CIL-NET Presents…

1. CIL-NET Presents… Implementing and Enforcing Olmstead A National Onsite Training Illinois Community Integration Litigation May 12, 2011 Atlanta, Georgia Presenter: Karen Ward Equip for Equality 1

2. What Led to Filing Community Integration Cases in IL • Heavy reliance on institutions to serve people with all developmental disabilities, mental illness, and physical disabilities • ADA’s “Integration Mandate” • Supreme Court’s decision in Olmstead 2

3. What Led to Filing Community Integration Cases in IL, cont’d. 3 Various efforts by State of Illinois did not result in meaningful change No response by Governor to letter sent by advocates

4. Common Features of the Three Lawsuits 4 EFE, ACLU of IL and Access Living joined to bring the three Olmstead cases Each case has assistance of a pro bono law firm Each case is a class action Each case has resulted in push back from facility owners

5. Common Features of the Three Lawsuits, cont’d. We made extensive outreach efforts to the disability community regarding all three cases We used media in all three cases

6. Ligas v. Hamos Case Background Suit filed in 2005 by 9 individuals with DD Nearly 6000 people living in large private ICFDDs (9 or more) and thousands more living at home “at risk of institutionalization” Suit does not cover DD State-Ops or kids EFE co-counseling case with Access Living, ACLU and SNR Denton (formerly Sonnenschein Nath & Rosenthal)

7. Ligas Case Background, cont’d. Case seeks meaningful choice of community alternatives Does not ask State to move people into community against their will or to close institutions In 2006, court granted class certification 3 groups tried unsuccessfully to intervene Parties engaged in extensive discovery

8. Ligas Case Background, cont’d. 2 Plaintiffs had 5 expert witnesses Parties began serious settlement negotiations in 8/08 – trial scheduled for 10/08 Trial postponed when negotiations progressed Parties reached a proposed Consent Decree in 11/08 and trial was avoided

9. Ligas Case Background, cont’d. 3 Notice provided to class members Over 2,000 people objected to the proposed agreement Concerns about provisions for bed closure, evaluations and single point of entry After Fairness Hearing in July 2009, Judge denied request for final approval and de-certified the class

10. Ligas Case Background, cont’d. 4 To address concerns of the objectors and the Judge, the parties modified the class to be limited to people who have a “current record” of wanting community services. A new agreement was reached. Previous objectors again raised concerns and the Judge allowed them to join the case as Intervenors in April 2010.

11. Ligas Case Background, cont’d. 5 • After extensive negotiations, in January 2011, the Plaintiffs, the State, and the Intervenors reached a new agreement that all could support • Judge certified new class and granted preliminary approval of new agreement • Notice of agreement sent to class members • Comments on agreement are due by May 13th • Fairness Hearing will be held on June 15th

12. Terms of Proposed Consent Decree • Class Definition: • 18 or older with DD and Medicaid eligible; and • Lives in a private ICF/DD with 9 or more residents or lives in the family home seeking services; and • The State of Illinois has a “current record” of the person seeking Community-Based Services or placement in a Community-Based Setting

13. Terms of Proposed Consent Decree, cont’d. • Consent Decree – not a settlement • Development of Community Capacity • Resources and Budget Requests • Annual budget requests sufficient to develop and maintain services outlined in Decree • Implement funding mechanisms that facilitate transition among service settings – including combining appropriations • No legislative contingency

14. Terms of Proposed Consent Decree, cont’d. 2 ICF-DD residents desiring community placement will receive an individualized, independent evaluation. Over 6 year period, any of the approximately 6,000 ICF-DD residents who desire placement in the community would transition to the most integrated community-based setting appropriate for their individual needs.

15. Terms of Proposed Consent Decree, cont’d. 3 • All ICF-DD residents happy with their current placement are not in the class and would not be required to move. • The proposed Consent Decree ensures that resources necessary to meet the needs of those who choose to continue to reside in ICF-DDs will be made available.

16. Terms of Proposed Consent Decree, cont’d. 4 For people with DD living at home: • Within 1 year, State must screen all people with DD living at home who have a current record of wanting Community-Based Services or placement in a Community-Based Setting. • Screening must include whether person meets Crisis criteria

17. Terms of Proposed Consent Decree, cont’d. 5 • Crisis includes: • Imminent risk of abuse or neglect • Imminent risk of homelessness • Caregiver is deceased • Caregiver unable to meet needs of individual jeopardizing individual’s health and safety • Individual’s behaviors put individual or family member at risk of serious harm

18. Terms of Proposed Consent Decree, cont’d. 6 • Crisis: • No limit on # of people in Crisis to be served • Services to be provided expeditiously • Non-Crisis: • At least 1000 people provided community services within first 2 years • At least 500 people provided community services in each of the 3rd, 4th, 5th and 6th years • After 6th year, people not served will move off waiting list at a reasonable pace

19. Terms of Proposed Consent Decree, cont’d. 7 Implementation Plan: • State to develop draft plan within 90 days which will be finalized within 6 months • Plan will include timetables, strategies and protocols to ensure fulfillment of Decree’s terms • Plan will describe necessary resource development activities • Plan will identify services and supports not currently available

20. Terms of Proposed Consent Decree, cont’d. 8 Monitor • Will assess compliance with Decree and develop measurable standards for compliance • Will try to resolve issues, but can recommend action by court if unable to resolve • Parties shall try to reach consensus on Monitor, but Court will appoint if parties cannot agree • Must be independent and knowledgeable

21. Terms of Proposed Consent Decree, cont’d. 9 Termination of Decree • Court will retain jurisdiction of decree for at least 9 years • Court will grant State’s termination request if the Court finds that: • the State has substantially complied with the terms of the Decree; and • the State has implemented and is maintaining a system that complies with the Decree

22. Status of Consent Decree • People can join the class anytime throughout the duration of the Consent Decree

23. Williams v. Quinn case background • Suit on behalf of people with mental illness living in IMDs (Institutions for Mental Diseases) • Approximately 4,500 people reside in IMDs statewide • IMDs are 100% state funded • Suit against state officials • EFE co-counseling with ACLU, Access Living, Bazelon Center and Kirkland & Ellis • Certified as a class action in 2007

24. Williams v. Quinn case background, cont’d. • Parties reached an agreement in March 2010 • Over 1000 people objected to proposed Consent Decree • Judge found improper communication by IMDs • U.S. Department of Justice filed brief supporting agreement and testified at Fairness Hearing • Following Fairness Hearing, Judge approved the proposed Consent Decree

25. Terms of Proposed Consent Decree Class Definition • All Illinois residents 18 years old or older and who: • have a Mental Illness; • are institutionalized in a privately owned Institution for Mental Diseases; and • with appropriate supports and services may be able to live in an integrated community setting.

26. Terms of Proposed Consent Decree, cont’d. Evaluations: • Within 2 years, IMD residents will receive evaluations to determine what’s required to live in community (residents can refuse evaluation) • Evaluations conducted by professionals independent of the IMD • Evaluations must address the individual’s own vision and desires for the future and their needs

27. Terms of Proposed Consent Decree, cont’d. 2 Timing of Community Placements • All residents not opposing community shall be placed in community setting within 5 years • Not less than 256 class members placed after 1 year of finalization of Implementation Plan and a total of 640 placed after 2 years • 40% of class members will be placed after 3 years and 70% of class members will be placed after 4 years

28. Terms of Proposed Consent Decree, cont’d. 3 • Permanent Supportive Housing (PSH) will be considered most integrated setting for class members unless class member: • has severe dementia or other severe cognitive impairments • has medical needs requiring a high level of skilled nursing care that may not safely be provided in PSH • presents an imminent danger to themselves or others

29. Current Status of Williams decree • Independent Monitor appointed in November, 2010 – Dennis Jones • Named plaintiffs placed in the community • Draft Implementation Plan released • Implementation Plan to be finalized at end of June, 2011

30. Colbert v. Quinn • Community integration litigation on behalf of people with disabilities living in nursing homes • Limited to Cook County • Certified as a class action in 2008 • Over 20,000 class members – class comprised of people with physical disabilities and mental illness • Parties are engaged in settlement negotiations • EFE co-counseling with ACLU, Access Living and SNR Denton

31. Working With Your P&A on Olmstead Litigation • CILs can play an important role in Olmstead litigation. • Roles include: - providing P&As with information about the nature and scope of institutionalization based on the experience of CIL staff - outreach to the disability community

32. Working With Your P&A on Olmstead Litigation - Outreach • Outreach prior to filing of the lawsuit: - to define the problem and the solution; - to get support from the disability community; and - to identify named plaintiffs (if case is going to be filed as a class action).

33. Working With Your P&A on Olmstead Litigation – Outreach, cont’d. • Outreach during the lawsuit: - to keep the disability community apprised of developments; - to seek suggestions from the disability community; and - to help prepare for trial or fairness hearing.

34. Questions?

35. Thank You Karen Ward www.equipforequality.org karen@equipforequality.org 312-341-0022, ext. 7330 Laura Miller laura@equipforequality.org 312-341-0022, ext. 7316

36. CIL-NET Attribution Support for development of this training was provided by the U.S. Department of Education, Rehabilitation Services Administration under grant number H132B070002-10. No official endorsement of the Department of Education should be inferred. Permission is granted for duplication of any portion of this PowerPoint presentation, providing that the following credit is given to the project: Developed as part of the CIL-NET, a project of the IL NET, an ILRU/NCIL/APRIL National Training and Technical Assistance Program.