The following information is forwarded to you by the DBTAC-Great Lakes ADA Center (www.adagreatlakes.org) for your information:

 The Arc has launched a national disability needs survey.

 Finds – A meaningful way to involve individuals with intellectual and developmental disabilities (I/DD) and their families in understanding services needed, provided and desired.

 Help us spread the word:  http//www.surveymonkey.com/s/TheArcFinds2010

 The Art FINDS (Family and Individual Needs for Disability Supports) is a free, online survey designed to tap into the knowledge and perspectives of individuals and families within the I/DD community, including self-advocates.

 Available on July 20, 2010, results from this confidential survey will provide greater understanding about what services are available, what gaps exist and what new supports are needed.

 Thank you to these organizations and others for promoting The Arc FINDS:

 American Association on Intellectual and Developmental Disabilities

Autism Society of American

Best Buddies

National Association of Councils on Developmental Disabilities

National Council on Independent Living

National Association of State Directors of Developmental Disabilities Services

Office of disability Employment Policy in the Department of Labor

Questions?  Contact Ann Cameron Caldwell at 202-534-3711 or Caldwell@thearc.org

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FOR IMMEDIATE RELEASE                                                                                      CRT

TUESDAY, JULY 20, 2010                                                                         (202) 514-2007

WWW.JUSTICE.GOV                                                                        TDD (202) 514-1888

BRIEFS FILED IN CALIFORNIA AND ILLINOIS SUPPORTING THE SUPREME COURT’S OLMSTEAD DECISION

 WASHINGTON – The Justice Department today announced it has filed briefs in cases in California and Illinois as part of its continuing effort to enforce civil rights laws that require states to end discrimination against and unnecessary segregation of persons with disabilities.  The briefs were filed as the department prepares to celebrate the 20^th Anniversary of the enactment of the Americans with Disabilities Act (ADA) on July 26, 2010.

 The briefs allege that public entities in both California and Illinois administer their health care systems for Medicaid-eligible individuals in a manner that violates the ADA and the Supreme Court’s decision in Olmstead v. L.C.  The Olmstead ruling requires states to eliminate unnecessary institutionalization of individuals with disabilities and provide those individuals with services in the most integrated setting appropriate.  The department’s briefs follow a series of recent filings in Florida, Illinois, New Jersey, New York, Georgia and Arkansas that demonstrate the administration’s increased enforcement efforts following President Obama’s proclamation of the “Year of Community Living.”

 “Unnecessary institutionalization deprives individuals of the opportunity to live their lives as they choose.  We are working tirelessly to end the unjustified institutionalization of individuals with disabilities,” said Thomas E. Perez, Assistant Attorney General for the Civil Rights Division. “The department is committed to ensuring that community-based services are provided to enable individuals with disabilities to live fully integrated lives in their communities.”

 The Justice Department’s brief in Napper v. County of Sacramento asserts that Sacramento County’s redesign of its outpatient mental health service system puts thousands of Medi-Cal, California’s Medicaid program, recipients with mental illness at substantial risk of institutionalization in violation of Olmstead’s community integration mandate. According to the brief, the plan proposed by the county will decrease the availability of necessary mental health outpatient services, putting plaintiffs at risk of entry into institutional settings.  The brief also alleges that the time frame for the new system roll-out puts some persons at risk of institutionalization. 

 In Illinois, the Justice Department filed a brief in Hampe v. Hamos, supporting the plaintiffs’ motion for class certification of a group of young adults with severe disabilities who have “aged out” of a Medicaid program which provides home and community-based services.  Under the state regulatory scheme, Illinois restricts eligibility for this program to individuals under the age of 21.  Because the adult program to which most of these individuals transfer has significant funding caps and does not provide community services at the same level, plaintiffs may be forced to enter institutions in order to receive the medical services they need to survive or to remain in their homes without adequate medical care.  In its brief, the Justice Department states that certification of the proposed class is proper because class actions are an effective means of achieving the systemic reform that is necessary to address community integration claims.

 The full and fair enforcement of the ADA and its community integration mandate is a major priority of the Civil Rights Division. During the past year, the department has filed briefs or filed suit in federal court in 18 different cases raising Olmstead issues.

            People interested in finding out more about the ADA can call the Justice Department’s toll-free ADA Information Line at 1-800-514-0301 or 1-800-514-0383 (TTY), or access its ADA website at www.ada.gov, where all relevant case filings can be found.

A Model to End Unnecessary Institutionalization.http://www.stevegoldada.com with a searchable Archive at this site divided into different subjects. http://www.stevegoldada.com

Information Bulletin # 312 (5/2010)

It’s been 11 years since the Supreme Court ruled in the Olmstead case that unnecessary institutionalization of people with disabilities violated the ADA. On May 6, 2010, the United States Department of Justice filed a lawsuit against the State of Arkansas and its Governor, Mike Beebe. I believe this is the first legal complaint that really begins to spell out what an Olmstead violation looks like. While some of you may have become cynical or discouraged, take heart with this lawsuit. The principles are applicable to all institutions that segregate people with disabilities.

When reading over what the DOJ lawsuit alleges as a violation of the ADA, think about your State. Are the conditions in your State similar to Arkansas? Could a similar lawsuit be brought in your State? If the situation in your State is similar to Arkansas, we are confident that there are disability rights, public interest, legal aid, law school, and/or private attorneys in your state who will know how to apply the Arkansas DOJ model. Talk to them.

Because of this lawsuit’s importance, we are providing many of its highlights, albeit with some edits.

BACKGROUND:

“The State segregates hundreds of individuals with … disabilities in institutions that are not the most integrated setting appropriate to their needs, and fails to provide adequate community supports and services to individuals who are discharged from the institutions or who are at risk of institutionalization.” [Note: This applies to people who are either in institutions, or discharged from institutions, or at risk of going into an institution.]

“The State gives individuals with … disabilities the draconian choice of receiving services in segregated institutions or receiving no services at all.”

“Congregate institutions … segregate individuals with … disabilities from the community.” These institutional “settings discourage its residents from engaging independently in activities of daily living, fosters dependence on institutional supports, and erodes the skills necessary for community living.”

PERSONS CONFINED TO INSTITUTIONS:

“Most, if not all, of the residents confined to the institution can handle or benefit from community settings, and therefore can be served successfully in a more integrated setting in the community.”

“State’s treatment professionals agree that many of the residents currently confined could be served in the community with appropriate supports and services.”

“The State has not given many residents, and/or their family/guardian, the opportunity to make an informed objection to receiving services in a setting less-restrictive than the institution.”

STATE FAILS TO TRANSITION PERSONS TO THE MOST INTEGRATED SETTING APPROPRIATE TO THEIR NEEDS:

“Typically, the State does not meaningfully consider a resident for a more integrated setting unless the resident or their family/guardian proactively requests a more integrated setting.

“Most residents do not proactively request a more integrated setting because the State does not properly educate residents on what community resources are available, or the possible benefits of community placements.

“The States does not adequately assess whether residents could be served in a more integrated setting appropriate to their needs.”

“The States does not properly educate staff at the institution on how to appropriately assess a resident for community placement.

“Institution staff typically tailor an assessment of a resident’s appropriateness for community placement based upon their limited understanding of what community resources are available (or not available), rather than specifically what supports and services a resident needs in order to be adequately supported in the community.”

“While confined in the institution, residents do not receive appropriate treatment to support their eventual discharge to a less restrictive setting in the community.”

“Residents who have been confined for many years are not actively reassessed for opportunities to move to a less restrictive setting appropriate to their needs.”

“The State fails to properly evaluate individuals with disabilities for a more integrated setting before these individuals become residents of the institution. Institutionalizing these individuals fosters their dependence on institutional supports, and erodes the skills necessary for community living.”

THE STATE’S INADEQUATE COMMUNITY SERVICES:

“The State fails to provide services in the community in sufficient quality, quantity, and geographic diversity to enable individuals with disabilities to be served in the most integrated setting appropriate to their needs.”

“The State has not conducted an adequate assessment of the needs of its disability services system, including, particularly, those services necessary in order to provide services to all residents in the most integrated setting appropriate to their needs.”

“Numerous residents are confined to institutions because the services necessary to address their needs in the community are not offered by the State in sufficient quality, quantity, and geographic diversity to serve residents’ needs.”

“Many individuals with disabilities are segregated in institutions for no reason other than they are waiting for funding to become available to support their placement in a Home and Community-based waiver slot under the federal Medicaid Waiver Program.”

“The current wait list for a Home and Community-based waiver slot total approximately 1,400 people waiting for community services. This wait list moves at an extremely slow pace, with most people waiting several years for funding for community services. Individuals currently at the bottom of the wait list will likely wait more than a decade to receive community services.”

****************

You know your State. Does the Arkansas

complaint sound familiar? Please, get to the legal advocates in your State and tell them about what DOJ has written. This Arkansas complaint should be the first step in a cascade of other lawsuits, but only if disability advocates on a local and state level take the lead.

Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at

To contact Steve Gold directly, write to stevegoldada@cs.com or call 215-627-7100.

–

Steve Gold, The Disability Odyssey continues

Back issues of other Information Bulletins are available online at

The following is from the March 15th Issue of the Chicago Tribune:

Chicago Tribune reporters

March 15, 2010

Thousands of psychiatric patients are likely to move out of nursing homes and into community-based settings in the next five years under a landmark legal agreement designed to reshape Illinois’ troubled long-term care system.

The agreement, expected to be filed Monday in federal court in Chicago, lays out a schedule for state officials to offer approximately 4,500 mentally ill nursing home residents the choice to move out of two dozen large facilities known as “institutions for mental diseases” and into smaller settings that experts say are more appropriate and less expensive.

“This is a momentous day for people with disabilities in Illinois,”

said Benjamin Wolf, associate legal director for the ACLU of Illinois, which filed a lawsuit in 2005 that led to the agreement. “It is the beginning of transforming a system that has been focused on institutionalizing people for decades into one that actually delivers what people want and need.”

More than any other state, Illinois relies on nursing facilities to house younger adults with mental illness, including thousands with felony records. A recent Tribune investigation detailed numerous reports of sexual assault, violence and drug abuse in some facilities where psychiatric patients got little treatment or supervision. Some of the homes failed to create adequate programs or discharge plans for residents who milled about or watched TV in dreary common areas.

One of the state’s most troubled mental institutions, Somerset Place in Uptown, was shuttered Friday after Tribune reports and state and federal inspections documented a pattern of abuse, violence and substandard care.

The ACLU sued Illinois for reform, citing a 1999 U.S. Supreme Court ruling known as the Olmstead decision that requires states to place patients in the least restrictive setting appropriate to their disability.

Settling that lawsuit was considered critical to 38 proposals recently introduced by Gov. Pat Quinn’s Nursing Home Safety Task Force, formed in reaction to the Tribune’s investigation. Chairman Michael Gelder said a settlement would bring federal court oversight to Quinn’s push for alternative treatment and housing options for psychiatric patients.

The panel’s proposals also were designed to make facilities safer for elderly and disabled residents. State lawmakers are negotiating with industry representatives and advocates to transform the recommendations into law this spring.

While Monday’s settlement covers only residents of the mental institutions, there are at least 10,000 other mentally ill people living among elderly and disabled residents in other nursing homes that ar e not classified as mental institutions.

In a statement, Gelder said, “several thousand new units of supportive housing will be identified in partnership with community providers over the next five years to serve those who no longer wish to receive care in such nursing homes. This commitment can be fulfilled, even in this severe recession, by receiving significant federal financial support for care in the community.”

Another advocate, Mark Heyrman, a University of Chicago Law School professor and chair of public policy for Mental Health America of Illinois, said it was “a very happy day for everyone who cares about persons with mental illnesses in Illinois. Many years ago the state embarked upon an ill-conceived policy of placing thousands of our most vulnerable citizens in nursing homes where they received little care and little effort was made to help them recover. … Hundreds of millions of tax dollars have been wasted. This settlement marks the beginning of the end of this tragedy.”

Under the settlement, every resident of a mental institution will be evaluated to determine whether he or she is eligible to be moved into a less-restrictive setting, and what is needed to thrive there. The evaluation is voluntary, and residents can decline to take part and remain where they are.

All 4,500 mental institution residents would be evaluated within two years, and then annually after that. The settlement outlines a strict timetable for moving those who want to leave the institutions – slowly for the first two years, then more rapidly as the state builds its capacity for serving and treating people in communities.

The former nursing home residents will be placed in so-called supportive housing – subsidized apartments or group homes where staff are on-site or visit frequently to provide therapy, job and life-skills training, substance-abuse programs and case management.

State officials made a commitment to provide adequate therapeutic, vocational and life-skills programs to support the former institution residents as they transition into communities. The court will appoint a mental health expert to independently monitor the state’s compliance with the agreement.

“The main thing is to have someone who has independence and expertise,”

said Wolf’s co-counsel Barry Taylor, legal advocacy director at Equip for Equality.

The lawsuit’s plaintiffs contend the agreement will be less costly than the state paying for housing people in mental institutions. The state also will be eligible to receive federal Medicaid reimbursements for medications and health care that the former residents receive in a community-based setting. Ed Mullen, managing attorney for community integration at Access Living, said the state could save more than $50 million over the next few years.

The papers expected to be filed Monday ask U.S. District Judge William Hart, who is overseeing the case, to schedule a “fairness hearing” to consider the specifics of the plan. There will be a period of at least two months in which interested parties can file objections, Wolf said.

In reaching the settlement, the state denied violating the Americans with Disabilities Act and other laws that protect people with disabilities.

Tony Zipple, head of the community mental health provider Thresholds, called Monday’s settlement a “historic moment for public mental health in Illinois. This is probably the single best opportunity in 10, 20 years to really do systemwide reform and not have people relegated to nursing homes.”

dyjackson@tribune.com

gmarx@tribune.com

http://www.chicagotribune.com/news/local/ct-met-sub-nursing-home-olmstead-0315-20100314,0,20514.story

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The following information is forwarded to you by the DBTAC-Great Lakes ADA Center (www.adagreatlakes.org) for your information:

Press Release · Press Release · Press Release · Press Release

Contact:  Edwin C. Yohnka, ACLU of Illinois, 312.201.9740, ext. 305

                Barry Taylor, Equip for Equality, 312.895.7317

                Ed Mullen, Access Living, 312.640.2131

                M. Emily McKee, Bazelon Center, 202.46.5730, ext. 120

                Kate Kortenkamp, Kirkland & Ellis LLP, 312.862.2890

March 15, 2010

Historic agreement reached to transition Illinois residents unnecessarily housed in large, impersonal nursing homes

CHICAGO – A landmark agreement between the State of Illinois and thousands of persons with mental illnesses will result in significant reforms of Illinois’ outmoded, overcrowded and scandalized nursing home system.   The agreement, filed in federal district court in Chicago on March 15, 2010 will begin a systemic process of giving approximately 4,500 persons with mental illnesses the choice to move out of large nursing homes known as “Institutions for Mentally Diseases” (IMDs) and into community-based settings with the supports they need to be successful.   These large, impersonal IMDs are operated in a manner that allows individuals little opportunity for independent living and personal growth.  

Today’s settlement, if approved by the court, will offer people who no longer want to live in these institutions the opportunity to move to community-based settings with the kind of care and services that is appropriate for their individual circumstance.   

“This is a momentous day for our clients,” said Benjamin Wolf, associate legal director for the ACLU of Illinois, one of five legal organizations representing the plaintiffs.   “It also is a good day for the people of Illinois.  This agreement moves us from antiquated, failed policies that forced people into these large institutions and embraces the current best practice across the nation of permitting persons with mental illness to live in the most independent setting possible.”

“We are pleased that the administration has made the commitment to improve the care and services provided to these often ignored citizens,” said Donna Welch, a partner with Kirkland & Ellis, LLP.      

The agreement is the latest development in the case Williams v. Quinn, originally filed in August 2005 by two individuals forced to live in Chicago area nursing homes.   The process for transition outlined in the agreement builds on recently-released recommendations of the Governor’s Nursing Home Safety Task Force.  After examining the state’s troubled and scandalized nursing home system, the Task Force concluded that “(t)here is . . .  remarkable consensus that many people currently admitted to nursing homes with serious mental illness would be better cared for in specially designed and monitored community residential settings.” 

If the agreement reached between the parties is approved by the court, the State will develop a specific plan (in consultation with the plaintiffs’ counsel) to transition those persons with mental illness currently housed in IMDs to community-based settings.   Trained professionals will be hired to evaluate eligible members of the class who reside in IMDs to determine: a.) if they are able to transition to permanent supportive housing and other community-based settings; and, b.) what additional services will be necessary for each individual as part of the transition process.   An individualized plan for each person will be developed, implemented and tracked.  

“This settlement is about people with mental illnesses in Illinois having the freedom to the live the lives that we take for granted everyday, like making their own breakfast and buying their own groceries,” said Jennifer Mathis, deputy director of the Bazelon Center for Mental Health Law.  “With appropriate supports, people with mental illnesses can live and thrive independently in the community and disprove the myth that people with mental illnesses are unable to live on their own.”

The parties have agreed that the transition of all those eligible for transfer will take place over the next five years.   It is estimated by most experts that a vast majority of the more than 5,000 persons with mental illness who are housed in IMDs across the State would flourish living in a community-based setting.  

“Congress and the Supreme Court of the United States have found that unjustified institutionalization of people with disabilities is a form of discrimination under the Americans with Disabilities Act,” said Barry Taylor, Legal Advocacy Director at Equip for Equality.   “By entering into this agreement, the State is demonstrating its commitment to making the ADA’s promise of integration a reality for people with mental illness in Illinois.”   

Ironically, the agreement actually will relieve some of the state’s financial burden created by housing individuals in IMDs, which are supported by 100% state funding.   Not only will the costs be less expensive, but the state will be eligible to receive federal Medicaid reimbursements for medications and health care when an individual is receiving those services in a community-based setting.  

“Illinois’ antiquated policy has been bad for the individuals and costly for the State,” added Ed Mullen, Managing Attorney for Community Integration at Access Living.   “Estimates are that the State could save more than $50 million over the next few years by transitioning residents from IMDs into the community.  Given the state’s current fiscal crisis, this is a welcome development.” 

Lawyers representing the plaintiffs are from a coalition of organizations, including Access Living, the Bazelon Center for Mental Health Law, Equip for Equality, the Roger Baldwin Foundation of the ACLU of Illinois and the Chicago office of the law firm Kirkland & Ellis.

The papers filed today ask Judge William Hart who is overseeing the case to schedule a “fairness hearing” to consider the specifics of the plan.  Once the agreement is approved, the State and the advocates involved on behalf of the class of IMDs residents will move quickly to begin the planning process.