DOJ: S.C. likely violates federal law in how it treats adults with serious mental illness

COLUMBIA, S.C. (WIS) - Disability rights advocates in South Carolina say they have been ringing the alarm for years about what they describe as “appalling” conditions in adult care homes.

Now the U.S. Department of Justice says South Carolina is likely violating federal law by not doing enough to avoid unnecessarily institutionalizing adults with serious mental illness.

A complaint sparked a federal investigation at the beginning of 2022 into whether South Carolina unnecessarily segregates individuals with serious mental illness in adult care homes.

In a 23-page report released Thursday, the Department of Justice’s Civil Rights Division concluded there is reasonable cause to believe South Carolina violates the Americans with Disabilities Act.

“It’s not a surprise to us. This is a red flag that we’ve been raising for a very long time,” Kimberly Tissot, president, and CEO of the statewide disability advocacy organization AbleSC, said.

The investigation focused on South Carolina’s Community Residential Care Facilities (CRCF), also known as adult care homes.

It details about 2,000 adults with serious mental illness are living in them and found both private and state-run facilities restrict these adults’ independence and choice.

“A sacred promise of the ADA includes giving people a meaningful choice for where they wish to live, including in their own private home,” U.S. Attorney Adair F. Boroughs for the District of South Carolina said in a statement. “I hope that the violations identified by the Justice Department can be remedied so that these South Carolinians will be able to leave the shadow of institutional living and instead live in and contribute to their communities.”

The Department of Justice interviewed employees and residents of these facilities, who told them they are “something like a little asylum” and that “the longer you stay here, the less likely you are to leave.”

“Just as an outsider, it’s traumatizing to see the living conditions that people are put through at the hands of our state,” Tissot said. “There’s hundreds of Community Residential Care Facilities, and I’ve inspected roughly around 400 of them within my career, and about 10 or 15, maybe, were decent.”

The DOJ said the state relies on these facilities instead of providing sufficient opportunities to avoid or move out of adult care homes or live in the community.

The report notes South Carolina has some resources available like supported employment and permanent supportive housing, but said those are not sufficiently available statewide.

“They deserve the opportunity to live where they want to live, be engaged in the community, and that all helps in the healing process,” said Beth Franco, executive director of Disability Rights South Carolina, which filed the complaint launching the investigation.

The state provided “exceptional assistance, cooperation, and candor” throughout the investigation, according to the DOJ, which said it looks forward to working together to reach a resolution.

But the report noted if that does not happen, the federal government could take further action, including potentially suing the state.

The investigation’s findings were sent to the South Carolina Department of Mental Health and the South Carolina Department of Health and Human Services.

“Consistent, with the spirit of ‘exceptional assistance, cooperation, and candor’ noted in the report, SCDHHS looks forward to continuing to work with DOJ to bring resolution to the concerns that were raised,” the Department of Health and Human Services wrote in a statement.

In response to the report, the South Carolina Department of Mental Health said it was surprised by its findings, writing in a statement it has made “significant efforts and successes in diligently addressing these exact issues.”

DMH said since settling a previous complaint in 2019, it has implemented and expanded services, including community housing programs, and streamlined the hospital discharge process.

“It’s not that the state is not trying, but there’s other opportunities for us to engage and provide even more options for people,” Franco said.

A spokesperson for Gov. Henry McMaster said their office is reviewing the reporting, continuing, “But it is widely known that South Carolina is facing a mental health crisis. The governor has been calling for the state’s behavioral health delivery systems to be re-evaluated and re-invented for years. This year, the governor signed a bill that will allow for the restructuring of the state’s healthcare agencies, including the Department of Mental Health, which will lead to significantly improved outcomes.”

In a release, the DOJ said people with information relevant to this matter can contact them by emailing Community.SouthCarolina@usdoj.gov]Community.SouthCarolina@usdoj.gov.

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