Case: DOJ Investigation of Rhode Island Community-Based Services

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Case Summary

This is a case about the level of service required of state medicaid providers under the Americans with Disabilities Act to ensure that persons with disabilities can live in their own communities. On May 18, 2022, the U.S. Department of Justice (DOJ) reached an out-of-court settlement agreement with the Rhode Island Executive Office of Health and Human Services to resolve alleged violations of the ADA. The State Medicaid Director and the Department within the Executive branch that administers t…

This is a case about the level of service required of state medicaid providers under the Americans with Disabilities Act to ensure that persons with disabilities can live in their own communities. On May 18, 2022, the U.S. Department of Justice (DOJ) reached an out-of-court settlement agreement with the Rhode Island Executive Office of Health and Human Services to resolve alleged violations of the ADA. The State Medicaid Director and the Department within the Executive branch that administers the “Katie Beckett” program were also parties to the agreement (collectively, “Rhode Island”). The settlement resolved a complaint filed with the DOJ that Rhode Island failed to provide appropriate benefits to a family whose autistic son was qualified under the Katie Beckett program, which provides medicaid-eligible families with home-based therapeutic services.

The complaint alleged that the state provided only half of the hours of services authorized per week, on average, due to a failure to reasonably modify its policies to provide back-up care when staff became unavailable. The purpose of the Katie Beckett program was to enable children with disabilities to remain in their own homes and communities, but, due to the state’s failure to provide adequate services, the family in question was forced to send their son to an out-of-state residential treatment facility and then an in-state group home. 

The DOJ opened an investigation based on the complaint in July 2018. The DOJ’s source of authority was Title II of the ADA, 42 U.S.C. §§ 12131-12134, as interpreted in Olmstead v. L.C., 527 U.S. 581 (1999), and Title II’s implementing regulation, 28 C.F.R. pt. 35. In Olmstead, the Supreme Court held that public entities must provide community-based services to persons with disabilities when reasonable and appropriate. The DOJ determined that Rhode Island’s failure to provide adequate staffing placed the Complainants’ son at serious risk of unnecessary segregation and in fact did cause segregation in an out-of-state residential treatment facility.

The terms of the settlement were that the DOJ agreed to refrain from filing a lawsuit under Title II of the ADA, and Rhode Island agreed to undertake a number of remedial measures, including:

  1. Within three months of the settlement, Rhode Island would provide the family with an individualized service plan that would enable their son to live at home. The plan was required to meet several criteria set out in the settlement agreement.
  2. Within 45 days, the state would begin providing services to enable the child to live with his family.
  3. The state would pay $75,000 in damages to a trust for the son’s benefit.
  4. The state would review and modify its practices to ensure other families would not be denied adequate service in the future, according to a number of criteria set out in the agreement.
  5. The state would inform provider agencies of the new policy changes and require them to provide informational materials according to criteria set forth in the agreement.

The agreement also provided a reporting and enforcement structure. The enforcement provision included a 90-day negotiation period over any dispute over interpretation or compliance with the agreement, after which the DOJ retained its right to file a civil action against the state. Additionally, the enforcement provision provided that the agreement will terminate after 18 months if the parties agree that Rhode Island has substantially complied with its provisions.

Summary Authors

Terry Howard (9/26/2023)

Documents in the Clearinghouse

Docket

Last updated Aug. 30, 2023, 1:33 p.m.

Docket sheet not available via the Clearinghouse.

Case Details

State / Territory: Rhode Island

Case Type(s):

Disability Rights

Key Dates

Case Ongoing: Yes

Plaintiffs

Plaintiff Description:

The Department of Justice on behalf of a family who filed a complaint in response to Rhode Island's inadequate provision of health benefits.

Plaintiff Type(s):

Private Plaintiff

U.S. Dept of Justice plaintiff

Attorney Organizations:

U.S. Dept. of Justice Civil Rights Division

Public Interest Lawyer: Yes

Filed Pro Se: No

Class Action Sought: No

Class Action Outcome: Not sought

Defendants

Rhode Island "Katie Beckett" program administrator (Providence, Providence), State

Defendant Type(s):

Jurisdiction-wide

Case Details

Causes of Action:

Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12111 et seq.

Special Case Type(s):

Out-of-court

Available Documents:

Monetary Relief

Injunctive (or Injunctive-like) Relief

Outcome

Prevailing Party: Plaintiff

Nature of Relief:

Injunction / Injunctive-like Settlement

Damages

Source of Relief:

Settlement

Form of Settlement:

Private Settlement Agreement

Amount Defendant Pays: 75,000

Content of Injunction:

Reasonable Accommodation

Reporting

Issues

General:

Government services

Public benefits (includes, e.g., in-state tuition, govt. jobs)

Disability and Disability Rights:

Mental impairment

Autism

Benefit Source:

Medicaid