New York state violated the Americans with Disabilities Act by housing more than 4,300 mentally ill people in large nursing homes rather than integrating them into the community, a federal judge ruled Tuesday.
U.S. District Judge Nicholas Garaufis of Brooklyn ruled that under federal law, the state must provide services to the disabled "in the most integrated setting appropriate to their needs," enabling them to interact with people who aren't disabled as much as possible.
Disability Advocates, the Albany-based nonprofit group that sued the state in 2003, said many people in adult homes would be better off in their own apartments -- at no more cost to the state.
"We're thrilled with today's decision," said Cliff Zucker, executive director of Disability Advocates. "We think it will make an extraordinary difference in the lives of more than 4,000 people who are now warehoused in institutions when they could be housed in the community."
Jill Daniels, spokewoman for the state Office of Mental Health, said the agency was reviewing the ruling. She said it had no immediate comment.
In his 210-page decision, the judge said Disability Advocates had proven in a bench trial that virtually all its constituents were qualified to live in "supported housing," including apartments scattered throughout the community while receiving needed services.
The adult home system resulted from practice nationwide in the 1960s and 1970s to move people with mental illness out of large, regimented institutions. New York shut down state-run psychiatric hospitals and settled former residents into the community or profit-making adult homes.
"The court found it was pretty much the luck of the draw," Zucker said. "If there were openings in the community, the resident went there. Otherwise they went to adult homes -- big institutions."
According to the court documents, the state has 380 adult homes; New York City has 44. Some homes house more than 120 to 200 people.
During the trial, witnesses testified the large homes were in some respects more restrictive than the mental institutions they replaced. They told of lines of 200 residents waiting for medications and residents having virtually no privacy. In addition, witnesses said, the homes foster "learned helplessness" because residents are not allowed to cook, clean, do laundry, or manage their own finances.
The court said the state failed to show that it would cost more to provide services in a community setting than in an adult home. Moreover, the judge said, it would save Medicaid costs to move residents to apartments. When Medicaid costs are considered, the annual cost of serving a resident in supported housing is on average $146 cheaper than serving that person in an adult home, the court found.
With the ruling, the state Office of Mental Health must propose a remedy. Disability Advocates will be able to critique it. The judge will then issue an injunction spelling out what changes the state must make.