Assisted living communities cannot be considered “community-integrated housing” for purposes of helping Louisiana comply with the Americans with Disabilities Act in serving people with serious mental illness, according to an agreement recently signed by the U.S. Justice Department and Louisiana Department of Health.

Neither can licensed or unlicensed personal care, boarding or “room and board” homes or provider-run group homes, according to the document.

The agreement, announced June 6, resolves a federal lawsuit alleging that Louisiana fails to serve people with serious mental illness in the most integrated setting appropriate to their needs, which is in violation of the ADA. The Justice Department’s complaint alleged that that state places undue reliance on providing services in institutionalized settings, such as nursing facilities, instead of in the community, for people with serious mental illness.

Under the terms of the agreement, Louisiana will create and implement a plan to expand community-based services such as mobile crisis, case management, assertive community treatment and supported housing to meet people’s needs. In addition, state officials will assess all existing nursing facility residents with mental illness and all new referrals for admission to determine whether they can be served appropriately in the community.

“Community-integrated housing,” however, cannot include assisted living and the other aforementioned types of settings, according to the agreement, although it can include “monitored in-home care provided to individuals in the target population eligible for Medicaid waiver services.”

A subject matter expert chosen by the parties “will review all transition plans that identify an assisted living facility, personal care home, group home, supervised living house or apartment, rooming house, or psychiatric facility as the individual’s residence, for the first two years of this agreement,” the document states.