Agreement requires state to implement new safeguards, assessments, and family-based placement options to comply with the ADA
Montgomery, Alabama — Advocates for children and the state of Alabama have reached a preliminary settlement agreement in A.A. v. Buckner, a federal class action lawsuit filed in 2021 challenging the state’s widespread practice of unnecessarily institutionalizing children with mental health disabilities in psychiatric residential treatment facilities (PRTFs).
The lawsuit alleges that the Department of Human Resources (DHR), the agency responsible for administering the child welfare system in Alabama, is violating the Americans with Disabilities Act (ADA) by isolating children in highly rigid and often dangerous settings instead of meeting their mental health needs in a loving home or community-based setting.
Research shows that children placed in PRTFs experience life outcomes far worse than their non-institutionalized peers, such as languishing in care for longer than medically necessary, being less likely to be placed with their siblings, and experiencing higher rates of maltreatment in care.
Under the settlement, the State must:
- Institute standardized assessments for children at risk of PRTF placement, requiring physician certification of need in 95% of cases.
- Strengthen Individualized Service Planning through six-month quality reviews to ensure children’s care plans meet professional standards.
- When appropriate, place children in community-based and family-like placements, including kinship care and therapeutic foster care, while capping congregate care at no more than 7% of children in state custody.
“All children and young people deserve to grow up in community with their communities,” said Claire Sherburn, senior supervising attorney, SPLC. “But when the state relies on highly restrictive PRTF placements to serve children with disabilities, those children lose out on that chance. And they lose out on the chance to be kids — to go to their community schools with their friends and neighbors, play team sports, explore, pursue hobbies, and be in relationship with the people who love and care for them. This settlement safeguards children with disabilities in Alabama from entering and languishing in segregated institutional placements when they could and should be receiving the support and services that they need in their communities. We celebrate this victory, and we also know that there is so much work to be done to ensure that all children in the deep south can thrive.”
“This agreement is a long overdue win for children and families across Alabama,” said Lindsey Frye, Senior Staff Attorney at Children’s Rights. “Children with disabilities deserve to grow up in safe, loving family homes, not locked away in institutions. For too long, Alabama’s overreliance on psychiatric facilities has inflicted lasting harm. This settlement affirms that the ADA protects children from unnecessary institutionalization and guarantees their right to services that help them thrive at home and in their communities. It marks an important step toward bringing Alabama in line with federal law and the standards of care every child deserves.”
Experts who testified in the case underscored the harms of institutionalization. Thomas Simpatico, MD, a psychiatrist and nationally recognized child mental health systems expert, found that Alabama’s failure to require standardized clinical assessments led to children being institutionalized when community care would have sufficed, ensnaring them in a cycle of restrictive placements. Social work expert Mary Armstrong similarly documented that extended PRTF stays often worsened children’s conditions rather than improving them.
The settlement will now go before a federal judge for approval at a fairness hearing, where the court will determine final certification of the class and settlement.
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About Southern Poverty Law Center
The Southern Poverty Law Center is a catalyst for racial justice in the South and beyond, working in partnership with communities to dismantle white supremacy, strengthen intersectional movements, and advance the human rights of all people. For more information, visit www.splcenter.org.
About Children’s Rights
Children’s Rights is a national advocacy organization dedicated to improving the lives of children living in or impacted by America’s child welfare, juvenile legal, immigration, education, and healthcare systems. We use civil rights impact litigation, advocacy and policy expertise, and public education to hold governments accountable for keeping kids safe and healthy. Our work centers on creating lasting systemic change that will advance the rights of children for generations. For more information, please visit childrensrights.org.