Jun. 22—The U.S. Justice Department announced Wednesday that Maine is in violation of the Americans with Disabilities Act for over-institutionalizing disabled children in psychiatric hospitals, residential treatment facilities and even the state-operated juvenile detention facility.
Federal investigators have concluded Maine unnecessarily segregates children with mental health and developmental disabilities even though federal courts have ruled they have a right to live and receive services in appropriate integrated settings, typically their homes and communities.
In a written statement issued later Wednesday, a spokeswoman for Maine Department of Health and Human Services said the agency agreed with the findings and that the failings of the state's behavioral health system date back decades.
"The administration has worked over the past three and a half years to rebuild a system of services that was dismantled during the previous administration, dedicating new funding to strengthen behavioral health in every budget and reestablishing the Children's Cabinet," said spokeswoman Jackie Farwell.
The investigation was sparked by a complaint from Disability Rights Maine, an advocacy agency for disabled Mainers, on behalf of a group of children with disabilities, alleging these children cannot access needed community-based services, resulting in their institutionalization.
Many children with disabilities in Maine, especially those in rural areas or with more intensive needs, are unable to live at home with their families because of a lack of community-based behavioral health services, investigators found.
Such services can range from assistance with daily activities to counseling to crisis services that can prevent a child from being institutionalized during a mental health crisis. Without them, too many Maine children wind up in emergency rooms, juvenile detention or institutions.
"Children with disabilities deserve the opportunity to live at home with the services they need and grow up in the community alongside their nondisabled peers," said Assistant Attorney General Kristen Clarke of the U.S. Justice Department's Civil Rights Division.
"With the increase in children's mental health needs during the pandemic, it is more important than ever to provide support to children and families" Clarke continued. "We look forward to bringing Maine into compliance with federal law."
The department found a number of barriers to accessing children's behavioral health services in the community, including lengthy waitlists, an insufficient provider network, inadequate crisis services, and a lack of support for foster care parents who care for children with behavioral health needs.
As a result, Maine children must enter treatment facilities in and out of state, or even the state-operated juvenile detention facility, Long Creek Youth Development Center, to receive behavioral health services they have a right to get in their homes and communities.
This announcement comes as the U.S. Department of Justice is celebrating the 23rd anniversary of the groundbreaking U.S. Supreme Court decision Olmstead v. L.C., which holds that unjustified segregation of people with disabilities in institutions is a form of unlawful discrimination.
Maine DHHS said it shares the Justice Department's goal of improving behavioral health services for Maine children in their homes and communities, and that it is fully cooperating with the investigation into the behavioral health system's shortcomings, Farwell said.
Unfortunately, the pandemic, along with its resulting challenges, from providers' inability to hire and retain qualified staff to a greater need for behavioral health services due to anxiety and isolation caused by COVID-19, has slowed the department's progress and more work remains, Farwell said.
"We share the strong sense of urgency in ensuring that Maine children with disabilities have timely access to an array of high-quality, evidence-based services that prevent institutionalization whenever possible," Farwell said, "and will continue to work diligently towards that end."
To strengthen Maine's behavioral health system, the department is expediting more than $12.1 million in state funding to providers to strengthen services to help keep those having behavioral health crises out of inpatient settings for behavioral health crises, Farwell said.
These payments — to be made today — will go to such services as assertive community treatment for those with serious and persistent mental illness, targeted case management, home- and community treatment programs, and outpatient therapy for children and adults, Farwell said.
She said DHHS designed the one-time, pandemic-related payments to offset pandemic-related setbacks, reduce the use of hospital emergency departments for behavioral health crises, meet increased demand due to the mental health effects of the pandemic, and stabilize and reduce wait lists for services.
As passed by the Legislature, Gov. Janet Mills' supplemental budget and the biennial budget, along with the bonus payments for workers funded by the American Rescue Plan, invest $230 million across 2022 and 2023 to support the behavioral health workforce, capacity, and resilience of providers, Farwell said.
"The Administration believes Maine children with disabilities or behavioral health needs should have timely access to high-quality services in their communities to prevent unnecessary institutionalization," Farwell said. "The department welcomes the opportunity to engage with the Department of Justice and other stakeholders to improve the children's behavioral health system in Maine."
This story will be updated.