article: On October 11, 2006, individuals with disabilities in need of long-term care filed a lawsuit under the Americans with Disabilities Act, the Rehabilitation Act, and California law in the United States District Court for the Northern District of California. Plaintiffs, represented by public interest and private counsel, claimed that Defendant failed to provide them with services in the most integrated setting appropriate. Specifically, Plaintiffs claimed that Defendants' policies and practices resulted in Plaintiffs' unnecessary isolation at Laguna Honda Hospital and Rehabilitation Center (Laguna Honda). Plaintiffs sought declaratory and injunctive relief to compel Defendants to provide them with timely access to home and community-based long-term care services. Named Plaintiffs were a number of current adult residents of Laguna Honda who had disabilities but had been recommended for discharge or who had been identified as being able to live in the community with appropriate service provision. At the time of filing, Laguna Honda housed more than 1,000 individuals. It had been repeatedly cited for standard of care deficiencies, and CMS had threatened to withdraw federal funding from the hospital. In 2003, the Department of Justice issued a letter of findings against Defendant for violations of the ADA with respect to Laguna Honda. The DOJ ordered Defendant to implement certain remedial measures, but they had not been implemented at the time Plaintiffs filed their complaint. On January 30, 2007, the court (Judge William Alsup) denied the parties' joint request to stay litigation for the purposes of settlement. The court granted Plaintiffs' motion for class certification on July 12, 2007. Defendants had filed a statement of non-opposition. The class was defined as: "All adult Medi-Cal beneficiaries who are: (1) residents of Laguna Honda Hospital and Rehabilitation Center; (2) on waiting lists for Laguna Honda Hospital and Rehabilitation Center; (3) within two year post-discharge from Laguna Honda Hospital and Rehabilitation Center; or (4) patients at San Francisco General Hospital or other hospitals owned or controlled by the City and County of San Francisco, who are eligible for discharge to Laguna Honda Hospital and Rehabilitation Center." On November 16, 2007, the court issued an order regarding preliminary approval of the settlement agreement. The court ordered the parties to meet with Judge Alsup to consider preliminary approval of the settlement agreement before ruling on the request for administrative relief. On November 26, 2007, the court issued an order regarding the request for administrative relief. The parties had agreed that no individual claims for damages by class members were waived under the settlement agreement. The parties also jointly recommended a $300,000 fee award to class counsel for fees and costs, and $200,000 for compliance oversight. In light of the agreement, the Court approved the parties' joint request for administrative relief. The parties signed a settlement agreement in December 2007. The parties agreed as follows: the parties would assess the services and housing being provided to named Plaintiffs who had been discharged from Laguna Honda; San Francisco would provide a rental subsidy for independent housing for named Plaintiffs where appropriate; Defendant would alter or begin certain practices to maximize opportunities for class members to access home and community-based services through the Nursing Facility/Acute Hospital Waiver; Defendant would make a Diversion and Community Integration Program fully operational; Defendant would provide case management and wrap-around services; Defendant would preserve, provide, and monitor community-based housing for appropriate class members; Defendant would enhance mental health and substance abuse services at Laguna Honda; and Defendant would limit the capacity of Laguna Honda. The settlement agreement also established grievance procedures for class members and data collection and reporting obligations. The agreement was scheduled to terminate three years from the date of final approval by the Court. On September 18, 2008, the Court granted final approval of the settlement agreement. The Court entered judgment, awarded attorney fees and costs as agreed by the parties, and retained jurisdiction for the purpose of assuring compliance. The parties filed a series of joint case management statements from 2009 through 2011 detailing the status of the implementation of the settlement agreement. On Feb. 7, 2011, the court issued an order stating that its jurisdiction would end on Sept. 18, 2011 "as to all rights and obligations of the parties except with regard to the Laguna Honda Hospital Rent Subsidy Program," and on Sept. 18, 2013 "as to all other rights and obligations of the parties." On Sept. 3, 2013, the court issued an order indicating that the defendants had complied with the last of the Settlement terms. In the order, the court modified a Settlement term requiring the defendants to subsidize 500 rental homes for Laguna Honda residents down to 270 homes due to significantly lower demand for such homes. There has been no further litigation, and it appears to be closed.
summary: This case was brought by adult individuals with disabilities who were in need of long-term services against the City and County of San Francisco seeking declaratory and injunctive relief to compel Defendants to provide services in the most integrated setting appropriate. The case was settled in September 2008, resulting in injunctive relief for Plaintiffs, as well as attorneys' fees and costs.