Case: DOJ Investigation of South Dakota Use of Nursing Facilities to Serve Individuals with Disabilities

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Case Summary

On May 1, 2016, the U.S. Justice Department released a letter reporting the findings of an investigation into South Dakota’s system of care for persons with disabilities. The report found that South Dakota unnecessarily relied on nursing facilities to provide services to people with disabilities, in violation of the community integration mandate of the Americans with Disabilities Act (ADA) and the Supreme Court’s decision in Olmstead v. L.C. The ADA and the Olmstead ruling required states to ma…

On May 1, 2016, the U.S. Justice Department released a letter reporting the findings of an investigation into South Dakota’s system of care for persons with disabilities. The report found that South Dakota unnecessarily relied on nursing facilities to provide services to people with disabilities, in violation of the community integration mandate of the Americans with Disabilities Act (ADA) and the Supreme Court’s decision in Olmstead v. L.C.

The ADA and the Olmstead ruling required states to make services available to people with disabilities in the most integrated setting appropriate to their needs, regardless of age or type of disability. The Olmstead court ruled that unless a nursing home is medically necessary, people have a right under the Americans With Disabilities Act to receive care without being segregated from society. However, the report found that in South Dakota, thousands of patients were being held unnecessarily in restrictive group homes.

The investigation was initiated on August 11, 2014 by the Civil Rights Division and the U.S. Attorney’s Office of the District of South Dakota. The investigation focused on the availability of community-based, long-term care services for nursing facility residents and those at serious risk of nursing facility admission.

The report concluded that the State planned, administered, and funded its public healthcare service system in a manner that unnecessarily segregated persons with disabilities in institutional nursing facilities, rather than providing services in community-based settings. The findings letter also suggested that South Dakota had spent an inordinate amount of its Medicaid dollars on nursing home care that unnecessarily deny individuals with disabilities the “supports and services in the most integrated setting appropriate to their needs” that the ADA requires.

For example, one 51-year-old man told the Justice Department that he had entered the nursing facility to recover after a leg amputation, but had been trying to leave the nursing facility for months, without help. Other interviewees talked about nursing home staff causing “induced helplessness” by forbidding them from engaging in activities like opening cans or putting on their own shoes, the kinds of activities residents could practice to work toward living on their own at home again.

The findings letter included a section with recommendations on how the State could reasonably modify its service system. For example, the letter mentioned that the State could modify and expand these existing services to serve all individuals who are unnecessarily institutionalized in nursing facilities or are at serious risk of nursing facility admission; ensure each person receives an appropriate amount of services to meet his or her needs; and eliminate unnecessary limitations and barriers that lead to unnecessary nursing facility admission.

The letter also included recommended remedial measures. These measures included increasing capacity by expanding services and addressing limitations to adequately serve individuals who are currently living in nursing facilities or who are at serious risk of entering nursing facilities; preventing unnecessary admissions of individuals with disabilities to nursing facilities by developing a system to identify potential admissions and to promptly arrange for in-home care; developing a system to disseminate information about community services, identifying individuals in nursing facilities who are appropriate for and do not oppose community placement, and conducting adequate transition planning to ensure that people with disabilities receive services in the most integrated setting appropriate to their needs.

The investigation is on-going.

Summary Authors

Ginny Lee (3/5/2017)

People


Attorney for Plaintiff

Gupta, Vanita (District of Columbia)

Attorney for Plaintiff

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Documents in the Clearinghouse

Document

Findings Letter

May 2, 2016

May 2, 2016

Findings Letter/Report

Docket

Last updated Aug. 30, 2023, 1:47 p.m.

Docket sheet not available via the Clearinghouse.

Case Details

State / Territory: South Dakota

Case Type(s):

Public Benefits/Government Services

Special Collection(s):

Olmstead Cases

Key Dates

Case Ongoing: Yes

Plaintiffs

Plaintiff Description:

The investigation was conducted by the Civil Rights Division with assistance by the U.S. Attorney’s Office of the District of South Dakota.

Plaintiff Type(s):

U.S. Dept of Justice plaintiff

Attorney Organizations:

U.S. Dept. of Justice Civil Rights Division

Public Interest Lawyer: No

Filed Pro Se: No

Class Action Sought: No

Class Action Outcome: Not sought

Defendants

Office of the Governor, State

Defendant Type(s):

Hospital/Health Department

Case Details

Causes of Action:

Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12111 et seq.

Special Case Type(s):

Out-of-court

Available Documents:

Any published opinion

None of the above

Outcome

Prevailing Party: None Yet / None

Nature of Relief:

None yet

Source of Relief:

None yet

Content of Injunction:

Discrimination Prohibition

Implement complaint/dispute resolution process

Issues

General:

Housing assistance

Jails, Prisons, Detention Centers, and Other Institutions:

Confinement/isolation

Disability and Disability Rights:

disability, unspecified

Discrimination-area:

Disparate Treatment

Discrimination-basis:

Disability (inc. reasonable accommodations)

Type of Facility:

Government-run