full continuum of care that includes both inpatient care and home and community-based care for people with mental illnesses has been a long-standing challenge in Louisiana that has spanned multiple administrations,” Zimmerman said.