Enforcing the ADA’s Integration Mandate

Since our landmark victory in Helen L., DRP has used the ADA’s integration mandate to secure community services for literally hundreds of Pennsylvanians who were unnecessarily institutionalized, including the following:

• Charles Q. v. Houstoun – In 1995, DRP filed this case on behalf of several residents of Harrisburg State Hospital. The court granted summary judgment for two of the clients and judgment following trial for a third client, finding that Pennsylvania’s continued institutionalization of the clients violated the ADA’s integration mandate.
• Kathleen S. v. Dep’t of Public Welfare – In 1997, DRP filed this class action lawsuit on behalf of Haverford State Hospital (“HSH”) residents. To our knowledge, this was the first lawsuit in the country that sought to enforce the ADA’s integration mandate on behalf of a class.  While Pennsylvania had decided to close HSH, it planned to transfer many residents to another state hospital.  Following trial, the court determined that Pennsylvania’s failure to ensure community placements for class members who were appropriate for discharge violated the ADA’s integration mandate.  After Pennsylvania appealed, the parties entered into a settlement agreement that resulted in development of community placements for approximately 225 individuals.
• Litman v. Dep’t of Public Welfare – In 1999, DRP filed this lawsuit on behalf of a class of Norristown State Hospital (“NSH”) residents who were elderly and/or medically fragile and scheduled to be transferred to South Mountain Restoration Center, a state-operated nursing facility far from their family and friends. We asserted that, under the ADA’s integration mandate, the class members should be placed in the community or, if necessary, in facilities closer to their friends and family.  After we filed the lawsuit, Pennsylvania agreed not to transfer class members to South Mountain Restoration Center and implemented a plan to ensure their placement closer to their families and friends.
• Frederick L. v. Dep’t of Public Welfare – In 2000, DRP filed a class action lawsuit to enforce the ADA’s integration mandate on behalf of residents of Norristown State Hospital. Although the trial court ruled against our clients, the decision was overturned.  In two rulings, the Court of Appeals held that Pennsylvania could not establish a fundamental alteration defense to refute an ADA integration mandate claim based merely on its history of deinstitutionalization.  Rather, the court held that Pennsylvania must have a viable integration plan that includes benchmarks and timelines for discharges.
• Pennsylvania Protection & Advocacy, Inc. v. Dep’t of Public Welfare – In 2000, DRP filed an ADA integration mandate lawsuit on behalf of residents of South Mountain Restoration Center, a state-operated nursing facility that primarily served former state hospital residents. The Court of Appeals held that Pennsylvania was not entitled to use the fundamental alteration defense to defeat the  ADA claims because Pennsylvania completely excluded South Mountain residents from access to its community mental health system.  Following that decision, the parties entered into a settlement agreement that included provisions for community placements for South Mountain residents who were appropriate for and not opposed to discharge.
• Benjamin v. Dep’t of Public Welfare – In 2009, DRP filed a class action lawsuit on behalf of residents of the state-operated institutions for people with intellectual disabilities. The court determined that Pennsylvania violated the ADA’s integration mandate by failing to provide community services for those residents who wanted those services.  The parties subsequently settle the case and Pennsylvania agreed to provide community services for class members not opposed to discharge.
• Jimmie v. Dep’t of Public Welfare – In 2009, DRP filed a class action lawsuit on behalf of state hospital residents with diagnoses of intellectual disability. Pennsylvania agreed to a settlement that resulted in community placements for class members.

DRP has also successfully invoked the ADA’s integration mandate to protect individuals with disabilities who were at risk of unnecessary institutionalization due to the lack of community services.  For instance:

• Marston v. Dep’t of Public Welfare – In 2014, DRP filed and successfully resolved an ADA integration mandate lawsuit for a man with intellectual disability and traumatic brain injury who was at risk of placement in a state institution after his community residential service provider terminated his services. After a hearing on our motion for a temporary restraining order, the parties stipulated to an order to prevent his commitment and then a willing community services provider was identified and developed a program for him.
• Hijazi v. Dep’t of Human Services – In 2015, DRP filed and successfully settled a lawsuit on behalf of a woman with mental illness and physical disabilities who was unable to access home and community-based services because, for one reason or another, she was deemed unqualified for available programs. As a result, she was at risk of going into a nursing home.  The lawsuit resulted in the client being admitted to a program that provided her the in-home and community services and supports she needed.
• Doxzon v. Dep’t of Human Services – In 2019, DRP filed this lawsuit on behalf of a young woman with cerebral palsy who could not timely access community services. In the summer of 2020, when the client was at risk of homelessness or institutionalization because she was living in an inaccessible basement room, DRP secured a temporary restraining order and preliminary injunction that required Pennsylvania to provide her with safe housing and support services pending development and implementation of an appropriate service plan.

Preventing and ending unnecessary institutionalization of people with disabilities remains one of DRP’s core goals.  We are committed to using litigation and other strategies to achieve it.