Disability Law & Advocacy Center of Tennessee (DLAC) is a private non-profit organization which advocates for the rights of Tennesseans with disabilities to ensure they have an equal opportunity to be productive and respected members of our society. Since 1983, DLAC has been designated as the protection and advocacy system for the State of Tennessee. Under federal law, DLAC has the authority to investigate allegations of abuse and neglect of persons with disabilities. [See generally 42 U.S.C. §10805 et seq., 42 C.F.R. § 51.41, and 45 CFR §1386.22 et seq.]

DLAC has completed an investigation in regard to whether the staff at the Chad Youth Enhancement Center (Chad) inappropriately restrained Omega Leach on June 2, 2007. After being by restrained Chad staff on June 2, 2007, Omega Leach died at Vanderbilt Children’s Hospital on June 3, 2007. While investigating the Chad facility’s June 2, 2007 restraint of Omega Leach, DLAC also reviewed information about other restraint incidents which have occurred at the Chad facility. 

DLAC’s full investigation report[2] demonstrates the danger and potential fatal outcome of physical restraint uncovered by DLAC’s investigation. Restraint refers to actions which restrict the free movement of a person’s body and can be performed in several ways including the following: the administration of sedative or psychotropic medications; the use of mechanical devices; or the application of physical force without the use of a device. 

The restraint utilized on Omega Leach was a “prone restraint,” which is the use of a mechanical device or physical force to restrict movement by holding an individual in a facedown position. As a result of extensive literature review and the findings of this report, it is DLAC’s position that restraint is a very dangerous intervention that should be used only as a last resort and only in situations in which a person is engaging in actions that constitute an immediate threat to the health/safety of self or others. Facilities should make active and concerted efforts to decrease the use of restraint and, if possible, to eliminate its use entirely. DLAC’s position is consistent with federal law and with the clear consensus of professional judgment regarding the use of restraint.

 

Chad Youth Enhancement Center (Chad)[4] is a privately owned mental health facility for children seven through seventeen years of age.  The 90 bed residential facility is located on a 20-acre campus approximately 40 miles west of Nashville in Ashland City, Tennessee.  Chad serves a wide variety of youth including children with mental illness, children who have been neglected, and children who have been accused of crimes.  Juveniles are sent to Chad from a number of other states, including New York, Kentucky, and Pennsylvania, to seek treatment.  Chad is owned by the for-profit corporation Universal Health Services, and is licensed by the State of Tennessee.

 

Seventeen-year-old Omega Leach was from Philadelphia and became a resident at Chad on May 2, 2007 after he was arrested for racing a stolen car around his neighborhood.  Leach was a troubled teen who struggled at school and home with behavioral issues and disabilities such as mood disorder, oppositional defiant behavior, and conduct disorder.  Known as “Manny” to his loved ones, Leach loved basketball and videogames.  He had plans to go to college and become a lawyer, but died on June 3, 2007 before those aspirations could be realized.

 

On June 4, 2007, DLAC received information that Omega Leach had died the day after a prone restraint was performed on him at Chad Youth Enhancement Facility (Chad). After receiving this information, DLAC launched an investigation into whether staff at Chad inappropriately restrained Omega on June 2, 2007. In addition, DLAC reviewed information about other restraint incidents which have occurred at the Chad facility. DLAC investigates reports of alleged abuse/neglect throughout the state of Tennessee, including those which result in death, for the purpose of helping to prevent future similar incidents. DLAC does not perform investigations in order to make determinations about the cause of death or criminal liability but instead leaves such matters to law enforcement authorities. Based upon its investigation, DLAC has concluded that Chad inappropriately executed a prone restraint of Omega Leach on June 2, 2007. In addition, DLAC has concluded that Chad staff members use restraint/physical holds too frequently and without sufficient grounds (e.g. restraints are implemented in non-emergency situations in violation of federal law and facility policy).  DLAC has issued a full report with detailed findings and recommendations to attorneys for Universal Health Services, Inc.[6]  the Tennessee Department of Children’s Services,[7] and the Tennessee Department of Mental Health and Developmental Disabilities.[8] 

Other than issuing this Limited Public Report, DLAC will not comment on this investigation. DLAC encourages anyone who is aware of incidents of abuse/neglect of people with disabilities to report such incidents to our agency by calling 1-800-342-1660 or 1-888-852-2852 (TTY). During the fiscal year beginning on October 1, 2008, DLAC’s investigations of abuse/neglect of people with disabilities will be focused on alleged incidents which occur in nursing homes, private residential treatment facilities and group homes.

Please note that Tennessee law requires anyone who is aware of child abuse or abuse of an adult to report abuse to the Department of Children’s Services (DCS) or the Department of Human Services (DHS), respectively. See, T.C.A. § 37?1-403 and T.C.A. § 71?6?103.

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