On May 30, 2007, the Department of Justice Civil Rights Division (DOJ) opened an investigation of the Northwest Habilitation Center (Northwest), a state-run, residential care facility in St. Louis, Missouri that provided services to individuals with developmental disabilities. The facility housed up to 80 individuals while it was operational. The investigation appears to have been in response to two deaths at the facility: in November 2005, one resident—who required constant supervision—died after swallowing a pen; and in March 2006, another resident died from burns he suffered when a staff member placed him in a dangerously hot shower.

On August 27–29, the DOJ conducted an on-site review of the facility with expert consultants. They reviewed pertinent documents and policies, interviewed administrators and staff, and visited residents.

On August 12, 2008, the DOJ issued its findings letter and provided notice to the Governor of Missouri, alleging violations of the Civil Rights of Institutionalized Persons Act (CRIPA) and Americans with Disabilities Act (ADA). The DOJ reported that Northwest failed to address serious harm in a timely manner, adequately protect residents with pica, or collect reliable risk management data. While Northwest had sufficient policies in place, the DOJ found that staff failed in practice to implement proper intervention strategies in a timely manner or document incidents of injury or use of restraints. Despite the high ratio of supervising staff to residents, the DOJ found residents were still at risk of inflicting self-harm and assaulting one another. The DOJ also found that residents at the facility were subjected to treatments without adequate informed consent from residents' guardians. The report highlighted a particularly egregious example where Northwest staff had a resident's toe amputated despite objection from the resident's family and court-appointed guardian. The report concluded that the facility provided inadequate staff training, program monitoring, and data. It suggested that the facility develop and implement adequate systems and policies to ensure compliance.

In 2010, this investigation was listed as part of the DOJ's compliance with President Obama's "Year of Community Living" initiative—a program to improve facilities and living arrangements for individuals with developmental disabilities.

Based on a DOJ spreadsheet acquired in a Freedom of Information Act request, the DOJ did not file a complaint in response to these allegations. In 2012, the state of Missouri closed the Northwest Habilitation Center and moved residents into community-based homes and other private and state-run institutions that year. This was part of the effort to move developmentally disabled individuals into "community settings." According to the DOJ's fiscal year 2012 report, the investigation subsequently closed on May 31, 2012.

Chelsea Rinnig - 08/29/2018


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