/State DOJ should not communicate with mental health staff

State DOJ should not communicate with mental health staff

Patrick Holkins, a DOJ attorney, wrote in an email to one CMHC executive director that he and his colleagues were “reengaging” with Mississippi’s key stakeholders to discuss the plan. He wrote that he was also interested in receiving feedback from key stakeholders about their experiences in providing and receiving adult mental healthcare services in the state. The executive director replied enthusiastically, saying that she and her team would be happy to meet with federal lawyers. The state of Mississippi intervened. According to documents filed in federal court by the Justice Department, Mississippi lawyers claimed that a rule of professional conduct prohibits the DOJ communicating directly with CMHCs. According to the Justice Department, Mississippi has not made this claim in over five years of litigation. The Justice Department is asking a federal judge not to allow the state to interfere in communications with community mental healthcare staff who are not employed or represented by the state. The dispute is another example of what Mississippi mental health advocates see as a pattern that avoids scrutiny and transparency. Disability Rights Mississippi, a non-profit oversight group, sued DMH in November for refusing state hospitals to provide incident reports. The state claims it has sufficiently expanded community mental healthcare services. Talking to the CMHCs, who are the primary providers of local mental healthcare services in Mississippi could help you find out about what’s happening at the local level. Joy Hogge (executive director of Families As Allies), a non-profit organization that advocates for children with behavioral challenges and their families, said, “It really begs to the question of what they do not want people know.” Mississippi’s 13 Community Mental Health Centers provide the most comprehensive mental health services for the community. They are funded through Medicaid, federal grants, county contributions and state Medicaid. An increasing portion of DMH’s budget is also going to them. They provide intensive outpatient and mobile services as well as emergency response teams. Their goal is to prevent people from falling into a mental illness that will require hospitalization. The federal lawsuit is asking how well they actually do all that. Mississippi claims services are in place during its appeal to U.S. Court of Appeals, Fifth Circuit. Advocates and Dr. Michael Hogan, the court’s special monitor have said that it is too early to make such a claim. Mississippi has yet to respond to the DOJ’s motion. Rule 4.2, which it cited, prohibits attorneys from speaking directly to someone they know who is representing them in the same matter. It is intended to protect those who might not be able to understand the dangers of speaking to a lawyer from the opposing side of a dispute. The 2018 order of F. Keith Ball, Southern District Magistrate, is the basis for Mississippi’s invocation Rule 4.2. When Rule 4.2 was enacted to prevent federal lawyers from communicating with state employees (current and former), Ball stated that the rule applies to any person “whose act or omission in relation to the claims and allegations in the Complaint could be imputed the State of Mississippi for purposes civil or criminal liability”. In other words, anyone who could be considered speaking on behalf the state. Michelle Williams, chief staff for the attorney General, stated that state lawyers have concluded that this includes CMHC managerial personnel. U.S. District Judge Carlton W. Reeves stated that CMHCs were key to ending the practice in Mississippi, which he found had violated the Americans with Disabilities Act. He wrote that DMH is ultimately responsible for managing the expansion of community-based services at CMHCs. DOJ claims that Ball’s order only addressed current and former state employees, and had no impact on the CMHCs. DOJ claims that “the State has not claimed that it represents CMHCs” or that the United States can’t communicate with CMHC staff over more than five years. The DOJ sued Mississippi, and not the CMHCs for violating civil rights of individuals through its mental-health practices. The CMHCs now have responsibility for implementing a large portion of the remedial plan. Hogge suggested that federal lawyers might want to meet with them to discuss the details of the plan and what is happening on a daily basis. Hogge stated that “The CMHCs are aware of who is receiving the services and that voice has never been heard at the table.” The legislature established the position of coordinator for mental health accessibility in 2020 to add an additional layer of oversight. Bill Rosamond was the first coordinator and has produced two quarterly reports about the CMHCs. The latest report was released in December and focused on Region 11, a financially troubled region that serves nine counties in southwest Mississippi. Rosamond concluded that “this region does not have sufficient operational resources to sustain the required mental healthcare services” and that delivery is inconsistent across the nine-county region. In an email to Mississippi Today Adam Moore, DMH communications director said that the department doesn’t have any information on the Rule 4.2 dispute. He referred questions regarding the ongoing litigation to DMH’s office. He stated that the department was expanding community-based services. The American Rescue Plan Act funding proposal would fund 60 additional crisis stabilization units, and also provide funding for mobile crisis response teams. This would be in addition to the 988 system (the new three-digit number for National Suicide Prevention Lifeline), which was launched this July. He wrote that the DMH is adding an Office of Utilization Review, which will be responsible for monitoring and analysing the use of behavioral health services by state-operated programs and key community-based service providers. Mississippi could respond to the Justice Department’s motion, before the judge issues an Order allowing or prohibiting DOJ communication with staff at these mental hospitals. Williams said that Mississippi Today is currently evaluating its options.