Unhappy with the lack of progress on a 2011 legal settlement, U.S. District Court Judge Donovan Frank on September 3 granted broader powers to a federal court monitor. Frank’s decision effectively puts state services for people with disabilities under heightened federal oversight for the next two years.

It also draws awareness to community frustration over the state of the 2011 Minnesota Extended Treatment Options (METO) settlement.

In his latest filing, Frank stated that delays in compliance cannot be tolerated. He scolded the Minnesota Department of Human Services (DHS) for failure to comply with the METO settlement. The settlement is meant to provide a number of improvements in the lives of Minnesotans with disabilities.

“Continued implementation delays can no longer be tolerated,” Frank said in his order. He added, “Multiple admonitions to the DHS have been insufficient to secure effective action by the DHS to close the significant gaps between its stated intentions and actions.”

The settlement won approval in late 2011. It is centered on a 2009 lawsuit filed by three families against the State of Minnesota and other defendants for restraining and secluding residents with developmental disabilities, The families had children at METO. They contended METO staff routinely restrained residents in a prone face-down position and placed them in metal handcuffs and leg hobbles, placed residents in seclusion and isolation rooms for extended time periods, and deprived them of visits from family members, among other claims. One resident was physically disciplined after he touched a pizza box.

The lawsuit sought damages for violations of the federal civil and constitutional rights of residents with developmental disabilities, and asked the court to enter an injunction against the state to prohibit its re-straint and seclusion practices, and to declare them unconstitutional.

METO, which was located in Cambridge, was a program intended to serve individuals with developmental disabilities who posed a risk to public safety. The program was created in 1995. One child in the METO case was sent there for throwing paint at school. Parents were not only upset with how decisions were made to send children to METO; they also decried their lack of access of information and to their children themselves.

METO was closed by the state as a result of the settlement, and its facility housed the Minnesota Specialty Health System — Cambridge program. That program was closed August 29, when the last resident moved out.

DHS recently informed members of the Cambridge Community Liaison Committee of the closing and noted that state officials are working on a successor program, the Minnesota Life Bridge Program. That program began in March, housing residents in community-based settings. DHS is working to find program sites in communities around the state and to develop mobile teams to serve people in their homes.

The settlement called for a number of measures, including having families and state officials develop appropriate policies and procedures for use at state facilities. A key goal was to promote the move of people with disabilities from institutions to less restrictive settlings. Another goal; was to reduce the use on physical restraints on patients in state-operated facilities.

It also included scrutiny of the DHS rule known as Rule 40, which governs and protects people with developmental disabilities. Yet another key piece of the settlement is the development of an Olmstead Plan consistent with the 1999 U.S. Supreme Court’s decision in Olmstead v. L.C., 527 U.S. 582 (1999).  The Olmstead planning process is currently underway.

But in his most recent ruling Frank said DHS has repeatedly failed to comply with the settlement. He empowered a federally appointed court monitor assigned to the case to supervise the timely implementation of the settlement. The monitor was also give more authority to develop specific compliance standards and as well as ways to measure outcomes.

The judge also extended court jurisdiction over the settlement until December 4, 2016, putting state disability services under federal oversight for a longer time.Deputy DHS Commissioner Anne Barry sent a letter to the court in late August. She said the state has made much progress in meeting the settlement’s objectives. Barry also noted that state officials are continuing to work with the court monitor to make changes as spelled out in the settlement.

Barry gave examples of what has been done, citing the ongoing work on the Olmstead Plan as an example. The plan, which is called for in a United States Supreme Court ruling, calls for measures to fully integrate people with disabilities in all aspects of community life.

Gov. Mark Dayton called for work to jump-start the Olmstead Plan after the METO settlement. Work on the plan continues, after the release of a draft plan late last year.

Another sign of progress Barry cited is that training of state employees in person-centered planning. More than 6,000 state workers have undergone this training.

But the court monitor’s reports have indicated that Minnesota still has a long ways to go. One red flag has recently been raised over the lack of training for county social workers around the state. The settlement requires that when people with disabilities are moved out of institutions, county social workers are to provide personalized support. But that hasn’t been the case everywhere, which means some people have not been able to move onto independent living.