OM: NC DOJ Deal Offers Housing, Job Training, Crisis Supports to 3, 000 Adult Home Residents

NYAPRS Note: Thanks to the US Department of Justice, a number of statesare agreeing to aggressively move people in segregated community institutions like adult homes into communities with a broader range of employment and crisis related assistance.

New York has recently issued regulations that would require adult homes with more than 25% of residents with psychiatric disabilities to move them into the community and has proposed closing the front door to those homes by proposing a ban on psych inpatient unit referrals to the homes (see

While the state has proposed to move 1,050 residents into supportive housing over the next 3 years, housing and supports are needed for the thousands who await such relief.

North Carolina DOJ Agreement To Add 3,000 Housing Slots For People With Serious Mental Illness

Open Minds August 27, 2012

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On August 23, 2012, the North Carolina Department of Health and Human Services (DHHS) and the United States Department of Justice (DOJ) announced an agreement on an eight-year plan that will add 3,000 community-based supportive housing slots for adult Medicaid beneficiaries with serious mental illness (SMI). Priority for the new housing slots will be given to individuals with SMI who reside in an adult care home (ACH) determined by the state to be an Institution for Mental Disease (IMD); residents of an ACH licensed for at least 50 beds and in which 25% or more of the resident population has a mental illness; and residents of an ACH homes licensed for between 20 and 49 beds and in which 40% or more of the resident population has a mental illness. Priority will also be extended to individuals discharged from a state psychiatric hospital who have unstable housing or are homeless, and to individuals with SMI who are diverted from placement in an ACH.

The housing units must be permanent, afford tenancy rights, and enable people with disabilities to interact with people without disabilities to the fullest extent possible and must not limit access to the community. Virtually all of these housing units must be scattered throughout the community. The plan has the following benchmarks for housing capacity by July 1, the start of each new fiscal year, to meet the 2020 target of 3,000 housing slots:

* By July 1, 2013-Provide at least 100 housing slots and up to 300 slots * 2014- Provide at least 150 more slots for individuals * 2015- Provide slots to at least 708 individuals * 2016- Provide slots to at least 1,166 individuals * 2017- Provide slots to at least 1,624 individuals * 2018- Provide slots to at least 2,082 individuals * 2019- Provide slots to at least 2,541 individuals * 2020- Provide slots to at least 3,000 individuals

The state will also invest in job training and employment assistance for those citizens and will set up a comprehensive, 24/7 crisis care program for people with SMI. This agreement is similar to ones signed by governors of a number of other states including, among others, the governors of Virginia and Georgia.

The agreement resolves a complaint to DOJ filed in 2010 by Disability Rights North Carolina. The DOJ investigated the complaint, and in its 2011 letter of findings to the state said North Carolina had violated the Americans with Disabilities Act (ADA) by failing to provide sufficient access to community-based services for 5,800 ACH residents with SMI and instead relying on institutional and inappropriate ACHs as the only option for services rather than providing an equal level of support to help people remain in their own homes. DOJ also said the ACH setting illegally segregates residents from community interaction with people without disabilities.

DHHS released its plan on July 26, 2012, and the budget passed by the General Assembly appropriated funding to make the agreement possible. The eight-year timeline for completing the plan is intended to allow sufficient time for North Carolina's mental health infrastructure adapt to implement the terms of the agreement. However, DOJ was concerned that the plan lacked enforcement mechanisms and was considering filing a lawsuit because the state refused to enter into a formal consent decree.

A link to the full text of "North Carolina Agreement With DOJ On Eight-Year Plan To Transition Adult Care Home Residents With Serious Mental Illness To Community Settings" may be found in The OPEN MINDS Circle Library

OPEN MINDS also reported on this topic in "U.S. DOJ Investigates North Carolina's Use of Adult Care Homes for Possible ADA Violations." The article is available at

For more information, contact: Julie Henry, Acting Director, Public Affairs Office, North Carolina Department of Health and Human Services, 101 Blair Drive, Raleigh, North Carolina 27603; 919-855-4842; Fax: 919-733-7447; Web site:; or Vicki Smith Trader, Executive Director, Disability Rights North Carolina, 2626 Glenwood Avenue, Suite 550, Raleigh, North Carolina 27608; 919-856-2195; E-mail: vicki.smith at; Web site: <> .

North Carolina DOJ Agreement To Add 3,000 Housing Slots For People With Serious Mental Illness. (2012, August 27). OPEN MINDS Weekly News Wire.

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