The state of Mississippi filed its initial brief Monday with the U.S. Fifth Circuit Court of Appeals in a case over the state’s treatment of the seriously mentally ill.
The state says that the September 7 ruling by U.S. Judge Carlton Reeves relies on a groundbreaking theory of liability and will subject the state’s mental health system to perpetual federal oversight.
The appealed decision says the state needs to end its over-reliance on the institutionalization of the seriously mentally ill (in violation of the Americans with Disabilities Act) and devise a plan to correct it while being monitored by the court.
The state maintains the decision wasn’t predicated on a risk of unjustified institutionalization but on a handful of non-treating physicians who determined that several individual patients — who are not parties to this case — were unjustifiably hospitalized. No court has ever held a mental health system liable on that theory, according to the state.
In its brief, attorneys for the state also say it wasn’t given enough credit for the changes made during the litigation process to expand community-based care.
By the time the remedial order by Reeves (which created a position of an independent monitor) was issued, the state had already voluntarily implemented all the changes that were required by the U.S. Department of Justice, according to the attorneys. The state says Reeves’ order created additional steps beyond the previously agreed standard
The state asked and received a partial stay in September of some components of the remedial plan as it appeals the case.
One of those is the requirement to provide Peer Support Services at its county mental health centers around the state in fiscal 2022 (which began on July 1). The legal team says that funding for this requirement was not appropriated by the Legislature
The stay also struck the requirement for 250 CHOICE housing vouchers for the severely mentally ill for fiscal 2022 and 250 more in fiscal 2023 and sustain funding for those services. Those services cost $2 million each fiscal year until after 2023, when the requirement for additional vouchers will double.
This federal program, which also serves the very low income, is administered by local public housing authorities and provides housing assistance for rentals or even the purchase of a modest home.
The stay also temporarily halted the clinical review process of 100 to 150 patients annually and the requirement the state develop an implementation plan within 120 days.
The federal government has successfully argued that the state's mental health system violates the 1999 U.S. Supreme Court decision, Olmstead v. L.C., in which the court says individuals with mental disabilities have the right to live in the community under the Americans with Disabilities Act rather than be institutionalized.
The Department of Justice commenced an investigation in 2011 and sent a findings letter to then-Gov. Haley Barbour. The state and the DOJ attempted to negotiate a solution acceptable to both sides, but the DOJ later filed a lawsuit against the state on August 11, 2016 in U.S. District Court.
The federal government won on September 3, 2019 in a bench trial conducted by Reeves. Reeves ruled in favor of the federal government and designated a special master, Dr. Michael Hogan, to help the court draft a remedial plan.