Case: DOJ Investigation of Maine's Behavioral Health System for Children

No Court

Clearinghouse coding complete

Case Summary

This was an out of court matter initiated by the United States Department of Justice Civil Rights Division (DOJ), in response to a complaint it received from Disability Rights Maine, the protection and advocacy agency for people with disabilities in Maine. Disability Rights Maine filed a complaint on behalf of a group of children with disabilities, alleging that the children could not access needed community-based services, resulting in their institutionalization or the risk of their institutio…

This was an out of court matter initiated by the United States Department of Justice Civil Rights Division (DOJ), in response to a complaint it received from Disability Rights Maine, the protection and advocacy agency for people with disabilities in Maine. Disability Rights Maine filed a complaint on behalf of a group of children with disabilities, alleging that the children could not access needed community-based services, resulting in their institutionalization or the risk of their institutionalization, in violation of Title II of the Americans with Disabilities Act (ADA). 

Following a thorough investigation, the DOJ detailed its findings in a letter to the Governor and Attorney General of Maine on June 22, 2022, concluding that Maine violated the ADA by failing to provide behavioral health services to children in the most integrated setting appropriate to their needs, typically in their homes and communities instead of in institutions. The DOJ determined that Maine failed to provide adequate community based services, leading to the unnecessary segregation of hundreds of children in institutions, and placing others at serious risk of institutionalization. Despite promoting behavioral health services through its Medicaid program, the state did not make these services available in a meaningful or timely manner. The shortcomings included lengthy waitlists for services, a lack of sustained providers, understaffed crisis services, and a scarcity of Treatment Foster Care providers (a specialized service in which foster parents are trained, supervised, and supported by qualified staff to meet the needs of children in their care who have behavioral health needs). Maine was aware of these issues for a long time, yet the experiences of families struggling to access services remained largely unchanged, and children remained institutionalized long after they were ready for discharge.

The DOJ recommended remedial measures to modify Maine’s services and prevent the unnecessary segregation of children. The proposed modifications included ensuring access to community-based services, addressing waitlists, providing crisis services instead of law enforcement response, allocating resources for trained providers, and implementing a policy to prohibit the refusal of services to eligible children. The DOJ emphasized the importance of evidence-based screening for service needs, improving access to existing community programs, and providing crisis services to prevent institutionalization. It also urges the state to address waitlists, invest in community-based services, and allocate resources for trained providers.

As of December 2023, negotiations to reach a settlement appear to be ongoing.

Summary Authors

Simran Takhar (12/2/2023)

Documents in the Clearinghouse

Document

Letter of Findings

United States’ Investigation of Maine’s Behavioral Health System for Children Under Title II of the Americans with Disabilities Act

June 22, 2022

June 22, 2022

Findings Letter/Report

Docket

Last updated Aug. 30, 2023, 1:37 p.m.

Docket sheet not available via the Clearinghouse.

Case Details

State / Territory: Maine

Case Type(s):

Child Welfare

Disability Rights

Special Collection(s):

Olmstead Cases

Key Dates

Case Ongoing: Yes

Plaintiffs

Plaintiff Description:

U.S. Department of Justice Civil Rights Division

Plaintiff Type(s):

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

Maine, State

Defendant Type(s):

Jurisdiction-wide

Facility Type(s):

Government-run

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:

Injunctive (or Injunctive-like) Relief

Findings Letter/Report

Outcome

Prevailing Party: None Yet / None

Nature of Relief:

None yet

Source of Relief:

None yet

Issues

General/Misc.:

Classification / placement

Counseling

Failure to supervise

Failure to train

Foster care (benefits, training)

Funding

Government services

Juveniles

Pattern or Practice

Reassessment and care planning

Record-keeping

Relative caretakers

Staff (number, training, qualifications, wages)

Wait lists

Disability and Disability Rights:

disability, unspecified

Integrated setting

Intellectual/developmental disability, unspecified

Mental Illness, Unspecified

Mental impairment

Mobility impairment

Reasonable Accommodations

Discrimination Basis:

Disability (inc. reasonable accommodations)

Jails, Prisons, Detention Centers, and Other Institutions:

Placement in mental health facilities

Medical/Mental Health Care:

Intellectual/Developmental Disability

Intellectual disability/mental illness dual diagnosis

Medical care, general

Mental health care, general