Fighting to End Unnecessary Institutionalization Before Olmstead

Many in the disability community are familiar with the Supreme Court’s important 1999 Olmstead decision, which interpreted the integration mandate of the Americans with Disabilities Act and held that unnecessary institutionalization is discrimination.  But DRP and other advocates were fighting long before Olmstead to end unnecessary institutionalization.

Disability advocates and attorneys tried a series of legal strategies beginning in the 1960s and 1970s, arguing, for instance, that the Constitution required services be provided in the least restrictive environment and arguing that the federal Developmental Disabilities “Bill of Rights” required  community services for people with disabilities who were unnecessarily institutionalized.  Those strategies ultimately proved unsuccessful, yet, disability advocates continued to strategize on how to accomplish less restrictive environments for people with disabilities.

In the mid-1980s, DRP, working with Stephen F. Gold, filed Clark v. Cohen, a lawsuit that would result in a winning legal theory using the due process clause of the Fourteenth Amendment to attack unnecessary institutionalization. Carolyn Clark was placed in a state institution for people with intellectual disabilities when she was 15.  Ms. Clark repeatedly told staff that she did not want to be in the institution and wanted to live in the community.  Ms. Clark’s treating staff at the institution had agreed for at least nine years that Ms. Clark should be placed in a community residential facility. Yet, she remained institutionalized.  We filed a lawsuit for Ms. Clark, challenging her confinement and secured an injunction requiring her discharge and  fulfilling  her wish—to live in the community.  The decision was upheld by the Court of Appeals for the Third Circuit in 1985.  Interpreting the Supreme Court’s decision in Youngberg v. Romeo that the Constitution prohibits the use of restraints unless required by the judgment of treating professionals, the Third Circuit held it is a violation of the Constitution to confine a person in an institutional setting when the person’s treating professionals recommend discharge.

While Clark involved a single client with intellectual disability, DRP successfully used the substantive due process theory established in Clark in multiple lawsuits that secured community services for many others.  For instance:

• DRP filed Richard C. v. Snider in 1989 and Nelson v. Snider in 1993 on behalf of classes of residents of Western Center and Embreeville Center, state institutions for people with intellectual disabilities. Both cases resulted in  settlements that provided community services to virtually all Center residents.  Both Centers closed.
• DRP filed Edward K. v. White in 1988 after Pennsylvania announced its plan to close Philadelphia State Hospital (“PSH”). We filed the lawsuit to prevent residents from being transferred indefinitely to other state hospitals rather than placed in the community.  In tandem with this lawsuit, DRP worked with a broad coalition of consumers, advocates, and professionals to ensure that almost all PSH residents ultimately were discharged to community programs and that Philadelphia received adequate funding to provide comprehensive, community-based mental health services for them and others with mental illness to prevent their unnecessary institutionalization.
• In 1990, DRP became counsel to the class in Daniel B. v. White, and we secured a court order to require Pennsylvania to fund community placements for the remaining class members with intellectual disabilities at Woodhaven Center.
• DRP filed Ruth L. v. Snider in 1990 on behalf of a class of approximately 200 state psychiatric hospital residents with exclusive or primary diagnoses of intellectual disability. The lawsuit resulted in a settlement that required placements of class members into community programs.
• DRP filed Cooney v. White in 1991 on behalf of current and former residents of Southwest Habilitation Center, a state-operated unit for people with intellectual disabilities on the grounds of Mayview State Hospital. Cooney resulted in a settlement that provided community services for class members.
• DRP filed Phillip M. v. Snider in 1992 and Michael R. v. Snider in 1993 on behalf of, respectively, two Norristown State Hospital residents and eight Haverford State Hospital residents. Beyond resulting in community placements for the individual clients, these lawsuits helped secure a commitment from Pennsylvania to fully fund its “CHIPP” programs in southeastern Pennsylvania to allow expansion of community services and close state hospital beds.