Six Massachusetts residents with disabilities who say they’ve been unnecessarily institutionalized in nursing facilities for prolonged periods filed a class action lawsuit in federal court, calling for the state to expand its residential programs so they, and others with disabilities, can return to living in a community setting.
The lawsuit, filed Tuesday in US District Court in Boston, alleges Governor Charlie Baker and other top state officials have failed to provide adequate services and support to help individuals with physical or mental disabilities progress from a nursing facility, where they are segregated from the community, to more independent living, while still having access to medical care through the state’s Home and Community-Based Services programs.
The alleged failure disproportionately impacts people of color and is a violation of the Medicaid Act as well as the Americans with Disabilities Act, which prohibits the unjustified segregation of people with disabilities in institutions.
“These are people who want to live in a community and have the ability to with support, but the Commonwealth isn’t giving them that opportunity,” Andrew London of the Boston law firm Foley Hoag said in an interview Tuesday night.
The firm is collaborating with the Northampton-based Center for Public Representation, the national advocacy organization Justice in Aging, and Greater Boston Legal Services to represent the plaintiffs.
They range in age from a 73-year-old man to a 54-year-old woman, all of whom struggle with various physical disabilities and mental health illnesses.
Baker and Marylou Sudders, the state’s secretary of health and human services, are listed as defendants, as well as Michael Heffernan, secretary of administration and finance, Elizabeth Chen, secretary of elder affairs, and Amanda Cassel Kraft, assistant secretary of MassHealth, the state’s Medicaid program.
Messages sent to Baker’s office and the Office of Health and Human Services seeking comment were not returned.
About 22,000 adults with disabilities are institutionalized in nursing facilities across the state, the lawsuit claims, and their paths to those facilities can vary.
Steven Schwartz of the Center for Public Representation said nursing facilities have become a “dumping ground” for other state-supported services, such as mental health programs, when they are no longer willing to support someone due to problematic behavior, staffing levels, or other reasons.
“Sometimes they just want to get rid of them,” he said in an interview.
Some have landed in nursing homes for rehab after going to a hospital for acute care following an injury or illness, Schwartz said. In other cases, the person may have lived with their family but, as they aged, their support needs grew to be too much for the family to handle.
Schwartz said he hopes the lawsuit will reach a similar conclusion as prior litigation has on behalf of people who were placed in nursing homes with brain injuries and intellectual disabilities. The state settled those cases in 2008, opening the door for thousands of people to leave nursing facilities and move into an apartment, family home, or group setting.
“The critical part of the settlements in those cases was for the state to create a process by which people could make meaningful, informed choices,” Schwartz said. Currently, “that does not exist for anyone else.”
The lawsuit asserts that the state should be capable of expanding its residential programs to include all individuals with disabilities considering it has already done so for people with brain injuries and intellectual development issues.
“The Commonwealth knows how to provide appropriate remedies for its illegal segregation of people with disabilities and has done so successfully for residents with [developmental disabilities] and [acquired brain injuries],” the lawsuit says. “It also knows how to provide information, opportunities, and meaningful choice about whether to remain in a segregated nursing facility ... Its systemic failure to do so for persons with other disabilities in nursing facilities leaves thousands of these persons unnecessarily institutionalized in nursing facilities, in violation of the ADA ...”
The everyday decisions people make — what to eat and when, what time to go to bed, or when to wake up — are taken away when living in a nursing facility, Schwartz said. And for someone who may not need to be there, life can quickly become miserable.
“Simple aspects of daily life that we take for granted are the very essence of what it is to leave a nursing facility and got to someplace you can truly call home,” Schwartz said.