BATON ROUGE, La. (AP) - Louisiana unnecessarily isolates and segregates thousands of mentally ill people in costly nursing homes instead of providing them with community-based services, according to a two-year federal investigation.
In a 30-page letter to Gov. John Bel Edwards last week, the Justice Department said its civil rights division concluded the state violates the Americans with Disabilities Act by relying on nursing facilities to house approximately 4,000 people with serious mental illness. Many of them can and want to live in their own homes or other community settings “appropriate to their needs,” the letter says.
“On average, these individuals are younger and have fewer physical care needs than the broader nursing facility population,” the letter says.
The department notified the state in October 2014 that it was opening its investigation. In its Dec. 21 letter to Edwards, the department warns that it may file a lawsuit to ensure the state’s compliance with the federal law if negotiations don’t resolve the matter.
Kelly Zimmerman, spokeswoman for the state Department of Health, said in an email that the agency will review the department’s recommendations and “work with stakeholders and legislators to determine the best path forward.”
“Creating a full continuum of care that includes both inpatient care and home and community-based care for people with mental illnesses has been a long-standing challenge in Louisiana that has spanned multiple administrations,” Zimmerman wrote.
Louisiana has one of the nation’s highest percentages of people with serious mental illness living in nursing facilities, according to the Justice Department. Housing a mentally ill person in a nursing facility instead of a community setting can cost the state an additional $7,000 per person annually, the department noted.
“And while the state provides community-based services to 20,000 individuals with serious mental illness, it is approving nursing facility admissions for these individuals at a rate of about 1,000 per year,” the letter adds.
The department’s letter says many mentally ill residents often spend years in nursing facilities that provide “minimal” mental health services and infrequent contact with people outside the facilities.
One nursing facility resident in his 30s told investigators that he sleeps most of the day because he doesn’t want to see his “depressing” surroundings. At least two other residents compared their living conditions to prison.
“With the lack of meaningful engagement, some residents said they were often bored, and they reported their days passing the time by watching television, sleeping, or smoking,” the letter said.
Mark Berger, executive Director of the Louisiana Nursing Home Association, said his group hasn’t had an opportunity to review the data supporting the Justice Department’s findings but is eager to assist in “finding viable solutions” to improve care.
“The report mentions hundreds of instances where Louisiana’s nursing facilities successfully discharged residents into the community,” Berger said in a statement. “It is important to note that nursing facility residents are voluntarily admitted and are free to leave the facility except in the rare case of a court order.”
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