A lengthy legal battle, which has had many implications for Minnesotans with disabilities, officially comes to an end October 24. But in a September filing, U.S. District Court Judge Donovan Frank emphasized that the fight for improved care for adults with disabilities isn’t over.
If mistreatment occurs again at two state-run facilities for people with disabilities, Frank warned that state officials could face additional consequences. The facilities in question are the Anoka-Metro Regional Treatment Center and the St. Peter Forensic Mental Health Program.
The judge is urging state officials to continue working with disability right advocates. Otherwise, he said the settlement could become an “entirely empty promise.” And more lawsuits against the state could be forthcoming.
In his September 4 ruling Frank scolded the Minnesota Department of Human Services (DHS) for continuing to delay and object to responsibilities established in a 2011 settlement. In the past the judge has repeatedly denied state requests to end federal court oversight, saying that more must be done to make sweeping reforms in care.
“The termination of the court’s jurisdiction over this matter, though, should in no way imply that the court feels that justice has been served,” Frank’s ruling stated. “At some point, the purpose of the agreement was lost—overcome by litigation tactics to end this court’s jurisdiction at the expense of making meaningful lasting improvements in the lives of people with disabilities. At best, these actions fall short of the ideals defendants initially espoused; at worst, they are an embarrassment to the State of Minnesota as a whole and a manifest injustice against the persons the agreement was intended to serve. Had defendants directed their litigious energy into implementing the agreement, they may have established a national model. Sadly, they did not.”
“Justice requires no less,” Frank said. “If not, the court fears that it is not a matter of if, but when, future lawsuits will arise.”
The long and complex court battle began in July 2009, when three families filed suit on behalf of their adult children with disabilities. At the center of the lawsuit was the Minnesota Extended Treatment Options (METO) facility in Cambridge, which was a state mental health treatment facility.
Before the lawsuit was filed, METO had long been a topic of scrutiny for the disability community, closely monitored by the Minnesota Disability Law Center, parents and family members of residents, and a number of disability rights, advocacy and service provider organizations.
Use of restraints and placement of patients in seclusion at METO were at the heart of the lawsuit, filed by the Jensen, Jacobs and Allen-Brinker families. They contended their adult sons were subject to seclusion and restraint, and cruel treatment. One of the young men was sent to METO for throwing paint at school. All of the families struggled to get their sons out of METO.
The lawsuit soon became a class action involving more than 300 families.
Court documents stated that METO staff routinely restrained patients in a prone face-down position and placed them in metal handcuffs and leg hobbles at risk of injury, causing them to struggle, cry and shout once they were in the restraints. METO also placed patients in seclusion rooms for extended time periods, and deprived them of visits from family members.
Restraints and seclusion were used by METO as a practice of behavior modification, coercion, discipline, convenience and retaliation. METO staff allegedly restrained some patients hundreds of times, and used these tactics for conduct as benign as touching a pizza box, not staying within eyesight of staff, or even after patients were calmly eating a snack or watching television.
State officials argued that restraint of patients at METO is necessary. But families and their legal counsel said that their case is one about human dignity and respect for those with developmental disabilities.
A $3 million settlement was reached in fall 2010. METO was closed. Use of mechanical restraints at state facilities ended. Another key condition of the settlement was that the families and state officials would work together to develop appropriate policies and procedures for use at METO and DHS facilities. The parties formed a committee to include stakeholders within the developmental disabilities community to study, review and modernize the DHS rule (Rule 40), which governs and protects people with developmental disabilities, to reflect current best practices including the use of positive and social behavioral supports.
Another major outcome of the case was that it jump-started work on Minnesota’s long-awaited Olmstead Plan. All states are required to have an Olmstead Plan, as a result of the 1999 U.S. Supreme Court’s decision in Olmstead v. L.C. The plans are to guide states on how to help people with disabilities live lives that are fully integrated into their communities.
But disability advocates had hoped for more reforms, and were frustrated by the years of court oversight of DHS dragged on. Court filings and hearings over the years centered on the progress of reform or the lack thereof. Outside reviews and what they indicate have been a flash point in the case.