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Federal judge rules in favor of Department of Justice in Mississippi mental health suit

Northeast Mississippi Daily Journal - 9/8/2021

Sep. 8—TUPELO — A federal judge has ruled in favor of the Department of Justice over litigation against the state of Mississippi's embattled mental health care system that has lasted half a decade.

U.S. District Judge Carlton Reeves on Tuesday issued a final order and other remedial orders that appointed an external monitor to ensure the mental health system complies with federal law and listed a litany ways the state can improve its community mental health care systems.

"In accordance with the terms of this Plan, the State of Mississippi must develop and implement effective measures to prevent unnecessary institutionalization in State Hospitals," Reeves wrote. "Those measures shall include providing — either directly or through certified providers — adequate and appropriate services and supports to adults with serious mental illness."

One remedial order gives the monitor, Dr. Michael Hogan, the ability to review and validate various data, speak with state officials, and participate in the annual clinical review the state is now required to conduct, all items the state previously objected to.

The cost of the monitor, including the cost of any staff or consultants to the monitor, will be paid by the state, although the monitor and his staff are not agents or representatives of the state.

Representatives from the Mississippi Attorney General's Office and the Department of Justice did not immediately respond to a request for comment.

The issue of a monitor became a thorny in the litigation, which drew a strong rebuke from the state. The state vehemently objected to the appointment of a monitor, but argued that if a monitor was going to be appointed, it should only act as an independent agent confirming the state is meeting pre-determined benchmarks of success.

"The Court should expressly instruct the Monitor not to consider matters that go beyond reporting to the Court on whether Mississippi has met the capacity and funding criteria in the Remedial Plan," the state previously wrote.

The state also wanted to deny the monitor the authority to enforce a remedial plan, interfere with the management of Mississippi's mental health system, conduct investigations or record evidence — a direct contrast with the final order.

The DOJ, on the other hand, asked the court for a more robust monitoring process that would allow Hogan to conduct regular assessment, advise mental health providers and speak with state officials — similar to Reeves' final order.

"To preserve, as much as possible, the State's resources for the services that prevent unnecessary hospitalizations, the monitor should work efficiently," the DOJ previously argued. "Toward this same end, the monitor should make recommendations and provide technical assistance to guide the state toward compliance."

Joy Hogge, the director of the advocacy nonprofit organization Families with Allies, has closely watched the litigation and said the final ruling legally confirms what many have known for years about "Mississippi's failed system."

"It's long past time for the Department of Mental Health and the Attorney General's office to admit that and start working with the court, Dr. Hogan and most importantly, people with mental illness, their families and service providers to fix that," Hogge said. "An appeal would waste even more time and money and also show all of us how little those filing it care about people with mental illness."

Will the lawsuit spark an appeal by Mississippi?

Now that Reeves has issued a final order in the litigation, the Mississippi Attorney General's Office could appeal the ruling to the U.S. Court of Appeals for the 5th Circuit in hopes of a friendlier, less burdensome ruling.

Toward the end of litigation, attorneys representing the state in the suit objected multiple times to an external monitor. At one point, they asked the court to dismiss the DOJ suit altogether.

Attorney General Lynn Fitch previously told the Daily Journal that an appeal to a higher court is not outside the realm of possibility. If the state does appeal Reeves' final order, the litigation could be extended by years.

The federal government began investigating the state's mental health system 10 years ago and concluded that Mississippi was unnecessarily segregating people with mental health into state-run hospitals for lengthy periods.

The state initially attempted to enter into a mediation process with the federal government, but that process eventually fell apart. The justice department then sued the state in 2016.

The state was forced to enter into a remedial process after Judge Reeves ruled in September 2019 that Mississippi violated the federal Americans with Disabilities Act by having inadequate resources in Mississippi communities to treat people with mental illnesses — a violation of their civil rights.

Although a final order has been entered in the case, the litigation is not necessarily over.

Reeves' order requires the state, with participation from the federal government and Hogan, a clinical review process to evaluate the effectiveness of the mental health services it offers. The state would be required to conduct the clinical review each year.

Only when the court believes that the state has substantially come into compliance with federal law for at least a year, will the court's latest order be terminated.

taylor.vance@djournal.com

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(c)2021 the Northeast Mississippi Daily Journal (Tupelo, Miss.)

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