U.S. v. Georgia

On October 29, 2010, a federal court in Atlanta approved an historic, comprehensive settlement agreement resolving Georgia’s unlawful institutionalization of individuals with mental illnesses and developmental disabilities in its state hospitals, in violation of the Americans with Disabilities Act (ADA) and the Supreme Court’s landmark 1999 decision in Olmstead v. L.C. The case was originally brought by the U.S. Department of Justice. Earlier, a coalition of stakeholders convinced the court to withhold approval of a settlement that would have ended the litigation without adequate ADA relief. The Bazelon Center and the Georgia Advocacy Office represent the group, which fully endorses the October settlement.

The case began after a series of 2007 articles in the Atlanta Journal Constitution described the disastrous and deteriorating situation of the state’s public mental health system since the Olmstead decision. The Civil Rights Division of the Department of Justice (DOJ) opened an investigation under the Civil Rights of Institutionalized Persons Act (CRIPA).  In 2008, the DOJ issued scathing findings of serious constitutional and statutory violations in the psychiatric hospitals, including failure to protect patients from harm, failure to provide adequate mental health care, abusive seclusion and restrain practices, substandard medical and nursing care and inadequate discharge planning.

The Department entered into settlement negotiations with the State. Although mental health advocates and stakeholders had assisted DOJ investigators, they were excluded from the settlement process. Then, in January 2009–literally in the final hours of the Bush administration—the Department and the State filed a settlement agreement in federal court.  It was little more than a promise by Georgia to improve the hospitals.  Mental health advocates and stakeholders were shocked and asked the Bazelon Center to help organize, and ultimately represent them, in attempts to improve the agreement. The court ordered the DOJ and the State to meet with the attorneys for the coalition, which includes the Carter Center.

The new agreement expands community mental health services so that Georgia can serve people with mental illnesses and developmental disabilities in the most integrated setting appropriate to their individual needs. Over the next five years, the state will increase its supported housing, supported employment, assertive community treatment (ACT) and case management programs to serve 9,000 individuals with mental illnesses in community settings. The agreement will also increase community crisis services, including crisis centers, crisis stabilization programs, mobile crisis units and crisis apartments, so that people with mental illnesses can receive such services without admission to a state hospital. The agreement also requires Georgia to increase its efforts to link people leaving the hospitals with appropriate community-based services.

As attorneys for the stakeholder group, the Bazelon Center and the Georgia Advocacy Office will monitor the State’s efforts to implement the agreement and provide needed community services to people with mental illnesses and developmental disabilities. The court will retain jurisdiction to enforce the settlement agreement until it is implemented.