Cuomo Agrees to Plan for Housing Mentally Ill, Ending Legal Battle
By Mosi Secret New York Times July 23, 2013
The Cuomo administration agreed on Tuesday to give 4,000 mentally ill people who have been kept in institutional homes in New York City the opportunity to move into their own subsidized apartments, settling a contentious legal battle over the care for such patients that dragged on for a decade.
Under the consent decree, which would fundamentally reshape the way long-term mental health care is delivered in the city, the state is required to present all but the most severely mentally ill residents with plans for moving into their own apartments, where they would continue to receive specialized treatment and services under an arrangement known as supported housing.
The decision to move out of the institutional settings known as adult homes and into the new housing would be left to the residents, but the agreement assumes that many will want to move. The state must set up a minimum of 2,000 supported housing units and establish more if there is additional demand.
Three years ago a judge ruled that the state was illegally warehousing the residents and ordered officials to move the residents to supported housing. But an appellate court struck down that decision, ruling on procedural grounds that Disability Advocates, the nonprofit organization that brought the lawsuit, never had legal standing to sue.
The Justice Department, which intervened in the case before the appellate ruling and has aggressively brought claims on behalf of disabled people who live in isolation, considered bringing its own lawsuit against the state, but the agreement halts that litigation. Federal law requires that people with mental illness be cared for in the least restrictive setting possible, and the agreement on Tuesday was the second attempt to bring the state into compliance.
Gov. Andrew M. Cuomo, in a statement, said, “Our state will continue to reform how we provide care and housing for all vulnerable New Yorkers to ensure they are getting treatment and support that best fits their needs.”
Cliff Zucker, the general counsel of Disability Rights New York, which changed its name from Disability Advocates, praised Mr. Cuomo for his commitment.
One of the plaintiffs in the case, Ilona Spiegel, said in a statement that she was thrilled. “At my adult home, they don’t do anything to inspire you or encourage you to move forward,” Ms. Spiegel said. “I know how to take care of myself. I want to work my way back to independence.”
As a formality, the Justice Department filed a complaint against the state and simultaneously filed the consent decree, in Federal District Court in Brooklyn on Tuesday, and Ms. Spiegel and two other plaintiffs filed a class-action suit along with the decree. The agreement was signed by representatives from the Justice Department, the state and three advocacy groups, and is subject to the approval of Judge Nicholas G. Garaufis, who presided over the case through four gubernatorial administrations.
The lawsuit started after a series of articles in The New York Times described a system in which residents of the group homes were neglected, left to swelter in the summer and sometimes subjected to needless medical treatment and operations for Medicaid reimbursement.
The lawsuit not only challenged the conditions in the homes, but also sought to change the way the state spends its money to provide care. Since the 1960s, when New York closed its psychiatric wards, the state has paid profit-making group homes to provide meals, activities and supervision and bring in providers for psychiatric and medical care.
This model, which came under sharp criticism from advocates for people with mental illness, remained in place even after a Supreme Court decision in 1999 ruling that the Americans with Disabilities Act requires states to use their limited resources to provide care in the most integrated settings possible and despite strides the state has made to provide supported housing to other needy populations like the homeless.
The state denies it violated the law as part of the agreement.
Officials from the State Office of Mental Health have five years to assess the most appropriate housing for each of the approximately 4,000 people living in group homes, with the assumption that residents should leave rather than stay. They must hire and train people to advise the residents of their options and help them decide.
Patients who have significant dementia, are dangerous or need nursing care will not be eligible.
The owners of the group homes, who receive payment from the state and federal governments for each mentally ill person they house, will see their business erode as the state redirects resources under the new deal.
The agreement included several provisions to prevent the owners from interfering with patients who are deciding whether to leave. Owners who violate the terms could face civil penalties or lose their operating certificate.
The agreement also names an independent reviewer, Clarence Sundram, who will oversee the implementation of and compliance with the agreement. The agreement is set to expire in five years.