The special master in charge of helping the state Department of Mental Health meet federal requirements says the state is making progress, but it needs outside monitoring for compliance.
In a report filed with the U.S. District Court for the Southern District of Mississippi, Dr. Michael Hogan also told the court that state and federal officials remain far apart on whether the state has properly implemented a larger community-based care program for the mentally ill.
“The parties have not reached agreement on the capacity and quality of these services, but they represent considerable forward progress,” said Hogan in the court filing. “Additionally, there are several areas where the parties appear to agree on additional services that are needed.”
Hogan said in his report that the recommendations made by both sides are substantive and that the right approach in either the state or DOJ's case or a compromise between the two could be found.
The lawsuit by the U.S. Department of Justice's Civil Rights Division, which was filed in 2016, alleges that Mississippi depends too much on segregated state hospital settings and not enough community-based alternatives in violation of the 1999 U.S. Supreme Court decision, Olmstead v. L.C. The U.S. Supreme Court ruled in that case under the Americans With Disabilities Act that individuals with mental disabilities have the right to live in the community rather than be institutionalized.
The report says the level of institutionalization statewide, as measured by the number of individuals remaining in state hospitals for a long period, was reduced.
Hogan said that much of the needed services that weren't in place during the trial have already been or will be funded and he doesn't recommend an open-ended expansion of services.
“However, as the Court also noted, the ability to 'measure success along the way' is also essential, and therefore reporting of progress by the state will be necessary to assess whether the planned services are working to assure compliance with the ADA’s requirements,” said Hogan in the report.
The report was as the U.S. Department of Justice seeks to force the state to transition from institutionalization for the seriously mentally ill to a community-based program, which can provide an alternative to hospitalization for many with serious mental illnesses.
Areas where the parties differ include needed levels of supported housing and the exact type of services to fill the need. While the state has a variety of community-based mobile services that it says will be adequate to provide service, the DOJ focuses on a research-validated program known as Program of Assertive Community Treatment or PACT.
The DOJ also wants a monitor in place to ensure that the Mississippi complies with the Olmstead decision, something that Dr. Hogan said in the report is essential to meet the requirements and ensure the state has resolved the inadequacies.
As far as supported housing, the present program serves about 350 individuals for 12 months. The DOJ in its filings wants the number of served individuals expanded to 450, something that was addressed by the Legislature when it appropriated an additional $150,000 for the program for fiscal 2021 (which ends June 30) and $400,000 for fiscal 2022.
The Department of Justice began an investigation in 2011 and issued a findings letter to then-Gov. Haley Barbour. The state and the DOJ went into a round of negotiations to come up with a solution acceptable to both sides, but the DOJ later filed a lawsuit against the state on August 11, 2016 filed in U.S. District Court.
The federal government won the first round on September 3, 2019 after a four-week bench trial conducted by U.S. District Judge Carlton Reeves. He ruled in favor of the federal government and later designated Dr. Hogan as the special master to help draft a remedial plan.
The two sides were unable to work toward an agreement with Dr. Hogan's assistance and Judge Reeves ordered the parties on February 4 to submit separate plans due on April 31 (state plan) and 21 days later (federal plan).