The Rhode Island Department of Children, Youth, and Families (DCYF) has reached a consent decree with federal authorities following allegations that children with mental and behavioral health disabilities were being kept at Bradley Hospital for extended periods—sometimes lasting months or even over a year.
On Thursday, U.S. Attorney Zachary A. Cunha announced that the U.S. Department of Justice (DOJ), in partnership with the Department of Health and Human Services Office of Civil Rights, had secured a proposed agreement with the state. The agreement commits Rhode Island to improving community-based services that allow children with behavioral health needs to remain in their homes. Additionally, the state will recruit more therapeutic foster families to support children with higher care needs.
“Providing these services is not optional—it is the state’s obligation,” Cunha stated, referencing the Americans with Disabilities Act (ADA), which requires states to offer programs and services in the most integrated setting appropriate to individuals’ needs. The consent decree aims to address the state’s noncompliance with the ADA, facilitating children’s return to community settings and preventing prolonged hospitalizations.
The agreement will be enforced under the oversight of a court-appointed monitor and U.S. District Chief Judge John J. McConnell Jr. for a five-year period. Noncompliance could result in contempt proceedings against the state.
Federal Investigation and Allegations
The investigation, initiated by the Department of Health and Human Services in 2021 and later joined by the DOJ in 2022, uncovered systemic issues. Instead of prioritizing community-based care, DCYF was overly reliant on hospitalizing children with disabilities. Cunha criticized the state’s approach, stating, “Rhode Island has consistently failed to meet its legal responsibilities to children with mental health and developmental disabilities.”
Federal prosecutors filed a complaint alongside the proposed decree, alleging that the state neglected to provide intensive in-home and community-based services, leading to unnecessary and extended hospitalizations.
Terms of the Consent Decree
The agreement outlines several measures the state must implement:
- Transition children currently hospitalized at Bradley to family or home settings when appropriate, with the support of a transition coordinator.
- Enhance access to intensive in-home services, such as therapy and behavioral mentoring.
- Address shortages in therapeutic foster care and community service providers by increasing payment rates and support.
- Provide 24/7 mobile crisis interventions to prevent hospitalizations.
- Maintain a crisis hotline staffed around the clock to connect callers with mental health professionals.
- Monitor service outcomes and timeliness.
Additionally, the state must identify children most affected by prolonged hospital stays or frequent emergency room visits and provide a detailed plan within 180 days. The state will also establish a flexible fund to address barriers to reintegrating children into community settings.
Broader Implications and Ongoing Advocacy
Susan Rhodes, regional manager for the Health and Human Services Civil Rights Office, noted that Rhode Island’s case reflects a troubling national trend of unnecessary institutionalization of children with disabilities. Rhodes praised the consent decree as a potential model for other states.
However, advocacy groups, including the ACLU of Rhode Island and Disability Rights Rhode Island, emphasized that this agreement is only a first step. Their ongoing class-action lawsuit seeks broader reforms to address what they describe as “systemic failures” in Rhode Island’s behavioral health system for children.
These organizations stressed the need for further action, highlighting that many children remain in restrictive residential settings instead of receiving the family-based care required by law. They remain committed to ensuring lasting changes that prioritize children’s rights and well-being.
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