"Unjustified isolation" is what a judge called New York's adult homes in a decision last week that found the state guilty of violating the Americans for Disability Act. The case asked whether adult homes re-segregated people with a mental illness who could live more successfully in supported housing. Yes, wrote U.S. District Court Judge Nicholas G. Garaufis, the evidence was "overwhelming." The case was brought six years ago by Disability Associates on behalf of 4,300 New York City residents who were assigned to homes licensed by the state's Department of Health and Office of Mental Health.
Last week's bold and lengthy ruling (210 pages) states clearly that New York didn't do enough to make sure people with a mental illness got the best shot at living fulfilled lives. Their residences in adult homes were originally seen as alternatives to locked wards, stepping stones to returning to the community. But they became impediments not opportunities. The picture that emerged from 300 exhibits and 29 witnesses included: lack of privacy; punitive rules; locked doors; policies inhibiting social contacts; and minimal opportunities to interact outside the home. Monthly trips to Wendy's and after-hour visits to museums in ambulettes promoted interaction with other residents, not the community.
To answer whether the residents were qualified to live in supported housing throughout the community, rather than in "urban ghettos," DAI relied on experts and the court accepted their professional assessment. It also noted that evaluations conducted by the defendant, New York City, came from an electronic application form and doctors did not perform clinical assessments. This contributed to the judge's decision that many of the people found in the adult homes could have been better served in supported housing.
Judge Garaufis left little doubt that the system continues to fail residents:
Given the very nature of the Adult Homes, the opportunities to develop social and employment contacts are extremely limited. As Defendants' experts conceded, living in a place where the phone is answered "Brooklyn Adult Care Center" diminishes work options and social contacts, and being subject to visiting hours diminishes opportunities to cultivate social or family relationships.
Integration in the community is more than that simply locating homes, some in excess of than 120 residents, near stores and parks, as the state argued. Nor is it adequate that these homes and their operators meet state regulations, sometimes deemed ineffective and substandard. The ruling clarified that New York cannot discriminate against people with a disability, something decided by Olmstead a decade ago.
How ironic that this case, six years in the courts, was announced soon after the 10th anniversary of Olmstead.
Let's hope business as usual doesn't slow implementing the services that should have been delivered long ago.
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