Case: DOJ Investigation of Rhode Island Executive Office of Health and Human Services

This investigation concerned allegations of failure to provide adequate home-based disability services for a minor with autism under the Rhode Island Executive Office of Health and Human Services (EOHHS) Rhode Island Medicaid/Katie Beckett program. The parents of the child filed a complaint with the U.S. Attorney's Office, District of Rhode Island, leading to an investigation by the DOJ under Title II of the Americans with Disabilities Act (ADA). The investigation substantiated the parents' claims that the State of Rhode Island failed to provide sufficient services, providing only half of the authorized weekly home-based therapy hours due to policy failures in arranging back-up care, placing the parents' son at risk of unnecessary segregation and violating the ADA's mandate for services in the most integrated setting.

To resolve these allegations without protracted litigation, a settlement agreement was reached on May 28, 2022. The settlement outlined specific remedial actions the State must undertake, including developing an individualized service plan for the complainant's son, ensuring adequate and appropriate services are provided, and modifying state policies to comply with the ADA. The agreement mandated the provision of medically necessary services to children with intellectual and developmental disabilities within specified timelines and established mechanisms for oversight, including the assignment of children eligible for home-based therapy or applied behavioral analysis to Cedar Family Centers (a State-contracted entity that provides evolving, family-centered, intensive care management and coordination to assist families of children and youth with special health care needs) for care coordination. The State also agreed to pay $75,000 in damages to the minor for the alleged failures.

The agreement stipulated deadlines for these actions and the State was tasked with maintaining records and providing regular reports to the DOJ to demonstrate compliance with the agreement's provisions. The agreement set a framework for informal resolution of disputes, with the possibility of civil action by the DOJ if the State fails to comply, and emphasized that immediate threats to health or safety will prompt quicker federal action. It included provisions for potential extension of deadlines upon mutual agreement and clarifies that the agreement was set to terminate in 18 months if parties agree that the State has substantially complied with all of its provisions.