findings and legal conclusions binding on, or admissible in, any court, and nothing in this Notice should be construed as such. Accordingly, this Notice is not intended to be admissible evidence and does not create any legal rights or obligations. Specifically, the United States provides notice of the following identified conditions: • The Jail fails to provide constitutionally adequate medical care to prisoners. Many prisoners at the Jail have serious medical needs requiring treatment, and these prisoners are placed at a substantial risk of serious harm when they do not receive adequate treatment. The Jail fails to provide adequate intake, discharge planning, sick call, chronic care, and emergency care such that prisoners are subjected to an unacceptable risk of harm due to delays or lack of treatment. • The Jail fails to provide constitutionally adequate mental health care to prisoners. The Jail’s mental health program lacks many of the hallmarks of a constitutionally adequate system. Specifically, the Jail’s current program fails to: properly screen prisoners for mental illness; provide adequate treatment planning; adequately administer medications and psychotherapy; and properly treat and supervise suicidal prisoners. • The Jail’s use of prolonged restrictive housing under current conditions, including the failure to provide adequate medical and mental health care, violates the constitutional rights of prisoners with serious mental illness. The Jail subjects prisoners with serious mental illness to prolonged periods of restrictive housing under conditions that place them at a substantial risk of serious harm. During the first six months of 2017, an average of 70 prisoners with serious mental illness were held in restrictive housing on any given day. Of the almost 500 prisoners the Jail identified as having serious mental illness between July 2016 and July 2017, more than 175 of them spent at least 30 consecutive days in restrictive housing. More than 60 prisoners with serious mental illness spent three consecutive months or more in restrictive housing. The majority of “suicide threat” and “self-inflicted injury” incidents occur in the Jail’s restrictive housing cells. Though only 15% of the Jail’s population is housed in restrictive housing, between 2014 and August 2017, 60% of both the approximately 400 suicide threat incidents and the nearly 300 self-inflicted injury incidents occurred in a restrictive housing cell. Also, of the 300 transfers from the Jail to a state-run psychiatric 2 hospital between 2016 and August 2017, 60% had been housed in restrictive housing immediately prior to being transferred to the state hospital. Eighty-seven of those transfers occurred after a prisoner had spent 30 consecutive days or more in restrictive housing. • The Jail’s restrictive housing practices discriminate against prisoners with mental health disabilities in violation of the ADA. The Jail places prisoners with mental health disabilities in restrictive housing on administrative status specifically because they are “mentally deficient,” with no disciplinary or other reason given. By placing these prisoners in restrictive housing because of their disability and denying them the benefits of the Jail’s services, programs, and activities when they would otherwise be qualified to access these benefits in non-restrictive housing, the Jail violates the ADA. II. INVESTIGATION On December 12, 2016, the Department of Justice notified the Hampton Roads Regional Jail of our intent to conduct an investigation of the Jail pursuant to CRIPA and the ADA. Our investigation focused on whether there is reasonable cause to believe the Jail (1) violates prisoners’ rights to adequate medical and mental health care, (2) violates the constitutional rights of prisoners who have mental illness by secluding them in restrictive housing for prolonged time periods under current conditions, and (3) v
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