A comprehensive investigation by the United States Attorney’s Office for the District of Rhode Island and the United States Department of Health and Human Services Office for Civil Rights (HHS OCR) has found that the State of Rhode Island violated federal civil rights laws. The state has been systematically and unnecessarily segregating children with mental health and developmental disabilities at Bradley Hospital, an acute-care psychiatric facility, according to U.S. Attorney Zachary A. Cunha and HHS OCR Director Melanie Fontes Rainer.
The findings, detailed in a Letter of Findings sent to the Governor of Rhode Island and the Director of the Rhode Island Department of Children, Youth and Families (DCYF), revealed that the state failed to comply with its legal obligation to provide services in the most integrated setting appropriate for these children. Instead, many children remained hospitalized at Bradley Hospital for extended periods, often far exceeding the intended one to two weeks. Some children were hospitalized for over a year despite being ready for discharge.
The investigation concluded that DCYF did not ensure that children with disabilities had access to intensive in-home and community-based services, leading to unnecessary and prolonged hospitalizations at Bradley. These actions violated federal laws, including Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973.
U.S. Attorney Zachary A. Cunha strongly criticized the state’s actions, stating, “It is nothing short of appalling that the state has chosen to warehouse children in a psychiatric institution, rather than stepping up to provide the community care, support, and services that these kids need, and that the law requires. I am hopeful that the findings we announce today will spur swift action by the state to meet its obligations under federal law, and far more importantly, to ensure that the civil rights of these children are upheld.”
Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division emphasized the importance of community-based services, saying, “Children with disabilities should be able to come home to the love and support of their families and not be confined to an institution for months on end. We will continue our vigorous enforcement of the ADA to ensure that children with disabilities can receive the community-based services they need to live with their families and participate in their communities.”
HHS OCR Director Melanie Fontes Rainer highlighted the broader implications of the findings, stating, “Today’s finding follows on the heels of the Office for Civil Rights’ efforts to strengthen access to care for people with disabilities like these children. We must do better by our children and the communities we serve, and states and others must follow federal civil rights laws to ensure every child can access care free from discrimination. As we approach the 25th anniversary of the Olmstead decision, today’s action also emphasizes our commitment to continue to protect the critical right of individuals to live in their own homes and communities.”
The federal investigation covered the period from January 1, 2017, through September 30, 2022. During this time, 527 children either in DCYF care or receiving services voluntarily through DCYF were admitted to Bradley Hospital. Of these, 116 were hospitalized for more than 100 consecutive days, 42 for over 180 days, and seven for more than one year. These extended hospitalizations were due to DCYF’s failure to provide necessary community-based services, which only exacerbated the children’s conditions.
The Letter of Findings also noted that DCYF did not adequately plan for hospital discharges to place children in the most integrated settings appropriate for their needs. This lack of planning resulted in delayed discharges and inappropriate post-discharge placements, leading to repeated hospitalizations.
This investigation was conducted by Assistant U.S. Attorney Amy R. Romero and Equal Opportunity Specialist Erin Walker of HHS. The enforcement of Title II of the ADA, Section 504, and the integration mandate of the Olmstead decision remains a priority for the Department of Justice and the Department of Health and Human Services.
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