The United States District Court for the District of Columbia held in its December 31, 2024 Opinion: “the Court finds that the District of Columbia has failed to comply with the integration mandate of Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581 (1999), thereby violating the Americans with Disabilities Act and Section 504 of the Rehabilitation Act. The Court also considered the “fundamental alteration defense” under Olmstead and has concluded, based on the evidence presented at trial, that the District has failed to demonstrate that three of the four accommodations requested by plaintiffs are unreasonable. The Court therefore will enter judgment for the plaintiffs.”
The plaintiffs are a class of physically disabled individuals who have received Medicaid-funded long-term care in nursing facilities for more than 90 days but wish to transition – and are capable of transitioning – to the community to receive home- and community-based long-term care. The plaintiffs contended that the District has for decades violated Title II of the Americans with Disabilities Act of 1990 (“ADA”), 42 U.S.C. § 12131 et seq., and Section 504 of the Rehabilitation Act, 29 U.S.C. § 794 et seq., by causing their unjustified segregation in nursing facilities (i.e., institutions). Proceeding under the framework of Olmstead, the plaintiffs sought declaratory and injunctive relief to compel the District to alter its policies and procedures so as to better facilitate the plaintiffs’ successful transition to the community.
Following the trial, the federal court stated, in part: “The Court concludes that the District of Columbia has violated both the Americans with Disabilities Act and Section 504 of the Rehabilitation Act. It has violated the integration mandate of Olmstead, because it does not have a comprehensive and effectively working Olmstead Plan in place. As a result, the Court has considered the alternative established by Olmstead: whether the District has shown that “in the allocation of available resources,” providing immediate relief to the plaintiffs “would be inequitable, given the responsibility the [District] has undertaken for the care and treatment of a large and diverse population of persons with . . . disabilities.” Olmstead, 527 U.S. at 604. Applying this “fundamental alteration defense” to the facts found based on the evidence at trial, the Court concludes that three of plaintiffs’ requested accommodations are reasonable; one is not.”
“Consistent with the foregoing Findings of Fact and Conclusions of Law, the Court finds the defendant District of Columbia liable for violating the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973. The Court also concludes that plaintiffs continue to satisfy the class certification requirements under Federal Rule of Civil Procedure 23(a) and 23(b)(2). The Court therefore orders relief on behalf of all members of the class, defined as: All persons with physical disabilities who, now or during the pendency of this lawsuit: (1) receive D.C. Medicaid-funded long-term care services in a nursing facility for 90 or more consecutive days; (2) are eligible for Medicaid covered home and community-based long-term care services that would enable them to live in the community; and (3) would prefer to live in the community instead of a nursing facility but need the District of Columbia to provide transition assistance to facilitate their access to long-term care services in the community.”
“Pursuant to the Declaratory Judgment Act, the Court declares that defendant’s failure to provide plaintiffs with long-term care services in the most integrated setting appropriate to their needs violates Title II of the Americans with Disabilities Act. It further declares that defendant’s failure to provide plaintiffs with long-term care services in the most
integrated setting appropriate to their needs violates Section 504 of the Rehabilitation Act.”
“The Court will enter a permanent injunction requiring defendant to promptly take the following steps that are necessary to serve plaintiffs in the most integrated settings appropriate to their needs: (1) develop and implement a working system of transition assistance for plaintiffs whereby defendant, at a minimum, (a) informs D.C. Medicaid-funded nursing facility residents, upon admission and at least every three months thereafter, about community-based long-term care alternatives to nursing facilities; (b) elicits D.C. Medicaid-funded nursing facility residents’ preferences for community or nursing facility placement upon admission and at least every three months thereafter; (c) begins D.C. Medicaid-funded nursing facility residents’ discharge planning upon admission and reviews at least every month the progress made on that plan; and (d) provides D.C. Medicaid-funded nursing facility residents who do not oppose living in the community with assistance accessing all appropriate resources available in the community; (2) ensure sufficient capacity of community-based long-term care services for plaintiffs under the EPD, MFP, and PCA programs, and other long-term care service programs, to serve plaintiffs in the most integrated setting appropriate to their needs, as measured by enrollment in these long-term care programs; and (3) to demonstrate the District’s ongoing commitment to deinstitutionalization by publicly reporting on at least a semi-annual basis the total number of D.C. Medicaid-funded nursing facility residents who do not oppose living in the community; the number of those individuals assisted by defendant to transition to the community with long-term care services through each of the MFP, EPD, and PCA, and other long-term care programs; and the aggregate dollars the defendant saves (or fails to save) by serving individuals in the community rather than in nursing facilities.”
Source Ivy Brown v. District of Columbia, Civil Action No. 10-2250 (PLF).
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