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Cripa Delaware Oh Investigation Findings 5-9-07

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U.S. Department of Justice
Civil Rights Division

Assistant Attorney General
950 Pennsylvania Avenue, NW - RFK
Washington, DC 20530

May 9, 2007
The Honorable Ted Strickland
State of Ohio
30th Floor
77 South High Street
Columbus, OH 43215-6117
Re: 	 Investigation of the Scioto Juvenile

Correctional Facility, Delaware, Ohio

Dear Governor Strickland:
I am writing to report the findings of the Civil Rights
Division’s investigation of conditions at the Scioto Juvenile
Correctional Facility (“Scioto”), located in Delaware, Ohio. On
March 16, 2005, we notified you of our intent to conduct an
investigation of Scioto, pursuant to the Civil Rights of
Institutionalized Persons Act, 42 U.S.C. § 1997 (“CRIPA”), and
the pattern or practice provision of the Violent Crime Control
and Law Enforcement Act of 1994, 42 U.S.C. § 14141
(“Section 14141”). We informed you that our investigation of
Scioto would focus on protecting residents from harm, medical
care, mental health care, grievances, and provision of special
education.1 As we noted, both CRIPA and Section 14141 give the
Department of Justice authority to seek a remedy for a pattern or
practice of conduct that violates the constitutional or federal
statutory rights of children in juvenile justice institutions.
We note that the State has worked cooperatively and, under
the leadership of Director of Ohio Youth Services
Thomas Stickrath, has unequivocally indicated its clear desire to
improve both facilities since being placed on notice of possible
constitutional deficiencies. Prior to the Department of Justice
investigations of Scioto and Marion, the State hired a team of
expert consultants, led by Mr. Fred Cohen, to evaluate the


Shortly thereafter, on April 15, 2005, we notified you
of our intent to conduct an investigation of the Marion Juvenile
Correctional Facility in Marion, Ohio (“Marion”) regarding
similar issues. Our findings regarding Marion are addressed in a
separate letter.

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constitutional conditions at the girls’ section of the Scioto
facility.2 Mr. Cohen issued an Interim Report on August 16, 2004
and an Action Plan on September 28, 2004. In each of these
documents, Mr. Cohen found constitutional deficiencies in the
areas of protection from harm, medical care, mental health care,
grievances, and provision of special education. The State agreed
to adopt and stipulate to Mr. Cohen’s findings, for the purpose
of our investigation, and to apply those findings to the entire
Scioto facility and the Marion facility.
Given the State’s stipulation that the conditions identified
in our March 16, 2005 notice letter are constitutionally
deficient, we agreed to conduct limited facility tours.3 On
June 29-July 1, 2005, we conducted an on-site inspection of
Scioto, accompanied by expert consultants in mental health care
and medical care. During our inspections, we interviewed mental
health providers, medical providers, other staff, youth
residents, and facility administrators. Before, during, and
after our visit, we reviewed an extensive number of documents,
including policies and procedures, mental health records, youth
detention records, unit logs, and orientation materials.
Consistent with our commitment to provide technical assistance
and conduct a transparent investigation, we conducted an exit
conference with facility staff and Ohio Department of Youth
Services officials upon the conclusion of the tour, during which
our expert consultants conveyed their initial impressions and


Although the main Scioto facility houses female youth,
a separate section of the facility acts as state-wide intake for
all male youth.

This investigation is anomalous because Mr. Cohen's
2004 factual findings regarding the conditions of confinement at
Scioto revealed significant deficiencies in each of the areas
that were the subject of our investigation and because the State
has stipulated to all of Mr. Cohen's generally well-supported
findings. Together, these factors created the unusual
circumstance in which it was not necessary for the Department to
conduct a facility tour regarding each of the specific subject
areas of our investigation. However, we did tour Scioto
regarding areas in which we required additional factual
information to make a thorough and complete finding or to frame
appropriate corrective measures. For example, as Mr. Cohen's
2004 report is admittedly not thorough regarding its assessment
of medical and mental health care, we reviewed these subjects onsite with expert consultants before issuing our findings.

- 3 

We commend the Scioto staff for their helpful, courteous,
and professional conduct throughout the course of this
investigation. We also wish to express our appreciation for the
cooperation of Ohio Department of Youth Services officials and
Consistent with our statutory obligation under CRIPA, we set
forth below the findings of our investigation, the facts
supporting them, and the minimum remedial steps that are
necessary to address the deficiencies we have identified. As
described below, we conclude that youth confined at Scioto suffer
harm or the risk of harm from constitutional deficiencies as to:
protecting residents from harm; certain discrete elements of
medical care; mental health care; grievances; and special
education services. Notwithstanding the foregoing, we are
pleased to report that our review indicates that Scioto’s general
medical programs are, for the most part, good. In particular we
find that Scioto’s medical quality improvement program,
environmental conditions, and management of special dietary needs
for youth are appropriate. However, certain discrete aspects of
medical care, identified below, substantially depart from
generally accepted professional standards of care and expose
youth to harm.


The State of Ohio, through its Department of Youth Services,
owns and operates Scioto, located approximately 15 miles north of
Columbus, Ohio. Scioto is the reception center for all juvenile
males entering Department of Youth Services’ juvenile justice
facilities and serves as Ohio’s sole facility for girls
adjudicated, of felony-level crimes, in juvenile courts.
Reportedly, many of these girls were in the State’s foster care
system before being confined. The facility has a rated capacity
of 192 and currently houses approximately 185 males and 120
females, aged 12 to 21.


As a general matter, States must provide confined juveniles
with reasonably safe conditions of confinement. Youngberg v.
Romeo, 457 U.S. 307 (1982); Nelson v. Heyne, 491 F.2d 352
(7th Cir. 1974); see also Miletic v. Natalucci-Persichetti,
No. C-3-89-299, 1992 WL 1258522, *2, *4 (S.D. Ohio Feb. 6, 1992)
(holding, in a case against the Ohio Department of Youth
Services, that “a juvenile who is involuntarily committed to a
correctional as opposed to mental health facility has a right to
treatment under the Fourteenth Amendment similar to that which
was recognized in Youngberg . . . .”).

- 4 



Juveniles in state custody have a constitutional right to
reasonable safety. See Youngberg, 457 U.S. at 315-16 (“personal
security constitutes a historic liberty interest protected
substantively by the Due Process Clause”) (internal quotation
Our review of conditions of confinement at Scioto reveals
significant constitutional deficiencies regarding use of physical
force, grievance investigation and processing, and use of
seclusion. For purposes of our investigation, the State has
stipulated to Mr. Cohen’s August 2004 findings, agreeing to the
applicability to Scioto’s intake program of Mr. Cohen’s findings
for each of the above-mentioned subject areas. In addition, our
experts concur with Mr. Cohen's findings and suggested remedies.

Use of Physical Force

Juveniles at Scioto have a right to be free from unnecessary
restraint and the use of excessive force. Youngberg, 457 U.S. at
315-16. Since 2003, 14 Scioto staff have been indicted on
charges relating to physical and sexual abuse of youth at Scioto.
In response to this crisis, the State hired Mr. Cohen and a team
of experts in 2004 to review protection from harm issues in
Scioto’s Girls’ Program. For purposes of our investigation, the
State has stipulated to Mr. Cohen’s August 2004 findings,
agreeing to the applicability of Mr. Cohen’s findings to Scioto’s
intake section.
In his report, Mr. Cohen concludes that “there has been (and
remains) a culture of violence among the uniformed staff, that
verbal and physical abuse are common, [and] sexual misconduct by
staff occurs . . . .” Mr. Cohen indicates that he and his team
of experts “have the most serious reservations as to whether [the
State’s] investigators are presently able to produce the quality
of investigative work required to identify those use of force
incidents that merit corrective actions for staff who violate the
[Department of Youth Services’] use of force policy.” Finally,
Mr. Cohen concludes that “there can be no debate on the
constitutional obligation under the Fourteenth Amendment to
provide a safe environment. Scioto has not met its obligations
to provide such an environment . . . .”
In reviewing Scioto’s use of force incidents, Mr. Cohen
reported that “verbal and physical abuse are common” at Scioto.
Since 2003, five defendants have been convicted of various
charges such as sexual battery, attempted sexual battery,

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assault, falsification, and dereliction of duty. In addition, as
of July 2006, one defendant awaits trial on charges of assault,
child endangerment, falsification, dereliction of duty, and
tampering with evidence.4
One officer was convicted of attempted sexual battery as a
result of allegations that he ordered a female youth to undress
while he watched and engaged in inappropriate sexual touching.
Another officer pled guilty to misdemeanor assault for slapping
and punching a youth, and then kicking the youth after she fell
to the floor. A female officer pled guilty to dereliction of
duty as a result of allegations that she ordered a male youth to
expose himself and engage in inappropriate sexual touching.
Another officer tendered an Alford plea5 to misdemeanor assault
and falsification charges for striking a youth during an
altercation, puncturing her eardrum. Finally, an officer was
convicted of sexual battery and attempted sexual battery for
forcing one youth to perform sex acts on him and for
inappropriately sexually touching another female youth.
In his report, Mr. Cohen stated that he and his team “found
countless examples of situations where no force at all should
have been used and others where the force used was excessive.”
Further, according to Mr. Cohen, verbal abuse is rampant and
often serves, perhaps intentionally, to precipitate physical
confrontations with juveniles.
Finally, we note that Scioto currently allows use of a
physical restraint technique directing staff to place an arm
across a youth’s chest below the neck and push on the cheek with
the back of the hand. As our medical expert observed during the
tour, use of any technique calling for an arm to be placed across
the neck during a physical altercation or other incident exposes
the youth to a significant risk of harm. This practice is
especially problematic in light of allegations that we have
received that youth have been choked by staff during
Based on these assessments and the State’s stipulation as to
the applicability of Mr. Cohen’s findings, we agreed that it was


One defendant was acquitted and seven other defendants
were indicted, but the charges were later dismissed.

In an Alford plea a defendant does not admit the act,
but admits that sufficient evidence exists with which the
prosecution could likely convince a judge or jury to find the
defendant guilty. North Carolina v. Alford, 400 U.S. 25, 38

- 6 

not necessary to perform additional fact-finding regarding use of
force at Scioto and we conclude that youth at Scioto are subject
to use of excessive physical force and physical abuse.

Grievances (Investigations and Processing)

Just as prisoners and juvenile detainees have a
constitutional right of access to the courts, they have a right
to a grievance system that does not carry risk of punishment as a
price for using it. See Thaddeus-X v. Blatter, 175 F.3d 378, 394
(6th Cir. 1999); see also Bounds v. Smith, 430 U.S. 817, 822 n.17
(1977) (“Our main concern here is protecting the ability of an
inmate to prepare a petition or complaint.”) (internal quotation
marks and citations omitted).
We adopt the following findings by the State’s experts. As
part of Mr. Cohen’s assessment, the State’s experts conducted a
review of Scioto’s incident investigation and grievance process,6
finding that several factors contribute to its inadequacy. In
particular, Mr. Cohen’s report finds that Scioto investigations
are “pedestrian, time consuming, and full of errors or
oversights.” The State’s experts also determined that, with the
exception of a few cases, investigators rarely attempt to
determine if officers followed existing protocol.
In his report, Mr. Cohen found that investigations contain
few facts other than repetition of the complaint and denials by
involved individuals. The investigations reveal a trend of
repetitive questioning of involved youth, as though questioning
was to continue until the youth provided the “correct” answer.
Incidents involving physical aggression contained no evaluation
of events preceding the incident, nor questions regarding use or
attempted use of lesser physical interventions.
Although Scioto grievances contain serious allegations, such
as verbal harassment and abuse, use of physical force, loss of
programs and privileges, sexual harassment, and medical issues,
such investigations rarely result in corrective action for staff
or youth or any attempt to recognize or identify patterns of
behavior requiring intervention.
Finally, given the facility’s population, the number of
grievances filed appears low and, when examined in conjunction
with the above, supports the conclusion that Scioto youth view
the grievance process as ineffective. We note that some
investigations completed by the Department of Youth Services'


Mr. Cohen’s team reviewed the 984 incidents filed from
January 1, 2003 through August 18, 2004.

- 7 

Bureau of Chief Inspector contained more facts than those
completed by Scioto personnel. However, these investigations
varied widely in quality and accuracy and were not completed in a
timely manner necessary to sustain a proper incident review and
grievance system and implement warranted corrective actions.
The dysfunctional grievance system at Scioto contributes to
the State’s failure to ensure a reasonably safe environment. An
adequately functioning grievance system ensures that youth have
an avenue for bringing serious allegations of abuse and other
complaints to the attention of the administration. It also
provides an important tool in evaluating the culture at the
facility, and alerting the administration about dangers and other
problems in the facility’s operations.


The State's experts reviewed over 200 seclusion reports
regarding Scioto girls from May 2004 to June 2004. In his
report, Mr. Cohen concluded that staff use seclusion as a
“knee-jerk, prolonged first response” and often hold youth in
seclusion for hours even though they do not pose an imminent
threat. For example, many Scioto youth are held in seclusion for
lengthy periods for refusing breakfast, cursing, and talking in
class. In one instance, Scioto held a youth in seclusion for 14
hours for being “argumentative” and using a racial epitaph.
Additionally, the State's expert found that Scioto's routine use
of seclusion as immediate punishment is often accompanied by use
of force. We adopt Mr. Cohen's findings.


Juveniles in state custody have a due process right to
adequate mental health care. The Supreme Court in Youngberg
broadly labeled health care as “medical care,” but recognized
that this would include care provided by various disciplines,
including persons with appropriate training in psychology. See
id., 457 U.S. at 322-323, n.30. The Sixth Circuit also has
recognized that medical care encompasses mental health care. See
Horn v. Madison County Fiscal Court, 22 F.3d 653, 660 (6th Cir.
1994) (“A detainee’s psychological needs may constitute serious
medical needs, especially when they result in suicidal


We are pleased to report that our review indicates that
Scioto’s general medical programs are, for the most part, good.
In particular we find that Scioto’s medical quality improvement
program, environmental conditions, and management of special

- 8 

dietary needs for youth are appropriate. However, certain
discrete aspects of medical care, identified below, substantially
depart from generally accepted professional standards of care and
expose youth to harm.

Identification of Health Problems and Initial Health

Based on our review, Scioto’s health records are inadequate
insofar as they do not contain problem lists identifying all
active health problems. Problem lists are necessary tools in
monitoring youth health status and providing adequate health
care. Scioto’s initial health assessments are similarly
inadequate, due to the absence of problem lists. These lists and
plans of care should be reviewed and approved by a physician
after reviewing all relevant assessment information.

Evaluation and Treatment of Sick Residents

Scioto’s sick call procedures make youth access to medical
care dependent upon line staff and force youth to submit requests
through line staff in a non-confidential manner. It is a
generally accepted professional standard of care that youth
should be able to submit sick call requests confidentially and
independent of the line staff.

Dental Care

Scioto’s dental program fails to meet the dental needs of
its youth. We found numerous instances of youth with
significant, untreated, dental health needs.
We find that Scioto dentists' practice of not providing
crowns and rarely replacing missing or damaged front teeth
conflicts with Department of Youth Services policies and
generally accepted professional standards of care requiring that
such services are to be provided, as needed, upon the dentist's
recommendation. We also note that Scioto’s dental program for
the girls’ section of the facility fails to provide timely
restorative care for youth with cavities. As a general matter,
Scioto must develop a system for tracking the dental needs of its
youth and providing services in a timely manner. The treating
dentist should determine the necessity of dental care on a
patient-by-patient basis.
We also found that documentation of oral surgery procedures
and recommendations of post-operative management of youth was
missing in the files we reviewed.

- 9 

Finally, Scioto has no dental assistant or dental hygienist.
Consequently, its dentists are forced to choose between foregoing
basic dental care that such practitioners provide, or delaying or
ignoring more significant dental needs.

Special Services for Chronically Ill and Disabled Youth

We find Scioto’s care provided to patients with asthma
substantially departs from generally accepted professional
standards. The facility must acquire peak flow meters to
properly assess patients when healthy and ill, to determine the
effectiveness of treatment. Scioto nurses also do not clinically
assess youth when administering rescue inhalers, and youth who
use such inhalers frequently are not referred to the physician
for more intense treatment. Scioto’s current treatment approach
results in preventable asthma hospitalizations due to inadequate
treatment of active asthma.

Disease Prevention and Health Promotion

Fifteen percent of Scioto’s youth had incomplete
immunizations, and youth are not fully immunized for their age.
This is a substantial departure from generally accepted
professional standards.
In addition, Scioto’s blanket discontinuation of all oral
contraception for youth entering the facility and Scioto’s
failure to offer emergency contraception conflict with applicable
standards of care, exposing female youth to harm.

Medical Quality Improvement Program

While we find that Scioto’s current medical quality
improvement program is adequate, we suggest that Scioto begin to
place more emphasis on health outcomes and use the topics
identified in this section to establish such a system.

Environmental Conditions

As a matter of technical assistance, Scioto youth should be
provided opportunities to practice appropriate hygiene in order
to reduce transmission of communicable diseases.

Special Dietary Needs for Youth

Scioto adequately manages food allergies and special medical

- 10 


Abuse Reported By Medical Professionals

While nurses at Scioto assess youth after a use of physical
restraint, they only report suspected abuse to the facility
administration, rather than to State child abuse authorities.
This reporting scheme is a substantial departure from generally
accepted standards of practice and, in light of the State’s
stipulation regarding use of excessive force, is especially

Mental Health Care

The Constitution requires that youth in juvenile justice
institutions receive adequate mental health care. Youngberg,
457 U.S. at 323, n.30; Nelson, 491 F.2d at 360; see also K.H. v.
Morgan, 914 F.2d 846, 851 (7th Cir. 1990); A.M. v. Luzerne County
Juvenile Detention Center, 372 F.3d 572, 585 n.3 (3d Cir. 2004).
We find that mental health care at Scioto’s intake facility and
girls’ facility is constitutionally inadequate.
As a threshold matter, we note the assessment of the State’s
expert that the girls’ mental health unit “is little more than a
residence for girls with mental disorders” and that “[m]ental
health care is so deficient” that it was not feasible to comment
on the various elements of such care, indicating that “[a] more
refined analysis must await another day – a day when
constitutionally required, minimally acceptable care is
instituted.” Given this assessment, we conducted an independent
review of mental health care at the facility and found
significant deficiencies in almost every aspect of mental health
care encompassed within screening and assessment services and the
provision of treatment.

Scioto Intake


Screening and Assessment Services

Upon arrival at Scioto, all male juveniles receive an
assessment in the reception area. The assessment includes a
review of the youth’s offense history, his behavior in the
reception facility, his scores on various assessments, and a
social worker’s recommendations for specific programming. We
found that assessments were implemented in a consistent manner
and often contained an impressive range of information collected
from sources outside the facility (i.e., court records, previous
mental health records). Nevertheless, we conclude that there are
a number of constitutional deficiencies with respect to the
assessment of youth for mental illness.

- 11 

(i) Reception Assessments: We found that many reception
assessments were incomplete, failing to address numerous factors
important to an accurate and complete assessment of a youth’s
mental condition. In addition, the assessments are primarily
deficit oriented, focusing little on strengths or family
functioning. As a result, they fail to identify important bases
for treatment interventions. We also note that assessment
records are poorly integrated and that there is no reliable
system of communication among various contributors to the
assessment. Furthermore, the assessments do not include
structured consideration of data to determine placement or
appropriate programming. In this regard, placement and planning
recommendations are often made with no justification. As a
result of these weaknesses, placement decisions and specific
treatment plans for youth are arbitrary in important respects and
are otherwise excessively generic.
(ii) Mental Health Assessments: In addition to the
reception assessment, youth entering Scioto receive a mental
health assessment. A social worker administers the Massachusetts
Youth Screening Instrument (“MAYSI”) checklist to each youth and
the MAYSI is scored by a psychologist. Youth answering positive
to questions regarding suicidal thinking or behavior on the
MAYSI, or on medical screening questions, meet with a
psychologist or psychologist assistant for a mental health
assessment. Youth receiving psychiatric medication upon arrival
at Scioto and youth whose psychological assessment reveals
serious acute psychopathology are referred to a psychiatrist for
psychopharmacological assessment and treatment.
Like the reception assessment, the mental health assessment
follows a consistent, reliable format. Nevertheless, the process
suffers from poor data gathering and recording. In this regard,
we note that assessments often fail to address important
considerations such as cognition problems, impact of trauma,
school history, past treatment experiences, past treatment
responses, and dysphoric (i.e., anxious or despairing) moods.
Moreover, we found that data collection regarding positive
adaptions, peer relationships, developmental information, and
family history and functioning is completely inadequate. As a
result, the assessment lacks information that is fundamental to
making appropriate recommendations.
In addition, Scioto’s mental health assessments do not
employ validated structured instruments for diagnosis or
functional assessment. Without such instruments, assessments
tend to be arbitrary as to identifying clinical disorders and
appropriate treatment. Additionally, the assessments rely
heavily on a structured interview of the youth, which provides
questionable information and fails to make use of information

- 12 

regarding current behavior adaption or school functioning.
Lastly, Scioto’s use of checklists to be read and completed by
youth is problematic, because these checklists are used without
establishing that the youth can read and comprehend them.
Scioto’s psychological assessments are also inadequate.
Most assessments we reviewed rarely include specific treatment
recommendations or consider multiple concurrent conditions,
despite the prevalence of such conditions among the facility’s
population. The assessments fail to contain differential
diagnoses (considering alternative diagnostic hypotheses) and do
not link the diagnoses to likely functional problems, such as
socialization problems and aggressiveness. As a result, Scioto’s
assessments do not provide information and opinions adequate for
coherent treatment planning.
We found similar problems with Scioto’s psychiatric
assessments, in that the assessments appeared perfunctory, with
little follow-up. Also, we noted that a number of obvious
candidates for psychiatric care were not referred for psychiatric
Finally, we found that Scioto’s overall mental health
staffing is inadequate, allowing for only superficial assessment
without any routine follow-up. We also could not find any
explicit criteria used for determining who should receive ongoing
mental health treatment while in reception.
As a consequence of these deficiencies, youths’ mental
health needs are often untreated or inappropriately treated,
resulting, among other things, in no treatment, counterproductive
treatment, exposure to inappropriate or unnecessary medications
posing serious physical and other side effects, longer periods of
confinement, and needlessly greater potential for recidivism.

Scioto Girls’ Program

Girls come to Scioto only after failing to complete a number
of other, less restrictive, state-sponsored juvenile programs.
Given the Scioto girls’ prior programming failures, and that our
consultants have estimated the prevalence of mental disorders
among female juvenile offenders to be as high as 87 percent, a
female youth at Scioto without significant mental health problems
would be in the minority. Nevertheless, it was evident from our
expert’s review of randomly selected files that Scioto’s current
process for identifying youth with mental illness is inadequate,
and that girls’ significant mental disorders often go
unidentified and untreated. For example, in three randomly
selected cases our consultant reviewed, each youth showed clear
signs of mental health issues. Two of the youth were identified

- 13 

as having mental health issues within nine months (one was only
identified after undergoing multiple risk assessments in response
to several instances of self-injurious behavior and reports of
hallucinations instructing her to hang herself).7 The third
youth showed clear signs of mental distress but did not complain
of specific symptoms, and she received no mental health followup. Scioto’s failure to reliably identify girls in its custody
with significant mental health concerns is a substantial
departure from generally accepted standards of practice that
exposes girls to risk of significant harm, in the form of
serious, untreated mental disorders.

Provision of Treatment

Scioto’s attempt to establish and implement individual
treatment plans for its residents is clearly in its beginning
stages. We noted that few records of girls with identified
mental disorders included a treatment plan. Records containing
such plans provided no indication that the treatment services
provided to the girl were linked to a specific plan. In
addition, we found no regularly scheduled treatment meetings
involving clinicians and residents with clearly identified
treatment needs. In fact, apparently because of current
inadequate staffing, most Scioto youth with mental health
disorders do not receive regular, scheduled treatment sessions,
allowing these disorders to go neglected. As a result, the
quality and effectiveness of the treatment provided is deficient,
resulting in an ongoing risk of self harm and disruptive
behavior, and lack of progress in rehabilitation, which, in turn,
can lead to an extended period of confinement.
While we note that Scioto provides psychopharmacological
treatment in a more consistent manner, our record review
indicates underutilization of applicable medications for
attention problems and impulse control disorders. In addition,
we noted a lack of collaboration between psychiatry and
psychology regarding psychopharmacological treatment. Such lack
of collaboration causes the psychiatrist to be less informed
regarding youth behavior, thus reducing the effectiveness of
psychiatric treatment regarding attention and impulse control


Although these two youth were eventually identified as
having mental health problems, the significant delay was a factor
causing each youth to spend additional time in the program, to
suffer behavioral and emotional instability over a longer period
of time resulting in impairment in their growth and
rehabilitation, to remain at increased risk for self harm, and to
create considerable disruption in the program.

- 14 

Indicative of many of these problems, Scioto’s Special Needs
Unit for girls with heightened mental health or behavioral needs
provides no improvement in the intensity, specificity, or
consistency of mental health care in comparison to other units,
other than having a better youth-to-social worker ratio and a
dialectical behavioral therapy skills group. In this regard, we
note that the State’s expert determined that Scioto’s Special
Needs Unit “is little more than a residence for girls with mental
We do note that Scioto’s risk assessment procedures have
resulted in preventing self-harm among its population. However,
as implemented, these procedures contribute to Scioto’s current
crisis atmosphere (teaching youth that the way to get attention
is to engage in, or to threaten, self-harm) and divert
psychologists from providing consistent treatment to other youth.
In summary, Scioto does not provide supports and services
adequate to meet the needs of its population, in contravention of
generally accepted professional standards, exposing girls to harm
or a significant risk of harm in the form of significant,
untreated mental health disorders, and leading to heightened
emotional distress, longer periods of confinement, and greater
potential for recidivism.


Students with disabilities have federal statutory rights
to special education services under the Individuals with
Disabilities Education Act (IDEA), 20 U.S.C.A. §§ 1400-1482 (West
2000 & Supp. 2006).8 As part of the review conducted by the
State’s expert, Mr. Cohen, the Ohio Department of Youth Services
retained Ms. Ava Crow to review special education services at
Scioto.9 Ms. Crow conducted an exhaustive study, including two
three-day site visits, numerous interviews, classroom
observation, and document review. In her August 31, 2004 report,
Ms. Crow concluded that Scioto’s special education program
suffers from systemic failure and violates residents’ rights
under the IDEA by failing to provide adequate special


We note that the IDEA was reauthorized and amended by
the Individuals with Disabilities Education Improvement Act of
2004, Pub. L. No. 108-446, 118 Stat. 2647 (2004), effective
July 1, 2005.

The IDEA provisions cited herein are substantively the
same as those in force at the time of Ava Crow’s review. At the
time of Ms. Crow’s tour, slightly less than half of Scioto
residents had been identified as qualifying for special education
services under the IDEA.

- 15 

education.10 As indicated earlier, the State has stipulated, for
the purpose of resolving this investigation, to the following
deficiencies identified in Ms. Crow’s report. In addition, our
expert consultant concurs with Ms. Crow's findings and

Child Find

The IDEA requires that states implement systems to identify
all students who are eligible for special education services and
provide such services to all those identified as having
disabilities. 20 U.S.C. § 1412. The State’s expert determined
that Scioto does not meet “Child Find” requirements of the IDEA.
In this regard, school guidance counselors acknowledge that
Scioto does not comply with “Child Find.”

Parental Involvement

Parental involvement is an essential element of the IDEA,
which requires parental consent for decisions about eligibility,
evaluation, and placement. 20 U.S.C. § 1414.
However, based on the State expert’s review of a sample of
youth files, Scioto often fails to contact parents, sometimes
sending parental notices and consent forms to social services
agencies. In one instance, a consent form was signed by a
“former social worker.” In the same manner, two additional files
revealed students whose placements were restricted in scope
without parental consent or notification, in clear violation of
the IDEA.

Provision of Transition Services

The IDEA requires schools to actively attempt to involve
outside agencies in transition plan meetings to help students
progress from school to adult life. The State’s expert found
that Scioto’s transition plans are inadequate: students do not
have written transition plans, and there is no indication of any
outside agency involvement or any evidence of sustained efforts
to involve outside agencies.

Implementation and Monitoring of Individualized
Education Plans

The IDEA requires that each student with a disability have
an IEP (“Individual Education Plan”), and describes the IEP
components required to ensure that each student receives adequate
special education services. The State’s expert determined that



Scioto's school program is called the William K. Willis

- 16 IEPs developed at Scioto do not ensure that students with
disabilities receive required special education services.
For example, all Scioto IEPs reviewed by Mr. Cohen’s team
contain an identical, barely exploratory list of services.
Document review also revealed a pattern in which Scioto adopts
IEPs from local education authorities but fails to implement
them. In addition, while the IDEA requires consideration of
positive behavioral interventions for students whose behaviors
interfere with their learning or that of other students, document
review revealed almost no individualized interventions for any
Scioto student. Given the makeup of the Scioto population, lack
of such clearly relevant interventions is telling. Finally,
classroom observations indicate that there is substantially no
difference in Scioto regular education classrooms versus special
education classrooms and no indication that special education
students were expected to perform less work or offered extended
time to complete projects.
Separately, the IDEA requires a multidisciplinary team
reevaluation of the information included in a youth’s
multifactored evaluation, which is the basis for the IEP, every
three years. We find that Scioto failed to update its
multifactored evaluations for more than one-third of its special
education population within the required three-year period.
The IDEA also requires that all IEPs are to be reviewed
periodically and at least annually. The State’s expert found
that Scioto failed to complete the required reviews and that
60 percent of Scioto’s IEPs had expired.
Lastly, the State’s expert found that Scioto has no
appropriate system to monitor specific IEP goals. Document
review indicated that some teachers at Scioto use weekly
reporting forms to attempt compliance with IDEA monitoring
requirements. However, such forms appear inadequate to document
specific IDEA goals and fail to inform parents of students’
progress as required by the IDEA. Even if Scioto’s current forms
were adequate, they are not sent to parents for review as
In light of these findings by the State’s expert and of the
State’s stipulation, we find that the State fails to comply with
the IDEA in the areas set forth above.


In order to rectify the identified deficiencies and protect
the constitutional and statutory rights of the youth confined at
Scioto, the facility should implement, at a minimum, the
following measures:

- 17 


Protection from Harm


Ensure that youth are provided with safe living conditions
and are protected from abuse, use of excessive force, undue
seclusion, and undue restraint.


Develop appropriate policies and procedures that govern the
use of force, requiring reliable documentation and limiting
use of force to situations where a youth is physically
violent and poses an immediate danger to himself and/or
others or the youth is physically resisting institutional
rules and the institution has attempted a hierarchy of non
physical alternatives.


Prohibit verbal and physical punishment, and use of force
practices that are incompatible with minimum actions
necessary to prevent harm or obtain compliance with
reasonable orders, including practices such as shoving,
pushing, kicking, striking, or using inappropriate holds on


Monitor and supervise staff, maintaining appropriate staff
ratios and holding staff accountable for the use of
excessive force or abuse.


Develop policies and procedures to ensure that seclusion and
restraint are only used in appropriate, documented,
instances by trained staff.


Provide youth with an effective and reliable process to
raise grievances, without exposing them to retribution from
staff, ensuring that all grievances are reviewed and
addressed in a timely matter that provides youth with
notification of the final resolution.


Employ sufficiently trained and independent investigators to
ensure that all incidents of violence, use of force, or
serious injury are adequately investigated, and documented,
and that appropriate personnel actions are taken in response
to substantiated findings.

Medical and Mental Health Care


Ensure that youth receive routine, preventative, and
emergency medical and dental care consistent with current,
generally accepted professional standards, including
identification, assessment, diagnosis, and treatment of
health problems.


Develop policies and procedures to ensure that youth are
provided with: complete and accurate health records, access
to confidential health care, a complete initial health

- 18
assessment, appropriate access to health services,
appropriate medications and care to manage chronic illness,
access to specialty consults, proper immunizations, and
female reproductive health care managed according to
generally accepted medical standards.

Maintain appropriate dental staffing and require that
generally accepted professional standards are followed to
ensure that: youths’ restorative needs are met in a timely
manner, youth are not denied appropriate pain medication,
needed prosthetic dental services are provided, and health
records contain adequate documentation of outside dental


Provide mental health and rehabilitative treatment
consistent with generally accepted professional standards
and ensure that there are an adequate number of qualified
mental health professionals to provide mental health and
rehabilitative services in a timely manner to all youth who
require such services.


Develop and implement policies, procedures, and practices to
ensure that, consistent with generally accepted professional
standards of care, youth are: (1) comprehensively screened
by appropriately trained personnel for mental disorders,
including substance abuse, depression, and serious mental
illness within 24 hours of admission; (2) systematically
evaluated in response to problem indicators to address
potential manifestations of mental or behavioral disorders
in youth who have not been previously identified as
requiring treatment; and (3) provided appropriate mental
health care, substance abuse care, and treatment services.


Ensure that any youth determined at screening to be at
immediate risk is immediately referred to a qualified mental
health treatment professional for: assessment, treatment,
and other appropriate actions, including facility transfer
when necessary.


Implement policies, procedures, and practices according to
generally accepted professional standards to ensure that:
mental health assessments, including health, risks,
strengths, and needs are performed within two weeks of a
youth’s arrival at Scioto; youth identified in screening
receive timely, comprehensive, and accurate assessments by
qualified mental health professionals; and assessments are
designed to incorporate data necessary to identify youth
with mental disorders and contribute to a plan for managing
the youth’s risk.


Develop and implement policies and procedures consistent
with generally accepted professional standards of care to:

- 19
(1) ensure that treatment determinations are made by an
interdisciplinary team through integrated treatment
planning; (2) create and implement treatment plans that are
current and individualized; (3) maintain readily accessible
records containing meaningful, accurate and coherent
assessments of the individual’s treatment plan progress,
goals, and objectives.

Develop and implement a system to ensure that mental health
issues are adequately considered in making housing decisions
and that mentally ill youth receive appropriate housing.

10. 	 Prior to administration of prescribed psychoactive
medication, Scioto must: (1) ensure that youth and their
parents (or guardians, if parents have lost custody due to
abuse or neglect) are provided with goals, risks, benefits,
and potential side effects of the medication, along with the
potential consequences of not treating with the medication;
(2) follow state law in order to administer such medication
without consent.
11.	 Develop and implement policies, procedures, and practices to
ensure that psychoactive medications are prescribed,
distributed, and monitored properly and safely, consistent
with generally accepted professional standards of care.
12.	 Provide training to all staff who interact directly with
youth regarding mental health information, developmental
disabilities, recognition of signs and symptoms of trauma,
teenage development, strength-based treatment strategies,
suicide risks, and (for staff working with female youth)
female development.
13. 	 Develop and implement policies and procedures that comply
with generally accepted professional standards for the
management of suicidal youth.
14.	 Create transition plans for youth leaving the facility that
are consistent with generally accepted practice standards.
15.	 Develop and implement polices and procedures to maintain
oversight of mental health services and ensure that such
services are provided consistent with generally accepted
professional standards of care.

Special Education

Provide prompt and adequate screening, and ongoing
rescreening and referral, of youth for special education
needs and ensure that all students requiring special
education services receive services in compliance with the
IDEA within a reasonable time following intake.

- 20 


Ensure that all eligible youth have current, accurate IEPs
that are developed and implemented consistent with IDEA


Create and implement a system to routinely develop,
implement, and monitor youths' IEPs, with involvement of
parents and guardians, as required by the IDEA.


Develop and implement a staffing plan that allows for a
sufficient number of certified special education teachers
and staff to provide all youth with the opportunity to
attend school full-time and to obtain adequate educational
services while providing teachers with sufficient time to
plan lessons, grade assignments, and participate in special
education meetings.


Develop a quality assurance program to ensure the quality of
IEPs, compliance with the IDEA, and monitoring of teaching
staff on compliance issues.


Ensure that special education staff receive in-service
training and maintain current educator licenses appropriate
to the courses they teach.



As stated above, we appreciate the cooperation we have
received from Ohio Department of Youth Services officials and
facility staff throughout this investigation. We hope to be able
to continue working with the State in an amicable and cooperative
fashion to resolve the deficiencies found at Scioto. Provided
that our cooperative relationship continues, we will forward our
expert consultant reports under separate cover. Although this
report is our consultants’ work – and does not necessarily
reflect the official conclusions of the Department of Justice –
the observations, analyses, and recommendations contained in the
reports provide further elaboration of the issues discussed in
this letter and offer practical assistance in addressing them.
In the unexpected event that we are unable to reach a
resolution regarding our concerns, the Attorney General is
empowered to institute a lawsuit pursuant to CRIPA to correct the
deficiencies of the kind identified in this letter 49 days after
appropriate officials have been notified of them. 42 U.S.C.
§ 1997b(a)(1).
We would prefer, however, to resolve this matter by working
cooperatively with you. We have every confidence that we will be
able to do so in this case. The lawyers assigned to this matter
will be contacting your attorneys to discuss this matter in
further detail. If you have any questions regarding this letter,

- 21
please contact Shanetta Y. Cutlar, Chief of the Civil Rights
Division’s Special Litigation Section, at (202) 514-0195.

/s/ Wan J. Kim
Wan J. Kim
Assistant Attorney General
cc:	 The Honorable Marc Dann
Ohio Attorney General
Department of the Attorney General
Thomas J. Stickrath


Ohio Department of Youth Services

Amy Ast
Scioto Juvenile Correctional Facility
The Honorable Gregory G. Lockhart
United States Attorney
Southern District of Ohio



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