Effort to Deinstitutionalize Illinois Averts Challenge

     CHICAGO (CN) – With Illinois focusing on ramping up community-based care for its residents with developmental disabilities, the Seventh Circuit refused to block the closing of a large state-run facility.
     Illinois operates seven institutions for citizens with developmental disabilities, serving approximately 1,800 residents, but the state has been lagging behind in the modernizations of its care.
     Studies have shown that individuals get better care from smaller residential programs, and that such facilities are cheaper to operate, but Illinois had the second lowest percentage in 2013 of developmentally disabled persons living in apartments that house six of fewer persons.
     Mississippi was at the bottom of the list. Meanwhile, 13 states no longer fund state-operated institutions that house 16 or more residents.
     As part of an effort to focus on these community-based facilities, Illinois announced a plan in 2012 to close its Warren G. Murray Developmental Center in Centralia, Ill., and its center in Jacksonville.
     The Illinois League of Advocates for the Developmentally Disabled quickly filed suit, contending that the state’s $13 billion deficit was driving the measure.
     With Illinois planning to have residents assessed for possible transfer to a community-based facility, a federal judge refused to issue an injunction.
     A three-judge panel of the Seventh Circuit affirmed Thursday, noting that the Jacksonville center closed in the interim.
     The Murray Center remained open “only because of this litigation,” according to the ruling. It serves 229 residents, some of whom have the developmental level of an infant or toddler. A majority have additional behavioral problems requiring high levels of staff supervision.
     “To be ‘institutionalized,’ whether in a prison, a madhouse, or a ‘state-operated developmental center,’ is to be frozen out of society – a situation that even a severely developmentally disabled person can experience as deprivation,” Judge Richard Posner said, writing for the three-judge panel.
     The court noted that residents of a community-based facility are more likely to have their own room, and have access to stores, parks and movie theaters – places where they can participate in society, even if under staff supervision, rather remaining isolated in a medical facility.
     “The plaintiffs say that residents of community-based facilities are treated worse on average than residents of institutional facilities,” Posner wrote. “But they have not substantiated their claim by a systematic comparison of residents of the two types of facility,” Posner said. “Their claim is undermined, indeed vitiated, by their refusal to recognize a tradeoff between possibly better staff assistance in an institutional facility and the greater freedom – the closer approach to normality – of life in a community-based facility.”
     Posner acknowledged that, as the population of Murray Center shrinks, it will eventually be closed, forcing the residents who remain to transfer or move to a community center, perhaps against the wishes of their guardians.
     But “that will not be a discriminatory outcome,” the 11-page opinion states (emphasis in original).
     “The handful not transferred until Murray closes will not be treated worse than residents transferred earlier,” Posner added.
     Posner and his colleagues also rejected claims that the Medicaid Act entitles the guardians of Murray Center residents to insist that their wards remain there.
     “The plaintiffs have presented no evidence that their wards would be denied the lawfully required level of care even if Illinois were to close all its SODCs [state-operated developmental center],” Posner said.
     “The urgency required for emergency relief has not been shown,” he concluded.
     Zena Naiditch, the president of Equip for Equality, an Illinois-based disability rights organization, praised the ruling in a statement.
     “Equip for Equality has long-strived to ensure that people with disabilities have the opportunity to lead fuller, more independent lives in the community,” Naiditch said. “The result in this case reaffirms the importance of increasing community-based options for people with developmental and other disabilities. Illinois must continue to bridge the gap that exists between it and most other states in fulfilling the federal community integration mandate.”

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