San Francisco, CA (Jan. 5, 2004)—The recent settlement of a major class
action lawsuit against the state of California and the city of San Francisco
is seen
by disability
advocates
to
be an important
step toward the community integration of people with disabilities,
as required by the Supreme Court’s 1999 Olmstead decision that their
unnecessary institutionalization constitutes illegal discrimination based on
disability.
The two-year-old lawsuit, Davis et al. v. California Health and Human Services
Agency et al., challenged the state’s and city’s practice of serving
people with disabilities, including many seniors, in the city’s Laguna
Honda Hospital and Rehabilitation Center (LHH), a 1,200-bed nursing home, without
considering community alternatives as mandated by the Americans with Disabilities
Act.
The settlement was approved on December 18 by Judge Saundra B. Armstrong
of the U.S. District Court, Northern District of California. It requires San
Francisco
to develop a system of assessment and hospital-discharge planning that allows
people who are in Laguna Honda or eligible for admission there in the future
the option of receiving supports and services in the community.
Plaintiff Jesse Fitchett spent more than six years in the nursing home but
now lives in an apartment with part-time attendant care and other supports. “I
was so happy to get out and have my freedom back and get better care,” Mr.
Fitchett said. Now “I want to see other people get out and be able to
live independently like I do.”
By March 29, 2004, San Francisco has agreed to start a state-of-the-art
program to screen, assess and develop individual service and discharge
plans to members
of the Davis class and provide ongoing case management after their discharge.
Program staff will receive training on community-living alternatives
and Laguna Honda residents will have training and support resources.
“
The settlement is a key step in helping to guarantee the rights of people at
such facilities, but it’s not the last,” said Jennifer Mathis,
co-counsel in the lawsuit and a staff attorney with the Bazelon Center, a national
legal advocacy group for people with mental disabilities. “We’re
committed to seeing the city create adequate community alternatives
to Laguna Honda.”
The plaintiffs have reserved the right to go back to court if the new
assessment process demonstrates that the need for community-based
services is greater
than San Francisco has the capacity to provide.
"By informing class members about community options and reassessing all
LHH residents, San Francisco is taking a first step in recognizing the right
to
live free of institutionalization," said Arlene B. Mayerson,
directing attorney of the Disability Rights Education and Defense
Fund , a nonprofit
law and policy center for disability civil rights that has co-counseled
in the case.
The Davis case also settles longstanding deficiencies in the state
mental health department’s Pre-Admission Screening and Resident Review (PASRR) program
for individuals with psychiatric disabilities. The new assessment process will
identify personal goals for housing, work, relationships and health. State
evaluators will consider whether the person's goals and needs can be met with
community-based alternatives to nursing home care. According to co-counsel
Michael Stortz of California’s Protection and Advocacy, Inc., “The
settlement helps put an end to an evaluation process that steers too many people
into nursing homes.”
“
Polls show that people would never go into nursing homes if they had the services
necessary to help them stay in their community,” commented Herb Levine,
executive director of the Independent Living Resource Center of San Francisco. “For
the first time, San Francisco will gather the information to determine what
people need to live successfully in the community.”
In April 2003, the US Department of Justice (DOJ) concluded a five-year
investigation of Laguna Honda for practices that discriminate on
the basis of disability.
In a letter finding the city in violation of the ADA for failing “to
ensure that LHH residents are being served in the most integrated setting appropriate
to their needs,” Assistant Attorney General Ralph Boyd, Jr.
concluded that residents are not adequately assessed for community-based
services, either
on admission or at discharge.
DOJ also questioned the cost-effectiveness of San Francisco’s plan to
spend $401 million for a 1,200-bed replacement facility that will cost $127,000
per bed each year to operate, noting that “community integrated options
could be provided at a fraction of the cost of staying in LHH.” The
Department filed a friend of the court brief in support of the
Davis plaintiffs.
The plaintiffs are represented by a coalition: Protection & Advocacy, Inc.
(PAI) in Oakland, California; Disability Rights Education and Defense Fund,
Inc.(DREDF).