Jackson v. Los Lunas Ctr. for Persons With Developmental Disabilities

• Decision Date: 12 October 2012
• Docket Number: Civ. No. 87-0839 JP/KBM
• Parties: WALTER STEPHEN JACKSON, et al., Plaintiffs, v. LOS LUNAS CENTER FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, et al., Defendants, and ARC OF NEW MEXICO, Intervenor, and MARY TERRAZAS, et al., Intervenors pro se.
• Court: U.S. District Court — District of New Mexico

WALTER STEPHEN JACKSON, et al., Plaintiffs,

v.LOS LUNAS CENTER FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, et al., Defendants,and ARC OF NEW MEXICO, Intervenor,and MARY TERRAZAS, et al., Intervenors pro se.

Civ. No. 87-0839 JP/KBM

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO

Dated: October 12, 2012

FINDINGS OF FACT AND CONCLUSIONS OF LAW

AND ORDER

TABLE OF CONTENTS

INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

BACKGROUND. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

I. Pertinent Orders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

A. The Court’s December 28, 1990 MEMORANDUM OPINION AND ORDER (Doc. No. 679).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

B. Relevant Portions of the JSD and POA. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

C. APPENDIX A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

D. Appointment of Sue Gant, Ph.D, as the Rule 706 Expert. . . . . . . . . . . . . 11

II. Recent Procedural History. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

FINDINGS OF FACT AND CONCLUSIONS OF LAW. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

I. Standard for Determining Substantial Compliance. . . . . . . . . . . . . . . . . . . . . . . . 16

II. Whether Defendants have Substantially Complied with General Directives and Whether Defendants have Attempted to Comply with Recommendations by the 706 Expert and by the Community Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

A. Discussion of General Directives and Recommendations by the 706

Expert and by the Community Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . 17

1. JSD ¶ 31: Defendants to implement the systemic recommendations of the 1998 community audit or CPR. . . . . . . . . . . . . . . . . . . . . . 18

2. JSD ¶ 33: If Defendants do not meet the rate of continuous improvement required in the JSD, Defendants will develop regional corrective action plans approved by the Community Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

3. Communication guidelines require Defendants to report actions

they have taken to implement individual audit or CPR

recommendations every 30, 60, and 90 days. . . . . . . . . . . . . . . . . 19

4. Compliance with the 706 Expert’s Findings and Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

5. Compliance with the Community Monitor’s Findings and Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

B. Findings of Fact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

C. Conclusions of Law. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

III. Whether Defendants have Substantially Complied with Their Obligations under the JSD, POA, and APPENDIX A to Provide Adequate Health Care to Class Members. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

A. Defendants’ Obligations under the JSD, POA, and APPENDIX A to

Provide Adequate Health Care to Class Members.. . . . . . . . . . . . . . . . . . 31

1. Medical Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

2. Quality Enhancement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

3. Summary of Issues Affecting Defendants’ Ability to Comply with Health Care Obligations.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

B. Findings of Fact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

C. Conclusions of Law. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

IV. Whether Defendants have Substantially Complied with Their Obligations under the JSD, POA, and APPENDIX A to Provide a Reasonably Safe Environment to Class Members. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

A. Defendants’ Obligations under the JSD, POA, and APPENDIX A to Provide a Reasonably Safe Environment to Class Members.. . . . . . . . . . 86

1. Quality Enhancement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

2. Incident Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

3. Summary of Issues Affecting Defendants’ Ability to Comply with Safety Obligations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116

B. Findings of Fact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

C. Conclusions of Law. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120

V. Whether Defendants have Substantially Complied with Their Obligations under the JSD, POA, and APPENDIX A to Provide Supported Employment to Class Members. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

A. Defendants’ Obligations under the JSD, POA, and APPENDIX A to Provide Supported Employment to Class Members. . . . . . . . . . . . . . . . 122

1. JSD and POA Provisions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

2. APPENDIX A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

3. JSD ¶¶ 32 and 33: Continuous Improvement of Supported Employment Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

4. Summary of Issues Affecting Defendants’ Ability to Comply with Supported Employment Obligations. . . . . . . . . . . . . . . . . . . . . . 150

B. Findings of Fact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151

C. Conclusions of Law. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

VI. Whether Defendants have Violated § 504 of the Rehabilitation Act and Title II of the ADA by Discriminating Against Severely Disabled Class Members with Respect to the Provision of Health Care Services and Supported Employment Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

A. Discussion of Rehabilitation Act and ADA Claims. . . . . . . . . . . . . . . . 159

1. Standards for Discrimination Based on Disability Under the

Rehabilitation Act and the ADA. . . . . . . . . . . . . . . . . . . . . . . . . 160

2. Health Care Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164

3. Supported Employment Services. . . . . . . . . . . . . . . . . . . . . . . . . 170

4. Summary of Rehabilitation Act and ADA Issues. . . . . . . . . . . . 176B. Findings of Fact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

1. Health Care Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

2. Supported Employment Services. . . . . . . . . . . . . . . . . . . . . . . . . 179

C. Conclusions of Law. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180

1. Health Care Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180

2. Supported Employment Services. . . . . . . . . . . . . . . . . . . . . . . . . 181

VII. Remedies for Substantial Noncompliance with the JSD, POA, and APPENDIX A in the Areas of Health Care, Safety, and Supported Employment. . . . . . . . . . . 182

A. Appointment of a Jackson Compliance Administrator. . . . . . . . . . . . . . 183

B. Other Remedies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193

C. Final Comments on Plaintiffs’ Requests for Remedies. . . . . . . . . . . . . . 195

D. Findings of Fact. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196

E. Conclusions of Law. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197

CONCLUSION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198

INTRODUCTION

Plaintiffs contend that Defendants have not complied with the November 19, 1997 JOINT STIPULATION ON DISENGAGEMENT (JSD) and accompanying PLAN OF ACTION (POA)¹ and with the 2005 APPENDIX A² by failing to provide class members with (1) adequate health care, (2) a reasonably safe environment, and (3) supported employment services. See PLAINTIFFS' RENEWED MOTION FOR FURTHER REMEDIAL RELIEF TO REMEDY NONCOMPLIANCE (Doc. No. 1888) (Renewed Noncompliance Motion), filed Nov. 14, 2011. Plaintiffs also assert that Defendants' failure to provide adequate health care to severely disabled class members and to afford those class members supported employment opportunities violates § 504 of the Rehabilitation Act of 1973 (Rehabilitation Act) and the Americans with Disabilities Act (ADA) by discriminating against persons with severe disabilities. See id.; PLAINTIFFS' MEMORANDUM IN SUPPORT OF THEIR MOTION FOR FURTHER REMEDIAL RELIEF BASED UPON VIOLATIONS OF SECTION 504 OF THE REHABILITATION ACT AND THE AMERICANS WITH DISABILITIES ACT (Doc. No. 1896), filed Dec. 9, 2011. In response, Defendants proclaim they have substantially complied with the provisions of the JSD, POA, and APPENDIX A that are at issue here and that they have not violated the Rehabilitation Act or the ADA. See DEFENDANTS' RESPONSE TO PLAINTIFFS' RENEWED MOTION FOR FURTHER REMEDIAL RELIEF TO REMEDY NONCOMPLIANCE AND PLAINTIFFS' MEMORANDUM IN SUPPORT OF THEIR MOTION FOR FURTHER

REMEDIAL RELIEF BASED UPON VIOLATIONS OF SECTION 504 OF THE REHABILITATION ACT AND THE AMERICANS WITH DISABILITIES ACT (Doc. No. 1899), filed Dec. 23, 2011.

Plaintiffs ask the Court to appoint a ...