Federal probe finds RI regularly warehoused children in psychiatric hospital
by: Eli Sherman, Tim White, Shaun Towne
PROVIDENCE, R.I. (WPRI) — Federal investigators announced Monday the state’s child welfare agency repeatedly violated the civil rights of hundreds of Rhode Island children who were warehoused sometimes for more than a year in a psychiatric hospital.
U.S. Attorney Zachary Cunha unveiled the findings of a yearslong federal probe into the state’s practice of regularly leaving children with behavioral and developmental disabilities admitted at Bradley Hospital for months after their treatments ended.
In one example, he said his office found a 9-year-old girl spent 826 days — more than two years — living at the acute-care psychiatric hospital over five admissions. Treatment at the hospital typically lasts one to two weeks.
Cunha said the warehousing of children violates various federal laws, including one called Olmstead, which requires states to provide community-based services when appropriate.
“The state failed to meet that obligation — not in isolated instances,” Cunha said. “Not sporadically, but repeatedly, unjustifiably and with dire consequences.”
The federal investigation examined a four-year window from 2017 through the first half of 2022 during which time 527 children under the care of the R.I. Department of Children, Youth and Families (DCYF) were admitted to Bradley Hospital.
Of those children, Cunha said 116 were hospitalized for more than 100 days, while 42 were hospitalized for more than 180 days and seven were hospitalized for more than a year. A Target 12 investigation in 2020 discovered that during these long admissions, the children were not being provided with education, meaning sometimes they’d go months without school.
Cunha referenced the reporting during a news conference Monday, saying the lack of education and interaction with peers were among the detrimental consequences that stemmed from the warehousing.
The U.S. Attorney’s Office transmitted a letter of findings to state officials and DCYF, giving them 10 days to respond with a plan for how they will address the issue that Cunha said has continued outside of the scope of their investigation.
He pointed to a monthly report that comes out of the child welfare agency, which showed the total number of children currently placed in psychiatric hospitals totaled more than 50 during April.
“The state must do better by some of the most vulnerable among us,” he said. “Our findings today call on the state to do precisely that, and they serve notice that if the state does not, we will hold them to account.”
Gov. Dan McKee spokesperson Olivia DaRocha said the state plans to respond to Cunha’s request for an answer within 10 days.
“This troubling report identifies long-standing issues where improvements are clearly needed—issues that are exacerbated by the national shortage of home and community-based behavioral health services,” she said in a statement.
“While our administration has taken actions to improve our current placement system, we understand that more must be done, and we support DCYF’s continued cooperation with the U.S. attorney and the U.S. Department of Health and Human Services,” she added. “Together, we will continue to seek short- and long-term solutions to provide each child with a behavioral health disability the appropriate services in the most integrated setting.”
Cunha said his office didn’t find Bradley Hospital, a division of Lifespan, to have violated any laws. And he pointed out that hospital officials regularly advocated for the discharge of children patients, but the state nonetheless kept them there because Cunha said they have been unwilling to create community-based opportunities where they could go otherwise.
The state’s top federal prosecutor said he’s hopeful the state will comply with their request, but he’s willing to file a lawsuit if they don’t adequately respond to the findings of the investigation.
“It’s not an issue of not having enough beds,” he said, adding the state just hasn’t prioritized creating enough community-based beds for these children and instead has gone with the “easy solution of putting them into a hospital setting.”
The federal government has twice gone after the state previously for not providing adequate care for people with behavioral and development disabilities under Olmstead.
DCYF spokesperson Damaris Teixeira said the agency takes the federal findings “very seriously and is committed to continuing to work closely” with the federal government “to a reach a resolution in the best interest of the youth in DCYF’s care.”
Teixeira also said the state has taken steps to begin addressing some of the issues in the investigation, including working with the hospital to “expedite discharges to appropriate placements as quickly as possible.”
She pointed to a new intervention program that’s designed to help children who are struggling more rapidly. Teixeira said 90% of the children in the program did not end up needing psychiatric hospitalization.
“To address the need for more residential beds, to provide step-down care for youth who have been hospitalized, the state is investing approximately $45 million to expand in-state residential capacity, including a facility in Exeter that will serve 16 youth,” she added. “Additionally, the state legislature appropriated $11 million for the building of a 12-bed psychiatric residential facility to address in-state capacity need.”
Cunha’s office investigated the Bradley issue with the U.S. Department of Health and Human Services Office of Civil Rights.