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Case Name United States v. Louisiana PB-LA-0008
Docket / Court 3:18-cv-608 ( M.D. La. )
State/Territory Louisiana
Case Type(s) Disability Rights-Pub. Accom.
Public Benefits / Government Services
Special Collection Olmstead Cases
Attorney Organization U.S. Dept. of Justice Civil Rights Division
Case Summary
On December 21, 2016, after a two-year investigation, the U.S. Department of Justice Civil Rights Division released its findings that Louisiana unnecessarily relied on nursing facilities to service people with mental disabilities in violation of the community integration mandate of the Americans ... read more >
On December 21, 2016, after a two-year investigation, the U.S. Department of Justice Civil Rights Division released its findings that Louisiana unnecessarily relied on nursing facilities to service people with mental disabilities in violation of the community integration mandate of the Americans with Disabilities Act (ADA) as well as the Supreme Court ruling in Olmstead v. L.C.

The investigation focused on Louisiana residents with serious mental disabilities who received care and services in nursing facilities. The DOJ found that individuals who needed to obtain health services from the state for serious mental disabilities were forced to live in nursing facilities to receive proper care. This system isolated these individuals from their communities when they could live in an integrated setting if given access to adequate evidence-based community services.

The DOJ found that around 4,000 residents with serious mental disabilities were housed in nursing facilities in Louisiana each year. These residents were generally younger, had less nursing needs and lived in the facilities longer than a typical nursing home resident. Further, the report alleged that Louisiana could likely serve these individuals more effectively and for less money in their communities.

The findings letter emphasized four key conclusions:
  • That individuals with serious mental disabilities are confined to nursing home care in Louisiana because the state does not adequately arrange community-based services or properly identify those who would benefit from such services.
  • That individuals who would benefit from community-based services don’t know these services are available because the state has not told them.
  • That many of the individuals receiving service in nursing facilities can successfully live in the community rather than institutions.
  • And that other states successfully provide these services without unnecessarily relying on nursing facilities and the Louisiana already provides many of the necessary services and could serve more people by expanding pre-existing programs.

  • The DOJ and Louisiana reached a settlement to address the findings in the DOJ's report Louisiana agreed to review and augment its current policies for the seriously mentally ill. The DOJ then filed this lawsuit alleging that Louisiana failed to serve people with serious mental illnesses in the most integrated situation appropriate to their needs in violation of Title II of the Americans with Disabilities Act in the U.S. District Court for the Middle District of Louisiana on June 6, 2018, and immediately moved to dismiss due to the settlement.

    Specifically, the settlement agreement focused on diversion and screening for the target population of Medicaid-eligible individuals over the age of 18 with serious mental disabilities who either reside in nursing facilities or who have been referred for review for placement in nursing facilities. The state agreed to design and implement a system designed to quickly identify individuals under review for nursing home care who would benefit from community-based services and divert them away from institutionalization. The state also agreed to screen all individuals in the target population currently in nursing home care to determine whether they should be allowed to return to the community. The screening process starts with the assumption that all individuals with serious mental disabilities in nursing homes would benefit more from community-based services.

    The agreement also called for specific elements of the plan such as outreach to affected individuals, transition support committees, post-discharge case management and tracking. It also required the expansion of community-based service programs. These included mandatory crisis support services including a 24/7 emergency hotline, intensive community support services such as psychiatric treatment and housing and tenancy support.

    In addition, the agreement stipulated that the state had to implement a quality assurance program to make sure individuals in the target population received proper care. The state also agreed to retain a subject matter expert, John O’Brien, who will provide technical expertise to help the state fully comply with the agreement and produce a report every six months on the quality and progress of the plan.

    The agreement called for an initial plan to be submitted by the Louisiana Department of Health immediately that laid out the goals and details of the first 18 months. After 18 months, the LDH must produce a yearly report detailing goals for the coming year.

    The agreement was set to expire in five years provided the parties agree that the state has established compliance with the agreement and maintained compliance for one year. Under the settlement, the court retained jurisdiction and DOJ could reinstate the suit at any time to remedy a breach of the settlement as long as it first followed the dispute resolution laid out in the agreement. The case is ongoing for compliance with the settlement agreement.

    Michael Cronin - 03/23/2021


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    Issues and Causes of Action
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    Issues
    Defendant-type
    Hospital/Health Department
    Disability
    Integrated setting
    Least restrictive environment
    Mental impairment
    Discrimination-basis
    Disability (inc. reasonable accommodations)
    General
    Placement in mental health facilities
    Reasonable Accommodations
    Reasonable Modifications
    Mental Disability
    Mental Illness, Unspecified
    Plaintiff Type
    U.S. Dept of Justice plaintiff
    Type of Facility
    Government-run
    Causes of Action Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12111 et seq.
    Declaratory Judgment Act, 28 U.S.C. § 2201
    Defendant(s) State of Louisiana
    Plaintiff Description U.S. Department of Justice Civil Rights Division
    Indexed Lawyer Organizations U.S. Dept. of Justice Civil Rights Division
    Class action status sought No
    Class action status outcome Not sought
    Filed Pro Se No
    Prevailing Party Plaintiff
    Public Int. Lawyer Yes
    Nature of Relief Injunction / Injunctive-like Settlement
    Source of Relief Settlement
    Filed 06/06/2018
    Case Ongoing Yes
    Court Docket(s)
    M.D. La.
    06/07/2018
    3:18-cv-00608-JWD-EWD
    PB-LA-0008-9000.pdf | Detail
    Source: PACER [Public Access to Court Electronic Records]
    General Documents
    not recorded
    12/21/2016
    RE: United States' Investigation, Pursuant to the Americans with Disabilities Act, of Louisiana's Use of Nursing Facilities to Serve People with Mental Health Disabilities
    PB-LA-0008-0001.pdf | External Link | Detail
    Source: U.S. Department of Justice, Civil Rights Division, Special Litigation Section
    M.D. La.
    06/06/2018
    Complaint [ECF# 1]
    PB-LA-0008-0002.pdf | Detail
    Source: PACER [Public Access to Court Electronic Records]
    M.D. La.
    06/06/2018
    Agreement to Resolve Department of Justice Investigation [ECF# 2-1]
    PB-LA-0008-0003.pdf | Detail
    show all people docs
    Judges DeGravelles, John Wheadon (M.D. La.) show/hide docs
    PB-LA-0008-9000
    Wilder-Doomes, Erin Court not on record [Magistrate] show/hide docs
    PB-LA-0008-9000
    Plaintiff's Lawyers Bohan, Mary (District of Columbia) show/hide docs
    PB-LA-0008-0002 | PB-LA-0008-0003
    Fremin, Brandon J (Louisiana) show/hide docs
    PB-LA-0008-0002
    Gaupp, John (Louisiana) show/hide docs
    PB-LA-0008-0002
    Gore, John M. (District of Columbia) show/hide docs
    PB-LA-0008-0002 | PB-LA-0008-0003
    Gupta, Vanita (District of Columbia) show/hide docs
    PB-LA-0008-0001
    Mallinson, C Adrienne (District of Columbia) show/hide docs
    PB-LA-0008-0002 | PB-LA-0008-0003
    Rosenbaum, Steven H. (District of Columbia) show/hide docs
    PB-LA-0008-0002 | PB-LA-0008-0003
    Defendant's Lawyers Russo, Stephen Robert (Louisiana) show/hide docs
    PB-LA-0008-0003
    Sullivan, Kimberly Lacour (Louisiana) show/hide docs
    PB-LA-0008-0003

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