Department of Justice Activities
Under the
Civil Rights of Institutionalized Persons Act
Fiscal Year 2003

Table of Contents

I.


Introduction and Overview

1

II.


Filing of CRIPA Complaints/Resolution of Lawsuits and Investigations

4

A.	

Cases Filed

4


B.	

Settlements in Cases Filed in Prior Fiscal Years

4


C. 	

Out of Court Settlement Addressing Deficiencies
Identified in CRIPA Investigation


7


III.


Prison Litigation Reform Act

7


IV.


Compliance Evaluations

8


V.


Enforcement Activities

10


VI.

Termination of CRIPA Consent Decrees and Partial Dismissal

of Complaints


11

New CRIPA Investigations


11

VII.


VIII.
 Findings Letters


12

IX.


Investigation Closures


15

X.


New Freedom Initiative


15

XI.


Technical Assistance


17

XII.	

Responsiveness to Allegations of Illegal Conditions

19

I.	

Introduction and Overview

The Attorney General has authority to investigate conditions in public residential
facilities1 and to take appropriate action if a pattern or practice of unlawful conditions
deprives persons confined in the facilities of their constitutional or federal statutory
rights, pursuant to the Civil Rights of Institutionalized Persons Act (CRIPA),
42 U.S.C. §§ 1997- 1997j.2 The Attorney General has delegated day-to-day
responsibility for CRIPA activities to the Civil Rights Division and its Special Litigation
Section.
Protecting the rights of institutionalized persons is an important part of the
Department's civil rights law enforcement effort. According to the Assistant Attorney
General of the Civil Rights Division, R. Alexander Costa, "Protecting the rights of
America's most vulnerable citizens -- the elderly, children, victims of abuse, persons
with mental illness or developmental disabilities, as well as others who are similarly
defenseless -- is one of the Department's highest civil rights priorities. This
Administration is firmly committed to vigorously enforcing CRIPA and rooting out
systemic conditions of abuse and physical injury."
The Division’s commitment to the vigorous enforcement of CRIPA is evidenced
by recent activities under that statute: since January 20, 2001, the Division has opened
40 CRIPA investigations, issued 26 findings letters, filed six cases, and obtained 20

1

Institutions covered by CRIPA include nursing homes, mental health facilities, mental
retardation facilities, residential schools for children with disabilities, jails, prisons, and
juvenile justice facilities.

2

CRIPA does not cover the federal statutory rights of persons in jails and prisons.

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substantial agreements.3 For investigations alone, this figure is double the 20 such
investigations over the preceding three years.
From May 1980, when CRIPA was enacted, through September 2003, the
Division investigated conditions in 395 nursing homes, mental health facilities, mental
retardation facilities, residential schools for children with disabilities, jails, prisons, and
juvenile justice facilities. As a result of the Department's CRIPA enforcement,
thousands of persons residing in public institutions across our country no longer live in
dire, often life-threatening, conditions.
At the end of fiscal year 2003, the Division was active in CRIPA matters and
cases involving over 180 facilities4 in 33 states and the District of Columbia, as well as
the Commonwealths of Puerto Rico and the Northern Mariana Islands, and the
Territories of Guam and the Virgin Islands.5 The Division continued its investigations of
85 facilities, and monitored the implementation of consent decrees, settlement
agreements, memoranda of understanding, and court orders involving 97 facilities.6

3

These figures are for the three year period January 2001 through mid-March 2004.

4

This figure does not include the Division’s monitoring of the District of Columbia
community system for persons with mental retardation, in Evans and United States v.
Williams (D. D.C.), a pre-CRIPA suit.
5

Fiscal year 2003 began on October 1, 2002, and ended on September 30, 2003. This
report is submitted to Congress to supplement the Attorney General's report on Fiscal
Year 2003 Department activities by providing additional details about CRIPA actions
during the fiscal year pursuant to 42 U.S.C. § 1997f.
6

In addition, the Division is monitoring compliance with court orders that cover persons
who previously resided in institutions, but who currently reside in community based
residential settings in Hawaii, Indiana, Pennsylvania, Puerto Rico, Tennessee, and
Wisconsin.
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During the fiscal year, the Division conducted 145 tours of facilities to evaluate
conditions and monitor compliance.
The Division filed one institutional lawsuit during the fiscal year;7 a consent
agreement was entered in this case within one week of filing suit. The Division initiated
12 investigations and sent 18 findings letters regarding investigations of 24 facilities
during the fiscal year.8 In addition, during fiscal year 2003, the Division closed six
investigations of six facilities. Four other facilities covered by CRIPA settlements were
closed voluntarily by the jurisdictions.9
In keeping with the statutory requirements of CRIPA and the Attorney General’s
initiative, the Division engaged in negotiations and conciliation efforts to resolve a
number of CRIPA matters both before and after filing CRIPA cases. The Division
maximized its impact and increased its efficiency by continuing to focus on multi-facility
investigations and cases, obtaining widespread relief whenever possible. Lastly, the
Division consulted with public officials and provided technical assistance to a substantial
number of jurisdictions to assist in the correction of deficient conditions.
II.

Filing of CRIPA Complaints/Resolution of Lawsuits and Investigations
A. Cases Filed

7

United States v. Arkansas (E.D. Ark.) was investigated under authority of CRIPA, but
filed pursuant to 42 U.S.C. § 14141which provides the Department jurisdiction to bring
suit regarding “the administration of juvenile justice.”
8

Many of the agreements and findings letters are available on the Division’s website at
http://www.usdoj.gov/crt/split/index.html.

9

The Division also joined with defendants to dismiss Williams and United States v.
Saffle (E.D. Okla.), a pre-CRIPA case involving conditions in 17 prisons in Oklahoma.
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1. On March 10, 2003, the Division filed a complaint and settlement
agreement in United States v. State of Arkansas (E.D. Ark.) concerning Alexander
Youth Services Center in Alexander, Arkansas. The court entered the agreement on
March 12, 2003. The agreement requires the State to revise the juvenile facility’s
suicide prevention policy and provide mental health treatment to all juveniles who
require such care; provide fire safety and emergency procedures; provide the juveniles
with educational opportunities that are available to other children in Arkansas; ensure
that all students needing special education services receive those services; and
safeguard the religious freedom of all juveniles. The Division is monitoring
implementation of the settlement agreement and the State has made substantial
progress towards compliance, particularly in the areas of suicide prevention and
protecting religious freedom.
B. Settlements in Cases Filed in Prior Fiscal Years
1. On January 17, 2003, the Division filed a settlement agreement in
United States v. Louisiana (M.D. La.). This agreement replaces a 1999 agreement that
was set to expire and requires the State to enhance its efforts to reduce violence,
expand staff training, and improve medical and mental health services at four juvenile
justice facilities located in Tallulah, Baton Rouge, Monroe, and Bridge City, Louisiana.
The court appointed an Independent Monitor who will assemble a team of juvenile
justice experts to provide technical assistance to the State in operating the facilities, as
well as review the State’s compliance with the terms of the settlement. Additionally, on
the basis of substantial compliance, the new agreement terminates the 1999 agreement

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regarding educational services. The Division will continue to monitor compliance with
the new agreement.
2. On January 23, 2003, the court in United States v. Hawaii (D. Haw.)
entered as an order the Plan for Adult Community Mental Health Services that was
negotiated by the parties under the guidance of the Special Master. The previous year,
the court had ordered a Plan for services at Hawaii State Hospital. Relief under this
plan is directed at those persons who have been discharged, diverted, or transferred
from Hawaii State Hospital. The community plan requires improvements in five core
areas of treatment and support services for persons in the Hawaii adult community
mental health system, including: case management; crisis services; treatment services;
housing; and rehabilitation services. Quality assurance mechanisms are also required
by the plan. The Division will continue to monitor compliance with this Plan and the
Plan for Hawaii State Hospital.
3. On February 25, 2003, the court entered the Third Supplemental
Stipulation in United States v. State of New York (E.D. N.Y.) regarding Pilgrim
Psychiatric Center in West Islip, New York. The agreement requires the State to
provide more professional and direct care staff to provide care and treatment for all
Pilgrim patients; reduce use of mandatory overtime; redesign treatment planning to
provide more individualized treatment; improve medication administration practices; and
serve patients in the most integrated setting appropriate to their needs. The Division
will continue to monitor progress to ensure compliance with the original consent decree
and the subsequent stipulations.

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4. On March 13, 2003, the court entered a Stipulation amending the 1995
Consent Order in United States v. Sunflower County, Mississippi (S.D. Miss.) regarding
Sunflower County Jail in Indianola, Mississippi. The Stipulation requires the County to
correct deficiencies in the areas of classification procedures; operation and security,
including improved suicide prevention practices; mental health and medical care;
exercise; fire safety; inmate grievances; and maintenance and sanitation. The Division
will continue to monitor the facility to ensure compliance with the Stipulation and the
consent decree.
5. On April 30, 2003, the Division filed a joint agreement in United States
v. Connecticut (D. Conn.), that was entered by the Special Master and the court,
regarding requirements for speech, language, and communications services to persons
with developmental disabilities who reside at Southbury Training School in Southbury,
Connecticut. The Division will continue to monitor compliance with outstanding court
orders at Southbury.
6. On September 25, 2003, the Division filed a Stipulated Agreement for
further relief in United States v. Territory of the Virgin Islands (D. V.I.) regarding
conditions at the Golden Grove Correctional and Adult Detention Facility in St. Croix,
Virgin Islands. The Agreement requires the Territory to improve correctional practices;
medical and mental health care; life safety; and sanitation. The Division will continue to
monitor compliance with this agreement.
C. 	Out of Court Settlement Addressing Deficiencies Identified by CRIPA
Investigation

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1. On December 19, 2002, the Division signed a Memorandum of
Agreement with Los Angeles County, California regarding mental health services
provided to inmates at the Los Angeles County Jail. The agreement requires the
County to make improvements in: mental health screening at intake; mental health
evaluations for all inmates who screen positive for mental illness; referrals to a mental
health professional; and mental health treatment of all inmates determined to be
mentally ill. The agreement additionally calls for improvements in medication
administration; suicide prevention; staffing and staff training; and environmental
conditions. The Division is monitoring the progress in the County’s jails to ensure
compliance with the agreement. Since the agreement was signed, the County has
instituted important reforms in regard to medicine administration and intake screening
for mental illness.
III. Prison Litigation Reform Act
The Prison Litigation Reform Act (PLRA), 18 U.S.C. § 3626, which was enacted
on April 26, 1996, covers prospective relief in prisons, jails, and juvenile justice facilities.
The Division has defended the constitutionality of the PLRA and has incorporated the
PLRA’s requirements in the remedies it seeks regarding improvements in correctional
facilities. For example, the settlement agreement filed in United States v. Arkansas
(E.D. Ark.) in March 2003 is PLRA compliant in that it contains the requisite admission
of liability and requires only the minimum remedial measures needed to correct
constitutional violations in the areas of mental health, education and religious liberty.
IV. Compliance Evaluations

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During fiscal year 2003, the Division monitored defendants' compliance with
CRIPA consent decrees, settlement agreements, and court orders designed to remedy
unlawful conditions in publicly operated facilities throughout the United States.10 These
facilities are:
A. Facilities for persons with developmental disabilities: Southbury
Training School (United States v. Connecticut (D. Conn.)); Embreeville Center (United
States v. Pennsylvania (E.D. Pa.));11 Arlington Developmental Center (United States v.
Tennessee (W.D. Tenn.)); Clover Bottom Developmental Center, Greene Valley
Developmental Center, and Harold Jordan Center (United States v. Tennessee (M.D.
Tenn.)); Southern Wisconsin Developmental Center and Central Wisconsin
Developmental Center (United States v. Wisconsin (W.D. Wis.)); Centro de Servicios
Multiples de Camaseyes, and Centro de Servicios Multiples Rosario Bellber (United
States v. Commonwealth of Puerto Rico (D. P. R.)); and Ft. Wayne Developmental
Center and Muscatatuck Developmental Center (United States v. Indiana (S.D. Ind.)).
B. Facilities for persons with mental illness: Hawaii State Hospital and
children and adolescent residential services at Queens Medical Center and Kahi Mohala
Behavioral Treatment Center (United States v. Hawaii (D. Haw.)); Guam Adult Mental
Health Unit (United States v. Territory of Guam (D. Guam)); Pilgrim Psychiatric Center

10

As noted on page 3, supra, four facilities were closed voluntarily by the jurisdictions;

those facilities are not listed here, but are discussed infra at page 11.


11

Embreeville Center closed during fiscal year 1998 but, under the terms of the consent
decree, the Division continues to monitor conditions in community placements of former
Embreeville residents.
-8­

(United States v. New York (E.D. N.Y.)); and Memphis Mental Health Institute (United
States v. Tennessee (W.D. Tenn.)).
C. Juvenile justice facilities: 31 juvenile justice facilities in Georgia (United
States v. State of Georgia (N.D. Ga.)); Essex County Juvenile Detention Center (United
States v. Essex County (D. N. J.)); 14 juvenile justice facilities in Puerto Rico (United
States v. Commonwealth of Puerto Rico (D. P. R.)); Kagman Youth Facility (United
States v. Commonwealth of the Northern Mariana Islands (D. N. Mar. I.)); four juvenile
justice facilities in Louisiana (United Stated v. Louisiana (M.D. La.)); and Alexander
Youth Services Center (United States v. Arkansas (E.D. Ark.)).
D. Jails: Hagatna Detention Center and Fibrebond Detention Facility
(United States v. Territory of Guam (D. Guam)); Tupelo City Jail (United States v. Tupelo
City (N.D. Miss.)); Forest City Jail (United States v. Forest City (S.D. Miss.)); Harrison
County Jail (United States v. Harrison County (S.D. Miss.)); Simpson County Jail
(Rainier and United States v. Jones (S.D. Miss.)); Sunflower County Jail (United States
v. Sunflower County (S.D. Miss.)); Gila County Jail (United States v. Gila County,
Arizona (D. Ariz.)); four jails in the Northern Mariana Islands (United States v.
Commonwealth of the Northern Mariana Islands (D. N. Mar. I.)); Muscogee County Jail
(United States v. Columbus Consolidated City/County Government (M.D. Ga.)); Morgan
County Jail and Sheriff’s Department (United States v. Morgan County, Tennessee (E.D.
Tenn.)); McCracken County Regional Jail (United States v. McCracken County,
Kentucky (W.D. Ky.)); Nassau County Correctional Center (United States v. Nassau
County, New York (E.D. N.Y.)); and Shelby County Jail (United States v. Shelby County,
Tennessee (W.D. Tenn.)).
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E. Prisons: Guam Adult Correctional Facility (United States v. Territory of
Guam (D. Guam)); Montana State Prison (United States v. Montana (D. Mont.)); Golden
Grove Correctional and Adult Detention Facility (United States v. Territory of the Virgin
Islands (D. V.I.)); Saipan Prison Complex (United States v. Commonwealth of the
Northern Mariana Islands (D. N. Mar. I.)); and Wyoming State Penitentiary (United States
v. State of Wyoming (D. Wyo.)).
F. Other Facilities: New Mexico School for the Visually Handicapped
(United States v. New Mexico (D. N. Mex.)).
V.

Enforcement Activities
The Division took enforcement action in our CRIPA cases during the fiscal year

where public officials failed to meet their legal obligations under consent decrees and
other court orders.
1. On May 28, 2003, the Division filed a motion in United States v.
Harrison County, Mississippi (S.D. Miss.) for an order to show cause why defendants
should not be held in contempt for failure to comply with the 1995 consent decree
regarding the Harrison County Jail in Gulfport, Mississippi. The Division’s motion seeks
to enforce provisions in the consent decree regarding protection from harm for inmates.
The motion is pending before the court.
VI.

Termination of CRIPA Consent Decrees and Partial Dismissals of Complaints

When jurisdictions comply with settlement agreements or court orders and correct
unlawful conditions in the institution, the Division joins with defendants to dismiss the
underlying action. During fiscal year 2003, the Division joined with defendants to seek
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dismissal of all claims regarding educational services in four juvenile justice facilities in
United States v. Louisiana (M.D. La.).
In addition, the Commonwealth of Puerto Rico voluntarily closed one juvenile
justice facility in United States v. Commonwealth of Puerto Rico (D. P.R.) (Centro de
Tratamiento Social), during the fiscal year. In a separate case, also United States v.
Commonwealth of Puerto Rico (D. P.R.), the Commonwealth voluntarily closed three
facilities for persons with developmental disabilities (Centro Servicios Integrales, Centro
Residential Cayez, and Hospital de Mayaguez).
VII.

New CRIPA Investigations
The Division initiated 12 CRIPA investigations during the fiscal year. These new

investigations involved the following facilities:

!

A. Holly Patterson Geriatric Center, New York;

!

Conway Human Development Center, Arkansas;

!

LeFlore County Jail, Oklahoma;

!

Women’s Eastern Reception and Diagnostic Correctional Center, Missouri;

!

Santa Clara County Juvenile Hall, California;

!

Nashville Metropolitan Bordeaux Hospital, Tennessee;

!

Mobile County Metro Jail, Alabama;

!

N.A. Chaderjian Youth Correctional Facility, California;

!

Woodbridge Developmental Center, New Jersey;

!

Oklahoma County Jail/Jail Annex, Oklahoma;

!

Laguna Honda Hospital and Rehabilitation Center, California (state
investigation); and
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!
VIII.

Boston Higashi School, Massachusetts.

Findings Letters
During the fiscal year, the Division issued 18 written findings letters12 setting forth

the results of its investigations, pursuant to Section 4 of CRIPA, 42 U.S.C. § 1997b,
regarding 24 facilities, including:

!

Mercer County Geriatric Facility, New Jersey;

!

Banks-Jackson-Commerce Medical Center and Nursing Home, Georgia;

!

Oakwood Communities, Kentucky;

!

Alexander Youth Services Center, Arkansas;

!

Nevada Youth Training Center, Nevada;

!

South Dakota Juvenile Justice Facilities:
Custer Youth Correctional Center
Girls’ Boot Camp
Patrick Henry Brady Boot Camp
Quest Program

!

Santa Fe County Adult Correctional Facility, New Mexico;

!

Patrick County Jail, Virginia;

!

Nim Henson Geriatric Center, Kentucky;

!

New Lisbon Developmental Center, New Jersey;

!

Los Angeles County Juvenile Justice Facilities, California:
Barry J. Nidorf Juvenile Hall

12

The full text of these findings letters may be found at the Division’s website at
http://www.usdoj.gov/crt/split/index.html.
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Los Padrinos Juvenile Hall
Central Juvenile Hall

!

Garfield County Jail and Garfield County Work Center, Oklahoma;

!

LeFlore County Jail, Oklahoma;

!

the Children and Adolescent Programs, Metropolitan State Hospital,
Californinia;

!

Laguna Honda Hospital and Rehabilitation Center, California;13

!

Reginald P. White Nursing Home, Mississippi;

!

Claudette Box Nursing Home, Alabama; and

!

Mississippi Juvenile Justice Facilities:
Oakley Training School
Columbia Training School.

In these investigations, the Division made significant findings of constitutional
deficiencies. For example, in the Division’s investigation of state juvenile justice
facilities, the Division found that staff hog-tied youth and shackled youth to poles in
public places. Girls were punished for their suicidal behavior by being stripped and
placed naked, for extended periods of time, in a windowless, empty cell called the “dark
room,” with only a hole in the floor to use as a toilet. Girls were forced to eat their own
vomit if they threw-up while exercising in the hot sun. Staff used excessive force with
impunity. Upon re-commitment to the facilities, youth were taken to the intake area and
punched and slapped by staff as punishment for re-commitment. Abusive staff members
13

This is the second findings letter sent to the City and County of San Francisco,
California regarding this facility; the first was sent on May 6, 1998.
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were not terminated because there was a severe staffing shortage. The dental clinic at
one juvenile justice facility was full of mouse droppings, dead roaches, and cobwebs;
medications in the cabinet had expired over 10 years ago.
At a state facility for persons with developmental disabilities, the Division found
that several residents with developmental disabilities died as a result of medically
ignored impacted bowels that ruptured, causing fecal matter to seep into their
bloodstreams. In another facility for persons with developmental disabilities, a staff
person stomped on the head of a resident, rendering the individual unconscious. In a
psychiatric hospital, children were routinely drugged with powerful mind-altering
medications, causing them to sleep, drool, shake, and, for boys, grow breasts. In a
nursing home, staff kept residents sedated to avoid potential staff injuries. One nurse
justified the use of an unsafe medication because without it, the nursing home resident
“would come alive.” One resident was fed through a feeding tube, a typically painful
process, even though she could eat food by mouth with no difficulty.
In an investigation of a county jail, the Division found major lapses in security. In
one instance, inmates seriously beat an inmate causing him to be in a coma for several
days.
IX.

Investigation Closures
During the fiscal year, the Division closed investigations of six facilities:

!

Harold Taylor Restricted Custody Facility, Kentucky;

!

Cape Girardeau County Jail, Missouri;

!

Lee County Jail, Georgia;

!

Black Hawk County Jail, Iowa;
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X.

!

Tulsa County Jail, Oklahoma; and,


!

Western State Hospital, Virginia.


New Freedom Initiative
The Division also enforces Title II of the Americans with Disabilities Act, 42 U.S.C.

§ 12131 et seq., and its implementing regulations 28 C.F.R.¶ 35.130(d), to ensure that
public officials operating healthcare facilities are taking adequate steps to provide
services to residents in the most integrated setting appropriate to their needs. In June
2001, President George W. Bush announced the New Freedom Initiative which set as a
high priority for this Administration efforts to remove barriers to community placement for
persons with disabilities. The executive order, “Community-based Alternatives for
Individuals with Disabilities”,14 emphasized that unjustified isolation or segregation of
qualified individuals with disabilities in institutions is a form of prohibited discrimination,
and that the United States seeks to ensure that America’s community-based programs
effectively foster independence and participation in the community. As part of the
mandate to fully enforce Title II of the Americans with Disabilities Act, the Division took
steps to secure increased access to residential, day, and vocational services where
appropriate in fiscal year 2003 in the following facilities:

!

Hammond and Pinecrest Developmental Centers, Louisiana;

!

Five facilities for persons with developmental disabilities, Puerto Rico:
Hogar de Grupo Las Mesas 

Facilidad de Cuidado Intermedia


14

Exec. Order No. 13217, 66 Fed. Reg. 33155 (June 18, 2001).
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Centro de Reeducacion para Adults
Centro de Servicios Multiples de Camaseyes
Centro de Servicios Multiples Rosario Bellber

!

Arlington Developmental Center, Tennessee;

!

Greene Valley Developmental Center, Tennessee;

!

Clover Bottom Developmental Center, Tennessee;

!

Harold Jordan Center, Tennessee;

!

Oakwood Communities, Kentucky;

!

New Lisbon Developmental Center, New Jersey;

!

Metropolitan State Hospital, California; and

!

Laguna Honda Hospital and Rehabilitation Center, California.
The Division is monitoring community placements or the community systems for

persons with developmental disabilities in a number of states, including the District of
Columbia (in a pre-CRIPA lawsuit), Indiana, Pennsylvania, Puerto Rico, Tennessee, and
Wisconsin, and for persons with mental illness in Hawaii.
XI.

Technical Assistance
Where federal financial, technical, or other assistance is available to help

jurisdictions correct deficiencies, the Division advises responsible public officials of the
availability of such aid and arranges for assistance, where appropriate. The Division
also provides technical assistance largely through the information provided to
jurisdictions by the Division’s expert consultants. After the expert consultants complete
on-site visits and program reviews of the subject facility, they prepare detailed reports of

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their findings and recommendations which provide important information to the facilities
on deficient areas and possible remedies to address such deficiencies. The Division
routinely provides such reports to the jurisdiction. In addition, during the course of the
investigatory tours, the Division’s expert consultants provide helpful information to
jurisdictions regarding specific aspects of their programs.
In fiscal year 2003, the Division provided numerous instances of technical
assistance in the process of enforcing CRIPA. For example, as part of the Division’s
investigation of Bradley County Healthcare and Rehabilitation Center in Tennessee, the
Division’s expert consultants conferred with facility staff to discuss challenging cases and
potential sources of assistance and relevant professional journal articles. As part of the
investigation of Claudette Box Nursing Home in Mt. Vernon, Alabama, the Division’s
expert consultants provided assistance regarding medication practices, nursing services,
and nutrition. For example, the expert consultants recommended that the facility provide
adaptive dining utensils and train direct care staff to identify cues provided by residents
to ensure safe swallowing during meals.
Officials from both the Maryland juvenile justice system, which is under
investigation, and the Arkansas juvenile justice system, which is under a consent decree,
visited programs operated by two of the Division’s expert consultants in Michigan and
Missouri; they met with youth and staff, and discussed program operations. In United
States v. Arkansas (E.D. Ark.), the Division’s fire safety consultant reviewed the State’s
plans for fire safety improvements to Alexander Youth Services Center in Arkansas and
provided comments to State officials. In the investigation of Maxey Training School in
Michigan, the Division provided technical assistance regarding education, fire safety,
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juvenile justice management, and mental health and medical care. As part of the
Division’s compliance review of the Puerto Rico juvenile justice facilities in United States
v. Commonwealth of Puerto Rico (D. P.R.), the Division provided suicide prevention
advice including information regarding screening, safe housing, supervision, intervention,
interdisciplinary communication, and post incident critical review. The Division’s expert
consultant later returned to the recently opened juvenile facilities in Puerto Rico to
assess the implementation of the suicide prevention practices. As part of the Division’s
compliance review in United States v. Georgia (N.D. Ga.), the Division provided
assistance to nurses of the Metro Regional Youth Detention Center on auditing the
necessary medical services that must be provided in accordance with the Memorandum
of Agreement in that case.
The Division’s expert consultants provided comments on the development of a
corrective action plan to address the deficiencies identified by the Division’s investigation
of the Los Angeles County Jails in California. The Division’s expert consultants provided
technical assistance to Mobile County Metro Jail in Alabama regarding security,
administration, sanitation, and medical and mental health concerns. In United States v.
Shelby County, Tennessee (W.D. Tenn.), the Division’s expert consultants evaluated
compliance with the Settlement Agreement and commented on proposed Shelby County
Jail policies including the Jail’s emergency evacuation plan, revised tool and key control
policies, sick call protocols, and an inmate handbook. In response to a specific request
from the County, the Division provided data from the Bureau of Justice Statistics
regarding bond setting practices, and a referral to the National Institutes of Corrections.
In United States v. Commonwealth of the Northern Mariana Islands (D. N. Mar. I.) the
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Division’s expert consultants offered technical assistance to remedy suicide risks in a
newly constructed juvenile justice facility prior to occupancy. The Division’s expert
consultants also provided assistance on classification systems in United States v.
Territory of Guam (D. Guam).

XII.

Responsiveness to Allegations of Illegal Conditions
During fiscal year 2003, the Division reviewed allegations of unlawful conditions of

confinement in public facilities from a number of sources, including individuals who live at
the facilities and their relatives, former staff of facilities, advocates, concerned citizens,
media reports, and referrals from within the Division and other federal agencies. The
Division received well over 4,000 CRIPA-related citizen letters and hundreds of CRIPArelated telephone complaints during the fiscal year. In addition, the Division responded
to over 195 CRIPA-related inquiries from Congress and the White House.
The Division prioritized these allegations by focusing on facilities where
allegations revealed systemic, serious deficiencies. In particular, with regard to facilities
for persons with mental illness or developmental disabilities and nursing homes, the
Division focused on allegations of abuse and neglect; adequacy of medical and mental
health care; use of restraints and seclusion; and services to institutionalized persons in
the most integrated setting appropriate to meet their needs as required by Title II of the
Americans with Disabilities Act and its implementing regulations, 42 U.S. C. §§ 12132 et
seq.; 28 C.F.R. § 35.130(d). With regard to juvenile justice facilities, the Division focused
on allegations of abuse, adequacy of mental health and medical care, and provision of
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adequate rehabilitation and education, including special education services. In jails and
prisons, the Division placed emphasis on allegations of abuse including sexual abuse,
adequacy of medical care and psychiatric services, and grossly unsanitary and other
unsafe conditions.

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