Summary Class action for institutionalized people with mental illness & MR/DD which set standards for right to treatment, privacy & services in the least restrictive setting.
Progress Settlement

Summary Plaintiffs claim the state failed to furnish them with ICF/MR or waiver services, leaving them on a wait list.
Progress Settlement discussion underway that would have the state agree to expand waiver services at the rate of 600 persons per year for a three-year period.

Summary Action to require Medicaid PAS for an individual in a reliable, non-arbitrary way in order to prevent unnecessary institutionalization.
Progress Case dismissed. State volunteered to increase provider reimbursement rates

Summary Plaintiffs (children & adults) in this case were indefinitely waitlisted for services.
Progress Case dismissed

Summary Plaintiffs (children & service providers) challenged plans to reduce Medicaid services (ending some day treatment & therapy for children with DD).
Progress Under appeal. District & Appeal Courts upheld the complaint, ruling that states are required to identify services in their Medicaid plan. If a physician determines services necessary for Medicaid eligible children, state must pay for them regardless whether they were listed in the state Medicaid Plan.

Summary Case concerns state's practice of wait listing individuals for its HCBS waiver program for people with disabilities instead of allowing them to submit an application.
Progress Settlement. State offered waiver services to individuals on the list, up to its CMS approved participant cap & conceded it was required to allow people to apply for services under federal law.

Summary Case challenges the constitutionality of the admission & discharge procedures for people with MR/DD in state institutions.
Progress. On appeal. In 2005, the Appeals court ordered defendants to submit a new set of post-admission review procedures and ruled that the amended rules are an adequate remedy to the case. Plaintiff's appeal is pending. Further details [http://www.arkdisabilityrights.org/law/alerts.html]

Summary Class action for Medicaid eligible plaintiffs alleges Medicaid payment rates for PAS are too low to ensure all HCBS are provided so people are at risk of institutionalization.
Progress Court ruled the state must make improvements to the program & pay sufficient to "attract enough health care workers to deliver all of the services for which the individual qualifies". The court found that the state violated the ADA by not providing enough care providers such that eligible persons are not able to get the services they need.

Summary Class action challenged denial of methadone maintenance treatment (MMT) to Medicaid eligible people because the county they live in did not have a MMT program.
Progress Appeal Court upheld ruling stating services should be provided; with 'reasonable promptness', evenly across the state & with adequate scope & duration of treatment, noting that if beneficiaries wait different lengths of time, it constitutes discrimination

Summary Case challenging the placement of people with MR/DD in institutions.
Progress Settlement (a net decrease of 2,000 in the institutional population over 5 years & improved HCBS).

Summary Case (brought by doctor) claiming that plaintiffs should not be discharged to the community because they were in the most integrated setting appropriate (DD Centers).
Progress Settlement (included provision that treating professionals can express an objection to a community placement).

Summary Class action challenging failure to comply with PASRR, improperly imposing caps on mental health rehabilitation & not providing services in the least restrictive setting.
Progress Case voluntarily dismissed as appropriate placements were identified

Summary Case regarding lack of provision of therapeutic behavioral health services to medically needy children receiving EPDST services under Medicaid.
Progress Complaint upheld.

Summary Case brought by the Administrator of the estate of a person with mental illness, claiming the state violated the ADA by discharging the individual from a private institution to the community.
Progress Complaint dismissed. Appeal Court ruled that Olmstead clarified that the ADA does not impose a standard of care on states & does not prohibit inappropriate community discharge

Summary Case brought by association of health association to include certain add-ons when the state determines reimbursement rates.
Progress. Appeals court ruled that the district court's award of summary judgment for the defendants were inappropriate and remanded for further proceedings.

Summary Plaintiffs (including service providers) challenged the disparity between wages for direct support professionals in institutions & in the community¹¹.
Progress Case dismissed. The court decided the trial would only examine whether payments are sufficient to provide quality services. The court dismissed the case as Medicaid law does not give individually enforceable rights. This was affirmed by the appeals court.

Summary Class action brought by a coalition of organizations on behalf of residents of Laguna Honda nursing facility. The US Dept of Justice also conducted an investigation & found it to be in breach of Olmstead.
Progress Settlement (includes targeted case management for people living in the facility or at risk of admission). The state will also revise their screening program for individuals with psychiatric disabilities with an emphasis on community alternatives versus nursing homes. The plaintiffs reserve the right to re-file the lawsuits if there are insufficient community options.

Summary Case brought by Medicaid recipients & a pharmacist providing Medicaid services to prevent California from instituting a 5% rate reduction in Medicaid payments.
Progress Case dismissed.

Summary Class action suit for all Californians with MR/DD in, or at risk of placement in institutions challenges that the state unnecessarily institutionalizes people with MR/DD & requests changes including that the state offers the full range of Medicaid & state HCBS.
Progress Settlement. Final approval of the settlement in April 2009. The settlement will see the state provide additional funds for case management to assist class members in state-run institutions called developmental centers (DC); improved information to class members and training for DC staff about community living options; increased state-level coordination of services for people diagnosed with developmental and mental health disabilities; and continued funding and program efforts to provide community living alternatives for class members.

Details of the settlement can be found at:
[http://www.disabilityrightsca.org/advocacy/CPFvDDS/Summary_of_Settlement-2009-04-27.pdf]

Additional information about the case can be found at:
[http://www.disabilityrightsca.org/advocacy/CPFvDDS/index.htm]

Summary Case challenging the closure of Rancho Los Amigos Rehabilitation Hospital. It argues that without the service, people with disabilities will not learn to live independently & risk institutionalization & are being treated differently to other Medicaid beneficiaries.
Progress Settlement. The County will keep Rancho open for at least three years from the date the settlement becomes final, unless a buyer appears before this time. During this time period, Rancho will continue providing medical services to people with disabilities and will a buyer for the hospital or establish a nonprofit organization to take it over. If the hospital closes, the County must provide adequate continuation of services for its patients with Medi-Cal.

To download the settlement agreement:
[https://www.disabilityrightslegalcenter.org/documents/SettlementAgreement.doc]

Summary Six residents of Laguna Hospital, joined by the Independent Living Resource Center of San Francisco, filed a class-action lawsuit challenging the City and County of San Francisco's policies regarding the institutionalization of people with disabilities. The plaintiffs argue that they are capable of and would prefer to live in the community.
Progress. Settlement. Final approval of the settlement given in Sept 2008. For plaintiffs and eligible Laguna Honda residents, the settlement consists of access to a Medi-Cal HCBS waiver, a rental subsidy program that will provide accessible housing and care coordination for programs such as attendant and nursing care, care management, mental health services, assistance with meals and substance abuse treatment

To view a summary of the lawsuit:
[http://www.pai-ca.org/advocacy/lhh/index.htm]

To review the entire settlement agreement:
[http://www.pai-ca.org/advocacy/LHH/Settlement_Agreement_FINAL_12-03-07.pdf]

Summary Class action suit challenged the state's practice of confining mentally ill children who are in the state's foster care system or at risk of removal from their families and who have mental health needs into hospitals and large group homes rather than home and community-based options.
Progress Ongoing. The district court ordered that the state must provide community services to children with mental health needs A special master was appointed by the court to facilitate an agreement between the parties in 2009.

For asummary of the case:
[http://www.bazelon.org/incourt/docket/katieA.htm]

To view the original complaint:
[http://www.bazelon.org/issues/children/incourt/KatieA/katiea_complaint.pdf]

Summary Class action alleging the state's refusal to make Medicaid HCBS available to people with mental illness was discriminatory under the Rehabilitation Act as these services were available to seniors & people who are blind & physically disabled.
Progress Complaint upheld.

Summary Case challenges waitlists & seeks services in small ICF/MR group homes or HCBS waiver services. An association of non-profit community services providers contended that state payments for HCBS are inadequate & waiver services should be expanded, not ICF/MR services.
Progress Under appeal. Court dismissed all claims (dismissed ADA claims on grounds that "Olmstead does not stand for the proposition that a state must create, expand or maintain programs for the purpose of preventing disabled individuals from becoming institutionalized")

Summary Class action about limits on payments for medical equipment to items on a Social Services list. It prompted HCFA (now CMS) to clarify policies on medical equipment coverage, requiring states to provide individuals "a meaningful opportunity for seeking modifications of or exceptions to a State's pre-approved list."¹⁵
Progress Settlement"

Summary Class action involving waiver recipients who are waitlisted/denied other services.
Progress Settlement. In late 2004 the parties arrived at a settlement agreement. The agreement provides the following: the class includes those individuals who applied and were found eligible plus individuals who would have been found eligible if they had the opportunity to apply; over a five-year period starting FY 2005-2009, the state agreed to expand its HCBS waiver programs to accommodate an additional 150 persons each year; the state agreed to create a new Individual and Family Support HCBS waiver; and the state agreed to revise its procedure to ensure potential applicants receive adequate information regarding the services and prompt determination of eligibility of those services.

Summary The elderly plaintiff had received HCBS & PAS under the state waiver but the provider agency repeatedly failed to provide the required amount of care. As a result the plaintiff experienced falls & some aides were injured. The agency withdrew services on the grounds that they could not provide safe care, leaving the plaintiff at risk of institutionalization.
Progress Ongoing

Summary Case claiming that in refusing to pay for medical equipment not covered by Medicare & operating an arbitrary list of approved devices, the State restricted access to equipment for independent living thereby increasing risk of institutionalization.
Progress Settlement. A revised list was formed, including rights for appealing decisions.

Summary Class action case sought to ensure reasonable care in the institutions and also to provide services to allow for transfer out of institutions.
Progress Consent agreement. In 2008, the court found that defendants were not in compliance and issued an injunction against the defendants.

Summary Plaintiffs alleged that more than 200 people with mental illnesses are 'needlessly segregated and inappropriately warehoused' in three Connecticut nursing homes.

To view the complaint:
[http://www.bazelon.org/issues/disabilityrights/incourt/opa-v-ct/complaint-opa-v-ct.pdf]

Summary Plaintiff is an elderly women suffering from dementia eligible for Medicaid who wished to move from a nursing home to an assisted living facility. She contends that Medicaid should pay for the cost of the assisted living facility.
Progress Case dismissed. Court found that although Olmstead required state to provide reasonable accommodation, payment for the assisted living facility would be special accommodation not required by Olmstead

Summary Class action asking the court to implement the HCBS waiver program & put class members in a less restrictive setting, & alleging the district was in contempt because it failed to provide timely payment to group home service providers.
Progress Settlement. Provides for the creation of a non-profit corporation to provide lay advocacy, legal services & support to ensure greater protections for all people with MR/DD.

Summary The plaintiff was a deaf inpatient at a state hospital who required interpreter services.
Progress The court ruled that the lack of interpreting services violated the ADA because the person couldn't engage with therapy & the state had not made reasonable accommodations to a public housing unit so the individual resided in an institution despite being suitable for community placement. Case dismissed after individual's situation changed.

Summary Class action alleged the State does not have a "comprehensive effectively working plan" for placing qualified persons in less restrictive settings & did not move its wait list at a reasonable pace.
Progress Settlement. Provides for expansion of waiver services, a new family support waiver & infrastructure improvements.

Summary Class action about wait listing for ICF/MR services.
Progress Complaint upheld. Court ruled that 'reasonable promptness' requires a state to furnish ICF/MR services promptly once an application has been approved & therefore wait lists violate Medicaid law. Appeal court upheld this ruling

Summary Class action alleging unnecessary institutionalization of people with MR/DD.
Progress Settlement. Provides for closure of 2 of the 4 state DD centers by 2010 & funds for a new waiver for people moving to the community.

Summary Case challenging state policies in operating its HCBS waiver. It was amended to challenge the wait listing of individuals.
Progress Settlement. Provides for expansion of waiver for people with MR/DD.

Summary Class action where plaintiffs had sought but not received community services through Brain or Spinal Cord Injury waiver & state does not have a comprehensive effectively working plan for community integration.
Progress. Settlement talks ongoing

Summary Case brought on behalf of 5 residents of a nursing home in the grounds of a state psychiatric facility scheduled for closure. Plaintiffs argue that they have not been assessed for or given the option of community-based alternatives & are instead being transferred to nursing homes.
Progress State filed to dismiss the case.

Summary Plaintiff brought case to obtain Medicaid coverage for the nursing assistant he requires to stay at home and avoid institutionalization.
Progress Preliminary injunction granted to plaintiff for the provision of necessary Medicaid coverage for plaintiff to stay at home.

Summary Case about 2 women with MR/DD both diagnosed with mental illness & voluntarily admitted to a state hospital for psychiatric treatment. Treating professionals concluded that the plaintiffs could receive community care but they remained institutionalized.
Progress Complaint upheld

Summary Class action alleges since Olmstead, the State made no significant effort to operate long-term care in a way that ensures people have the option of HCBS & are not unduly segregated.
Progress Settlement discussions underway

Summary Plaintiffs have mental illness & MR/DD & have not been provided with necessary therapeutic services to facilitate community placement.
Progress Court ordered state to develop a plan for the community placement of people inappropriately placed in the Adult Inpatient Unit.

Summary Class action for people at home waitlisted for HCBS due to lack of funding.⁶
Progress Settlement. Provides for the extension of the number of people served on waiver over 3 years. In addition, the states agreed to revise its policies and procedures regarding applications for waiver services. The state will also evaluate the eligibility of an applicant for waiver services at the receipt of the application rather than placing the individual on a wait list.

Summary The Disability Rights Center evaluated implementation of the Makin (HI1) settlement & brought this class action alleging there are still 300 people on the wait list because the state has furnished services to people who sought HCBS after the settlement (rather than class members) & class members are not receiving the full range of HCBS required.
Progress Settlement. The state is now required to eligibility for home- and community-based services within 90 days of the date of application for people presently on the waitlist and new applicants. The state is also required to make improvements on their intake procedures, eligibility criteria and other services for consumers.

To download the settlement agreement, go to:
[http://www.hawaiidisabilityrights.org/forms/S.M.SETTLEMENT8-12-05(final-redact).DOC]

Summary Court found that the class action plaintiffs (people with mental & physical disabilities) had a right to apply for HCBS even where the state limits on funding on these services would lead to a waiting list. Court also reinforced the right to services with reasonable promptness & that limited state resources is not a defense.

Summary Class action resulted in the state being ordered to reduce numbers of people with MR/DD in nursing homes & develop community-based services. The class does not include any person admitted to a nursing home after 1994.

Summary Plaintiff with cerebral palsy living in nursing home wanted to move to a community-based home but his application to join the Community Integrated Living Arrangement (CILA) program was denied because he is not developmentally disabled.
Progress Court ruled for the defendant. Appeals Court overruled, stating that under state law, cerebral palsy is included in the definition of developmental disability even if no mental impairment is present & therefore denial of community services was unjustified.

Summary Case concerned lack of access to Medicaid HCBS or ICF/MR services.
Progress Settlement

Summary Plaintiff requires 24 hour medical care and was at risk of unnecessary institutionalization when he 'aged out'.
Progress Court found in favor of plaintiff in 2008

For more information:
[http://www.nasddds.org/pdf/LitigationUpdates(7-2008).pdf]
[http://www.accessliving.org/index.php?tray=content&tid;=top683&cid;=84]

To download the 2008 opinion:
[http://www.nasddds.org/pdf/Radaszewski-v-Maram.pdf]

Summary Class action filed by an Independent Living Center on behalf of 3 nursing home residents who contend that they are unnecessarily confined to institutions because they have been denied Medicaid-funded motorized wheelchairs despite having been assessed as needing them.
Progress Settlement discussions ongoing.

Summary Case brought by an individual, challenging state policies in limiting HCBS waiver-funded residential services to people who need emergency services or who are in other priority groups. Plaintiff receives some HCBS waiver services but seeks Community Integrated Living Arrangements that are also provided through the waiver program.
Progress Settlement proposed

Summary Class action complaint that the state is denying some waiver services to waiver participants who require them.
Progress Ongoing. Both parties have filed motions for summary judgment in the case. The state also filed a motion opposing class certification.

Summary Class action alleges state policies mean people are unnecessarily institutionalized in privately operated ICF/DD facilities.
Progress Settlement.

For more information:
[http://www.equipforequality.org/news/pressreleases/ligasmaramfiles.php]

To download the consent decree:
[http://www.equipforequality.org/resourcecenter/Signed%20Consent%20Decree%20Final.pdf ]

Summary Class action alleging violation of ADA when individuals forced into nursing homes.
Progress. Ongoing

To view the case files, go to:
[http://www.equipforequality.org/news/pressreleases/williamsblagojevichfiles.php]

Summary Class action asserting that the state failed to comply with Olmstead. Plaintiff seeks an order permitting people with disabilities in Cook County to access long-term care services in their own homes or in community based settings rather than in nursing homes. The plaintiffs are asking the court to order the state to: ensure that nursing facility residents in Cook County are assessed for community long-term care services, both at admission and regularly thereafter; inform nursing facility residents of home- and community-based long-term care options and alternatives; and provide eligible nursing facility residents with long-term care services and supports in the community, rather than requiring individuals to submit to nursing home placement.
Progress Ongoing

For more information:
[http://www.equipforequality.org/news/pressreleases/illinoisresidentsfiles.php]

To download the complaint:
[http://www.accessliving.org/index.php?tray=content&tid;=top654&cid;=250]

Summary Plaintiff sued the state to receive HCBS rather than be institutionalized when he 'aged out'.
Progress Ongoing. In May 2008, court denied defendant's motion for summary judgment.

Summary Plaintiff sued the state to receive HCBS under the hospital level of care rather than the nursing home level of care. A hospital level of care rating would mean greater funding as compared to a nursing home level of care.
Progress Ongoing.

Summary Class action alleged 2,000 individuals were either on waiting lists or suffering 'institutional isolation' as enrollment in the state elderly & disabled waiver programs had been closed for 2 years & new applications were not accepted.
Progress Settlement. Provides for waiver to be expanded to serve 3,000 more people & assessment and quality assurance mechanisms to be developed.

Summary Class action regarding failure of state to provide children & young people long-term treatment in psychiatric residential facilities.
Progress Complaint upheld. Court found that any Medicaid service that is medically necessary must be provided.

Summary: Interhab (an association of providers) & 5 other community service providers claim that state is under funding HCBS.² individuals with MR/DD were added as plaintiffs.
Progress Ongoing.

Summary Class action alleged the state did not properly administer PASRR for people with MR/DD in nursing facilities. Under PASRR states must take steps to provide specialized services for these people &/or arrange for community placement if appropriate.
Progress Settlement

Summary Class action alleging the state was not providing information or services to children under 21 as required under the Medicaid EPDST program.
Progress Settlement. Provides that service provision to be based on medical need, not cost.

Summary Class action regarding a long waiting list for Medicaid services despite increases in state funding. Class is "all present & future Kentuckians with MR &/or related conditions who live with caretakers who are eligible for, & have requested but are not receiving medical assistance, community residential &/or support services."
Progress Settlement. Provides for the addition of $45 million in state funds during the 2006-08 biennium to expand community services with funding to increase through 2010. Total funding would increase from $303 million in 2006 to $485 million in 2010.

Summary Class action (seniors & people with disabilities) who lost eligibility for services after the state narrowed long-term care eligibility by raising the threshold of functional impairment to qualify for support.
Progress Settlement. Provides that the state revise eligibility regulations for nursing facility and waiver services and requires the state to re-evaluate applicants who were denied services under the previous rules.

Summary Class action concerning Medicaid-eligible children on the MR/DD waiver wait list who were not receiving EPDST services.
Progress Settlement

Summary Class action challenging waitlists for community services.
Progress Settlement. Provides for an increase in state spending & a reduction in the waiting time to less than 90 days.

Summary Class action following proposals for a waiver for children with severe disabilities that offered a capped set of benefits narrower than those in the existing waiver. It objected to the method of program implementation, where children would have to give up their place on the existing wait list if they enroll on the new list.
Progress Settlement. Provides for amendment to waiver criteria.

Summary Class action alleging plaintiffs were denied community-based placements or 'specialized services' when they opted to stay in a nursing facility.
Progress Settlement. Provides that nursing home residents with MR/DD are offered community residential services & community placements are provided for class members.

Summary Class action challenging state policy of applying more restrictive financial eligibility criteria to seniors than working age adults with disabilities on the Medicaid PAS program so seniors are at risk of institutionalization.
Progress Settlement. Provides for a more liberal financial eligibility criteria for seniors.

Summary Class action about wait lists for residential services.
Progress Settlement. Provides for state to spend $355.8 million to expand services between 2002 & 2006.

Summary Class action alleging children with mental illness have been hospitalized or are at risk of institutionalization because of lack of home based mental health services.
Progress Ongoing. Both parties were ordered by the court to develop various remedies.

Summary 2 clinically obese Medicaid beneficiaries sued the state's denial of breast reduction surgery.
Progress Ongoing.

Summary Case brought by the state P&A; on behalf of a woman diagnosed with psychosis & dementia who only speaks Portuguese. All PAS providers claimed they could not serve her as she only responds to her daughter.
Progress Court upheld complaint, ruling that as she qualified for PAS it would not be a fundamental alteration for the woman's family to be paid to provide services

Summary Plaintiff filed to re-open a consent decree that required the state's Department of Mental Retardation to offer the Fernald Developmental Center as an on-going option for its current residents. Defendant argued that the court lacked jurisdiction to reopen the Ricci case (previously known as Ricci v. Okin).
Progress. Case dismissed.

For more information:
[http://www.arcmass.org/StateHousePolicy/RegulationandPolicyDebates/FernaldSchoolClosingandRICCIClass/tabid/175/Default.aspx]
[http://www.arcmass.org/LinkClick.aspx?fileticket=%2fz8yFyhQ8JY%3d&tabid;=152∣=2247]

To download the Appellate Court opinion:
[http://www.nasddds.org/pdf/Massachusetts-RiccivPatrickUSCA1Opinion(10-1-2008).pdf]

Summary Class action requesting HCBS for 'non-retarded developmentally disabled people'⁶ (TBI or MR/DD).
Progress Complaint dismissed. Court ruled it would be a fundamental alteration as the state had decreased numbers in institutions, increased community services & further expansion would affect ability to serve others

Summary Class action alleged the state had not provided medically necessary EPSDT services to children with MR/DD or assured children's non-waiver Medicaid services.
Progress Settlement. Provides that no child would wait more than 6 months to receive approved treatment & services.

Summary Class action alleging state failure to provide services with reasonable promptness.
Progress Settlement. Provides that the state devise a plan & provide day habilitation & case management within 90 days & within 225 days to newly qualifying individuals.

Summary Plaintiff alleged a violation of ADA when the state reduced her daytime personal care hours from 91 hours a week to 74 hours a week under the 90% rule (cost of HCBS to be less than 90% of similar institutional care cost).
Progress Closed. The court found that the reduced hours was factually accurate but asked the administrative court of the department to settle the claims as to whether there is any violation of plaintiff's ADA claims.

Summary Class action alleged plaintiffs with mental, neurological & psychiatric disabilities11 in nursing facilities denied community placements or 'specialized services' if they stayed in nursing facilities.
Progress Settlement. State to "assure the appropriate & timely community placement of individuals determined to not require nursing facility care"²

Summary Case (covering seniors & people with disabilities) challenging a freeze (below capacity) on enrollment to the HCBS waiver.
Progress Settlement. Provides for increasing waiver slots & funding, consumer information & creation of a Medicaid LTC Task Force.

Summary Class action alleging the state has not ensured eligible individuals have access to home-based nursing equal to that of similarly situated people receiving similar non-Medicaid services.
Progress. Ongoing

Summary Class action where plaintiffs (including advocacy organizations & providers) seek to stop the state 'rebasing' funds allocated to counties for HCBS waiver services.
Progress Settlement. Provides that the state agrees to increase funding over the next two years and issue new guidelines regarding individual budgets. The state also agreed to explore new ways to fund their waiver program.

Summary Class action where plaintiffs (including advocacy organizations) seek to stop the state 'rebasing' funds allocated to counties for HCBS waiver services.
Progress Settlement. Provides that the state increase county allocations & establish a new funding method for waiver.

Summary Case argued that failure to prescribe newer anti-psychotic medication violated the ADA as it prevented people being discharged to the community.
Progress Case voluntarily dismissed.

Summary Case alleged that state policies lead to unnecessary segregation of individuals with disabilities in nursing homes by not making HCBS available.
Progress Settlement. Provides assessment mechanisms for nursing home residents to screen for community transition, provision of support to transition people to the community, increase payments to personal care attendants.

Summary Class action alleged the state failed to provide HCBS to residents of the 2 state MR/DD institutions (one of these has since closed) & individuals in the community at risk of institutionalization.
Progress Settlement. The state will move 45 residents from the Montana Developmental Center into the community over the next four years. The state also agreed to repeal a law that allows court commitment of individuals who have 'near total care' requirements.

Summary Class action on behalf of 8 individuals receiving HCBS & an association of community developmental disability provider agencies, seeking an injunction to bar the state from maintaining the disparity in wages & benefits between state institutional & community-based workers.
Progress Settlement. As part of the settlement agreement, the state will redesign and modify the nature and scope of services to persons with developmental disabilities in ICF/MR or home- and community-based settings. The state will also redesign and modify services funded by the Montana State Medicaid Plan for persons with developmental disabilities.

Summary Class action concerning people institutionalized in state psychiatric facilities. Court held that institutionalized persons with disabilities are entitled to services that are consistent with professional opinion & where it is assessed as appropriate people are entitled to receive community-based services.

Summary Class action on behalf of Medicaid-eligible children unable to obtain dental services due to a lack of Medicaid-participating dentists.
Progress Complaint upheld. The ruling in this case was one of the first that held that states cannot claim 'sovereign immunity' & that complainants have individually enforceable rights under Medicaid law

Summary Case challenging wait list for waiver & state methods for authorizing services which may mean inadequate services are provided to recipients. Plaintiffs want a state plan to move the wait list at a reasonable pace, provide services up to the number of available slots, expansion of the waiver & revamp its service authorization mechanism.
Progress Case dismissed.

Summary Plaintiff claims that the institution he has lived in for more than a decade should release him for non-institutional treatment.
Progress Ongoing

Summary Class action about wait list for Acquired Brain Disorder model HCBS waiver.
Progress Court ordered at least 200 slots be filled & with reasonable promptness. Appeal Court overruled, ruling states can limit numbers in a model waiver although services should be furnished with reasonable promptness up to the waiver limit.

Summary Case alleged that to revoke an individual's conditional discharge from a state hospital & involuntarily commit them without holding a hearing violates the ADA.
Progress Settlement. Provides that the state appoint attorney for anyone whose conditional discharge is revoked.

Summary Complaint alleged that the state's failure to develop an adequate system of community support violated ADA.
Progress Case dismissed.

Summary Case claimed the state moved 9 people with MR/DD & history of violence from group homes to locked state facilities without notice or hearings.
Progress Settlement. Provides that plaintiffs be moved to appropriate community placements.

Summary Class action alleges state has not developed comprehensive effectively working plan to transition unnecessarily institutionalized individuals from state facilities to HCBS.
Progress Ongoing.

For more information:
[http://www.drnj.org/litigation.htm]

To download a copy of the complaint:
[http://www.drnj.org/pdf/amended%20complaint.pdf]

To download a copy of the court's motion denying the motion to dismiss, go to:
[http://www.bazelon.org/pdf/NJP&A-MotToDismissDenied.pdf;]

Summary Complaint alleges people with DD are unnecessarily institutionalized in publicly operated state developmental centers.
Progress Ongoing.

For more information:
[http://www.drnj.org/litigation.htm]

Summary: Plaintiffs filed a complaint alleging 8,000 people with disabilities and developmental disabilities have had their rights violated by the state because they have been waiting too long to move into Division-sponsored community housing. The lawsuit alleges the state is failing to meet its legal responsibility to provide housing for people who want or need to live outside of their family homes. The state had a waiting list, but few ever leave it unless a parent or other caretaker becomes ill or dies.
Progress Ongoing

For more information:
[http://www.drnj.org/litigation.htm]

To view complaint:
[http://www.drnj.org/pdf/Waiting%20List%20Complaint%20(Filed).pdf]

Summary Class action claimed unsafe conditions & lack of discharge plans for residents to state DD facilities.
Progress Consent decree required closure of all state institutions & the last resident moved out in 1998. ²¹

Summary Class action for people in institutions & people in the community seeking waiver services.
Progress Complaint upheld. Court ruled that the state had not furnished services with reasonable promptness but did not require the state to expand its program to include the people on the waitlist because reasonable promptness only extends as far as there are available funds & slots. Court ordered state to allocate slots as soon as they are available, determine a person's eligibility within 90 days & provide waiver services within 90 days of finding eligibility.

Summary Action on behalf of an individual with autism to prevent the state from denying Medicaid supported living services & counseling because plaintiff did not qualify for placement in an ICF/MR.
Progress Complaint upheld

Summary Class action alleging the state failed to provide adequate notice & services with reasonable promptness.
Progress Settlement.

Summary & Progress Appeal Court held that the state did not have a duty to provide new PAS (safety monitoring) as well as other PAS already provided to plaintiffs with Alzheimer's & cognitive disabilities at risk of institutionalization. Appeal Court held that the plaintiffs had not been discriminated against as the same services were provided to mentally & physically disabled people & safety monitoring is not provided to any group.

Summary A compilation of 3 cases whereby plaintiffs challenged termination of home health services & referral for nursing facility placement after the state determined home health was no longer cost-effective because it exceeded 90% of the average cost of a nursing facility.
Progress Complaints upheld. Court prevented state from terminating the services as state failed to show that continuing to provide services would fundamentally alter its program. Court also found that Olmstead covers people with physical &/or sensory disabilities as much as mental or emotional disabilities¹⁴.

Summary Case challenged inadequate personal care & home health aide services.
Progress Settlement

Summary and Progress Court of Appeals ruled it was not a fundamental alteration to order NY to reform its state agency charged with assisting people with HIV to gain access to necessary services.

Summary Class action about service quality & unnecessary institutionalization. It demands the expansion of supported housing & better conditions in adult homes.
Progress Ongoing.

The U.S. District Court for the Eastern District of New York issued a memorandum and order regarding the case on 9/8/09. The court ruled that the State of New York violates the ADA and RSA by unnecessarily segregating approximately 4,3000 people with mental illness in large private �adult homes.�

The Memorandum and Order can be downloaded at: [http://www.nyed.uscourts.gov/pub/rulings/cv/2009/03cv3209mo090809.pdf]

For more information:
[http://www.bazelon.org/newsroom/2009/DAIruling9-8-09.htm]

and
[http://www.bazelon.org/incourt/docket/dai.html]

To download a copy of the plaintiff�s complaint, go to:
[http://www.bazelon.org/issues/disabilityrights/incourt/nycomplaint/finalcomplaint.pdf]

Summary Class action on behalf of people with mental illness & chemical addiction living in NY city jails alleging they have been discriminated against because other individuals who have chemical addiction but no/minor mental illness are released to community treatment programs more quickly.
Progress Ongoing.

Summary Plaintiffs claim that persons with MR/DD and mental illness were discharged from hospitals directly into nursing homes, with no services provided for in-home and community care.
Progress Ongoing.

Summary Complaint that state failed to provide integrated residential services to all eligible people with developmental disabilities and waiver wait list was not moving at a reasonable pace.
Progress Case dismissed.

Summary Case (brought by private providers of services for people with developmental disabilities) alleging the state is not ensuring that Medicaid services are administered uniformly across counties.
Progress Court ordered providers to either make new, mutual contracts or continue to operate under existing contracts until agreement was reached. CMS was asked to give technical assistance to facilitate the change in contracting rules.

Summary Class action (including seniors, people with disabilities & advocacy organizations) challenging the state decision to limit the number of prescribed medications that HCBS waiver participants could receive, arguing that this would force plaintiffs into institutions⁵
Progress Settlement. State policies were revised to allow waiver participants to have up to seven generic prescriptions and all Medicaid beneficiaries six per month. Individuals who need additional prescriptions will have the option to request them via a prior authorization process.

Summary Complaint alleged the state was not providing services in the most integrated setting to eligible individuals with developmental disabilities with 'reasonable promptness'.
Progress Settlement. Due to changes in state revenues, Court approved a modified settlement agreement proposing a slower rate of expansion & change (to 2011).¹²

Summary Class action for plaintiffs in a state psychiatric hospital despite being assessed as suitable for community placement.
Progress Settlement The state will create 75 community placements and establish a special $1.5 million fund to facilitate the community integration of eligible individuals by June 2005.

Summary Case challenging lost eligibility for waiver services after the state narrowed eligibility for long-term care services by raising the threshold for assessed functional impairment necessary to qualify for services. Services have resumed for some levels of need.
Progress Case dismissed but under appeal

Summary Case regarding 2 individuals, one with TBI, one with multiple sclerosis & mental illness. Both were denied access to the state attendant care program as they cannot hire/supervise attendants or manage legal/financial affairs.
Progress Court found their inclusion would be a fundamental alteration & is not 'state discrimination ...it is a case where an additional handicap...renders participation in the program ineffectual'

Further details
[http://www.cms.hhs.gov/smdl/downloads/smd072998.pdf]

Summary This successful case is lauded¹¹ (along with Richard C. v. Houstoun, PA9) as a key influence in the development of deinstitutionalization efforts in Pennsylvania.

Summary The plaintiff was confined to a nursing facility even though it was determined that she could live in the community with PAS⁵¹⁰.
Progress Court ruled the state's failure to provide services in the most integrated setting violated the ADA & the provision of waiver services would not fundamentally alter the nature of the program.

Summary Case regarding individual found not guilty of murder by reason of insanity & committed to state hospital. Plaintiff sued the hospital for extending his commitment & not treating his dyslexia in a more integrated setting.
Progress Court ruled the plaintiff was not a qualified person under the ADA since he had been assessed as dangerous & to treat him in the community would be a fundamental alteration of the state program.

Summary In this class action, the court ruled favorably for patients in a state psychiatric hospital who had a dual diagnosis & were seeking treatment in the community.¹⁰

Summary Case regarding people living in the state hospital despite being assessed as eligible for community placement.
Progress Settlement

Summary Class action regarding waitlists (filed by the Disability Law Center).

Summary Case regarding waitlists (filed by the Disability Law Center).
Progress Lawsuit withdrawn after the Governor announced a plan to reduce the waiting list.

Summary Lawsuit by families of people with DD who were to be moved out of a facility that was to be closed.
Progress Court ruled that Olmstead did not mean that people have the right to stay in institutions if they refuse HCBS

Summary Case regarding residents of a state nursing facility for seniors. Plaintiffs sought to remove eligible persons from the institutions into HCBS settings.
Progress Settlement. The state will evaluate residents of the nursing facility to see if they are appropriate for discharge to the community.

Summary Class action about a limit on the number of individuals served through the Person/Family-directed Supports waiver.
Progress Settlement. Provides that the state will request funding to serve the number of individuals authorized in the waiver program.

Summary Class action regarding plaintiffs institutionalized in state hospital despite recommendation for community placement.
Progress Settlement. The state submitted a four-year plan regarding the community placement of Norristown State Hospital

Summary Case brought by a coalition of agencies providing services to individuals in ICF/MR &/or the HCBS waiver program for people with MR/DD, which asks the court to order that direct care staff costs are reimbursed & updated.
Progress Case dismissed

Summary Plaintiffs are waitlisted for ICF/MR services & filed this case in response to a proposed reduction of funds for reducing the community services wait list.
Progress Settlement

Summary Plaintiffs were resident of ICF/MR which the state wants to close. Plaintiffs contend that moving them to another ICF/MR or to a HCBS setting would violate Olmstead's 'most integrated setting' rule.
Progress Case dismissed

Summary Class action alleged the state failed to fund sufficient small resident places for people in need of ICF/MR services.
Progress Complaint dismissed

Summary Case alleged that the state was acting unlawfully by failing to fund sufficient private & small public ICF/MR facilities for adults with mental & physical disabilities.
Progress Complaint dismissed. Court found the state was not violating 'reasonable promptness' because it was providing placements in large ICF/MRs.

Summary Class action alleges unnecessary institutionalization of people in residential facilities. The allegations regarded the same facilities cited in USA v. State of TN & the cases were considered together⁹

Summary Plaintiff's allegations about facilities cited in People First of TN v. Clover Bottom et al (TN3) & were considered with that case⁹.
Progress Settlement

Summary Class action brought against one of the state's residential facilities.
Progress Settlement

Summary Class action alleged state unlawfully denied home health to waiver participants in order to hold down costs and caused them to be unnecessarily institutionalized
Progress Settlement. The state agreed to remove any planned restrictions on home health services to waiver participants and to develop HCBS waiver alternatives to nursing facilities.

Summary Class action about lack of reasonable promptness in furnishing ICF/MR or waiver services to eligible individuals.
Progress Settlement The state agreed to form a new Self-Determination HCBS waiver to serve the individuals placed on the wait list as part of the settlement. Also, people who remain on the wait list are to receive $2,280 per year in 'consumer-directed support.' The state is to make additional improvements in their service infrastructure to this population as part of the settlement.

Summary Class action regarding wait list & people at risk of institutionalization¹¹. The complaint alleged the state gives insufficient attention to a backlog of people, committing new resources to placing residents out of state institutions to comply with court orders from other lawsuits (People First v. Clover Bottom & USA v. State of TN).
Progress Settlement

Summary Plaintiffs with varying levels of disability filed suit to prevent cuts in Home Health care hours which would result in reduced services and eventual forced institutionalization.
Progress Preliminary injunction granted to plaintiff to suspend cuts in Home Health services until further evaluation is made.

Summary Case alleging the state was not meeting obligations to furnish EPSDT services to children.
Progress Consent decree.

Summary Case alleging the lack of minimally adequate crisis intervention services had lead to the state incarcerating individuals while they await transportation to mental health services.
Progress Complaint upheld.

Summary Case challenges state policy of denying Medicaid community services to anyone whose needs exceed 95% cost of nursing home care, rather than providing 95% of services.
Progress Settlement. Provides for waiver & provision of Medicaid Home Health services.

Summary Case alleged state Medicaid denies children medically necessary EPDST services & puts them at risk of institutionalization.
Progress Settlement. The state to change policies and provide EPDST services & information.

Summary Class action brought by service providers when the state failed to change its ICF/MR & HCBS waiver payment system so that it could periodically update (rebase) payments to account for changes in cost. Payments were adversely affected & non-state payments were different to state operated services' payments.
Progress Ongoing

Summary Class action (brought by Arc of TX & 11 individuals living with their families or in ICF/MRs) asking for expansion of HCBS waiver.
Progress Ongoing.

Summary Class action (brought by 9 individuals & Arc of Utah) concerning 1,300 individuals waitlisted for services.
Progress Ongoing.

Summary Class action alleged the state impermissibly waitlisted individuals enrolled in the HCBS waiver. One factor in this action was a Dept. of Medical Services directive restricting new/expanded services to individuals who can no longer remain in the family home due to caregiver incapacity or other critical situations.
Progress Case dismissed. The state agreed to change its policies so that individuals receive all the services they are determined to require.

Summary Complaint regarding abuses at an assisted living facility. Although this case does not invoke an ADA integration mandate claim, one of the abuse claims is regarding failure to provide discharge planning to assist individuals to live in the community.
Progress Settlement. The terms of the settlement entails Brice's Villa, an assisted living facility, to do the following: increase training for staff on medication administration and emergencies; complete medication administration records in a timely and accurate manner; retain a registered nurse to monitor medication administration; retain a pharmacist to review and certify a monthly inventory of medications and needles; retain a healthcare professional responsible for oversight of the facility; improve screening procedures of residents and report critical incidents of residents.

Summary Case found that the exclusion of people with mental disabilities from eligibility for Medicaid personal care services violates the ADA20.

Summary Class action regarding patients in a state psychiatric hospital who have been denied opportunities for discharge.
Progress Court order requires a new system of services for people with mental illness &/or DD & plan to discharge residents to most integrated settings appropriate.

Summary Case regarding waitlists & lack of access to additional services for Medicaid recipients.
Progress Ongoing

Summary Class action challenges change in eligibility limits for a HCBS waiver. Medically needy people (who have higher incomes) became ineligible to participate but eligible for nursing facilities.
Progress Settlement. The state secured reinstatement of medically needy to a HCBS waiver. The new waiver was implemented in June 2004 with limits to services to no more than 200 individuals.

Summary Class action regarding the treatment & conditions of care for patients receiving forensic services in a state hospital.
Progress Court ordered state to ensure patients receive improved treatment & in the most integrated setting appropriate

Summary Case about failure to provide or make full range of services available on HCBS waiver.
Progress Ongoing.

Summary Class action challenging inadequate services in state hospital & lack of community support for residents.
Progress Settlement. Provides for quality assurance in hospital, improved discharge process, identification of class members who have mental health needs in the community.

Summary A consolidation of three cases alleging that the WA Shared Living Rule (which paid PAS providers living with the recipients 15% less than those who did not live with the recipients) was unconstitutional.
Progress Court found that there was violation but case was dismissed as the state rescinded the Share Living Rule during court proceedings.

Summary Class action lawsuit involving Wisconsin's Family Care program, a program operated under 1915(b) and 1915(c) HCBS waivers. Plaintiffs claim that low provider payments in the programs force providers to leave the programs and so force consumers into institution.
Progress Ongoing.

Summary West Virginia eliminated state institutions for persons with developmental disabilities as a result of the court orders in this case.
Progress Settlement

Summary Class action alleged state failed to provide Medicaid long-term care with reasonable promptness. Case demonstrates eligibility for ICF/MR services extends to HCBS & that states need to show "more than that [it]... has not appropriate enough funding"⁹.
Progress Settlement. Court ordered state to develop a plan to eliminate waiting lists & make other improvements. State agreed to increase the number of individuals with developmental disabilities who receive HCB waiver services by 875 over a five-year period in 2000. The state also agreed to revise their procedures regarding giving timely notice to applicants for services.

Summary Case challenging conditions at a hospital & insufficient HCBS
Progress Settlement to create a partnership process (including advocates) to monitor & recommend systems change.

To download the settlement agreement, go to:
[http://attorneygeneral.state.wy.us/SettlementAgreement4.pdf ]