LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

This docket is current through 11/05/2012

Current Date: 2/9/2019

Source: US COURT OF APPEALS FOR THE SEVENTH CIRCUIT

Court:

US COURT OF APPEALS FOR THE SEVENTH CIRCUIT

Case Title:

LIGAS, STANLEY, ET AL v. MARAM, BARRY S., ET AL

Appeal From:

UNITED STATES DISTRICT COURT

Date Filed:

01/27/2006

CASE INFORMATION
Case Number: Fee Status: Case Type: Nature of Suit: Key Nature of Suit:

06-1327 PAID APPEALS 3440 OTH CIVIL RIGHTS-FED. QUESTION CIVIL RIGHTS; OTHER FEDERAL CIVIL RIGHTS (110.45)

LOWER COURT INFORMATION
District: Lower Court Docket Number: Trial Judge(s): Court Reporter(s): Date Filed: Date Order/Judgment: Date NOA Filed:

0752-1 05 C 4331 JAMES F. HOLDERMAN, CHIEF JUDGE COLLEEN CONWAY, COURT REPORTER 07/28/2005 12/22/2005 01/26/2006

NAMES

STANLEY LIGAS, BY HIS SISTER AND NEXT FRIEND GINA FOSTER

Type: Attorney: Attorney Phone: Attorney Fax:

PLAINTIFF - APPELLEE BARRY C. TAYLOR 312-341-0022 312-341-0295

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

Firm Name: Firm Address:
Attorney: Attorney Phone: Attorney Fax: Firm Name: Firm Address:

EQUIP FOR EQUALITY, INCORPORATED
SUITE 300 20 N. MICHIGAN AVENUE CHICAGO, IL 60602
MAX LAPERTOSA
312-640-2100
312-640-2139
ACCESS LIVING
115 W. CHICAGO AVENUE CHICAGO, IL 60610

LORAINE BIERMAN, BY HER GUARDIANS DARLENE AND JOSEPH BIERMAN

Type: Attorney: Attorney:

PLAINTIFF - APPELLEE BARRY C. TAYLOR MAX LAPERTOSA

DAVID CICARELLI, BY HIS GUARDIANS JAMES AND JULIANNE CICARELLI

Type: Attorney: Attorney:

PLAINTIFF - APPELLEE BARRY C. TAYLOR MAX LAPERTOSA

ISAIAH FAIR, BY HIS GUARDIAN LUCRETIA FAIR

Type: Attorney: Attorney:

PLAINTIFF - APPELLEE BARRY C. TAYLOR MAX LAPERTOSA

ADAM KULIG, BY HIS GUARDIAN NORB KULIG

Type: Attorney: Attorney:

PLAINTIFF - APPELLEE BARRY C. TAYLOR MAX LAPERTOSA

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

BARRY S. MARAM, IN HIS OFFICIAL CAPACITY AS DIRECTOR OF THE ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

Type: Attorney: Attorney Phone: Attorney Fax: Firm Name: Firm Address:

DEFENDANT - APPELLEE
MARY E. WELSH
312-814-2106
312-814-2275
OFFICE OF THE ATTORNEY GENERAL
12TH FLOOR CIVIL APPEALS DIVISION 100 W. RANDOLPH STREET STATE OF ILLINOIS CENTER CHICAGO, IL 60601

CAROL L. ADAMS, IN HER OFFICIAL CAPACITY AS SECRETARY OF THE ILLINOIS DEPARTMENT OF HUMAN SERVICES

Type: Attorney:

DEFENDANT - APPELLEE MARY E. WELSH

ANNE GOLDEN, BY AND THROUGH HER FATHER AND GUARDIAN SAMUEL GOLDEN

Type: Attorney: Attorney Phone: Attorney Fax: Firm Name: Firm Address:
Attorney: Attorney Phone: Attorney Fax: Firm Name: Firm Address:

APPELLANT JAMES W. DUCAYET 312-853-7000 312-853-7036 SIDLEY AUSTIN ONE S. DEARBORN STREET CHICAGO, IL 60603 MICHAEL RATO 212-839-5300 212-839-5599 SIDLEY AUSTIN 787 SEVENTH AVENUE NEW YORK, NY 10019

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

BECKY LEVY, BY AND THROUGH HER PARENTS AND GUARDIANS DIANE AND EDWARD LEVY

Type: Attorney: Attorney:

APPELLANT JAMES W. DUCAYET MICHAEL RATO

ROSEMARY LOPEZ, BY HER GUARDIANS CAMILLE BARANCHIK AND ANNE MARIE MCKEE

Type: Attorney: Attorney:

APPELLANT JAMES W. DUCAYET MICHAEL RATO

EDWARD GROSSMAN, BY AND THROUGH HIS MOTHER AND NEXT FRIEND MARIANNA GROSSMAN

Type: Attorney: Attorney:

APPELLANT JAMES W. DUCAYET MICHAEL RATO

DOUGLAS SWAIN, BY AND THROUH HIS FATHER AND GUARDIAN DAVID SWAIN

Type: Attorney: Attorney:

APPELLANT JAMES W. DUCAYET MICHAEL RATO

DOCKET PROCEEDINGS (48)

Entry #:

Date:

03/19/2007

03/09/2007

02/15/2007
4

Description:
Filed mandate receipt. [06-1327] [2084965-1] (linj)
MANDATE ISSUED AND ENTIRE RECORD RETURNED. (Contents returned: 2 vol. pleadings; 1 vol. transcripts.) [06-1327] [1949353-1] (cove)
ORDER: Final judgment filed per opinion. With

LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

costs: y. [06-1327] [2075275-1] (mank)

02/15/2007

Filed opinion of the court by Judge Kanne. AFFIRMED. Chief Judge Frank H. Easterbrook, Circuit Judge Michael S. Kanne Circuit Judge Ann C. Williams. [06-1327] [1949353-1] (mank)

11/29/2006

Filed Appellant Anne Golden, Appellant Becky Levy Appellant Rosemary Lopez, Appellant Edward Grossman Appellant Douglas Swain Citation of Additional Authority per CR 28(e). Dist. [06-1327] [2050145-1] (scze)

11/22/2006

Filed Appellee Stanley Ligas, Appellee Loraine Bierman Appellee David Cicarelli, Appellee Isaiah Fair, Appellee Adam Kulig, Appellee Barry S. Maram, Appellee Carol L. Adams Citation of Additional Authority, per CR 28(e). Dist. [06-1327] [2048512-1] (scze)

10/30/2006

Case argued by Michael Rato for Appellant Douglas Swain Appellant Edward Grossman, Appellant Rosemary Lopez Appellant Becky Levy, Appellant Anne Golden, Mary E. Welsh for Appellee Carol L. Adams, Appellee Barry S. Maram, Max Lapertosa for Appellee Adam Kulig, Appellee Isaiah Fair Appellee David Cicarelli, Appellee Loraine Bierman Appellee Stanley Ligas. [06-1327] [1949353-1] (kare)

10/30/2006

Case heard and taken under advisement by panel: Circuit Judge Frank H. Easterbrook, Circuit Judge Michael S. Kanne Circuit Judge Ann C. Williams. [06-1327] [2040718-1] (kare)

10/26/2006

ORDER issued GRANTING motion to reschedule oral argument. The appeal will be rescheduled as the first case on call on 10/30/06. [2037957-1] MJO [06-1327] (kell)

10/25/2006

Added attorney Max Lapertosa for purposes of oral argument per filing of oral argument confirmation card for Appellee Stanley Ligas, Appellee Loraine

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

Bierman, Appellee David Cicarelli, Appellee Isaiah Fair, Appellee Adam Kulig by attorney Max Lapertosa. [06-1327] [1949353-1] (kare)

10/20/2006

Filed motion by Appellee Stanley Ligas, Appellee Loraine Bierman, Appellee David Cicarelli, Appellee Isaiah Fair Appellee Adam Kulig to reschedule oral argument. [2037957-1] [06-1327] (josh)

09/01/2006

Oral argument confirmation card filed by attorney Michael Rato for Appellant Anne Golden, Appellant Becky Levy Appellant Rosemary Lopez, Appellant Edward Grossman Appellant Swain. [06-1327] [1949353-1] (kare)

08/28/2006

Oral argument confirmation card filed by attorney Mary E. Welsh for Appellee Barry S. Maram, Appellee Carol L. Adams. [06-1327] [1949353-1] (kare)

08/21/2006

ORDER: Argument set for Monday, October 30, 2006 at 9:30 a.m. Each side limited to 15 minutes. [06-1327] [2017389-1] (trot)

08/15/2006

ORDER: The court, on its own motion, ORDERS that oral argument in this appeal set for Tuesday, September 26, 2006 is VACATED. [2015522-1] CF [06-1327] (andb)

08/11/2006

Added attorney Michael Rato for purposes of oral argument per oral argument confirmation card filed for Appellant Anne Golden, Appellant Becky Levy, Appellant Rosemary Lopez, Appellant Edward Grossman, Appellant Douglas Swain. [06-1327] [1949353-1] (kare)

08/01/2006

Oral argument telephone confirmation filed by attorney Mary E. Welsh for Appellee Barry S. Maram, Appellee Carol L. Adams. [06-1327] [1949353-1] (kare)

07/26/2006

ORDER: Argument set for Tuesday, September 26, 2006 at 9:30 a.m. Each side limited to 15 minutes.

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

[06-1327] [2009167-1] (andb)

07/25/2006

NOTICE: Michael Rato for Appellant Douglas Swain, Appellant Edward Grossman, Appellant Rosemary Lopez, Appellant Becky Levy, Appellant Anne Golden will not be available for oral argument Sept. 4-15, 2006. [06-1327] [1949353-1] (andb)

07/20/2006

Filed 15c appellant’s reply brief by Anne Golden, Becky Levy, Rosemary Lopez, Edward Grossman, Douglas Swain. Disk filed. [06-1327] [0-0] (linj)

07/11/2006

ORDER issued GRANTING motion for extension of time to file appellant’s reply br. [2003267-1] CMD [06-1327] Appellant’s reply brief due 7/20/06 for Douglas Swain, for Edward Grossman, for Rosemary Lopez, for Becky Levy, for Anne Golden. (mank)

07/10/2006

Disclosure Statements filed by attorneys Max Lapertosa Judith Gran, John Grossbart, and Ben Wolf for appellees. [06-1327] [1949353-1] (kell)

07/10/2006

Disclosure Statement filed by Barry C. Taylor for Appellee Adam Kulig, Appellee Isaiah Fair, Appellee David Childers Appellee Lorene Bierman, Appellee Stanley Ligas. [06-1327] [1949353-1] (kell)

07/10/2006

Filed motion by Appellant Anne Golden, Appellant Becky Levy, Appellant Rosemary Lopez, Appellant Edward Grossman Appellant Douglas Swain to extend time to file appellant’s reply brief. [2003267-1] [06-1327] (josh)

06/30/2006

Appearance entered per filing of brief for Appellee Barry S. Maram, Appellee Carol L. Adams by attorney Mary E. Welsh. Involvement of attorney Nadine J. Wichern for Carol L. Adams, attorney Nadine J. Wichern for Barry S. Maram terminated. [06-1327] [1949353-1] (josh)

06/30/2006

Filed 15c appellee’s brief by Barry S. Maram, Carol L. Adams. Disk filed. [06-1327] [0-0] (josh)

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

06/30/2006

Filed 10c appendix by Appellee Stanley Ligas, Appellee Lorene Bierman, Appellee David Childers, Appellee Isaiah Fair, Appellee Adam Kulig . [061327] [2001513-1] (leti)

06/30/2006

Filed 15c appellee’s brief by Stanley Ligas, Lorene Bierman, David Childers, Isaiah Fair, Adam Kulig. Disk filed. [06-1327] [0-0] (leti)

06/05/2006

ORDER issued GRANTING motion for extension of time to file appellee’s brief. [1991827-1] JKL [061327] 1. Appellee’s brief due 6/30/06 for Carol L. Adams, for Barry S. Maram for Adam Kulig, for Isaiah Fair, for David Childers, for Lorene Bierman, for Stanley Ligas. 2. The reply brief if any is due on 7/14/06 for Douglas Swain, for Edward Grossman, for Rosemary Lopez, for Becky Levy, for Anne Golden. (amyd)

06/02/2006

Filed motion by Appellee Barry S. Maram, Appellee Carol L. Adams to extend time to file appellee’s brief. [1991827-1] [06-1327] (josh)

05/04/2006

ORDER issued GRANTING motion for extension of time to file appellee’s brief. [1981946-1] CMD [061327] 1. Appellee’s brief due 6/9/06 for Carol L. Adams, for Barry S. Maram for Adam Kulig, for Isaiah Fair, for David Childers, for Lorene Bierman, for Stanley Ligas. 2. The reply brief if any is due on 6/23/06 for Douglas Swain, for Edward Grossman, for Rosemary Lopez, for Becky Levy, for Anne Golden. (amyd)

05/03/2006

Filed motion by Appellee Barry S. Maram, Appellee Carol L. Adams to extend time to file appellee’s brief. [1981946-1] [06-1327] (josh)

03/28/2006

ORDER issued GRANTING motion for extension of time to file appellee’s brief. [1967331-1] CMD [061327] 1. Appellee’s brief due 5/8/06 for Carol L. Adams, for Barry S. Maram for Adam Kulig, for Isaiah Fair, for David Childers, for Lorene Bierman,

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

for Stanley Ligas. 2. The reply brief if any is due on 5/22/06 for Douglas Swain, for Edward Grossman, for Rosemary Lopez, for Becky Levy, for Anne Golden. (amyd)

03/22/2006

Terminated attorney Deborah L. Ahlstrand for Carol L. Adams, attorney Deborah L. Ahlstrand for Barry S. Maram and added attorney Nadine J. Wichern per appearance form. Appearance form filed for Appellee Barry S. Maram, Appellee Carol L. Adams by attorney Nadine J. Wichern. [06-1327] [1949353-1] (amyd)

03/22/2006

Filed motion by Appellee Barry S. Maram, Appellee Carol L. Adams to extend time to file appellee’s brief. [1967331-1] [06-1327] (ocon)

03/16/2006

Filed 10c joint amended appendix by Appellant Anne Golden,per order. [06-1327] [1968979-1] (odea)

03/16/2006

ORDER issued GRANTING Joint Motion for Leave to File an Amended Appendix. The motion is GRANTED. The clerk shall file the tendered copy INSTANTER. [1965040-1] [1965040-1] MJO [061327] (amyd)

03/15/2006

Filed joint motion by Appellee Barry S. Maram, Appellee Carol L. Adams, Appellant Anne Golden, Appellant Becky Levy, Appellant Rosemary Lopez, Appellant Edward Grossman Appellant Douglas Swain for leave to file amended appendix. [1965040-1] [06-1327] (amyd)

03/08/2006

Filed 10c appendix by Appellant Anne Golden, Appellant Becky Levy, Appellant Rosemary Lopez, Appellant Edward Grossman, Appellant Douglas Swain . [06-1327] [1962788-1] (odea)

03/08/2006

Filed 15c appellant’s brief by Anne Golden, Becky Levy Rosemary Lopez, Edward Grossman, Douglas Swain. Disk filed. [06-1327] [0-0] Appellee’s brief due 4/7/06 for Carol L. Adams, for Barry S. Maram

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

03/02/2006 02/22/2006 02/17/2006 02/03/2006 01/31/2006 01/27/2006
01/27/2006

(odea)
Supplemental record on appeal filed. Contents of record: 1 vol. transcripts. [06-1327] [1960123-1] (darr)
Disclosure Statement filed by Max Lepertosa for Adam Kulig Isaiah Fair, David Childers, Lorene Bierman, Stanley Ligas. [06-1327] [1949353-1] (amyd)
Original record on appeal filed. Contents of record: 2 vol. pleadings. [06-1327] [1956088-1] (dave)
Disclosure Statement filed by James W. Ducayet for Appellant Douglas Swain, Appellant Edward Grossman Appellant Rosemary Lopez, Appellant Becky Levy, Appellant Anne Golden. [06-1327] [1949353-1] (fern)
Filed Appellant Anne Golden, Appellant Becky Levy Appellant Rosemary Lopez, Appellant Edward Grossman Appellant Douglas Swain jurisdictional statement. [06-1327] [1950231-1] (scze)
THIS CAUSE CONSISTS OF MORE THAN 5 PARTIES FOR EITHER SIDE. The following are those parties to this cause as reflected on the District Court docket, yet are not reflected on the Appellate docket/caption for administrative purposes PLAINTIFFS-APPELLEES: James McElroy, by his guardians Patricia and Robert McElroy; and Jennifer Wilson, by her guardians Nancy and Richard Wilson. APPELLANTS: Timothy Kiesow, by and through his mother and guardian Maureen Bradish; Jennifer Westberg, by and through her mother and guardian Wendy Schuppan; and Deborah Brown, by her brother and guardian Daniel Brown. [06-1327] [1949353-1] (hudk)
[06-1327] ROA from No. Dist. of Il., E. Div. due 2/16/06. (hudk)

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LIGAS, STANLEY, ET AL V. MARAM, BARRY S., ET AL, 06-1327 (2006)

01/27/2006

Private civil case docketed. [06-1327] [1949353-1] Transcript information sheet due 2/6/06. Appellant’s brief due 3/8/06 for Anne Golden, for Becky Levy, for Rosemary Lopez, for Edward Grossman, for Douglas Swain. Docketing Statement due 2/2/06. (hudk)

End of Document

11

 
 Page 1
LEXSEE 2006 U.S. DIST. CT. MOTIONS LEXIS 78358 View U.S. District Court Opinion View Original Source Image of This Document
STANLEY LIGAS, et al., Plaintiffs, vs. BARRY S. MARAM, et al., Defendants. No. 05 C 4331
UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS, EASTERN DIVISION
2005 U.S. Dist. Ct. Motions 54331; 2006 U.S. Dist. Ct. Motions LEXIS 78358 January 10, 2006
Motion to Certify Class VIEW OTHER AVAILABLE CONTENT RELATED TO THIS DOCUMENT: U.S. District Court: Motion(s); Pleading(s) COUNSEL: [*1] attorneys for Plaintiffs, Barry G. Lowy, Laura J. Miller, Barry C. Taylor, John W. Whitcomb, EQUIP FOR EQUALITY, Chicago, Illinois, John I. Grossbart, Kendra K. Hartman, SONNENSCHEIN NATH & ROSENTHAL LLP, Chicago, Illinois, Max Lapertosa, Kenneth M. Walden, ACCESS LIVING OF METROPOLITAN CHICAGO, Chicago, Illinois, Benjamin S. Wolf, AMERICAN CIVIL LIBERTIES UNION OF ILLINOIS, Chicago, Illinois, Judith A. Gran, PUBLIC INTEREST LAW CENTER OF PHILADELPHIA, Philadelphia, Pennsylvania. JUDGES: Holderman; Magistrate Judge Ashman TITLE: PLAINTIFFS' RENEWED MOTION FOR CLASS CERTIFICATION TEXT: Plaintiffs, through counsel, respectfully renew their request to this Court to enter an Order to maintain this case as a class action under Rules 23(a), 23(b)(2) and 23(c) of the Federal Rules of Civil Procedure. n1
n1 Plaintiffs' initial Motion for Class Certification was filed on August 8, 2005, and denied as moot on October 31, 2005, so that the Court could first address pending motions to intervene. On December 27, 2005, the Court denied the motions to intervene. In light of that ruling, Plaintiffs hereby renew their request for certification of a class that is more narrowly defined, consistent with the suggestion made by the Court in its December 27th ruling. [*2] Plaintiffs propose a class of all persons in Illinois with disabilities who:

2005 U.S. Dist. Ct. Motions 54331; 2006 U.S. Dist. Ct. Motions LEXIS 78358, *2

Page 2

(1) have mental retardation and/or other developmental disabilities and who qualify for long-term care services;
(2) with appropriate supports and services, could live in the community and who would not oppose community placement; and
(3) either (a) are institutionalized in private Intermediate Care Facilities for the Developmentally Disabled ("ICF-DDs") with nine or more residents or (b) are living in a home-based setting, and are at risk of institutionalization because of their need for services.
In support of this renewed motion, Plaintiffs aver as follows:
1. Plaintiffs seek declaratory and injunctive relief on their own behalf and on behalf of all others similarly situated. Plaintiffs allege that Defendants have unnecessarily segregated them or placed them at risk of unnecessary segregation in large, private ICF-DDs, in violation of the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 [*3] -1396v.
2. The defined class is so numerous that joinder of all individual claims is impracticable. The class potentially includes nearly 6,000 people in ICF-DDs and thousands more people at risk of ICF-DD placement.
3. There are questions of law and fact common to the class. Those questions predominate over questions affecting individual class members.
4. The claims of the named Plaintiffs are typical of those of the class. The named Plaintiffs are segregated unnecessarily in ICF-DDs, or at risk thereof, because Defendants have denied or failed to provide them appropriate supports and services that would allow them to live in the community.
5. The named Plaintiffs will fairly and adequately protect the interests of the class. They have no interests that conflict with or are antagonistic to the class, and they seek relief that will benefit all members of the class. Plaintiffs' counsel are competent and experienced in class-action civil rights cases of this nature.
6. Defendants, by unnecessarily segregating Plaintiffs in ICF-DDs or placing them at risk thereof, have acted on grounds generally applicable to the class. Therefore, declaratory and injunctive [*4] relief with respect to the entire class is appropriate.
7. Plaintiffs have prepared a Memorandum, attached hereto and filed concurrently with this Motion, articulating in greater detail the grounds for class certification.
WHEREFORE, Plaintiffs respectfully request this Court enter an Order certifying this case as a class action for the class of persons described above.
Respectfully submitted,
Dated: January 10, 2006
By /s/ Kendra K. Hartman One of the attorneys for Plaintiffs
Barry G. Lowy Laura J. Miller Barry C. Taylor

2005 U.S. Dist. Ct. Motions 54331; 2006 U.S. Dist. Ct. Motions LEXIS 78358, *4

Page 3

John W. Whitcomb EQUIP FOR EQUALITY 20 North Michigan Avenue, Suite 300 Chicago, Illinois 60602 Tel: (312) 341-0022 Fax: (312) 341-0295
John I. Grossbart Kendra K. Hartman SONNENSCHEIN NATH & ROSENTHAL LLP 7800 Sears Tower Chicago, Illinois 60606 Tel: (312) 876-8000 Fax: (312) 876-7934
Max Lapertosa Kenneth M. Walden ACCESS LIVING OF METROPOLITAN CHICAGO 614 West Roosevelt Road Chicago, Illinois 60607 Tel: (312) 253-7000 Fax: (312) 253-7001
Benjamin S. Wolf AMERICAN CIVIL LIBERTIES UNION OF ILLINOIS 180 North Michigan Avenue, Suite 2300 Chicago, Illinois 60601 Tel: (312) 201-9740 Fax: (312) 201-9760
Judith [*5] A. Gran PUBLIC INTEREST LAW CENTER OF PHILADELPHIA 125 S. Ninth Street, Suite 700 Philadelphia, Pennsylvania 19107 Tel: (215) 627-7100 Fax: (215) 627-3183
PLAINTIFFS' MEMORANDUM OF LAW IN SUPPORT OF RENEWED MOTION FOR CLASS CERTIFICATION
I. INTRODUCTION
Plaintiffs, on behalf of themselves and all others similarly situated, have brought this action to enjoin Defendants, state officials who run Illinois's long-term care system for people with disabilities, from compelling their unnecessary segregation in large, privately run institutions, known as Intermediate Care Facilities for the Developmentally Disabled ("ICF-DDs"). The proposed class consists of all persons in Illinois with developmental disabilities who, with appropriate supports and services, could live in the community and who would not oppose community placement; but who are either segregated unnecessarily in ICF-DDs or at risk of such segregation due to Defendants' failure to provide these community services. n1

2005 U.S. Dist. Ct. Motions 54331; 2006 U.S. Dist. Ct. Motions LEXIS 78358, *5

Page 4

n1 See Olmstead v. L.C., 527 U.S. 581, 589 (1999) (there is a right to community services when they are "not opposed by the affected individual").
[*6]
Plaintiffs submit this memorandum in support of their renewed motion to maintain this case as a class action under Rules 23(a) and (b)(2) of the Federal Rules of Civil Procedure.
II. ARGUMENT: CLASS DETERMINATION IS APPROPRIATE
A. PLAINTIFFS MEET THE REQUIREMENTS OF RULE 23(a)
When determining a class under Rule 23(a), the Court may not consider the merits of Plaintiffs' claims and must take all factual allegations in the complaint as true. Eisen v. Carlisle & Jacquelin, 417 U.S. 156, 177 (1974); Gomez v. Ill. State Bd. of Educ., 117 F.R.D. 394, 398 (N.D. Ill. 1987). Additionally, civil rights cases alleging discriminatory policies or practices are "by definition" class actions, provided they meet the other requirements of Rule 23(a). Gen. Tel. Co. v. Falcon, 457 U.S. 147, 157 (1982); see also Robert E. v. Lane, 530 F. Supp. 930, 944 (N.D. Ill. 1980) (a case alleging civil rights violations in an institutional setting represents a "prototypical candidate" for class certification).
Under Rule 23(a), courts may certify a class when 1) its members are so numerous that joinder of all claims is [*7] impracticable, 2) there are questions of law or fact common to the class, 3) the claims of the representative parties are typical of the class claims, and 4) the representative parties and their counsel will fairly and adequately protect the interests of the class. Fed. R. Civ. P. 23(a); Alliance to End Repression v. Rochford, 565 F.2d 975, 977 (7th Cir. 1977); Fields v. Maram, No. 04-C-0174, 2004 U.S. Dist. LEXIS 16291 at *8-*9 (N.D. Ill. Aug. 16, 2004). Additionally, courts have recognized two implied requirements under Rule 23(a): the class must be readily identifiable and the named plaintiffs must be part of the class. Alliance to End Repression, 565 F.2d at 977-78; Gomez, 117 F.R.D. at 397-98. As shown below, the proposed class here easily meets these requirements.
1. Joinder Would Be Impracticable
Although commonly referred to as the "numerosity" requirement, "the crux of the numerosity requirement is not the number of interested persons per se, but the practicality of their joinder into a single suit." Arenson v. Whitehall Convalescent & Nursing Home, 164 F.R.D. 659, 663 (N.D. Ill. 1996) [*8] (quoting Small v. Sullivan, 820 F. Supp. 1098, 1109 (S.D. Ill. 1992)). While the number of class members is an important factor, others include "judicial economy, geographic diversity of class members, and the ability of individual class members to institute individual lawsuits ...." Id.; see also Riordan v. Smith Barney, 113 F.R.D. 60, 61 (N.D. Ill. 1986) ("[T]he test for impracticability of joinder is not simply a test for the number of class members."). Under these guidelines, this Court has certified classes with as few as 29 members. Riordan, 113 F.R.D. at 61; see also Swanson v. Am. Consumer Indus., 415 F.2d 1326, 1333 (7th Cir. 1969) (40 members sufficient).
In this case, there is no question joinder is impracticable. According to the Illinois Department of Public Health, approximately 5,935 people resided in ICF-DDs with nine or more beds as of December 31, 2003. See www.idph.state.il.us. Thousands of other residents live in the community and are at risk of institutionalization. Based on their sheer number alone, joinder is impracticable. See Long v. Thornton Township High Sch., 82 F.R.D. 186, 189 (N.D. Ill. 1979) [*9] (plaintiff not required to specify exact size of class as long as good-faith estimate is provided); Fields, 2004 U.S. Dist. LEXIS 16291 at *13 ("[I]t is appropriate for the Court to make such common sense assumptions in determining whether the numerosity requirement is met."); Wyatt v. Poundstone, 169 F.R.D. 155, 164 (M.D. Ala. 1995) (in case on behalf of institutionalized persons with mental retardation, numerosity was met because "[t]here are approximately 1,000 mentally retarded individuals in the defendants' institutions ...").

2005 U.S. Dist. Ct. Motions 54331; 2006 U.S. Dist. Ct. Motions LEXIS 78358, *9

Page 5

Other circumstances also point to impracticability of joinder. As Medicaid recipients, class members are located throughout the state and do not have the financial means to bring individual lawsuits. Fields, 2004 U.S. Dist. LEXIS 16291 at *18 ("Because the class members reside throughout the state, and because they are disabled and therefore are often of limited financial resources, joinder would be particularly difficult in this case."); Arenson, 164 F.R.D. at 663 ("Class members who are residents of a nursing home may also lack the ability to pursue their claims individually."). It [*10] also is impracticable to join claims of future class members, who by their very nature cannot be readily identified. Gomez, 117 F.R.D. at 399 ("The Court also notes that numerosity is met where, as here, the class includes individuals who will become members in the future.") (emphasis in original). Finally, judicial economy plainly would be served by consolidating the actions of all similarly-situated persons rather than having them litigate individually. Arenson, 164 F.R.D. at 663.
2. There Are Questions of Law and Fact Common to the Class
Rule 23(a) requires that there "need be only a single issue common to all members of the class." Edmondson v. Simon, 86 F.R.D. 375, 380 (N.D. Ill. 1980); Hispanics United v. Vill. of Addison, 160 F.R.D. 681, 688 (N.D. Ill. 1995). "A common nucleus of operative fact is usually enough to satisfy the commonality requirement of Rule 23(a)(2)." Rosario v. Livaditis, 963 F.2d 1013, 1018 (7th Cir. 1992). See also Lightbourn v. County of El Paso, 118 F.3d 421, 425 (5th Cir. 1997) ("The commonality test is met when there is at least one issue, [*11] the resolution of which will affect all or a significant number of the putative class members.") (citations omitted); Baby Neal v. Casey, 43 F.3d 48, 55 (3d Cir. 1994) (commonality met where "named plaintiffs share at least one question of fact or law with the grievances of the prospective class."); Marisol A. v. Guiliani, 126 F.3d 372, 375 (2d Cir. 1997) (class must "share a common question of law or fact").
Even when the effect on each class member differs, an allegation that the defendant's discriminatory policy or practice affects the class as a whole will suffice to prove commonality of claims. Rosario, 963 F.2d at 1017 ("The fact that there is some factual variation among class grievances will not defeat a class action.") (citing Patterson v. Gen. Motors Corp., 631 F.2d 476, 481 (7th Cir.), cert. denied, 451 U.S. 914 (1980)). Thus, even if each class member's remedy differs, there is commonality if the injury flows from the same discriminatory acts or omissions. See Marisol A., 126 F.3d at 376 (in class action involving foster children, "[t]he unique circumstances of each [*12] child do not compromise the common question of whether, as plaintiffs allege, defendants have failed to meet their federal and state law obligations.").
In this action, Plaintiffs have challenged the systematic failure of Defendants to provide them with services in integrated community settings as opposed to segregated institutions. This is a "common nucleus of operative fact" that affects all members of the class. Additionally, the class members share overriding questions of law: whether Defendants' conduct violates the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v. Class actions routinely are certified in civil rights cases presenting common questions of this nature. See Wyatt, 169 F.R.D. at 164-65 (commonality and typicality existed where "[t]he named plaintiffs share multiple interests and claims identical to the class members' claims."). As this Court has recognized, "[w]here 'broad discriminatory policies and practices [*13] constitute the gravamen of a class suit, common questions of law or fact are necessarily presumed.'" Hispanics United, 160 F.R.D. at 688 (quoting Midwest Cmty. Council v. Chicago Park Dist., 87 F.R.D. 457, 460 (N.D. Ill. 1980)).
3. The Named Plaintiffs' Claims Are Typical of Those of the Class
The "typicality" requirement is met when the named plaintiffs' claims "arise[] from the same event or practice or course of conduct that gives rise to the claims of other class members and ... are based on the same legal theory." De La Fuente v. Stokely-Van Camp, 713 F.2d 225, 232 (7th Cir. 1983). This question is "closely related to the preceding question of commonality." Rosario, 963 F.2d at 1018; see also Falcon, 457 U.S. at 157 n.13 ("the commonality and typicality requirements of Rule 23(a) tend to merge..."). As with commonality, typicality does not require that all class members suffer the same injury as the named plaintiffs. "Instead, we look to the defendant's conduct and the plaintiffs'

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Page 6

legal theory to satisfy Rule 23(a)(3)." Id.; see also De La Fuente, 713 F.2d at 232 [*14] (typicality satisfied regardless of whether "there are factual distinctions between the claims of the named plaintiffs and those of other class members. Thus, similarity of legal theory may control even in the face of differences of fact.").
Here, the named plaintiffs have been refused community services by Defendants and as a result are, or are at risk of being, unnecessarily institutionalized; therefore, their claims are identical to those of the putative class, which consists of other persons with developmental disabilities who are unnecessarily institutionalized or at risk thereof. Because the named plaintiffs and the class share the same deprivations of federal rights, typicality is easily met here.
4. The Named Plaintiffs and their Counsel Will Fairly and Adequately Protect the Interests of the Class
The question of whether the named plaintiffs will adequately protect the interests of the class is twofold. The first inquiry is the adequacy of the named plaintiffs' representation of the interests of the class; the second is the adequacy of the named plaintiffs' counsel. Hispanics United, 160 F.R.D. at 689. As shown below, plaintiffs meet both requirements [*15] here.
a. The Named Plaintiffs' Interests are Not Antagonistic to Those of the Class
The ability of the named plaintiffs to represent the class goes to whether they have "sufficient interest in the outcome to ensure vigorous advocacy" (Rosario, 963 F.2d at 1018) as well as any interests "antagonistic to the interests of the class." Riordan, 113 F.R.D. at 64. Courts may deny certification based on grounds of antagonism only if that antagonism "goes to the subject matter of the litigation." Id. Potential conflicts that are remote or speculative will not defeat class certification. Hispanics United, 160 F.R.D. at 689.
In this case, Plaintiffs' interests are entirely coextensive with those of the class. They share the same claims as the class members as well as a strong interest in securing declaratory and injunctive relief to remedy their actual or threatened unnecessary segregation in ICF-DDs. This relief will benefit all members of the class. There are no conflicts or antagonism, whether actual or apparent, between the named plaintiffs and the class.
b. Plaintiffs' Counsel Are Qualified to Maintain This Action
Plaintiffs' [*16] counsel are personally experienced in disability civil rights and class action litigation and are well qualified to prosecute this action. The fact that counsel have been found adequate to represent classes of plaintiffs in the past constitutes "persuasive evidence" that they will serve as adequate counsel in this case. Gomez, 117 F.R.D. at 401.
Equip for Equality is the state-designated Protection and Advocacy agency for people with disabilities. See 42 U.S.C. § 15043. It serves as class counsel in Access Living v. Chicago Transit Auth., No. 00-C-0070 (N.D. Ill.) (see 2001 U.S. Dist. LEXIS 6041 (N.D. Ill. May 9, 2001)). Its lawyers regularly litigate individual cases on behalf of individuals with disabilities. Additionally, Laura Miller of Equip for Equality served as class counsel in the following disability rights cases: Corey H. v. Board of Educ., No. 92-C-3409 (N.D. Ill.) (see 995 F. Supp. 900 (N.D. Ill. 1998)) and Calvin G. v. Board of Educ., No. 90-C-3248 (N.D. Ill.). John Whitcomb of Equip for Equality has served as class counsel in Norman v. Johnson, No. 89-C-1624 (N.D. Ill.) and [*17] Bates v. Johnson, No. 84-C-10054 (N.D. Ill.).
Access Living served as class counsel in Access Living v. Chicago Transit Auth., supra, and was certified as class counsel in Fields v. Maram, No. 04-C-0174 (N.D. Ill.) (see 2004 U.S. Dist. LEXIS 16291, at *33 (N.D. Ill. Aug. 16, 2004)). It regularly litigates civil rights cases on behalf of people with disabilities. Additionally, Max Lapertosa of Access Living has served as class counsel in the following disability rights cases: Gaskin v. Pennsylvania, No. 94-CV-4048 (E.D. Pa.) (see 2002 U.S. Dist. LEXIS 14148 (E.D. Pa. July 22, 2002)) and Messier v. Southbury Training Sch., No. 94-CV-1706 (D. Conn.) (see 183 F.R.D. 350 (D. Conn. 1998)). Other disability civil rights cases where Mr. Lapertosa has served as counsel include: Jim C. v. United States, 235 F.3d 1079 (8th Cir. 2001); Birmingham v. Omaha Sch. Dist., 220 F.3d 850 (8th Cir. 2001); Bowers v. Nat'l Collegiate Athletic Ass'n, 171 F. Supp. 2d 389 (D.N.J. 2001) and 151 F. Supp. 2d 526 (D.N.J. 2001).

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Page 7

Benjamin Wolf of the American Civil Liberties Union [*18] of Illinois has over twenty years' experience representing institutionalized children and people with disabilities. He has served as class counsel in the following civil rights cases: B.H. v. McDonald, No. 88-C-5599 (N.D. Ill.) (see 49 F.3d 294 (7th Cir. 1995) and 856 F. Supp. 1285 (N.D. Ill. 1994)); K.L. v. Edgar, No. 92-C-5722 (N.D. Ill.) (see 2000 U.S. Dist. LEXIS 15404 (N.D. Ill. Oct. 6, 2000)); A.N. v. Kiley, No. 86-C-9486 (N.D. Ill.) (see 1995 U.S. Dist. LEXIS 13993 (N.D. Ill. Sept. 22, 1995)); and A.T. v. County of Cook, No. 85-C-0325 (N.D. Ill.) (see 613 F. Supp. 775 (N.D. Ill. 1985)).
Judith A. Gran of the Public Interest Law Center of Philadelphia has over twenty years' experience representing people with disabilities who are unnecessarily institutionalized. Cases in which she has served as class counsel include: People First v. Arlington Developmental Center, No. 92-02213 (W.D. Tenn.) (see 1998 U.S. App. LEXIS 9537 (6th Cir. May 7, 1998) (upholding class certification)); Haldeman v. Pennhurst State Sch. & Hosp., No. 94-1674 (E.D. Pa.) (see 43 F.3d 939 (3d Cir. 1995); [*19] 901 F.2d 311 (3rd Cir. 1990); 9 F. Supp. 2d 544 (E.D. Pa. 1998); 899 F. Supp. 209 (E.D. Pa. 1995)); Jackson v. Fort Stanton Hosp. & Training Sch., No. CIV-87-0839 (D.N.M.) (see 964 F.2d 980 (10th Cir. 1992)); Gaskin v. Pennsylvania, No. 94-C-4048 (E.D. Pa.) (see 2002 U.S. Dist. LEXIS 14148 (E.D. Pa. Jul 22, 2002)); Messier v. Southbury Training Sch., No. 3:94-CV-1706 (D. Conn.) (see 183 F.R.D. 350 (D. Conn. 1998)), and Bogard v. Duffy, No. 88-C-2414 (N.D. Ill.). Other prominent disability rights cases in which Ms. Gran served as counsel include Jim C. v. United States, 235 F.3d 1079 (8th Cir. 2001); Birmingham v. Omaha Sch. Dist., 220 F.3d 850 (8th Cir. 2001); Shaw v. Stackhouse, 920 F.2d 1135 (3d Cir. 1990); Thompson v. U.S. Dep't of Labor, 813 F.2d 48 (3d Cir. 1987).
Finally, counsel from Sonnenschein Nath & Rosenthal LLP, John Grossbart and Kendra Hartman, are experienced litigators who have represented clients in class action proceedings in more than 30 state and federal courts, including: In re The Prudential [*20] Ins. Co. of Am. Sales Practices Litig., No. 95-4704 (see 962 F. Supp. 450 (D.N.J. 1997), aff'd, 148 F.3d 283 (3d Cir. 1998), cert. denied, 525 U.S. 1114 (1999)) (an MDL of several nationwide class actions); Azar v. Prudential Ins. Co. of Am., 2003-NMCA-062 (N.M.); In re VMS Sec. Litig., No. 89-C-9448 (N.D. Ill.); Daniels v. Bursey, No. 03-C-1550 (N.D. Ill); and Sims v. Allstate Ins. Co., No. 99-L-393-A (20th Jud. Cir. Ill.).
5. The Class Is Readily Identifiable
A class under Rule 23(a) must be "readily identifiable." Specifically, "the description of the class must be sufficiently definite to permit ascertainment of the class members...." Alliance to End Repression, 565 F.2d at 977. A class description is sufficiently definite when its "scope is defined by the activities of the defendants." Id. at 978.
Here, the proposed definition identifies class members as persons with developmental disabilities who are unnecessarily institutionalized, or at risk thereof, due to Defendants' failure to provide appropriate community services and supports. This definition properly relies [*21] on objective, readily identifiable criteria. Whether a person is a class member is dependent upon Defendants' actions or inactions, and therefore "the Court can feasibly determine whether an individual is a class member ...." Fields, 2004 U.S. Dist. LEXIS 16291 at *40. See also Makin v. Hawaii, 114 F. Supp. 2d 1017, 1020 (D. Haw. 1999) (in case under ADA integration mandate, court certified class of "mentally retarded people living at home who are on a wait list for services ..."). Thus, the class meets Rule 23(a)'s requirement for definitiveness.
6. Plaintiffs Are Members of the Class
Finally, the named plaintiffs must show they are part of the class they seek to represent. Hendrix v. Faulkner, 525 F. Supp. 435, 442 (N.D. Ind. 1980), aff'd in relevant part, Wellman v. Faulkner, 715 F.2d 269 (7th Cir. 1983), cert. denied, 468 U.S. 1217 (1984). Here, each of the named plaintiffs is an actual resident of an ICF-DD, or is at risk of placement in an ICF-DD, who is nevertheless capable of living in the community; therefore, they meet the criteria for class membership.
B. PLAINTIFFS MEET [*22] THE REQUIREMENTS OF RULE 23(b)(2)

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In addition to meeting the requirements of Rule 23(a), Plaintiffs must meet one of the requirements of Rule 23(b). Plaintiffs move here under Rule 23(b)(2), which allows courts to certify a class if the defendant "has acted or refused to act on grounds generally applicable to the class, thereby making appropriate final injunctive relief or corresponding declaratory relief with respect to the class as a whole." Fed. R. Civ. P. 23(b)(2). Civil rights cases against parties charged with broad-based discrimination are "prime examples" of actions under Rule 23(b)(2). Amchem Prods v. Windsor, 521 U.S. 591, 613 (1997).
This case is exemplary of a Rule 23(b)(2) action because Defendants' policies and practices affect all members of the class as well as the named plaintiffs, the remediation of which is well-suited for and requires declaratory and injunctive relief. Plaintiffs do not seek monetary damages for themselves or the class. Indeed, it is commonplace for class actions to proceed under Rule 23(b)(2) where people with disabilities seek to enforce their rights to community integration and services. [*23] See Fields, 2004 U.S. Dist. LEXIS 16291, at *39-*42; Hawkins v. Comm'r, No. 99-143-JD, 2004 U.S. Dist. LEXIS 807, at *11-*12 (D.N.H. Jan. 23, 2004); Boulet v. Cellucci, 107 F. Supp. 2d 61, 81 (D. Mass. 2001); Verdow v. Sutkowy, 209 F.R.D. 309, 313 (N.D.N.Y. 2002); Benjamin H. v. Ohl, No. 3:99-0338, 1999 U.S. Dist. LEXIS 22454, at *11-*12 (S.D.W.V. Oct. 8, 1999); Makin, 114 F. Supp. at 1020 (class of persons living at home certified in claim under ADA integration mandate); Martin v. Taft, 222 F. Supp. 2d 940, 947 (S.D. Ohio 2002); Rolland v. Cellucci, 52 F. Supp. 2d 231, 233 (D. Mass. 1999); Haldeman v. Pennhurst State Sch. & Hosp., 995 F. Supp. 534, 536 (E.D. Pa. 1998); Wyatt, 169 F.R.D. at 164-68 (certifying class of "all current and future mentally-retarded and mentally-ill residents of any facility, hospital, center, or home, public or private, to which they are assigned or transferred for residence by the Alabama Department of Mental Health and Mental Retardation"); Jackson v. Fort Stanton Hosp. & Training Sch., 757 F. Supp. 1243, 1257 (D.N.M. 1990) [*24] (court certified class of "all persons presently residing at" four state institutions, "all persons who became or will become residents of the institutions during the pendency of the action; and all persons who have been transferred ... to skilled nursing facilities, intermediate care facilities, homes for the aged and similar facilities, and whose services are funded in whole or in part by defendants."), rev'd in part on other grounds, 964 F.2d 980 (10th Cir. 1992); Weaver v. Reagen, 701 F. Supp. 717, 722-23 (W.D. Mo. 1988), aff'd, 886 F.2d 194 (8th Cir. 1989); Mitchell v. Johnston, 701 F.2d 337, 345-46 (5th Cir. 1983).
III. CONCLUSION
For the reasons stated above, Plaintiffs respectfully request this Court grant their Renewed Motion for Class Certification.
Dated: January 10, 2006
Respectfully Submitted,
/s/ Kendra K. Hartman By: One of the Attorneys for Plaintiffs
Barry G. Lowy Laura J. Miller Barry C. Taylor John W. Whitcomb EQUIP FOR EQUALITY 20 North Michigan Avenue, Suite 300 Chicago, Illinois 60602 Tel: (312) 341-0022 Fax: (312) 341-0295
John I. Grossbart

2005 U.S. Dist. Ct. Motions 54331; 2006 U.S. Dist. Ct. Motions LEXIS 78358, *24
Kendra [*25] K. Hartman SONNENSCHEIN NATH & ROSENTHAL LLP 7800 Sears Tower Chicago, Illinois 60606 Tel: (312) 876-8000 Fax: (312) 876-7934
Max Lapertosa Kenneth M. Walden ACCESS LIVING OF METROPOLITAN CHICAGO 614 West Roosevelt Road Chicago, Illinois 60607 Tel: (312) 253-7000 Fax: (312) 253-7001
Benjamin S. Wolf AMERICAN CIVIL LIBERTIES UNION OF ILLINOIS 180 North Michigan Avenue, Suite 2300 Chicago, Illinois 60601 Tel: (312) 201-9740 Fax: (312) 201-9760
Judith A. Gran PUBLIC INTEREST LAW CENTER OF PHILADELPHIA 125 S. Ninth Street, Suite 700 Philadelphia, Pennsylvania 19107 Tel: (215) 627-7100 Fax: (215) 627-3183

Page 9

 
 Ligas ex rel. Foster v. Maram, Not Reported in F.Supp.2d (2006)

2006 WL 644474 United States District Court, N.D. Illinois, Eastern Division.
Stanley LIGAS, by his sister and next friend, Gina Foster, et al., on behalf of themselves and all others similarly situated, Plaintiffs, v. Barry S. MARAM, in his official capacity as
Director of the Illinois Department of Healthcare and Family Services, et al., Defendants.
No. 05 C 4331. | March 7, 2006.
Attorneys and Law Firms
Barry Charlton Taylor, Barry G. Lowy, John Warren Whitcomb, Laura J. Miller, Equip for Equality, Benjamin S. Wolf, Roger Baldwin Foundation of Aclu, Inc., John I. Grossbart, Kendra Kekelis Hartman, Sonnenschein, Nath & Rosenthal, LLP, Kenneth M. Walden, Access Living, Max P. Lapertosa, Access Living of Metropolitan Chicago, Chicago, IL, Judith A. Gran, Public Interest Law Center of Philadelphia, Philadelphia, PA, for Plaintiffs.
Karen Elaine Konieczny, Christopher Samuel Gange, John E. Huston, Kathleen Kreisel Flahaven, Thomas A. Ioppolo , Illinois Attorney General’s Office, Brent Douglas Stratton, Office of the Attorney General, Chicago, IL, for Defendants.
Opinion
MEMORANDUM OPINION AND ORDER REGARDING CLASS CERTIFICATION
HOLDERMAN, J.
*1 Stanley Ligas and eight other individually named plaintiffs (“named plaintiffs”) filed a renewed motion for class certification under Federal Rule of Civil Procedure 23(b)(2) against Illinois officials (“defendants”)) who administer state programs that provide long-term care services for people with developmental disabilities.1 (Dkt. No. 61.) For the reasons stated below, the renewed class certification motion under Rule 23(b)(2) is granted.

1

Plaintiffs’ first motion for class certification, filed on

August 8, 2005, was dismissed as moot, after parties

agreed to have the court first chose to address three

petitions to intervene.

BACKGROUND
The named plaintiffs filed a complaint individually and on behalf of similarly situated individuals alleging that the defendants’ failure to provide the plaintiffs with the option of long-term care services in the most integrated setting appropriate for their needs violates Title II of Americans with Disabilities Act, see 42 U.S .C. § 12111 et seq., Section 504 of the Rehabilitation Act of 1973, see 29 U.S.C. § 794, and Title XIX of the Social Security Act, see 42 U.S.C. § 1396 et seq. The plaintiffs seek as injunctive relief for the defendants to give eligible developmentally disabled individuals the option of being placed in community settings with appropriate services and support rather than in institutions, such as Medicaid-certified long-term care placements serving those with developmental disabilities called intermediate care facilities (“ICF-DD”). The plaintiffs’ lawsuit relies heavily on Olmstead v. L.C., 527 U.S. 581, 587, 119 S.Ct. 2176, 144 L.Ed.2d 540 (1999), which held that developmentally disabled individuals should be placed in community settings rather than institutions when a state’s treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account available state resources and the needs of others with disabilities. The Supreme Court explained that a state may rely on the reasonable assessments of its own professionals in determining whether an individual meets the essential eligibility requirements for community placement. Id. at 602.
The named plaintiffs allege in the complaint that they satisfy Illinois’s eligibility requirements for community placement: (1) they have been found eligible for Medicaid services, see 89 Ill. Admin. Code § 140.642(b); (2) they either qualify for or have been recommended for community placement, and six of the nine plaintiffs specifically allege that a state assigned pre-admission screening and resident review agent (“PAS agent”)
1

Ligas ex rel. Foster v. Maram, Not Reported in F.Supp.2d (2006)

determined that they are capable of living in a community-based setting, see 59 Ill. Admin. Code § 120.140; (3) and they or their guardians have requested to be placed in community settings or Community-Integrated Living Arrangements (“CILA”). The crux of the named plaintiffs’ allegations is that all the named plaintiffs could meet, and most do meet, Illinois’s eligibility requirements for living in a community setting, yet the state has refused to place the plaintiffs in such a setting.
*2 The proposed class that the named plaintiffs additionally seek to certify would consist of: “All persons in Illinois with disabilities who (1) have mental retardation and/or other developmental disabilities and who qualify for long-term care services; (2) with appropriate supports and services, could live in the community and who would not oppose community placement; and (3) either are institutionalized in private ICF-DDs with nine or more residents or are living in a home-based setting and are at risk for institutionalization because of their need for services.” (Pl. Renewed Mot. for Class Cert. at 1.)
LEGAL STANDARDS
As prerequisites for certification, the potential class must satisfy the following criteria: (1) numerosity; (2) commonality of facts and law; (3) typicality between the class claims and those of the named parties; and (4) adequacy of the representation by the named parties and class counsel. Fed.R.Civ.P. 23(a). Failure of the potential class to satisfy any one of these prerequisite elements precludes class certification. Retired Chicago Police Assoc. v. City of Chicago, 7 F.3d 584, 596 (7th Cir.1993); Rahim v. Sheahan, 2001 WL 1263493, *9 (N.D.Ill. Oct.19, 2001). In addition, because the plaintiffs are seeking to certify a class under Rule 23(b)(2), they also must establish that “the party opposing the class has acted or refused to act on grounds generally applicable to the class, thereby making appropriate final injunctive relief or corresponding declaratory relief with respect to the class as a whole.” Fed.R.Civ.P. 23(b)(2). In deciding whether the party who is seeking class certification has met its burden of demonstrating that certification is appropriate, the court should make whatever factual and legal inquiries are necessary under Rule 23. Szabo v. Bridgeport Machines, Inc., 249 F.3d 672, 675 (7th Cir.2001). The decision to certify a class does not depend on the strengths or weaknesses of the asserted claims, but instead

on whether the potential class satisfies the requirements under Rule 23. Eisen v. Carlisle & Jacquelin, 417 U.S. 156, 177, 94 S.Ct. 2140, 40 L.Ed.2d 732 (1974).
ANALYSIS
A. Commonality: The defendants first challenge the potential class’s ability to satisfy the commonality requirement. The defendants argue that, as a result of the broad class definition, common issues of fact and law do not predominate. According to the defendants, their alleged conduct does not apply to the entire proposed class in that “potential class members might not be entitled to all or any of the requested relief” under the defendants’ interpretation of the proposed class definition. (Defs. Resp. at 8.) The defendants also argue that the broad class definition would be inclusive of factual circumstances that vary too broadly among class members individuals with too diverse of factual circumstances. To exemplify this point, the defendants note that the proposed class would include as potential class members those who live at home “and are at risk for institutionalization because of their need for services.” (Pl. Renewed Mot. for Class Cert. at 1.) Defendants argue that this class definition would encompass “all developmentally disabled persons living at home because all such persons conceivably would be ‘at risk.” ’ (Defs. Resp. at 9.)
*3 To some extent, the defendants may misunderstand the class definition. In arguing against commonality, the defendants seem to overlook the limitation on the class definition that all members “qualify for long-term care” and “could live in the community.” For example, the defendants’ concern that the class would encompass all developmentally disabled living at home is resolved by the class requirement that members “could live in the community.” (Pl. Renewed Mot. for Class Cert. at 1.)
Whether the proposed class satisfies the commonality requirement, however, is a close question. See Wallace v. Chicago Housing Auth., 224 F.R.D. 420, 423 (N.D.Ill.2004) (courts have broad discretion in deciding whether to certify a class and should err in favor of maintaining a class action.) A defendant’s standardized conduct toward proposed class members, such as a generalized policy that affects all class members in the same way, has been considered sufficient to satisfy commonality. Keele v. Wexler, 149 F.3d 589, 594 (7th
2

Ligas ex rel. Foster v. Maram, Not Reported in F.Supp.2d (2006)

Cir.1998); see Gen. Tele. Co. of the SW v. Falcon, 457 U.S. 147, 159 n. 15, 102 S.Ct. 2364, 72 L.Ed.2d 740 (1982). Where a defendant’s standardized conduct is at issue, this court does not require that the putative class members all suffer the same injury, but rather the uniformity of the defendant’s conduct toward the potential members and the plaintiffs’ legal theory. See Rosario v. Livaditis, 963 F.3d 1013, 1018 (7th Cir.1992).
In this case, the proposed class seeks to require the defendants to enact standardized policies regarding the community placement of eligible developmentally disabled individuals. The proposed class challenges the defendants’ failure to provide developmentally disabled individuals with information about the option of community placement, systematically evaluate developmentally disabled individuals that qualify for long-term services to determine whether they are eligible for community placement, place those who are eligible in the community, and maintain a wait list for community placement. The fact that the named plaintiffs and some proposed class members may have learned about the option of community placement or already have been assessed qualified for community placement by a PAS agent relates to the level of the injury suffered and not whether the defendants’ conduct was sufficient standardized. See Rosario, 963 F.3d at 1018. The defendants have acted, or have failed to act, uniformly toward the proposed class based on their policies and lack of policies in place, and that is what the proposed class’s legal claims challenge. This court determines that the proposed class is challenging the defendants’ failure to enact policies regarding community placement, and in assessing this standardized conduct, common questions of law and fact predominate.
B. Typicality: The commonality discussion also resolves most of the defendants’ challenges to class certification based on the typicality requirement. See Falcon, 457 U.S. at 158 n. 13 (“The commonality and typicality requirements of Rule 23(a) tend to merge.”) Related to their argument against commonality, the defendants contend that the breadth of the class definition results in too many legal and factual differences between the named plaintiffs and the potential class members. The defendants assert that, consequently, a showing that the named plaintiffs are entitled to relief would not necessarily prove that the potential class was also so entitled. The claims of the named plaintiffs and the proposed class, however, only must share the “same essential characteristics”; factual differences may still

exist. Retired Chicago Police Ass’n, 7 F.3d at 597 (internal citations and quotations omitted); see Chapman v. Worldwide Asset Mgmt., LLC, No. 04-C-7625, 2171168, *3 (N.D.Ill. Aug. 30, 2005). That is the case here. The named plaintiffs, like the potential class members, seek to have the defendants establish a policy of informing individuals about community placement and of evaluating those interested in the placement, regardless of whether they each have learned about community services or have been assessed “qualified” by a PAS agent. By definition, the class would be necessarily entitled to the same relief as the named plaintiffs if the named plaintiffs were to prove their case. The class members all qualify for long-term services, “could live in the community,” and desire to do so. Part of the relief sought by the class is for the defendants to systematically evaluate those qualifying for long-term care who wish to be placed in the community. At this stage in the litigation, this court may presume based on the pleadings that a PAS agent would find qualified for community services the proposed class because by definition the class members qualify for long-term services and “could live in the community.” Fed.R.Civ.P. 23(c)(1)(C); see Morse v. Bankers Life & Cas. Co. and PCS, Inc., No. 99-C-0193, 2000 WL 246245, *4 (N.D.Ill. Feb.24, 2000).
*4 One issue regarding typicality remains. Whether the three named plaintiffs’, two of whom-David Childers and Tiffany McFadden-have been moved to CILAs and one of whom-Alex Tyner-now lives in a six-bed ICF-DD since the filing of the complaint, various residency circumstances destroy typicality. As a result of their moves, the three plaintiffs’ claims for injunctive relief to live in a more integrated setting are moot. In re Resource Tech. Corp., 430 F.3d 884, 886 (7th Cir.2005) (case is moot when no further judicial relief is possible). The plaintiffs contend that these three plaintiffs may remain class representatives because their moves in residences occurred in December 2005, after the filing of the first motion for class certification on August 8, 2005. That motion, however, was dismissed as moot. The relevant date is the filing of the pending motion for class certification on January 10, 2005, after the three plaintiffs were moved to the CILAs and the six-bed ICF-DD in December 2005. See Fields v. Maram, No. 04-C-0174, 2004 WL 1879997, *9 (N.D.Ill. Aug.17, 2004) (certification relates back to the time that the class certification motion was filed). The three plaintiffs’ claims do not relate back to the filing of the motion for class certification. Because their claims became moot prior to the filing of the motion for class certification, this court determines that David Childers, Tiffany McFadden,
3

Ligas ex rel. Foster v. Maram, Not Reported in F.Supp.2d (2006)

and Alex Tyner do not have claims typical of the class and are not adequate class representatives in this litigation. See Gates v. Towery, 430 F.3d 429, 430 (7th Cir.2005). The dismissing of David Childers, Tiffany McFadden, and Alex Tyner as named plaintiffs does not, however, affect class certification. Six adequate class representatives whose claims are not moot remain. See Robinson v. Sheriff of Cook County, 167 F.3d 1155, 1157 (7th Cir.1999) (suitability of new class representative must be determined independently of former proposed class representative found to be inadequate); Cowen v. Bank United of Texas, FSB, 70 F.3d 937, 941 (7th 1995) (disqualification of the named plaintiff moots question whether to certify class unless lawyers for class find another representative). The proposed class satisfies the requirements of typicality (and, for that matter, adequacy, a ground not challenged by the defendants).

individuals live in ICF-DDs. Although not all of these individuals could live or wish to live in the community, this court may infer based on common sense that there are enough individuals living in ICF-DDs, as well as those living at home, who qualify for long-term care, could live in the community, and want to do so as to make joinder impractical. See Mirfasihi v. Fleet Mortgage Corp., No. 01-C722, 2005 WL 1950386, *12 (N.D.Ill. Aug.11, 2005). As for adequacy, no reason has been brought to this court’s attention that would make this court question the remaining representatives’ and plaintiffs’ attorneys’ abilities to adequately represent the class. Finally, the proposed class fits the definition for certification under Rule 23(b)(2), in that the defendants allegedly have acted or refused to act on grounds generally applicable to the class and appropriate for injunctive relief. Fed.R.Civ.P. 23(b)(2).

C. Indefiniteness: The defendants also express concern that the proposed class is not sufficiently definite and so this court would have to engage in individual determinations to decide class membership. The individual determinations identified by the defendants are whether an individual is at risk for institutionalization because of their need for services, qualify for long-term care services, and could live in the community with appropriate support and services. As class is sufficiently definite if its membership may be determined by an objective criteria. See Wallace, 224 F.R.D. at 425. The plaintiffs represent that they “do not ask this Court to make those determinations but rather enjoin defendants to do so.” (Pl. Reply at 9.) In essence, the plaintiffs are willing to have the defendants make these determinations based on reasonable assessments from their own state treatment professionals in accordance with Olmstead, 527 U.S. 581, 119 S.Ct. 2176, 144 L.Ed.2d 540. Because the defendants would be evaluating based on their own criteria whether a potential class member would meet the state’s requirements and thus the class definition, court could order the defendants to engage in individual determinations should any relief be granted and not do so itself. See Fields, 2004 WL 1879997 at *7 n. 8.
D. Unchallenged Rule 23 Requirements: *5 The defendants appropriately do not raise objections to the other requirements of Rule 23(a), numerosity and adequacy, or of Rule 23(b)(2). With regard to the numerosity requirement, plaintiffs estimate that 6000

CONCLUSION

Accordingly, the plaintiffs’ renewed motion for class certification under Federal Rule of Civil Procedure 23(b)(2) for injunctive relief (Dkt. No. 61) is granted. This court certifies as class representatives Stanley Ligas, by his sister and next friend, Gina Foster; Lorene Bierman, by her guardians, Darlene and Joseph Bierman; Isaiah Fair, by his guardian Lutricia Fair; Adam Kulig, by his guardian, Norb Kulig; Jamie McElroy, by his guardian, Patricia McElroy; and Jennifer Wilson, by her guardians, Nancy and Richard Wilson. This court appoints the plaintiffs’ counsel as class counsel. The class is defined as:

A class for injunctive relief consisting

of all persons in Illinois with

disabilities who (1) have mental

retardation

and/or

other

developmental disabilities and who

qualify for long-term care services;

(2) with appropriate supports and

services, could live in the community

and who would not oppose

community placement; and (3) either

are institutionalized in private

ICF-DDs with nine or more residents

or are living in a home-based setting

and are at risk for institutionalization

because of their need for services.

Parties are to submit a revised Form 35 on or before 4

Ligas ex rel. Foster v. Maram, Not Reported in F.Supp.2d (2006)

3/20/06. Counsel are requested to submit a courtesy copy of the Form 35 to Chambers on the day of filing. This case is set for a report on status and entry of a scheduling

order at 9:00 a.m. on 4/4/06. The status report set for 3/30/06 is vacated.

5

 
 Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 1 of 29 PageID #:853

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, by his sister and next friend, Gina )

Foster; LORENE BIERMAN, by her guardians, Darlene )

and Joseph Bierman; DAVID CICARELLI, by his

)

guardians James and Julianne Cicarelli; ISAIAH FAIR, )

by his guardian, Lutricia Fair; ADAM KULIG, by his )

guardian, Norb Kulig; JAMIE McELROY, by his

)

guardian, Patricia McElroy; and JENNIFER WILSON, )

by her guardians, Nancy and Richard Wilson, on behalf )

of themselves and all others similarly situated,

)

)

Plaintiffs,

)

)

vs.

)

)

BARRY S. MARAM, in his official capacity as Director )

of the Illinois Department of Healthcare and Family

)

Services, and CAROL L. ADAMS, in her official

)

capacity as Secretary of the Illinois Department of

)

Human Services,

)

)

Defendants.

)

No. 05-4331 CLASS ACTION

FIRST AMENDED COMPLAINT FOR DECLARATORY AND INJUNCTIVE RELIEF INTRODUCTION
1. Plaintiffs are individuals with mental retardation and other developmental

disabilities who qualify for services under Defendants’ system of long-term care for people with

developmental disabilities, including Medicaid services. They bring this action against state

officials who administer Illinois’ program for providing such services for people with

developmental disabilities. Plaintiffs seek redress for Defendants’ practice of requiring them to

reside in large, privately-run congregate care institutions -- known as “intermediate care facilities

for people with developmental disabilities” (“ICF-DDs”) -- as a condition of receiving the long-

term care services they need and for which they qualify, in violation of Title II of the Americans

with Disabilities Act, 42 U.S.C. § 12132 (“Title II”); Section 504 of the Rehabilitation Act,

Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 2 of 29 PageID #:854
29 U.S.C. § 794(a) (“Section 504”); Title XIX of the Social Security Act, 42 U.S.C. §§ 13961396v (“Title XIX”) and 42 U.S.C. § 1983. Plaintiffs bring this action on their own behalf and on behalf of others similarly situated.
2. Like all human beings, Plaintiffs need “family relations, social contacts, work options, economic independence, educational advancement and cultural enrichment.” Olmstead v. L.C., 527 U.S. 581, 600 (1999). These needs can be met in community settings; Plaintiffs can appropriately be served in settings that would integrate them into the community while still meeting their need for services and support. Integration into the community benefits people of all levels of developmental disabilities; indeed, those with the most severe disabilities have been shown to achieve the most progress in the community. Many people with developmental disabilities prefer to live in a home that is integrated in the community, rather than an institution. In addition, community-based programs are cost-effective alternatives to large institutions such as ICF-DDs.
3. Despite the demonstrated advantages of community-based programs, Defendants administer an antiquated system for serving people with developmental disabilities that relies heavily on large public and private institutions, including ICF-DDs. This system defies the national trend of serving people with developmental disabilities in the community. Illinois ranks 49th among states in its placement of people with developmental disabilities in small community settings. While paying lip-service to the value of community-based programs, Defendants have made paltry efforts to reduce the state’s reliance on large institutions or to expand Illinois’ community-based programs.
4. Further, Defendants do not have a comprehensive, effectively working plan for moving persons into the community who are, or who are at risk of being, unnecessarily
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institutionalized. Defendants fail to advise ICF-DD residents and other individuals seeking developmental disability services that they may be eligible for community services and that they have the choice of such services; maintain no waiting list for community services; do not adequately evaluate residents of ICF-DDs or other individuals seeking services to determine if they could appropriately be served in a community setting; advise those people who seek community services that they can only obtain them in an “emergency” situation (which is not defined in any pertinent law or regulation); fail to provide community services to individuals who are capable of living in the community; and otherwise act arbitrarily in administering developmental disability services. Defendants channel Plaintiffs into ICF-DDs and severely curtail access to community services.
5. By requiring Plaintiffs to submit to institutionalization as a condition of receiving services, Defendants have caused Plaintiffs to experience unnecessary regression, deterioration, isolation and segregation. This segregation “perpetuates unwarranted assumptions” that Plaintiffs “are incapable or unworthy of participating in community life.” Olmstead, 527 U.S. at 600.
6. The “integration mandates” of Title II and Section 504 (implemented by 28 C.F.R. § 35.130(d) and 28 C.F.R. § 41.51(d)) require that state government services, programs and activities be provided in the most integrated setting appropriate to the needs of the person with a disability. The Supreme Court affirmed these mandates in Olmstead, finding that “unjustified institutional isolation of persons with disabilities is a form of discrimination.” 527 U.S. at 600. Defendants have defied this mandate by clinging to a segregated, outmoded, and, for Plaintiffs, harmful institutional system and by failing to develop a comprehensive,
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effectively working plan to offer developmentally disabled individuals services in the most integrated setting appropriate to their needs.
7. In addition, Defendants’ actions violate Title XIX’s requirements that Defendants: (1) offer persons with developmental disabilities who are Medicaid-eligible a choice between institutional and community services, and inform them of “feasible alternatives” under the Home and Community Based Services Waiver, which funds some community services in Illinois, see 42 U.S.C. § 1396n(c)(2)(C); (2) ensure that community services are provided with “reasonable promptness,” 42 U.S.C. § 1396a(a)(8); and (3) ensure that ICF-DDs are not unnecessarily utilized, through the use of effective assessments to determine whether persons could be served in community settings. See 42 U.S.C. §§ 1396a(a)(30)(A) & (B); 42 C.F.R. §§ 456.370-371.
8. Plaintiffs seek to enforce their legal rights to receive services in the community, and not in segregated, isolating institutions that deprive them of basic liberties.
JURISDICTION AND VENUE 9. This is an action for declaratory and injunctive relief to enforce the rights of the Plaintiffs and the class they seek to represent under the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), Title XIX of the Social Security Act, 42 U.S.C. §§ 1396, 1396a-1396v, and 42 U.S.C. § 1983. 10. Jurisdiction is proper pursuant to 28 U.S.C. § 1331 and 28 U.S.C. § 1343. Venue is proper in the Northern District of Illinois pursuant to 28 U.S.C. § 1391(b). 11. Declaratory relief is authorized by 28 U.S.C. § 2201 and Rule 57 of the Federal Rules of Civil Procedure. Injunctive relief is authorized by 28 U.S.C. § 2202 and Rule 65 of the Federal Rules of Civil Procedure.
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THE PARTIES Defendants
12. Defendants are sued in their official capacities. They are: the Director of the Illinois Department of Healthcare and Family Services, Barry S. Maram, or his duly appointed successor, and the Secretary of the Illinois Department of Human Services, Carol L. Adams, or her duly appointed successor.
13. Barry S. Maram is the Director of the Illinois Department of Healthcare and Family Services (“IDHFS”), which is the designated Medicaid Single State Agency and is responsible for the oversight and administration of the Medicaid program under Title XIX of the Social Security Act, including programs for persons with developmental disabilities. See 42 U.S.C. § 1396a(a)(5). In this capacity, Mr. Maram administers and funds the ICF-DD program as well as community-based residential services, including services provided under the Medicaid Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities pursuant to 42 C.F.R. § 430.25(c)(2). Director Maram is responsible for ensuring these programs comply with federal law.
14. Carol L. Adams is the Secretary of the Illinois Department of Human Services (“DHS”), which, through its Division of Developmental Disabilities, is responsible for providing comprehensive services to people with developmental disabilities in Illinois, including both institutional and community residential services, to help them achieve self-sufficiency, independence and health to the maximum extent possible. She is also responsible for administering the State of Illinois’ preadmission screening process, through which the State determines an individual’s eligibility for institutional or community services. DHS performs these screenings through local pre-admission screening (“PAS”) agencies. There are 17 such agencies in the State, staffed by qualified mental retardation professionals. Secretary Adams is
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also responsible for ensuring compliance with state and federal laws that govern the provision of services to people with developmental disabilities, including the ADA and Section 504.
The Named Plaintiffs Stanley Ligas 15. Stanley Ligas, age 37, has a diagnosis of Down Syndrome resulting in mild mental retardation, a developmental disability under 42 C.F.R. § 1009 and 405 ILCS § 5/1-106. He is eligible for Medicaid services. 16. Mr. Ligas is able to make decisions on his own behalf, with support from his siblings. 17. Mr. Ligas resided in his family’s home until 1993, when both parents passed away. During the time he lived at home, he attended schools in Chicago. Mr. Ligas values frequent contact with his siblings and their families, remembering special dates and events in their lives. 18. After residing temporarily with family members, in 1994 Mr. Ligas moved to Sheltered Village, a 96-bed ICF-DD in Woodstock, Illinois. 19. Mr. Ligas is independent in all of his activities of daily living. He is able to read and knows how to write checks and balance a checkbook. Mr. Ligas is a friendly and gregarious individual who has an engaging sense of humor. He expresses what he likes, dislikes, wants and needs. 20. While living at Sheltered Village, Mr. Ligas worked in a sheltered workshop environment, but later advanced to a combination of community job hours and the workshop. Having met the goals of the workshop, he “graduated” and worked briefly at a video store in Woodstock. When the store closed, Mr. Ligas’ job ended. After being unemployed for several months, he was placed back in a sheltered workshop setting. Recently, the sheltered workshop
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was able to secure a part-time supported employment position for Mr. Ligas at Popeye’s Chicken.
21. Mr. Ligas has expressed a strong desire to reside in a small community-based setting with one to three other individuals located in close proximity to one of his siblings. His Interdisciplinary Team at Sheltered Village identified his readiness to move to a community setting at his annual service plan meeting in 2004.
22. Sheltered Village informed his state-appointed PAS agency that Mr. Ligas could handle and benefit from community placement. Despite this recommendation, Mr. Ligas remains at Sheltered Village.
23. With suitable supports and services, Mr. Ligas could live in the community. The community is the most integrated setting appropriate to Mr. Ligas’ needs, but Defendants have only offered services in a segregated, institutional setting.
Lorene Bierman 24. Plaintiff Lorene Bierman, age 43, has a diagnosis of profound mental retardation. This is a developmental disability under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1-106. She is eligible for Medicaid services. 25. Darlene and Joseph Bierman, Ms. Bierman’s parents, are her legal co-guardians, and they are strong advocates on her behalf. Ms. Bierman visits her parents at their home on a regular basis. 26. Since 1991, Ms. Bierman has resided in Bethesda Lutheran Home in Aurora, Illinois, a 45-bed ICF-DD. Prior to moving to the Aurora ICF-DD, she resided at another large facility, Bethesda Lutheran Home in Watertown, Wisconsin, for nine years. 27. Ms. Bierman is non-verbal. She is able to communicate by using gestures and other sounds. She is easy-going, cooperative, and gets along well with staff and peers. Ms.
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Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 8 of 29 PageID #:860
Bierman is able to indicate her personal preferences by favorably or unfavorably responding to staff initiations. Ms. Bierman attends church regularly and enjoys listening to the hymns.
28. While at Bethesda Lutheran Home, Ms. Bierman attends an adult day care program at Keeler Center in Aurora. She chooses her routine on a daily basis. An emphasis of this day program is to increase her pre-vocational skills and her ability to respond to verbal cues.
29. Ms. Bierman’s parents would like her to move to a community-based residential program because they feel she will benefit from the smaller size residence and more attentive staff. They believe she will demonstrate greater adaptive skills in a more home-like environment than at a large facility like Bethesda Lutheran Home.
30. Ms. Bierman was accepted into Bethesda’s small community residential program in 2004 and her parents anticipated that she would have moved to there soon after. However, a DHS representative verbally informed Mrs. Bierman that her daughter would not be given funding for that program because she was not “an emergency.”
31. With appropriate supports and services, Lorene Bierman could live in a small group setting in the community. However, Defendants continue to only offer her services in a segregated, institutional setting.
David Cicarelli 32. David Cicarelli, age 32, is diagnosed with moderate mental retardation, a developmental disability under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1-106. He is eligible for Medicaid services. 33. Mr. Cicarelli’s parents, James and Julianne Cicarelli, are his legal co-guardians. Mr. Cicarelli lived with his parents in Arlington Heights, Illinois until 1997, when he moved to Riverside Foundation, a 96-bed ICF-DD facility located in Lincolnshire, Illinois.
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Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 9 of 29 PageID #:861
34. Mr. Cicarelli continues to have a close relationship with his parents, whom he visits regularly. They have been his advocates and have attempted to secure the most independent and integrated setting for their son’s needs.
35. Mr. Cicarelli is independent in most of his personal care skills. He is a friendly, engaging individual who enjoys dining out with friends, shopping, going to the movies, the library and to church. He also enjoys doing arts and crafts, painting and sewing.
36. After graduating from high school, Mr. Cicarelli worked in a supermarket as part of a vocational training program. Since moving to Riverside Foundation, Mr. Cicarelli works at the Riverside Developmental Services day program. Mr. Cicarelli’s 1995 Annual Review states that “he has reached his optimal level of functioning vocationally” in that setting. He is not working in the community, despite the ability to do so.
37. When Mr. Cicarelli was in his early twenties, his parents began seeking community-based residential alternatives to living at home. They felt strongly that he would benefit most from living in the community. However, there were no such services available. As a result, Mr. Cicarelli moved to Riverside Foundation, an ICF-DD which had immediate openings. Even after Mr. Cicarelli moved to this ICF-DD, his parents continued to pursue community services for him, as they did not feel that Riverside Foundation was an appropriate setting.
38. Most recently, approximately two years ago, Clearbrook, a service provider located near Mr. Cicarelli’s family home, informed the Cicarelli’s of opportunities for placement in one of its community homes. However, once Clearbrook learned that Mr. Cicarelli was placed at the Riverside Foundation ICF-DD, it informed Mrs. Cicarelli that she would need to contact the PAS agency caseworker. The caseworker, in turn, told Mrs. Cicarelli that because her son
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Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 10 of 29 PageID #:862
was already being served, albeit in an institution, the state would not provide him with services in the community, and Mrs. Cicarelli was discouraged from even re-opening her son’s case with them.
39. With appropriate supports and services, David Cicarelli would thrive in a small, more integrated community setting. Defendants, however, have only offered services in a segregated, institutional setting.
Isaiah Fair 40. Isaiah Fair, age 40, is diagnosed as having moderate mental retardation and epilepsy, which are developmental disabilities under 42 C.F.R § 435.1009 and 405 ILCS § 5/1106. 41. Mr. Fair is eligible for Medicaid and has been receiving developmental disability services from Defendants. Until May 28, 2003, Mr. Fair was residing in Matteson Court, a 16bed ICF-DD, in Matteson, Illinois. 42. Mr. Fair’s mother and guardian, Lutricia Fair, was unhappy with his placement in the ICF-DD because it failed to provide adequate integration into the community, because the housing of 16 individuals together with inadequate staff resulted in an atmosphere of turmoil, and because the staff of the ICF-DD failed to keep Ms. Fair informed about her son’s medical problems. In May 2002, Ms. Fair requested that Mr. Fair’s state-appointed PAS agent, Suburban Access, seek a placement for Mr. Fair in a small group home in the community to alleviate these problems. No such placement was offered. 43. In May 2003, Mr. Fair had a severe seizure at Matteson Court. Staff refused to call 911. Ms. Fair was present and called 911 from her cellular telephone. In response to this incident, Ms. Fair filed a complaint with the IDPH on her son’s behalf. The IDPH determined that the ICF-DD committed medical neglect. Ms. Fair then removed her son from the facility
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and decided to keep him at home while she attempted to secure community residential services for him.
44. In June 2003, Ms. Fair again requested that Suburban Access find a community placement for her son. Suburban Access has assessed Mr. Fair and deemed him qualified for community services.
45. DHS, however, denied Mr. Fair’s request for community placement on the grounds that he no longer was in an “emergency” situation. Instead, DHS suggested a large ICFDD or state-operated developmental center, which Ms. Fair has refused. Suburban Access, as state-assigned PAS agent for Mr. Fair, explained to Ms. Fair that the only way her son could have qualified for a community placement under existing DHS standards would be if she had left him in the life-threatening situation at Matteson Court, thereby creating an “emergency.”
46. As a result, Mr. Fair continues to live at home without necessary supports and services to avoid the more restrictive environment of an ICF-DD. As an adult, it is appropriate for Mr. Fair to live in the community with peers, rather than in his mother’s home. Additionally, because Ms. Fair must care for her son, she is unable to work and supports her son with her limited savings. Mr. Fair will not be able to continue to live with his mother and will need outof-home care, and so is at risk of institutionalization.
47. Suburban Access has not found an appropriate day program for Mr. Fair and has been unwilling to provide transportation for this purpose. Ms. Fair finally found a day program for her son with the assistance of a social worker at Ingalls Hospital. Mr. Fair has been attending the Addus Day Program in Homewood since July of 2004. Mr. Fair has been waiting approximately three years for residential community services.
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48. With appropriate supports and services, Mr. Fair could live in the community. The community is the most integrated setting appropriate to Mr. Fair’s needs, but Defendants have only offered services in a segregated, institutional setting.
Adam Kulig 49. Adam Kulig, age 22, resides in Johnston City with his father and guardian, Norb Kulig. Adam is diagnosed with moderate mental retardation, a developmental disability under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1-106. He is eligible for Medicaid services. In May of 2005, Adam graduated from Marion High School and entered into a day training program. 50. Due to Adam’s cognitive disabilities, he cannot be left unsupervised. His father is a single parent who is employed full-time and paid on an hourly basis as a maintenance worker. Adam attends a day program, but the hours of the program are shorter than the hours of his father’s work day. Adam’s father must arrive at work late and leave work early to be with Adam before and after the day program. This reduces his wages and jeopardizes his job. Norb Kulig faces the impossible choice of leaving Adam alone or quitting his job to care for Adam. 51. Adam wants to move to a small residential community program close to home so that he can live with people his own age, but at the same time be close to his family and access the community where he has grown up. He is very social and likes being with people. 52. In August 2004, Norb Kulig contacted Adam’s state-assigned PAS agent, Southern Illinois Case Coordination Services, and submitted a request for Adam to live in a small group home near the family home. The PAS agent deemed Adam appropriate for such a placement, and a provider agreed to serve him. On September 28, 2004, Southern Illinois Case Coordination Services submitted a funding request for Adam’s residential placement to DHS. 53. On October 22, 2004, DHS denied Adam Kulig’s request for community residential placement because DHS did not consider Adam’s situation an “emergency.” Adam’s
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father was shown an ICF-DD, but feels such a placement would be inappropriate for Adam due to its size.
54. DHS continues to fail and refuse to provide Adam Kulig with an appropriate placement in a small community group home.
55. With appropriate supports and services, Adam Kulig could live in the community. The community is the most integrated setting appropriate to Adam Kulig’s needs, but Defendants have only offered services in a segregated, institutional setting.
Jamie McElroy 56. Jamie McElroy, age 22, is diagnosed with moderate mental retardation, a developmental disability under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1-106. Mr. McElroy graduated from public high school. 57. Mr. McElroy currently lives at home with his mother in Williamsville, Illinois. He has been accepted to, and wishes to live in, a community placement in the Springfield, Illinois, area near his family. 58. Mr. McElroy’s state-assigned PAS agent found him eligible for Medicaid developmental disability services and community placement. 59. Nevertheless, DHS denied Mr. McElroy’s request for community placement, stating that: “Currently funded options must be pursued prior to consideration of new funding.” The only “currently funded options” are institutions. 60. With appropriate supports and services, Mr. McElroy could live in the community. The community is the most integrated setting appropriate to Mr. McElroy’s needs, but Defendants have only offered services in a segregated, institutional setting.
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Jennifer Wilson 61. Jennifer Wilson, age 20, has moderate mental retardation, cerebral palsy and epilepsy, which are developmental disabilities under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1106. Her disabilities are the result of a brain hemorrhage that she incurred when she was a day old. She uses a wheelchair for mobility. She graduated from Springfield High School. 62. Ms. Wilson currently lives at home with her parents in Springfield, Illinois, but receives no services. She wishes to live in a community placement, and has been accepted into such a program by United Cerebral Palsy of Land of Lincoln. 63. Ms. Wilson’s state-assigned PAS agent found her eligible for Medicaid developmental disability services and community placement. 64. DHS denied Ms. Wilson’s request for community placement, stating only that Ms. Wilson did “not meet the target population criteria.” 65. With appropriate supports and services, Ms. Wilson could live in the community. The community is the most integrated setting appropriate to Ms. Wilson’s needs, but Defendants have only offered services in a segregated, institutional setting.
CLASS ACTION ALLEGATIONS 66. The named Plaintiffs bring this action as a class action pursuant to Rule 23, sections (a) and (b)(2), of the Federal Rules of Civil Procedure. 67. The class of individuals that the named Plaintiffs seek to represent consists of those persons in Illinois who:
(1) have mental retardation and/or other developmental disabilities and who qualify for long-term care services;
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(2) with appropriate supports and services, could live in the community and who would not oppose community placement; and
(3) either are institutionalized in private ICF-DDs with nine or more residents or are living in a home-based setting and are at risk of institutionalization because of their need for services.
68. The class is so numerous that joinder of all Plaintiffs is impracticable. The exact number of individuals in the class is not known to the Plaintiffs, but is believed to number in the thousands.
69. The claims of the named plaintiffs are common to those of the class and raise common issues of fact and law, including, among others: whether Defendants are providing services to developmentally disabled individuals in the most integrated setting appropriate to their needs; whether Defendants have a comprehensive, effectively working plan for achieving that goal; whether Defendants administer a waiting list for community services that moves at a reasonable pace; whether Defendants adequately determine whether class members are eligible for community services; whether Defendants adequately inform developmentally disabled individuals of their right to community services; and whether Defendants violate Title XIX of the Social Security Act, the Americans with Disabilities Act and Section 504 of the Rehabilitation Act by failing to provide community-based services to qualified individuals.
70. Plaintiffs’ claims that Defendants have failed to administer the state’s developmental disabilities program so as to provide services in the most integrated setting appropriate to their needs are typical of the claims of the class.
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71. Plaintiffs will fairly and adequately protect the interests of the class because they suffer from deprivations identical to those of the class members and have been denied the same federal rights that they seek to enforce on behalf of the other class members, many of whom are unable to pursue claims on their own behalf as a result of their disabilities, their limited financial resources, and/or the actions of the Defendants to deprive them of their rights. Plaintiffs’ interests in obtaining injunctive relief for the violations of their legal rights and privileges are consistent with and not antagonistic to those of any person within the class. Furthermore, Plaintiffs’ counsel has extensive experience in the areas of class action litigation and civil rights laws concerning people with disabilities.
72. Defendants have acted or refused to act on grounds generally applicable to all members of the class by unnecessarily segregating class members. Defendants have failed to inform class members of their right to community services; failed to perform appropriate assessments of class members’ community service needs; failed to provide them with services in the most integrated setting appropriate to their needs, and failed to provide services with reasonable promptness. Therefore, declaratory and injunctive relief with respect to the entire class is appropriate.
STATEMENT OF THE CASE The Integration Mandates of the Americans with Disabilities Act and
Section 504 of the Rehabilitation Act 73. In 1990, Congress enacted the Americans with Disabilities Act, 42 U.S.C. §§ 12101 - 12181, to advance the civil rights of people with disabilities. 74. The ADA’s purpose and goal is “the elimination of discrimination against individuals with disabilities.” 42 U.S.C. § 12101(b)(1).
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75. In enacting the ADA, Congress stated that “historically, society has tended to isolate and segregate individuals with disabilities” and that such forms of discrimination “continue to be a serious and pervasive social problem.” 42 U.S.C. § 12101(a)(2).
76. Congress further determined that “the Nation’s proper goals regarding individuals with disabilities are to assure equality of opportunity, full participation, independent living, and economic sufficiency for such individuals.” 42 U.S.C. § 12101(a)(8).
77. Title II of the ADA provides that “no qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs, or activities of a public entity, or be subjected to discrimination by any such entity.” 42 U.S.C. § 12132 (emphasis added).
78. Discrimination under Title II of the ADA includes unnecessary segregation and institutionalization. As the Supreme Court stated in Olmstead v. L.C., 527 U.S. 581 (1999), “unjustified institutional isolation of persons with disabilities is a form of discrimination” because “[i]n order to receive needed medical services, persons with mental disabilities must, because of those disabilities, relinquish participation in community life …” Id. at 600-01.
79. The regulations to the ADA codify the prohibition against unnecessary segregation and institutionalization. 28 C.F.R. § 35.130(d) (“A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities”). Section 504 has an identical mandate. 28 C.F.R. § 41.51(d) (“Recipients shall administer programs and activities in the most integrated setting appropriate to the needs of qualified handicapped persons”).
80. Furthermore, the ADA prohibits public entities from utilizing “criteria or methods of administration” that have the effect of subjecting qualified individuals with disabilities to
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discrimination, which includes unnecessary institutionalization. 28 C.F.R. § 35.130(b)(3). Section 504 has an identical mandate. 45 C.F.R. § 84.4(b)(4); 28 C.F.R. § 41.51(b)(3).
The Illinois Medicaid Program for Persons with Developmental Disabilities A. Illinois’ Participation in Medicaid
81. Medicaid is a joint federal-state program through which the federal government reimburses a portion of expenses incurred by states to furnish health care services to low-income people, including services to persons with developmental disabilities.
82. States are not required to participate in the Medicaid program, but if they do, they must comply with the requirements of Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 – 1396v. Every state that elects to participate must submit a plan to the United States Department of Health and Human Services (HHS). This plan must contain reasonable standards to achieve the objectives and requirements of Title XIX. Id. § 1396a(a)(17).
83. One of Title XIX’s primary objectives is “to help families and individuals attain or retain capacity of independence and self care …” 42 U.S.C. § 1396.
84. Certain services under Title XIX are “mandatory” and must be provided to all eligible individuals. 42 U.S.C. § 1396a(a)(10)(A) (incorporating 42 U.S.C. §§ 1396d(a)(1-5), (17), (21)). States may additionally provide “optional” services, including ICF-DD (referred to as ICF/MR in Title XIX). Id. § 1396d(a)(15). However, once a state elects to provide an optional service that service becomes part of the state’s Medicaid plan and is subject to all requirements of Title XIX. Id. § 1396a(a)(1).
85. Illinois participates in Medicaid and its plan, approved by HHS, includes ICF-DD services.
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B. Medicaid Home and Community Based Services Waivers 86. Title XIX also allows states to “waive” certain Medicaid requirements in order to enable people with disabilities to receive services in the community as opposed to institutions. 42 U.S.C. § 1396n(c); 42 C.F.R. § 441.300. These are known as “Medicaid Home and Community Based Services waivers” (“HCBS waiver”). States can receive Medicaid reimbursement for waiver services up to the average cost of institutional care, including the cost of care in an ICF-DD. 42 U.S.C. § 1396n(c)(2)(D). 87. Illinois has an HCBS waiver for people with developmental disabilities. This waiver allows people who would otherwise be institutionalized to receive services in community settings, including their own home, their family home, or a community or other residential arrangement providing necessary care and services. These settings offer far more freedom and community integration than do ICF-DDs. 88. Although states must apply for a specific number of slots for their HCBS waiver programs, there is no limit on how many slots a state may apply for. Historically, the federal government has liberally granted state requests for additional waiver slots. The federal government has informed states that the lack of available waiver slots does not absolve a state from complying with the ADA’s integration mandate. See Letter from U.S. Dep’t of Health and Human Servs. to State Medicaid Directors at 4-5 (Jan. 10, 2001). Since the Olmstead decision, the federal government has encouraged and provided financial incentives to states to transfer people from institutions to the community.
C. Title XIX’s Requirements 89. Title XIX requires that individuals eligible for Medicaid be given the opportunity to choose alternatives to institutional care, if available under the Medicaid plan, and that such
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individuals be afforded their choice of placement options and services. 42 U.S.C. § 1396n(c)(2)(C).
90. Title XIX additionally requires states to “provide that all individuals wishing to make an application for medical assistance under the plan shall have the opportunity to do so, and that such assistance shall be furnished with reasonable promptness to all eligible individuals.” 42 U.S.C. § 1396a(a)(8) (emphasis added).
91. Finally, under Title XIX, states must ensure against “unnecessary utilization” of ICF-DD services, 42 U.S.C. § 1396a(a)(30)(A), and must ensure residents are screened and assessed prior to admission to determine whether their needs can be met in the community. 42 U.S.C. § 1396a(a)(30)(B); 42 C.F.R. §§ 456.370-71.
D. Defendants’ Unnecessary Segregation of People with Developmental Disabilities in ICF-DDs
92. In Illinois, approximately 6,250 people live in 246 private ICF-DDs with nine or more people, with some facilities housing hundreds of people. As state officials have acknowledged, these ICF-DDs are institutions and do not qualify as community settings.
93. An ICF-DD is not like a home but is rather a large and often self-contained facility, where recreational activities, social activities and medical care are provided in the same building or on the same campus where residents sleep and eat.
94. Because they are large, segregated and isolated from the rest of society, ICF-DDs inhibit meaningful community involvement by depriving residents of the opportunity to interact with non-disabled people in non-custodial relationships in the community. Residents are denied the experiences of observing how other people behave or interact, learning and developing ageappropriate behavior, and experiencing the dignity and freedom of living in the community as normally as possible.
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95. ICF-DD residents often live in large rooms with other residents and use communal bathrooms. Living areas lack privacy, are cold and unwelcoming, are sparsely furnished and do not contain furnishings or personal items one would normally associate with a home. Residents have few places to store their personal belongings.
96. The congregate nature of ICF-DDs prevents residents from expressing their individuality or freedom of association. Residents are deprived of the freedom to choose or reject their meals, their clothes, their roommates and their activities. They do not assist in shopping for food or personal items or in preparation of meals. They do not determine when and how they interact with their friends and family. As a result, many residents have regressed and become less independent.
97. Many ICF-DD residents are capable of living in the community with appropriate supports and services. For these individuals, segregation and institutionalization in ICF-DDs is unnecessary. Rather, the community is the most integrated setting appropriate to their needs.
98. Like Plaintiffs Fair, Kulig, McElroy and Wilson, many persons with developmental disabilities who are eligible for Medicaid services live at home with parents or other family members, even at the cost of doing without needed services, because Defendants have not provided sufficient community alternatives. These Plaintiffs are in imminent danger of institutionalization because Defendants have denied them the community services they need to avoid institutionalization.
99. Defendants do not provide information about community services to many people with developmental disabilities, including members of the Plaintiff class.
100. Defendants do not provide Plaintiffs or class members the choice between institutional and community services.
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101. Defendants do not systematically evaluate persons already residing in ICF-DDs to ascertain if they could be served in the community.
102. Defendants deny community residential services to persons already evaluated by the Defendants through the pre-screening system and determined capable of living in the community.
103. Defendants do not maintain a waiting list for community residential services. Defendants allocate community residential services in an arbitrary and capricious fashion, often ignoring the recommendations of the PAS agencies, the requirements of the State’s own Medicaid Plan, and federal law.
104. By arbitrarily denying community placement, Defendants have caused substantial, irreparable harm and prejudice to Plaintiffs as well as all similarly situated individuals with developmental disabilities, including unnecessary institutionalization or risk thereof, loss of life skills, loss of opportunities to develop to their fullest potential, and aggravation of their physical, mental, and emotional conditions.
LEGAL CLAIMS COUNT I: THE AMERICANS WITH DISABILITIES ACT 105. Plaintiffs reallege paragraphs 1 through 104 as though fully set forth herein. 106. Plaintiffs and the members of the class are qualified individuals with disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2). 107. Title II of the ADA requires that “a public entity shall administer services, programs and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” 28 C.F.R. § 35.130(d) 108. Regulations implementing Title II of the ADA provide that “a public entity may not, directly or through contractual or other arrangements, utilize criteria or other methods of
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administration: (i) that have the effect of subjecting qualified individuals with disabilities to discrimination on the basis of disability; [or] (ii) that have the purpose or effect of defeating or substantially impairing accomplishment of the objectives of the entity’s program with respect to individuals with disabilities …” 28 C.F.R. § 35.130(b)(3).
109. Plaintiffs and class members qualify for community services, and the community is the most integrated setting appropriate to meet their needs. Nevertheless, Defendants have denied them access to community placement and required that they be confined in segregated facilities in order to receive placement and services.
110. Plaintiffs and the members of the class are institutionalized in ICF-DDs with nine or more residents, or are living in a home-based setting and are at risk of institutionalization because of their need for community residential services. By requiring that Plaintiffs and class members be confined in the segregated institutional setting of ICF-DDs as a condition of receiving services, rather than providing services in integrated community settings, Defendants violate the ADA’s integration mandate.
111. Further, Defendants’ criteria and methods of administering Illinois’ long-term care system for people with developmental disabilities subject Plaintiffs to illegal discrimination because they unnecessarily segregate Plaintiffs in ICF-DDs.
112. It would not fundamentally alter the programs, services, or activities of the Defendants to provide Plaintiffs and class members with services in the community.
113. Defendants do not have a comprehensive, effectively working plan for serving people with developmental disabilities in the most integrated setting appropriate for their needs.
COUNT II: SECTION 504 OF THE REHABILITATION ACT 114. Plaintiffs reallege paragraphs 1 through 113 as though fully set forth herein.
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Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 24 of 29 PageID #:876
115. Plaintiffs are qualified individuals with disabilities under Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a).
116. Defendants direct state agencies that receive federal financial assistance. 117. The regulations to Section 504 provide that: “Recipients shall administer programs and activities in the most integrated setting appropriate to the needs of qualified handicapped persons.” 28 C.F.R. § 41.51(d). 118. The Section 504 regulations further prohibit recipients of federal financial assistance from “utiliz[ing] criteria or methods of administration … (i) [t]hat have the effect of subjecting handicapped persons to discrimination on the basis of handicap; [or] (ii) that have the purpose or effect of defeating or substantially impairing accomplishment of the objectives of the recipient’s program with respect to handicapped persons.” 28 C.F.R. § 41.51(b)(3); 45 C.F.R. § 84.4(b). 119. Plaintiffs and class members qualify for community services, and the community is the most integrated setting appropriate to meet their needs. Nevertheless, Defendants have denied them access to community services and have only offered them services in segregated institutional facilities. 120. By requiring that Plaintiffs and class members be confined unnecessarily in segregated environments as a condition of receiving services, rather than providing services in integrated community settings, Defendants violate Section 504’s integration mandate. 121. Further, Defendants’ criteria and methods of administering Illinois’ system of long-term care for people with developmental disabilities subject Plaintiffs to illegal discrimination because they unnecessarily segregate Plaintiffs in ICF-DDs.
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122. It would not fundamentally alter Defendants’ programs, services, or activities to provide Plaintiffs and class members with services in the community.
COUNT III: TITLE XIX OF THE SOCIAL SECURITY ACT 123. Plaintiffs reallege paragraphs 1 through 122 as though fully set forth herein. 124. Illinois participates in the Medicaid program and has chosen to provide both ICFDD services and HCBS waivers for eligible persons under its Medicaid plan. 125. Plaintiffs are recipients of, or are eligible for, Medicaid. A. Failure to Provide Choice between ICF-DD and HCBS Waiver Services 126. Plaintiffs require the level of care provided in an ICF-DD. Title XIX requires that when Plaintiffs are determined to be likely to require the level of care provided in an ICF-DD, states must inform them of feasible alternatives under the HCBS waiver and give them a choice of either ICF-DD or waiver services. 42 U.S.C. § 1396n(c)(2)(C), 42 C.F.R § 441.302(d). 127. Despite this requirement, Defendants have not given Plaintiffs the choice of community services available under the HCBS waiver for people with developmental disabilities.
B. Failure to Provide Services with Reasonable Promptness 128. Title XIX requires states to provide Medicaid benefits to all eligible persons with reasonable promptness. 42 U.S.C. § 1396a(a)(8). Provision of services must not be delayed by the agencies’ administrative procedures. 42 C.F.R § 435.930(a). 129. Plaintiffs qualify for both ICF-DD services and HCBS waiver services. Defendants have failed to provide HCBS waiver services with reasonable promptness.
C. Unnecessary Utilization of ICF-DD Services 130. Title XIX requires participating states to implement any “methods and procedures … as may be necessary to safeguard against unnecessary utilization” of institutional care,
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including ICF-DDs. 42 U.S.C. § 1396a(a)(30)(A). In accordance with this requirement, states must ensure that “each admission to a[n] … intermediate care facility for the mentally retarded … is reviewed or screened in accordance with criteria established by medical and other professional personnel….” Id. § 1396a(a)(30)(B).
131. Regulations implementing this requirement provide that, prior to admission to an ICF-DD, “an interdisciplinary team of health professionals must make a comprehensive medical and social evaluation and, where appropriate, a psychological evaluation of each applicant’s or recipient’s need for care in the ICF.” 42 C.F.R. § 456.370(a).
132. The regulations further require that if an ICF resident’s “needs could be met by alternative services that are currently unavailable, the facility must enter this fact in the recipient’s record and begin to look for alternative services.” 42 C.F.R. § 456.371.
133. Defendants’ methods and procedures cause unnecessary utilization of ICF-DD services for people with developmental disabilities. Defendants fail to ensure that people with developmental disabilities are adequately evaluated to determine their need for institutional care. Additionally, Defendants fail to ensure provision of community services for persons found not to require institutional care. As such, Defendants violate these requirements of Title XIX.
PRAYER FOR RELIEF WHEREFORE, the Plaintiffs individually and on behalf of the class, respectfully request that the Court: A. Enter an order certifying the named Plaintiffs as representatives for a class consisting of those persons in Illinois who:
(1) have mental retardation and/or other developmental disabilities and who qualify for long-term care services;
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(2) with appropriate supports and services, could live in the community and who would not oppose community placement; and
(3) either are institutionalized in private ICF-DDs with nine or more residents or are living in a home-based setting and are at risk of institutionalization because of their need for services.
B. Declare that Defendants’ failure to provide Plaintiffs with services in the most integrated setting appropriate to their needs violates Title II of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and Title XIX of the Social Security Act.
C. Issue a permanent injunction: (1) requiring Defendants to inform developmentally disabled individuals in the State that they may be eligible for community services and that they have the choice of such services; (2) requiring Defendants promptly to determine Plaintiffs’ and class members’ eligibility for community services; (3) prohibiting Defendants from arbitrarily denying eligibility to individuals who are capable of living in a community setting with appropriate supports and services; and (4) requiring Defendants promptly to provide eligible Plaintiffs and class members with appropriate services sufficient to allow them to live in the most integrated setting appropriate to their needs.
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Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 28 of 29 PageID #:880

D. Grant such other and further relief as this Court deems just and proper, including an award of reasonable attorneys’ fees, litigation expenses and costs.
Respectfully submitted:

Dated: April 26, 2006

By: _/s/ Kendra K. Hartman _ One of the attorneys for Plaintiffs

Barry G. Lowy (ARDC No. 6196719) Laura J. Miller (ARDC No. 6202721) Barry C. Taylor (ARDC No. 6199045) John W. Whitcomb (ARDC No. 6204744) EQUIP FOR EQUALITY 20 North Michigan Avenue, Suite 300 Chicago, Illinois 60602 Tel: (312) 341-0022 Fax: (312) 341-0295

John I. Grossbart (ARDC No. 3126133 ) Kendra K. Hartman (ARDC No. 6257264) SONNENSCHEIN NATH & ROSENTHAL LLP 7800 Sears Tower Chicago, Illinois 60606 Tel: (312) 876-8000 Fax: (312) 876-7934

Max Lapertosa (ARDC No. 6276608) Kenneth M. Walden (ARDC No. 6273221) ACCESS LIVING OF METROPOLITAN CHICAGO 614 West Roosevelt Road Chicago, Illinois 60607 Tel: (312) 253-7000 Fax: (312) 253-7001

Benjamin S. Wolf (ARDC No. 3125607) AMERICAN CIVIL LIBERTIES UNION OF ILLINOIS 180 North Michigan Avenue, Suite 2300 Chicago, Illinois 60601 Tel: (312) 201-9740 Fax: (312) 201-9760

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Case: 1:05-cv-04331 Document #: 91 Filed: 04/26/06 Page 29 of 29 PageID #:881 Judith A. Gran PUBLIC INTEREST LAW CENTER OF PHILADELPHIA 125 S. Ninth Street, Suite 700 Philadelphia, Pennsylvania 19107 Tel: (215) 627-7100 Fax: (215) 627-3183
14487509
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 STANLEY LIGAS, by his sister and next friend, Gina Foster, et al., on behalf of themselves and all others similarly situated, Plaintiffs, v.
BARRY S. MARAM, in his official capacity as Director of the Illinois Department of Healthcare and Family Services, et al., Defendants.
No. 05 C 4331.
United States District Court, N.D. Illinois, Eastern Division.
April 7, 2010.
MEMORANDUM OPINION AND ORDER
JAMES F. HOLDERMAN, Chief District Judge.
Pending before the court are Burton A. Brown and Barbara A. Reilly's "Motion to Intervene" (Dkt. No. 446) ("Brown/Reilly Motion")) and "Proposed Intervenors' Motion for Limited Intervention Pursuant to Fed. R. Civ. P. 24" (Dkt. No. 464 ("Group Motion")). For the reasons set forth below, the Brown/Reilly Motion is dismissed as moot and the Group Motion is granted.
BACKGROUND
The Named Plaintiffs[1] in this lawsuit are individuals with mental retardation and other developmental disabilities who seek to enforce their statutory rights to long-term care services from the State of Illinois in the most integrated setting appropriate to their needs, as set forth by the Supreme Court in Olmstead v. L.C., 527 U.S. 581 (1999). (Dkt. No. 436 ("2d Am. Compl.") ¶¶ 1-8.) The Named Plaintiffs wish to proceed on behalf of themselves and on behalf of "all others similarly situated." (Id. ¶ 1.) Although their initial attempt to certify a class in this lawsuit was successful (Dkt. No. 85), the court ultimately decertified the class on July 7, 2009, after thousands of class members submitted written and oral objections to the first Proposed Consent Decree. (Dkt. No. 420 ("7/7/09 Order").) The court's July 7, 2009 ruling was based on its finding that "commonality and typicality do not exist among class members." (7/7/09 Order 3.)
With a new class definition in hand, and a Second Amended Complaint on file (Dkt. No. 436), the Named Plaintiffs and the State Defendants[2] have again sought class certification and preliminary approval of a second proposed consent decree. (See Dkt. No. 455 ("Class Cert. Mot."); Dkt. No. 456 ("Class Cert. Mem."); and Dkt. No. 456, Ex. A ("Amended Proposed Consent Decree").) The movants wishing to intervene in this lawsuit are approximately 2,000 previous objectors who live in intermediate care facilities for people with developmental disabilities ("ICF-DD") or are on a waiting list for an ICF-DD, as well as at least one individual who currently resides in a community integrated living arrangement ("CILA") (collectively "Proposed Intervenors").[3] The Proposed Intervenors seek to intervene "for the limited purpose of (1) participating in the Court's consideration of the Joint Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan . . . and (2) filing objections to and participating in any fairness hearing on the proposed consent decree." (Dkt. No. 465 ("Group Mem.") 1.)
ANALYSIS

A non-party has a right to intervene in an action if (1) the non-party files a timely motion to intervene; (2) the movant claims an interest related to the subject matter of the action; (3) disposition of the action threatens to impair or impede the movant's ability to protect that interest; and (4) the movant's interest is inadequately represented by the existing parties. Ligas ex rel. Foster v. Maram, 478 F.3d 771, 773 (7th Cir. 2007) (citing United States v. BDO Seidman, 337 F.3d 802, 808 (7th Cir. 2003)).[4] "A failure to establish any of these elements is grounds to deny the petition." Id. It is undisputed that the Group Motion has been timely filed.
I. Interest in Proposed Class Settlement
The Proposed Intervenors first contend that their interest in this litigation is "to protect their rights under the Americans with Disabilities Act, 42 U.S.C. § 12101, et seq. ("ADA"), as interpreted by Olmstead v. L.C., 527 U.S. 581 (1999)." (Dkt. No. 470 ("Group Reply") 1.) In Olmstead, the Supreme Court held that "under Title II of the ADA, States are required to provide community-based treatment for persons with mental disabilities when [1] the State's treatment professionals determine that such placement is appropriate, [2] the affected persons do not oppose such treatment, and [3] the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities." Olmstead, 527 U.S. at 607. The Proposed Intervenors argue that their interest lies in enforcing "the mandate of Olmstead . . . that the needs of Intervenors and other ICF-DD residents be considered in determining the State's obligation to provide the `community-based' services required by the proposed consent decree." (Group Mem. 2.) The court finds that the Proposed Intervenors' reliance on Olmstead is well placed.
Olmstead's requirement that the court consider the needs of other individuals with mental disabilities must be read in its full intended context. The relevant portions of Olmstead address the government officials' asserted defense—that providing the community-based services requested by the plaintiffs would "fundamentally alter" the nature of the services provided by the State to individuals with mental disabilities. Id. at 594-95; see also 28 CFR § 35.130(b)(7). Accordingly, the Supreme Court's instruction in Olmstead that the district court "consider [on remand], in view of the resources available to the State, not only the cost of providing community-based care to the litigants, but also the range of services the State provides others with mental disabilities, and the State's obligation to mete out those services equitably" applies because the district court was charged with "evaluating [the] State's fundamental-alteration defense." Id. at 597.[5]
The State Defendants in this case have not raised a fundamental-alteration defense. Nevertheless, this court reads Olmstead to grant the Proposed Intervenors a right to intervene in this litigation. The Justices writing for the Olmstead Court were very much aware of competing claims on limited State resources. For example, Justice Ginsburg's plurality opinion notes the States' obligation "[t]o maintain a range of facilities and to administer services with an even hand." Id. at 605. Similarly, Justice Kennedy's concurring opinion recognizes the "continuing challenge" that States face "to provide . . . care in an effective and humane way," and it is in this context that he stresses the "central importance" of deferring to decisions made by State policymakers. Id. at 608-10. Accordingly, the Olmstead Court directed the lower courts to "tak[e] into account the resources available to the State and the needs of others with mental disabilities" if the fundamental-alteration defense is raised. Olmstead, 527 U.S. at 607. Because the State Defendants apparently do not believe it is proper, necessary, or advisable to raise the fundamental-alteration defense at this point in the litigation,[6] this court simply has no basis to address the third prong of the Olmstead equation. Yet, a settlement that does not consider the needs of the Proposed Intervenors—or a settlement promising relief to the Named Plaintiffs that the State admittedly cannot deliver—would run contrary to the rationale set forth in Olmstead. Accordingly, the court finds that the Proposed Intervenors have a right under Olmstead to have their needs considered before the Amended Proposed Consent Decree is approved. The interest the Proposed Intervenors have in this litigation is "direct, significant, and legally protectable." Solid Waste Agency of N. Cook County v. U.S. Army Corp of Eng'rs, 101 F.3d 503, 506 (7th Cir. 1996).

The State defendants argue that the Proposed Intervenors are prohibited from intervening in this case under Wade v. Goldschmidt, 673 F.2d 182 (7th Cir. 1982). Although relevant to this court's analysis, Wade is distinguishable. In Wade, the decision most directly impacting the rights of the proposed intervenors had already been made by the U.S. Department of Transportation. The only issue pending before the court was whether the agency's decision comported with relevant statutory requirements. Id. at 185. Accordingly, the Seventh Circuit determined that "the governmental bodies charged with compliance can be the only defendants." Id. In this case, the decision most directly impacting the rights of the Proposed Intervenors— whether to approve the Amended Proposed Consent Decree—has yet to be made. Pursuant to Rule 23(e)(2), this court will be obliged to evaluate the fairness of the Amended Proposed Consent Decree and, to satisfy itself that the Olmstead mandate is being fulfilled, the court believes hearing from the Proposed Intervenors is necessary.
The court further finds that the pending litigation threatens to impair the Proposed Intervenors' interest in having their needs considered before the Amended Proposed Consent Decree is approved. In Olmstead, the Supreme Court recognized that the needs of individuals with mental disabilities are often in conflict. Olmstead, 527 U.S. at 597. The balance set forth by the Olmstead Court implicitly acknowledges that the needs of one group can be threatened by the needs of another. In this case, the claims in the Second Amended Complaint address only the needs of the Named Plaintiffs and others who similarly desire community-based services. The Amended Proposed Consent Decree requires that the State Defendants "implement sufficient measures . . . to provide Community-Based Settings and CommunityBased Services pursuant to the Decree" (Decree ¶ 4), but does not include any specific mention of the Proposed Intervenors' need for State resources. Moreover, the Amended Proposed Consent Decree is slated to remain in effect "for at least nine (9) years." (Decree ¶ 45.) If the needs of the Proposed Intervenors are not considered before the Amended Proposed Consent Decree is approved, the Proposed Intervenors' future ability to have their needs considered in balance with the State's obligations to other individuals with mental disabilities would be significantly impaired "as a practical matter." Fed. R. Civ. P. 24(a)(2).
Finally, the court finds that the Proposed Intervenors' interest is not adequately represented by the existing parties. It is uncontested that the Named Plaintiffs do not represent the Proposed Intervenors' interest. This leaves to the State Defendants the task of representing the Proposed Intervenors' interest in this litigation. As representatives of "governmental bod[ies] charged by law with protecting the interests of the [P]roposed [I]ntervenors," the State Defendants are "presumed to adequately represent [the Proposed Intervenors'] interests unless there is a showing of gross negligence or bad faith." Ligas, 478 F.3d at 774. In other words, "`more is needed than a presumption of inadequacy based on the diversity' of the State Defendants' interests." (Dkt. No. 60 ("12/22/05 Order") 3 (quoting Solid Waste Agency, 101 F.3d at 508).) The events unfolding since the denial of the first motions to intervene in this case suggest that the presumption of adequacy has been overcome.
Specifically, in agreeing to the original Proposed Consent Decree (Dkt. No. 298-1 ("Original Decree")), the State Defendants agreed to a provision stating:
Within six (6) years of Approval of the Decree, Defendants shall, to the extent consistent with governing law, reduce the use or aggregate licensed capacity of the ICF-DD System by an amount equivalent to the number of Individuals who, in aggregate and consistent with their Evaluations, Service Plans and choices, have transitioned to Community Based Settings from ICF-DDs.
(Original Decree ¶ 10.) Counsel for the State Defendants took the position in open court that this provision was "a nod to the reality that you cannot rebalance the system without adjusting the overall capacity" and specifically acknowledged "it's the State's intention to try to reduce capacity" at ICF-DDs. (Dkt. No. 432 ("6/9/09 Hr'g Tr.") 48:19-21; 52:18-19.) Counsel further recognized that the Proposed Intervenors objected to the State Defendants' position. (Dkt. No. 433 ("6/11/09 Hr'g Tr") 7:23-8:6 ("That's what they object to, that the State is intending to reduce capacity. Well, that's going to remain whether [paragraph 10] is in there or not, and they're going to be able to point to my statements in open court . . .

that the State intends to reduce capacity. That's what they object to, and they're going to be able to object to that, and I suspect will object to that, whether paragraph 10 is in there or not.").)
It is certainly possible that the State Defendants have considered the needs of the Proposed Intervenors in agreeing to the Amended Proposed Consent Decree. However, the above-quoted statements make clear that the State Defendants do not represent the Proposed Intervenors' interests before this court. The court also cannot ignore its previous experiences with this litigation and the court agrees that the fact that the Proposed Intervenors are not adequately represented by either party in this litigation "is evidenced by the almost 2,000 objections they filed to the prior proposed decree." (Group Mem. 13.)[7]
The Proposed Intervenors have described their interest under Olmstead in a number of different ways— as an interest in "the care and placement of their children or wards" (Group Mem. 6); in "the quality of the essential services and supports" provided by the State (id. at 2); and in "maintaining the financial viability of their selected living arrangement" (id. at 11). Taken together in light of Olmstead, these formulations suggest that the Proposed Intervenors' main interest lies in the equitable distribution of State resources among individuals with mental disabilities. Assuming, without deciding, that the Proposed Intervenors have a right to equitable care under the ADA, see Olmstead, 527 U.S. at 601-02 ("We emphasize that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings."), there is nothing preventing them from bringing their own lawsuit against the State if and when their right to equitable services has actually been violated. See Wade, 673 F.2d at 186 ("if a time comes when applicants determine that their alleged interests were not given the required statutory consideration, they can then bring suit, as plaintiffs, to compel defendants to follow the statutorily mandated procedures"). However, inviting subsequent litigation when the issues raised by the Proposed Intervenors are so closely related to, and threatened by, this litigation seems duplicative, wasteful, and unjust. Even though the State has not raised the fundamental-alteration defense, the court finds that the Proposed Intervenors' stated interest under the Olmstead doctrine is sufficiently related to this litigation to require intervention as of right.
II. Interest in Class Certification
Because the State Defendants and Named Plaintiffs parties specifically excluded the Proposed Intervenors from the proposed class definition, the court separately addresses the question of whether the Proposed Intervenors have an interest related to class certification. In relevant part, the proposed class definition includes individuals "for whom Defendants . . . have a Current Record reflecting that the individual has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting." (Decree ¶ II.2.(a)(iii) and (b)(iii).) "Current Record," in turn, is defined as:
an accurate record reflecting that the Individual, or the Individual's legal guardian, has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting, and, to the best of Defendants' knowledge, that record has not been withdrawn or retracted by the Individual or the Individual's legal guardian. All Individuals who objected (either personally, or through the Individual's legal guardian) to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing in this Litigation, on the grounds that they do not wish to receive Community-Based Services or placement in a Community-Based Setting shall be deemed to have retracted any record reflecting that, prior to such objection, he or she had affirmatively indicated that he or she seeks to receive CommunityBased Services or placement in a Community-Based Setting.
(Decree III.3.(i) (emphasis added).)
The Proposed Intervenors argue that they have an interest in the proposed class definition because "it encompasses those, like the Intervenors, whose current choice is to live in an ICF-DD." (Group. Mem. 7.) Pursuant to Federal Rule of Civil Procedure 24, a non-party only has a right to intervene in a lawsuit when its interest is "direct and substantial." Lake Investors Dev. Group v. Egidi Dev. Group, 715 F.2d 1256, 1259 (7th Cir. 1983) (citing Meridian Homes Corp. v. Nicholas W. Prassas & Co., 683 F.2d 201, 204 (7th

Cir. 1982)). While the proposed class definition could encompass some individuals who at one point expressed an interest in receiving community care but who now desire care in an institutionalized setting, it is not immediately clear that the proposed class definition translates into a direct interest of the Proposed Intervenors, who themselves are explicitly excluded from the class.
On the other hand, the Proposed Intervenors note in their reply brief that, since filing their motion for class certification, the Named Plaintiffs and the State Defendants "have actively solicited individuals with disabilities to return a form to the State so that the State can claim that it has a `current record' of the individual requesting community-based services." (Group Reply 9.) This solicitation has been sent to at least one Proposed Intervenor (id., Ex. 4), and the Proposed Intervenors contend that "some recipients of [similar] unexpected solicitations are fearful that their failure to return the form as requested by the State will result in a loss of benefits." (Id. at 9-10; see also Ex. 5.)
The fact that the named parties have solicited one of the Proposed Intervenors to join a class definition that explicitly excludes the Proposed Intervenors has the court concerned. Again, the court's previous experience with this litigation cannot be ignored. The Named Plaintiffs and State Defendants have a poor record in terms of articulating a class definition that appropriately addresses the pending claims and proposed relief. As demonstrated in full force at the fairness hearing in July 2009, waiting until the class action fairness hearing to entertain concerns regarding the class definition can be both burdensome and costly. The court finds that the Proposed Intervenors are in the best position to apprise the court of any unforeseen or undisclosed impact that the class definition may have on its evaluation of the Amended Proposed Consent Decree. Additionally, because the ability to identify class members impacts both the question of class certification and the appropriateness of the Proposed Amended Consent Decree, the court finds the Proposed Intervenors have an interest in participating in the court's consideration of the "Joint Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan."
CONCLUSION
It is undisputed that the State's resources are limited—perhaps severely so. (See Group Reply, Ex. 3 (June 11, 2009 letter from the Illinois Department of Human Services, noting the State's intent to cut funding to both CILAs and ICF-DDs by 20-30% and recognizing that "[d]ue to the General Assembly's failure to approve the revenue plan proposed by Governor Quinn, the State of Illinois will no longer be able to afford even basic services for thousands of people with developmental disabilities").) If this court finds that, pursuant to Federal Rule of Civil Procedure 23, a class action settlement is appropriate to address the claims set forth in the Second Amended Complaint, it is likely that the State of Illinois will be able to save significant resources in terms of future legal costs and fees. These savings would enure to the benefit of all Illinois citizens, including individuals with disabilities who seek community-based care and those who seek institutionalized care. Accordingly, the court encourages representatives of all interested parties to continue settlement discussions with a view toward reaching a settlement that is fair for all interested parties.
For the reasons set forth above, Burton A. Brown and Barbara A. Reilly's "Motion to Intervene" (Dkt. No. 446) is dismissed as moot and "Proposed Intervenors' Motion for Limited Intervention Pursuant to Fed. R. Civ. P. 24" (Dkt. No. 464) is granted.
[1] The plaintiffs named in the Second Amended Complaint include: Stanley Ligas, by his sister and next friend Gina Foster; David Cicarelli, by his guardians James and Julianne Cicarelli; Isaiah Fair, by his guardian Lutricia Fair; Jamie McElroy, by his guardian Patricia McElroy; and Jennifer Wilson, by her guardians Nancy and Richard Wilson (collectively "Named Plaintiffs"). Although the individually-named plaintiffs have changed with each successive complaint, the court need not distinguish among the different plaintiff groups for purposes of its analysis.
[2] The defendants are Barry S. Maram, in his official capacity as Director of the Illinois Department of Healthcare and Family Services, and Michelle R.B. Saddler, in her official capacity as Secretary of the Illinois Department of Human Services (collectively "State Defendants").

[3] Burton A. Brown and Barbara A. Reilly have declined to file a reply brief in support of their original motion to dismiss, instead joining the Group Motion, the Group Memorandum, and the Group Reply. (Dkt. No. 471.) Accordingly, the court deems arguments in the Brown/Reilly Motion to have been subsumed by being included in the Group Motion and therefore moot.
[4] Because this court finds intervention is appropriate as a matter of right, the court does not address the Proposed Intervenors' alternative argument regarding permissive intervention.
[5] Although a majority of the Justices in Olmstead recognized that a State can raise the fundamental-alteration defense in appropriate circumstances, the Court did not deliver a majority opinion on the scope of the defense. Writing for a plurality, Justice Ginsburg (joined by Justices O'Connor, Souter, and Breyer) emphasized that a court's review of the fundamental-alteration defense would necessarily involve a complex analysis, beyond simply comparing a plaintiff's request for community-based services against the State's budget as a whole, or weighing the cost of community care for one individual against the cost of institutionalized care for that same individual. Id. at 603-04. In a concurring opinion, Justice Kennedy (joined by Justice Breyer) stressed the "central importance" of "apply[ing] today's decision with . . . appropriate deference to the program funding decisions of state policymakers." Id. at 610. Justice Stevens declined to address the scope of the fundamental-alteration defense, on the grounds that the question was not properly before the Court. Id. at 607-08. Throughout Olmstead, the Justices' cautious reluctance to question State funding decisions is apparent.
[6] The State Defendants did raise this affirmative defense in response to the original Complaint and the First Amended Complaint. (Dkt. No. 21 at 54; Dkt. No. 93 at 52.) The State Defendants have not filed an answer to the Second Amended Complaint.
[7] The State Defendants argue that they took "great pains" to protect the Proposed Intervenors' interests "in receiving the services of their choice and not being adversely affected by the proposed decree." (Dkt. No. 467 ("Defs.' Resp.") 12-13.) While the court appreciates the State Defendants' efforts, protecting an interest is not the same as representing it.

 
 Case 1:05-cv-04331 Document 458 Filed 01/26/10 Page 1 of 15

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

STANLEY LIGAS, et al., on behalf of themselves and all others similarly situated, Plaintiffs, vs. BARRY S. MARAM, et al., Defendants.

) ) ) ) Case No. 05-4331 ) ) Judge Holderman ) ) ) )

STATEMENT OF INTEREST OF THE UNITED STATES OF AMERICA Preliminary Statement
The United States files this Statement of Interest pursuant to 28 U.S.C. § 517 in support of a grant of preliminary approval of the parties’ jointly submitted Consent Decree. This litigation implicates the proper interpretation and application of Department of Justice regulations implementing the Americans with Disabilities Act, 42 U.S.C. § 12101 et. seq., (“ADA”) and compliance with the mandate of community integration under Olmstead v. L.C., 527 U.S. 581 (1999). Accordingly, the United States has a strong interest in the resolution of this matter.
Plaintiffs allege that Illinois relies on large, privately-run congregate care institutions1 to provide long-term care services for individuals with developmental disabilities while failing to offer services to these individuals in community-based settings. This practice, plaintiffs claim, violates Title II of the ADA, Section 504 of the Rehabilitation Act, Title XIX of the Social
1 Known as “intermediate care facilities for people with developmental disabilities” (“ICF-DDs”).

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Security Act, and 42 U.S.C. § 1983. (Second Amended Complaint for Declaratory and Injunctive Relief, Aug. 31, 2009 (“Compl.”), ¶ 1.)
Plaintiffs are a putative class of Medicaid eligible adults with developmental disabilities who either 1) reside in ICF-DDs and who have requested community placements, or 2) are at risk of institutionalization and have requested community placement. Plaintiffs maintain that the State has violated the “integration mandate” of Title II and § 504 by failing to develop a comprehensive, effectively working plan to offer developmentally disabled individuals services in the most integrated settings appropriate to their needs. (Compl. ¶¶ 6, 86.)
After lengthy litigation initiated in 2005, the parties proposed a consent decree in November 2008, which the Court subsequently rejected because of concerns raised by objectors about the definition of the class and the scope of the remedy. In response to these concerns, the parties revised their consent decree and filed with this Court on January 25, 2010. The Second Proposed Consent Decree addresses the objectors’ concerns by limiting the class for whom relief will be granted to individuals who have affirmatively “expressed preferences to reside in more integrated settings.”2 (Compl. ¶ 1.) Plaintiffs estimate that the class includes at least 320 current ICF-DD residents and more than 4,000 individuals with disabilities who live at home and have expressed a desire for placement in community settings. (Compl. ¶ 89.)
2 Specifically, the new class comprises “two sub-classes of individuals: (1) ICF-DD residents who have requested community placements; and (2) individuals who are at risk of institutionalization and who have requested community based services or placements.” (Compl. ¶ 86.) While the parties in this case have narrowed the class to individuals who have affirmatively expressed a desire to be placed in the community, Olmstead itself held that a broader class – those who can appropriately be served in the community and do not oppose such placement – should be served in an integrated setting. Olmstead, 527 U.S. at 607. The class in this case comprises a subset of the individuals who would be entitled to relief under Olmstead.
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The parties’ revisions to the class definition address the concerns raised by objectors that under Olmstead, community placement is only appropriate where “the affected persons do not oppose such treatment.” Olmstead, 527 U.S. at 607. The proposed consent decree ensures the autonomy of each class member to choose whether to live in a community placement, and does not force any individual out of a placement with which he or she is currently satisfied. The Consent Decree importantly excludes any individual who objected to the previous proposed consent decree. (Proposed Order at 3.) Indeed, the proposed consent decree requires that there be a “current record” reflecting the individual’s desire to live in a community placement. (Second Proposed Consent Decree at 2-3.)
The Consent Decree will ensure, however, that community capacity exists for individuals who choose to reside in community-based settings. In doing so, this decree offers the promise of relief for individuals who are appropriate for such placement and desire to be in such placements in a system that has failed to realize the goals of community integration in the ten years since Olmstead was decided.3 By committing to develop this infrastructure for community-based placements, the state of Illinois demonstrates its commitment to shift from relying on institutional settings that unnecessarily segregate individuals with developmental disabilities, to developing integrated, community-based settings, as required by Olmstead. The United States recognizes the systemic reform embodied in this Second Proposed Consent Decree as significantly advancing the enforcement of Olmstead in Illinois. Such reform aligns with the
3 Illinois “ranks 51st among all states and the District of Columbia in its placement of people with developmental disabilities in small Community Settings.” (Compl. ¶ 3.)
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Administration’s commitment to the goals of community integration.4
Statutory and Regulatory Background Congress enacted the Americans with Disabilities Act (“ADA”) in 1990 “to provide a
clear and comprehensive national mandate for the elimination of discrimination against
individuals with disabilities.” 42 U.S.C. § 12101(b)(1). Congress found that “historically,
society has tended to isolate and segregate individuals with disabilities, and, despite some
improvements, such forms of discrimination against individuals with disabilities continue to be a
serious and pervasive social problem.” 42 U.S.C. § 12101(a)(2). For those reasons, Congress
prohibited discrimination against individuals with disabilities by public entities.
[N]o qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the services, programs, or activities of a public entity, or be subjected to discrimination by any such entity. 42 U.S.C. § 12132.
As directed by Congress, 42 U.S.C. § 12134, the Attorney General issued regulations
implementing Title II, which are based on regulations issued under section 504 of the
4 “President Obama Commemorates Anniversary of Olmstead and Announces New Initiatives to Assist Americans with Disabilities,” June 22, 2009, Office of the Press Secretary, available at http://www.whitehouse.gov/the_press_office/President-Obama-Commemorates-Anniversary-ofOlmstead-and-Announces-New-Initiatives-to-Assist-Americans-with-Disabilities/). The United States has filed briefs in a number of Olmstead enforcement cases, including State of Connecticut Office of Protection and Advocacy for Persons with Disabilities, et al. v. State of Connecticut, et al., No. 3:06-CV-00179 (D. Conn. motion to participate as amicus filed Nov. 25, 2009); ARC of Virginia, Inc. v. Kaine, et al., No. 3:09-CV-686 (E.D. Va. amicus filed Nov. 24, 2009); and Marlo M. v. Cansler, et al., No. 5:09-cv-00535 (E.D. N.C. amicus filed Dec. 21, 2009). Additionally, the United States recently intervened in Disability Advocates, Inc. v. Paterson No. 03-CV-3209 (E.D.N.Y. intervention granted Nov. 23, 2009).
4

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Rehabilitation Act.5 See 42 U.S.C. § 12134(a); 28 C.F.R. § 35.190(a); Executive Order 12250, 45 Fed. Reg. 72995 (1980), reprinted in 42 U.S.C. § 2000d-1. The Title II regulations, 28 C.F.R. § 35.130(d), require public entities to “administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” The preamble to the “integration regulation” explains that “the most integrated setting” is one that “enables individuals with disabilities to interact with nondisabled persons to the fullest extent possible.” 28 C.F.R. §35.130(d), App. A, at 571 (2009).
Ten years ago, in a landmark decision, the Supreme Court held under Title II of the ADA and its integration regulation, that unjustified segregation of individuals with disabilities by public entities constitutes unlawful discrimination. Olmstead v. L.C., 527 U.S. 581, 586 (1999). Olmstead held that public entities are required to provide community-based services for persons with disabilities who would otherwise be entitled to institutional services when (a) treatment professionals reasonably determine that such placement is appropriate; (b) the affected persons do not oppose such treatment; and (c) the placement can be reasonably accommodated, taking into account the resources available to the entity and the needs of others who are receiving disability services from the entity. Olmstead, 527 U.S. at 607.
A public entity’s duty to provide integrated (i.e., community-based) services, however, is not absolute. A public entity is required only to make reasonable modifications that do not “fundamentally alter the nature of the service, program, or activity.” 28 C.F.R. § 35.130(b)(7) (2009). Thus, a public entity violates Title II if it segregates individuals in institutions when
5Section 504 prohibits state and local governments that receive federal funds from discriminating against individuals with disabilities. 29 U.S.C. § 794.
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those individuals could be served in the community through reasonable modifications to its program, unless it is able to demonstrate that doing so would result in a “fundamental alteration” of its program. Olmstead, 527 U.S. at 595-596.
Argument The proposed consent decree merits preliminary approval as it is “within the range of possible approval” that ultimately could be given final approval as it is fair, adequate, and reasonable. Kaufman v. American Exp. Travel Related Services Co., Inc., No. 07-1707, 2009 WL 5166229, *7-8 (N.D. Ill. Dec. 22, 2009) and Kessler v. American Resorts Intern.’s Holiday Network, Ltd., No. 05-5944, 2008 WL 687287, *3 (N.D. Ill. March 12, 2008) (citing Armstrong v. Bd. of School Directors of the City of Milwaukee, 616 F.2d 305, 312 (7th Cir. 1980), overruled on other grounds by Felzen v. Andreas, 134 F.3d 873 (7th Cir. 1998)). The consent decree fairly addresses Plaintiffs’ allegations that Defendants have systematically failed to provide them with services in appropriate community-based settings that Plaintiffs have requested. This allegation provides the “common nucleus of operative fact” to ensure that the commonality requirement is satisfied. Further, the creation of community-based services for individuals with developmental disabilities who have requested such placements is an appropriate class-based remedy for the systemic discrimination alleged by Plaintiffs. For the reasons set forth below, the relief afforded to the narrow class as defined under the proposed consent decree meets the standard for preliminary approval, and the settlement should proceed to the second step in the review process, the fairness hearing. I. Unnecessary Segregation of Individuals with Disabilities Violates Title II The Court in Olmstead found that “unjustified isolation . . . [is] discrimination based on
6

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disability.” Olmstead, 527 U.S. at 597. The Consent Decree before the Court advances an important public interest in allowing individuals with developmental disabilities to live in community settings. As noted in Olmstead, the unjustified segregation of persons with disabilities can stigmatize them, “perpetuat[ing] unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life.”6 Olmstead 527 U.S. at 600. And while 10 years have passed since Olmstead was decided, the same goals underlying that case and the ADA are present today: a goal of “full participation, independent living, and economic self-sufficiency for such individuals.” 42 U.S.C. 12101(a)(8).
Recently, in Disability Advocates, Inc. v. Paterson, No. 03-3209, 2009 WL 2872833 (E.D.N.Y. Sep. 8, 2009) (“DAI”), the court found that New York State was liable under Title II for denying thousands of individuals with mental illness in New York City the opportunity to receive services in the most integrated setting appropriate to their needs. The court further found that adult homes were not the most integrated setting appropriate to their needs and that “virtually all of DAI’s constituents are qualified to receive services in supported housing and are unopposed to receiving services in a more integrated setting” and that defendants failed to prove that the relief requested would constitute a fundamental alteration of the State’s mental health service system. DAI at *87. The instant case presents similar legal issues as in Disability Advocates. Here, defendants can make a reasonable modification to their existing administration of services by choosing to fund care in community settings, rather than in segregated institutional
6 See also U.S. Amicus Brief in Olmstead at 16-17, citing to 136 Cong. Rec. H2603 (daily ed. May 22, 1990) (statement of Rep. Collins) (“To be segregated is to be misunderstood, even feared,” and “only by breaking down barriers between people can we dispel the negative attitudes and myths that are the main currency of oppression.” The segregation of plaintiffs “has the potential to engender or perpetuate negative attitudes.”) (Attached as Exh. A.)
7

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settings.7 Thus, plaintiffs allege a straight-forward ADA Title II violation that is prohibited by the Supreme Court decision in Olmstead. II. Title II Claims May Require Systemic Reform and Class Actions are Appropriate
Tools for Such Claims A. Class Actions are Important Tools to Enforce the Integration Mandate The class action is an appropriate mechanism to achieve relief for violations of Title II in the community integration context. Rolland v. Patrick, No. 98-30208, 2008 WL 4104488 (D. Mass. Aug. 19, 2008), Williams v. Blagojevich, No. 05-04673, 2006 WL 3332844, *5 (N.D. Ill. Nov. 13, 2006). As a practical matter, integration claims typically involve large service systems that affect hundreds or thousands of individuals, and thus the class action device is a useful and necessary tool to address such systemic problems (rather than forcing individual plaintiffs to pursue innumerable individual complaints). To proceed as a class action, a class must satisfy the following criteria: (1) numerosity; (2) commonality of facts and law; (3) typicality between the class claims and those of the named parties; and (4) adequacy of the representation by the named parties and class counsel. Fed R. Civ. P. 23(a). Harper v. Sheriff of Cook County, 581 F.3d 511, 513 (7th Cir. 2009), Rosario v. Livaditis, 963 F.2d 1013, 1017 (7th Cir. 1992). A class must fit within one of the types of classes described in Rule 23(b). Fed R. Civ. P. 23(b). A common nucleus of operative fact is usually enough to satisfy the commonality requirement of Rule 23(a)(2). Rosario, 963 F.2d at 1018. Common nuclei of fact are typically
7The most integrated setting requirement applies not only to individuals currently in institutional settings, but also to individuals at “risk of institutionalization.” Fisher v. Oklahoma Health Care Authority, 335 F.3d 1175 (2003). Thus, the Proposed Consent Decree’s provisions relating to individuals residing in home settings appropriately addresses a Title II violation.
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manifest where, as in this case, the defendants have engaged in standardized conduct towards members of the proposed class. See Chandler v. Southwest Jeep-Eagle, Inc., 162 F.R.D. 302, 308 (N.D. Ill. 1995) (citing cases). The commonality requirement does not necessitate “every class member’s factual or legal situation to be a carbon copy” of those of the named plaintiffs. Wesley v. Gen. Motors Acceptance Corp., No. 91-3368, 1992 WL 57948, at *3 (N.D. Ill. Mar. 20, 1992). See also Smith v. Aon Corp., 238 F.R.D. 609, 614 (N.D. Ill. 2006) (“The commonality requirement is not difficult to meet” ); Gen. Tel. Co. of the Southwest v. Falcon, 457 U.S. 147, 155 (1982).
In decertifying a prior class in this case, the Court pointed to concerns with commonality and typicality: “sufficient commonality does not exist among the highly specialized needs and desires of the class members and their legal guardians. Similarly, because the named plaintiffs meet the conditions set forth in Olmstead insofar as they have been adjudged eligible for, and desirous of, community placement, the named plaintiffs’ claims are not typical of class members who may or may not satisfy the Olmstead criteria.” (Order Decertifying Class at 2, July 7, 2009.) Since decertification, Plaintiffs have revised the class covered by the Proposed Consent Decree before this Court to include “two sub-classes of individuals: (1) ICF-DD residents who have requested community placements; and (2) individuals who are at risk of institutionalization and who have requested community based services or placements.” (Compl. at 12, emphasis added.) The commonality requirement of Rule 23 is satisfied for this proposed class based on the defendants’ standardized conduct towards class members in its administration of services to individuals with developmental disabilities in allegedly unnecessarily segregated settings.
Differences in the individualized facts regarding putative class members’ specific medical
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needs and the specific supports they would need in the community do not serve as a bar to class certification. Rolland v. Patrick, No. 98-30208, 2008 WL 4104488, *4 (D. Mass. Aug. 19, 2008) (“any identified factual differences between the named Plaintiffs and some of the class they sought to represent did not undermine commonality and, in particular, did not preclude certification of a class of persons with mental retardation who were challenging Defendants’ practices.”) See also Ricci v. Okin, 537 F.Supp. 817 (D. Mass. 1982). Such factual differences can be addressed in the remedial phase, as the appropriate placement for each putative class member is determined. Rolland, 1999 WL 34815562 at *5 (noting that class certification was appropriate and “individualized determinations of needs and services were more properly left for post-judgment relief”); Marisol A. v. Guiliani, 126 F.3d 372, 375 (2d Cir. 1997) (individual needs of children within the class did not defeat commonality).
The question of typicality is closely related to the question of commonality. Rosario, 963 F.2d at 1018. A “plaintiff’s claim is typical if it arises from the same event or practice or course of conduct that gives rise to the claims of other class members and his or her claims are based on the same legal theory.” De La Fuente v. Stokely-Van Camp, Inc., 713 F.2d 225, 232 (7th Cir. 1983) (citations and internal quotation omitted). This requirement “primarily directs the district court to focus on whether the named representatives’ claims have the same essential characteristics as the claims of the class at large.” Retired Chicago Police Ass’n v. City of Chicago, 7 F.3d 584, 596-7 (7th Cir. 1993). Defendants engaged in the same course of conduct in administering services intended for the members of the class and the named Plaintiffs, and all have the same claim – that Defendants are violating Title II of the ADA integration mandate. Thus, typicality is satisfied.
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Furthermore, as this court has noted, the mere fact that a particular individual does not desire to have his or her civil rights vindicated cannot serve as a bar to the resolution of such rights. Imasuen v. Moyer, No. 91-C-5425, 1992 WL 26705, *2 (N.D. Ill. Feb. 7, 1992) (Holderman, J.) (“[T]he fact that some class members may be satisfied with an unconstitutional system and would prefer to leave violations of their rights unremedied is not dispositive under Rule 23(a)”); Wyatt v. Poundstone, 169 F.R.D. 155, 161 (M.D. Ala. 1995) (refusing to decertify class where some institutional residents opposed community placement because doing so “would, in effect, preclude the use of the class action device in many of the very cases where it could be the most advantageous”); Waters v. Berry, 711 F. Supp. 1125, 1131-32 (D.D.C. 1989); Lanner v. Wimmer, 662 F.2d 1349, 1357 (10th Cir. 1981); Wilder v. Bernstein, 499 F.Supp. 980, 993 (S.D.N.Y. 1980); Newberg on Class Actions § 16:17 (4th ed. 2009).
Class certification has regularly been granted in the Olmstead context.8 The individualized needs of potential class members do not defeat the ability to employ the class action device where the requirements of Rule 23 are nonetheless met. The class covered by the proposed consent decree easily satisfies the standards described above.
B. Federal Courts Have Frequently Approved Class-Based Remedies to Redress Violations of the Integration Mandate of Title II
Systemic reform is often necessary to remedy class-based community integration claims. For instance, in Rolland v. Cellucci, No. 98-cv-30208, 1999 WL 34815562 (D. Mass. Feb. 2, 1999), the court approved a class settlement to remedy allegations that Massachusetts relied on
8 See Ball et al v. Rodgers, 492 F.3d 1094 (9th Cir. 2007); Messier v. Southbury Training School, 562 F.Supp. 2d 294 (D. Conn. 2008); Colbert v. Blagojevich, No. 1:07cv4737 (N.D. Ill. Sept. 29, 2008); Williams v. Blagojevich, No. 1:05-cv-04673 (N.D. Ill. Nov. 11, 2006). (Unpublished Orders are attached as Exh. B.)
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inappropriate nursing home placements to serve individuals with developmental disabilities, in violation of the Nursing Home Reform Amendments to the Medicaid Act and the ADA.9 Under the 2000 settlement, the State successfully moved approximately 1,000 class members from the restrictive nursing home settings into the community. Voss v. Rolland, No. 08-1874, 2010 WL 157475 (1st Cir. Jan. 19, 2010); Rolland, 191 F.R.D. 3, 15-16 (D. Mass. 2000). A group of parents of individuals with developmental disabilities who desired to remain in nursing homes challenged the settlement and the class certification, objecting that it did not adequately protect class members who wished to remain in nursing homes. The District Court rejected this challenge, and the First Circuit affirmed the District Court’s finding that the settlement was fair, reasonable, and adequate. The First Circuit recognized that the settlement agreement reflected a preliminary determination that the class would be appropriate for community placement, but that individualized determinations would be made during the transition planning process that would result in community placement only where appropriate, and would take into consideration the wishes of the class members’ families. Voss, 2010 WL 157475 at *7.
Similar system-wide relief was reached in a settlement agreement in Long v. Benson, No. 4:08-cv-26-RH-WCS (N.D. Fla. Sept. 15, 2009) (Attached at Exh. C). Long involved a statewide class action brought on behalf of Florida residents who currently, or at any time during the litigation, are Medicaid eligible adults with disabilities; are unnecessarily confined to a nursing facility that receives Medicaid funds; desire to reside in the community instead of a nursing
9 The class certified was of “all adults with mental retardation and other developmental disabilities in Massachusetts who resided in nursing facilities on or after October 29, 1998, or who are or should be screened for admission to nursing facilities pursuant to 42 U.S.C. § 1396r(e)(7) and 42 C.F.R. 483.112 et seq.” Rolland, 1999 WL 34815562 at *2.
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facility; and could reside in the community with appropriate services. Plaintiffs alleged that class members were being unnecessarily institutionalized because of Defendants’ failure to cover services and support in appropriate, integrated community settings. The parties reached a settlement of the class claims requiring the state to spend $27 million on new waiver slots over a 12 month period. While the settlement did not expressly state the number of class members who would be served under the settlement, the amount of funds committed reflects the sort of systemic relief contemplated in the consent decree before this court.
Similar system-wide relief will likely be forthcoming in Disability Advocates, Inc. v Paterson. In September 2009, the court ruled for the plaintiffs on liability, finding that New York discriminated against DAI’s 4,300 constituents with mental illness by denying them services in the most integrated setting appropriate to their needs. DAI, 2009 WL 2872833 at *1. In Disability Advocates, the court cited to authority that the court has “broad discretion to fashion equitable relief that is commensurate with the scope of the violation” and outlined the basic elements of the proposed remedial plan that Plaintiffs had already submitted. Id. at *86. Plaintiffs’ proposed plan included large-scale capacity building of community placements; developing infrastructure to administer these community services; providing community based options for individuals at risk of entry into adult homes; and providing for oversight by an independent monitor.10 Id. at *87.
The United States intervened in DAI and filed a brief supporting the plaintiff’s proposed
10 Plaintiff’s proposal would require the development of at least 1,500 supported housing beds per year, ensuring that no fewer than 4,500 supported housing beds are developed. Additionally, plaintiff’s guidelines would require detailed descriptions of the responsibilities of the different State agencies and Defendants in carrying out the plan and a time line for accomplishing all aspects of the plan. Id. at *87.
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remedy. (Pl. Intervenor U.S.’s Mem. in Supp. of Pl.’s Remedial Plan and in Opp. to Defs.’
Proposed Remedial Plan, Nov. 24, 2009, Attached as Exh. D) The defendants’ proposal, while
differing on the ultimate number of beds (200 beds per year, for 5 years), nonetheless sets forth a
plan of systemic reform. (Defs.’ Proposed Remedy at 7, Attached as Exh. E) The consent decree
here contemplates exactly the sort of systemic reform that was reached in Long and Rolland and
that will likely result from the Disability Advocates, Inc. litigation.
In addition to the cases above, many community integration cases have reached
settlements resulting in systemic reform that has led to the development of community-based settings.11 Class-wide systemic relief is appropriate for integration violations of the state’s
administration of its programs and services. To impose more stringent rules on plaintiffs’ ability
to vindicate their rights to live in the most integrated setting would obstruct the ADA’s goals of
community integration.
Conclusion
For the above stated reasons, the Court should grant preliminary approval of the proposed
11 Chambers et al. v. the City and County of San Francisco, No. 06-06346 (N.D. Ca. Sept. 18, 2008) (order granting final approval of settlement providing for community-based living options to class members); Hawaii Disability Rights Center v. State of Hawaii, No. 0300524 (D. Hawaii Aug. 12, 2005) (settlement providing for Home and Community Based Services for class of individuals with developmental disabilities, available at http://www.hawaiidisabilityrights.org/forms/S.M.SETTLEMENT8-12-05(final-redact).DOC); Brown et al v. Bush et al, No. 98-673 (S.D. Fla. Aug. 11, 2005 Order approving settlement calling for community placements for a class of approximately 280 individuals with developmental disabilities in institutional settings, available at http://www.centerforpublicrep.org/uploads/1h/Ew/1hEw39KXGykQddtjztXKew/Approval-of-Se ttlement-Agreement.pdf ); ARC of Connecticut et al v. O’Meara & Wilson Coker, No. 01-1871 (D. Conn. May 20, 2005) (settlement providing for expansion of HCBS waiver for class of individuals who were eligible for, but had been denied waiver services). (Settlement agreements attached as Exh. F.)
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consent decree. With the Court’s permission, counsel for the United States will be present at the hearing scheduled for January 28, 2010.

Dated: January 26, 2010
Respectfully submitted,
PATRICK J. FITZGERALD United States Attorney Northern District of Illinois
/s/ Joan Laser JOAN LASER PATRICK JOHNSON Assistant United States Attorneys Chicago, Illinois 60604 joan.laser@usdoj.gov

ERIC H. HOLDER, JR. Attorney General of the United States
THOMAS E. PEREZ Assistant Attorney General Civil Rights Division
SAMUEL R. BAGENSTOS Deputy Assistant Attorney General Civil Rights Division
/s/ Amanda Maisels JOHN L. WODATCH, Chief PHILIP L. BREEN, Special Legal Counsel RENEE M. WOHLENHAUS, Deputy Chief AMANDA MAISELS, Trial Attorney Disability Rights Section, Civil Rights Division U.S. Department of Justice 950 Pennsylvania Avenue, N.W. - NYA Washington, D.C. 20530 Telephone: (202) 307-0663 Facsimile: (202) 307-1198 Amanda.maisels@usdoj.gov
Counsel for United States

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 Case 1:05-cv-04331 Document 436 Filed 08/31/2009 Page 1 of 30

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

STANLEY LIGAS, by his sister and next friend, Gina )

Foster; DAVID CICARELLI, by his guardians James and )

Julianne Cicarelli; ISAIAH FAIR, by his guardian,

)

Lutricia Fair; JAMIE McELROY, by his guardian,

)

Patricia McElroy; and JENNIFER WILSON, by her

)

guardians, Nancy and Richard Wilson, on behalf of

)

themselves and all others similarly situated,

)

)

Plaintiffs,

)

)

vs.

)

)

BARRY S. MARAM, in his official capacity as Director )

of the Illinois Department of Healthcare and Family

)

Services, and CAROL L. ADAMS, in her official

)

capacity as Secretary of the Illinois Department of

)

Human Services,

)

)

Defendants.

)

Case No. 05-4331 CLASS ACTION

SECOND AMENDED COMPLAINT FOR DECLARATORY AND INJUNCTIVE RELIEF1

INTRODUCTION 1. Plaintiffs are individuals with mental retardation and other developmental

disabilities who qualify for services under Defendants’ system of long-term care for people with

developmental disabilities, including Medicaid services. They bring this action against state

officials who administer Illinois’ program for providing such services for people with

developmental disabilities. Plaintiffs seek redress for Defendants’ practice of requiring them to

reside in privately-run congregate care facilities -- known as intermediate care facilities for

people with developmental disabilities or “ICF-DDs” -- as a condition of receiving the long-term

1 On August 28, 2009, Defendants stated in writing that they do not object to the filing of the Second Amended Complaint and, accordingly, Plaintiffs may amend their complaint pursuant to Fed. R. Civ. Proc. Rule 15(a)(2).

Case 1:05-cv-04331 Document 436 Filed 08/31/2009 Page 2 of 30
care services they need and for which they qualify, contrary to their expressed preferences to reside in more integrated community settings (including their own home, their family home, or a community or other small residential arrangement providing necessary care and services), and in violation of Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132 (“Title II”); Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a) (“Section 504”); Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v (“Title XIX”) and 42 U.S.C. § 1983. Plaintiffs bring this action on their own behalf and on behalf of others similarly situated.
2. Like all human beings, Plaintiffs need “family relations, social contacts, work options, economic independence, educational advancement and cultural enrichment.” Olmstead v. L.C., 527 U.S. 581, 600 (1999). For many individuals with developmental disabilities -including the named Plaintiffs and Class members -- these needs can best be met in settings that integrate these individuals into the community and enable them to interact with nondisabled persons to the fullest extent possible.
3. Defendants administer and regulate a system for serving people with developmental disabilities that relies heavily on large public and private institutions, including private ICF-DDs. This system defies the national trend of serving people with developmental disabilities in less restrictive, community settings. Illinois ranks 51st among all states and the District of Columbia in its placement of people with developmental disabilities in small Community Settings.
4. Further, Defendants do not have a comprehensive, effectively working plan for moving persons into the community who are, or who are at risk of being, unnecessarily institutionalized against their will. Defendants maintain no waiting list for community services; Defendants advise those people who seek community services that they can only obtain them in
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an “emergency” situation (which is not defined in any pertinent law or regulation); and Defendants otherwise act arbitrarily in administering developmental disability services.
5. By effectively requiring the unjustified institutionalization of Plaintiffs as a condition of receiving placement in community settings, Defendants have caused Plaintiffs to experience unnecessary segregation. This segregation “perpetuates unwarranted assumptions” that Plaintiffs “are incapable or unworthy of participating in community life.” Olmstead, 527 U.S. at 600.
6. The “integration mandates” of Title II and Section 504 (implemented by 28 C.F.R. § 35.130(d) and 28 C.F.R. § 41.51(d)) require that state government services, programs and activities be provided in the most integrated setting appropriate to the needs of the person with a disability. The Supreme Court of the United States affirmed these mandates in Olmstead, finding that “unjustified institutional isolation of persons with disabilities is a form of discrimination.” 527 U.S. at 600. Defendants have defied this mandate by failing to develop a comprehensive, effectively working plan to offer developmentally disabled individuals services in the most integrated setting appropriate to their needs.
7. In addition, Defendants’ actions violate Title XIX’s requirements that Defendants: (1) offer persons with developmental disabilities who are Medicaid-eligible a choice between institutional and community services, and inform them of “feasible alternatives” under the Home and Community Based Services Waiver, which funds some community services in Illinois, see 42 U.S.C. § 1396n(c)(2)(C); (2) ensure that community services are provided with “reasonable promptness,” 42 U.S.C. § 1396a(a)(8); and (3) ensure that ICF-DDs are not unnecessarily utilized, through the use of effective assessments to determine whether persons desirous of
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community settings could be served in such settings. See 42 U.S.C. §§ 1396a(a)(30)(A) & (B); 42 C.F.R. §§ 456.370-371.
8. Plaintiffs seek to enforce their legal rights to receive services in community settings.
JURISDICTION AND VENUE 9. This is an action for declaratory and injunctive relief to enforce the rights of the Plaintiffs and the class they seek to represent under the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), Title XIX of the Social Security Act, 42 U.S.C. §§ 1396, 1396a-1396v, and 42 U.S.C. § 1983. 10. Jurisdiction is proper pursuant to 28 U.S.C. § 1331 and 28 U.S.C. § 1343. Venue is proper in the Northern District of Illinois pursuant to 28 U.S.C. § 1391(b). 11. Declaratory relief is authorized by 28 U.S.C. § 2201 and Rule 57 of the Federal Rules of Civil Procedure. Injunctive relief is authorized by 28 U.S.C. § 2202 and Rule 65 of the Federal Rules of Civil Procedure.
THE PARTIES Defendants
12. Defendants are sued in their official capacities. They are: the Director of the Illinois Department of Healthcare and Family Services, Barry S. Maram, or his duly appointed successor, and the Secretary of the Illinois Department of Human Services, Carol L. Adams, or her duly appointed successor.
13. Barry S. Maram is the Director of the Illinois Department of Healthcare and Family Services (“DHFS”), which is the single state Medicaid agency for Illinois, responsible for the oversight and administration of the Medicaid program under Title XIX of the Social Security Act, including programs for persons with developmental disabilities. See 42 U.S.C.
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§ 1396a(a)(5). In this capacity, Mr. Maram administers and funds services provided under the Medicaid Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities pursuant to 42 C.F.R. § 430.25(c)(2). Mr. Maram is responsible for ensuring that the Waiver Program as administered in the State of Illinois complies with federal law.
14. Carol L. Adams is the Secretary of the Illinois Department of Human Services (“DHS”), which, through its Division of Developmental Disabilities (“DDD”), is responsible for providing comprehensive services to people with developmental disabilities in Illinois, to help them achieve self-sufficiency, independence and health to the maximum extent possible. DHS and DDD oversee Illinois’ private ICF-DDs, Community Integrated Living Arrangements (“CILAs”), and in conjunction with DHFS, approve Medicaid payments for individuals with developmental disabilities. Ms. Adams is also responsible for administering the State of Illinois’ preadmission screening (“PAS”) process, through which the State determines whether a person with developmental disabilities is eligible for institutional or community services. DHS performs these screenings through local PAS agencies. There are 17 such agencies in the State, staffed by qualified mental retardation professionals. Ms. Adams is also responsible for ensuring compliance with state and federal laws that govern the provision of services to people with developmental disabilities, including the ADA and Section 504.
The Named Plaintiffs Stanley Ligas 15. Stanley Ligas is diagnosed with Down Syndrome, a developmental disability under 42 C.F.R. § 1009 and 405 ILCS § 5/1-106. He is eligible for Medicaid services. 16. Since 1994, Mr. Ligas has been a resident at Sheltered Village, a 96-bed ICF-DD in Woodstock, Illinois.
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17. Mr. Ligas is able to make decisions on his own behalf, with support from his siblings.
18. Mr. Ligas has repeatedly expressed a strong desire to reside in a community setting located in close proximity to one of his siblings.
19. Mr. Ligas’ Interdisciplinary Team at Sheltered Village identified his readiness to move to a community setting at his annual service plan meeting in 2004.
20. Sheltered Village informed Mr. Ligas’ state-appointed PAS agency that Mr. Ligas could handle and benefit from placement in a community setting. Despite this recommendation, Mr. Ligas remains at Sheltered Village.
21. A community setting is the most integrated setting appropriate to Mr. Ligas’ needs.
22. Stanley Ligas is eligible for and would benefit from residing in a community setting.
23. In 2004, Illinois refused to provide Stanley Ligas with placement in a community setting.
24. Illinois has not given Stanley Ligas any indication of whether or when he could expect to receive placement in a community setting.
25. Stanley Ligas continues to be unnecessarily institutionalized at Sheltered Village, a setting that is not the most integrated setting appropriate to his needs.
26. Illinois has denied Stanley Ligas access to placement in a community setting and requires that he continue to be confined in a segregated institution in order to receive placement and services.
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David Cicarelli 27. David Cicarelli is diagnosed with moderate mental retardation, a developmental disability under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1-106. He is eligible for Medicaid services. 28. Since 1997, David Cicarelli has been a resident at Riverside Foundation, a 96-bed ICF-DD in Lincolnshire, Illinois. 29. David Cicarelli wants to live in a community setting. 30. David Cicarelli’s parents, James and Julianne Cicarelli, are his legal guardians, and they want him to live in a community setting. 31. A community setting is the most integrated setting appropriate to David Cicarelli’s needs. 32. David Cicarelli is eligible for and would benefit from residing in a community setting. 33. In 2001, Mrs. Cicarelli asked David’s PAS agency, Community Alternatives Unlimited, to attempt to obtain placement in a community setting for David Cicarelli. In 2002, the PAS agency terminated its case management services because of its inability to obtain funding from the State for David to live in a community setting. 34. Illinois has not offered David Cicarelli placement in a community setting. 35. Illinois refuses to provide David Cicarelli with placement in a community setting. 36. Illinois has not given David Cicarelli any indication of whether or when he could expect to receive placement in a community setting. 37. David Cicarelli continues to be unnecessarily institutionalized at Riverside, a setting that is not the most integrated setting appropriate to his needs.
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38. Illinois has denied David Cicarelli access to placement in a community setting and requires that he continue to be confined in a segregated institution in order to receive placement and services.
Isaiah Fair 39. Isaiah Fair is diagnosed as having moderate mental retardation and epilepsy, which are developmental disabilities under 42 C.F.R § 435.1009 and 405 ILCS § 5/1-106. Mr. Fair is eligible for Medicaid services. 40. Isaiah Fair currently resides at home with his mother, Lutricia Fair, who is his legal guardian. 41. Isaiah Fair would like to live in a community setting. 42. Lutricia Fair would like for her son, Isaiah Fair, to live in a community setting. 43. A community setting is the most integrated setting appropriate to Isaiah Fair’s needs. 44. Isaiah Fair is eligible for and would benefit from residing in a community setting. 45. In May 2000, Isaiah Fair was placed in Matteson Court, a 16-bed ICF-DD in Matteson, Illinois. 46. In May 2002, Lutricia Fair requested that Isaiah Fair’s PAS agent, Suburban Access, seek placement for Isaiah Fair in a community setting. At that time, no such placement was offered. 47. In May 2003, Mr. Fair had a severe seizure at Matteson Court. Staff refused to call 911. Ms. Fair was present and called 911 from her cellular telephone. In response to this incident, Ms. Fair filed a complaint with the Illinois Department of Public Health (“IDPH”) on her son’s behalf. The IDPH determined that the ICF-DD committed medical neglect. As a result, Ms. Fair removed her son from Matteson Court.
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48. In June 2003, Lutricia Fair again requested that Suburban Access find a placement for Isaiah Fair in a community setting.
49. Suburban Access evaluated Isaiah Fair and deemed him qualified and eligible for placement in a community setting.
50. Suburban Access applied for numerous community setting placements for Isaiah Fair. Illinois refused to provide community services to Isaiah Fair on the grounds that he no longer was in an “emergency” situation since he was residing at home. Instead, DHS suggested a large ICF-DD or state-operated developmental center, which Ms. Fair refused. Suburban Access, as state-assigned PAS agent for Mr. Fair, explained to Ms. Fair that the only way her son could have qualified for a community setting under existing DHS standards would be if she had left him in the life-threatening situation at Matteson Court, thereby creating an “emergency.”
51. Isaiah Fair currently lives at home, without necessary supports and services, to avoid the more restrictive environment of an institution.
52. Illinois refuses to provide Isaiah Fair with placement in a community setting. 53. Illinois has not given Isaiah Fair any indication of whether or when he could expect to receive placement in a community setting. 54. Because Ms. Fair must care for her son, she is unable to work and supports her son with her limited savings. Mr. Fair will not be able to continue to live with his mother and will need out-of-home care. Ms. Fair has significant health problems. 55. Isaiah Fair is at risk of institutionalization within the next year. 56. Illinois has denied Isaiah Fair placement in a community setting and will only provide placement and services through confinement in an institution.
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Jamie McElroy 57. Jamie McElroy is diagnosed with moderate mental retardation, a developmental disability under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1-106. He is eligible for Medicaid services. 58. Mr. McElroy currently resides at home with his mother, Patricia McElroy, who is his legal guardian. 59. Jamie McElroy would like to live in a community setting. 60. Patricia McElroy would like for her son to live in a community setting. 61. A community setting is the most integrated setting appropriate to Jamie McElroy’s needs. 62. Jamie McElroy is eligible and would benefit from residing in a community setting. 63. In 2002, a provider offered Jamie McElroy placement in a community setting. 64. Jamie McElroy’s PAS agency, Central Illinois Services Access, evaluated Jamie McElroy and determined that he was qualified and eligible for placement in this community setting. The PAS agent requested funding from DHS for a community setting. 65. In 2004, Illinois denied Jamie McElroy funding for the community setting and advised that the only “currently funded options” were in institutions. 66. Jamie McElroy currently lives at home, without necessary supports and services, to avoid the more restrictive environment of an institution. 67. Jamie McElroy is at risk of institutionalization within the next year. 68. Illinois refuses to provide Jamie McElroy with placement in a community setting. 69. Illinois has not given Jamie McElroy any indication of whether or when he could expect to receive placement in a community setting.
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70. Illinois has denied Jamie McElroy placement in a community setting and will only provide placement and services through confinement in an institution.
Jennifer Wilson 71. Jennifer Wilson has moderate mental retardation, cerebral palsy and epilepsy, which are developmental disabilities under 42 C.F.R. § 435.1009 and 405 ILCS § 5/1-106. Jennifer Wilson is eligible for Medicaid services. 72. Ms. Wilson currently resides at home with her parents, Nancy and Richard Wilson, who are her legal guardians. 73. Jennifer Wilson would like to live in a community setting. 74. Nancy and Richard Wilson would like their daughter to live in a community setting. 75. A community setting is the most integrated setting appropriate to Jennifer Wilson’s needs. 76. Jennifer Wilson is eligible for and would benefit from residing in a community setting. 77. Jennifer Wilson’s PAS agency, Central Illinois Service Access, evaluated her and determined that she was qualified and eligible for placement in a community setting. 78. In 2004, Jennifer Wilson’s PAS agency requested funding from DHS for placement in a community setting for Ms. Wilson. Illinois denied Jennifer Wilson funding for the program in a community setting. Instead, Illinois offered Ms. Wilson placement in an ICFDD. 79. A provider offered Jennifer Wilson placement in a community setting.
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80. Jennifer Wilson currently lives at home, without necessary supports and services, to avoid the more restrictive environment of an institution. Nancy Wilson, Jennifer’s mother, left her employment to care for Jennifer. Mrs. Wilson has significant back problems.
81. Jennifer Wilson is at risk of institutionalization in the next year. 82. Illinois refuses to provide Jennifer Wilson with placement in a community setting. 83. Illinois has not given Jennifer Wilson any indication of whether or when she could expect to receive placement in a community setting. 84. DHS has denied Ms. Wilson placement in a community setting and will only provide placement and services through confinement in an institution.
CLASS ACTION ALLEGATIONS 85. The named Plaintiffs bring this action as a class action pursuant to Rule 23, sections (a) and (b)(2), of the Federal Rules of Civil Procedure. 86. The named Plaintiffs seek to represent two sub-classes of individuals (collectively, the “Class”): (1) ICF-DD residents who have requested community placements; and (2) individuals who are at risk of institutionalization and who have requested communitybased services or placements. 87. The first proposed sub-class of individuals -- “ICF-DD Residents Who Have Requested Community Placements” -- consists of adult individuals in Illinois who:
(1) have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid services;
(2) reside in a private ICF-DDs with nine or more residents; and
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(3) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a record reflecting that the individual has affirmatively indicated that he or she seeks to receive services in a community setting.
88. The second proposed sub-class -- “Individuals At Risk of Institutionalization Who Have Requested Community Placements” -- consists of adult individuals in Illinois who:
(1) have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid services;
(2) are living in a home-based setting and are at risk of institutionalization because Defendants have determined that the individual is either (i) at imminent risk of abuse, neglect or homelessness or (ii) likely (without interventions) to be at imminent risk of abuse, neglect or homelessness within a year; and
(3) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a record reflecting that the individual has affirmatively indicated that he or she seeks to receive services in a community setting.
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89. The Class is so numerous that joinder of all plaintiffs is impracticable. The exact number of individuals in the Class is not known to the Plaintiffs, but is believed to number in the thousands. Defendants have previously acknowledged that just through its Prioritization of Urgency of Need for Services (PUNS) database, at least 320 current ICF-DD residents and more than 4,000 individuals with disabilities who live at home have expressed a desire for placement in community settings.
90. The claims of the named Plaintiffs are common to those of the Class and raise common issues of fact and law, including, among others: whether Defendants are providing services to individuals with developmental disabilities in the most integrated setting appropriate to their needs and expressed desires; whether Defendants have a comprehensive, effectively working plan for achieving that goal; whether Defendants administer a waiting list for community settings that moves at a reasonable pace; whether Defendants adequately determine whether placements in community settings are appropriate to the needs of individuals with developmental disabilities who seek and desire them; and whether Defendants violate Title XIX of the Social Security Act, the Americans with Disabilities Act and Section 504 of the Rehabilitation Act by failing to provide qualified individuals with services in community settings.
91. The rights and interests of the named Plaintiffs are common to and typical of those of all Class members. They share the same rights to integrated and community-based programs and services and nondiscriminatory placement.
92. The named Plaintiffs will fairly and adequately protect the interests of the Class because they suffer from deprivations identical to those of the Class members and have been denied the same federal rights that they seek to enforce on behalf of the other Class members,
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many of whom are unable to pursue claims on their own behalf as a result of their disabilities, their limited financial resources, and/or the actions of the Defendants to deprive them of their rights. Named Plaintiffs’ interests in obtaining injunctive relief for the violations of their legal rights and privileges are consistent with and not antagonistic to those of any person within the Class. Furthermore, Plaintiffs’ counsel has extensive experience in the areas of class action litigation and civil rights laws concerning people with disabilities.
93. Defendants have acted or refused to act on grounds generally applicable to all members of the Class by unnecessarily segregating Class members. Therefore, declaratory and injunctive relief with respect to the entire Class is appropriate.
STATEMENT OF THE CASE The Integration Mandates of the Americans with Disabilities Act and
Section 504 of the Rehabilitation Act 94. In 1990, Congress enacted the Americans with Disabilities Act, 42 U.S.C. §§ 12101 - 12181, to advance the civil rights of people with disabilities. 95. The ADA’s purpose and goal is “the elimination of discrimination against individuals with disabilities.” 42 U.S.C. § 12101(b)(1). 96. In enacting the ADA, Congress stated that “historically, society has tended to isolate and segregate individuals with disabilities” and that such forms of discrimination “continue to be a serious and pervasive social problem.” 42 U.S.C. § 12101(a)(2). 97. Congress further determined that “the Nation’s proper goals regarding individuals with disabilities are to assure equality of opportunity, full participation, independent living, and economic sufficiency for such individuals.” 42 U.S.C. § 12101(a)(8). 98. Title II of the ADA provides that “no qualified individual with a disability shall, by reason of such disability, be excluded from participation in or be denied the benefits of the
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services, programs, or activities of a public entity, or be subjected to discrimination by any such entity.” 42 U.S.C. § 12132 (emphasis added).
99. Discrimination under Title II of the ADA includes unnecessary segregation and institutionalization. As the Supreme Court stated in Olmstead v. L.C., 527 U.S. 581 (1999), “unjustified institutional isolation of persons with disabilities is a form of discrimination” because “[i]n order to receive needed medical services, persons with [] disabilities must, because of those disabilities, relinquish participation in community life …” Id. at 600-01.
100. The regulations to the ADA codify the prohibition against unnecessary segregation and institutionalization. 28 C.F.R. § 35.130(d) (“A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities”). Section 504 has an identical mandate. 28 C.F.R. § 41.51(d) (“Recipients shall administer programs and activities in the most integrated setting appropriate to the needs of qualified handicapped persons”).
101. Furthermore, the ADA prohibits public entities from utilizing “criteria or methods of administration” that have the effect of subjecting qualified individuals with disabilities to discrimination, which includes unnecessary institutionalization. 28 C.F.R. § 35.130(b)(3). Section 504 has an identical mandate. 45 C.F.R. § 84.4(b)(4); 28 C.F.R. § 41.51(b)(3).
The Illinois Medicaid Program for Persons with Developmental Disabilities A. Illinois’ Participation in Medicaid
102. Medicaid is a joint federal-state program through which the federal government reimburses a portion of expenses incurred by states to furnish health care services to low-income people, including services to persons with developmental disabilities.
103. States are not required to participate in the Medicaid program, but if they do, they must comply with the requirements of Title XIX of the Social Security Act, 42 U.S.C. §§ 1396 -
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1396v. Every state that elects to participate must submit a plan to the United States Department of Health and Human Services that provides “such safeguards as may be necessary to assure that . . . care and services will be provided . . . in a manner consistent with simplicity of administration and the best interests of the recipients.” 42 U.S.C. § 1396a(a)(19).
104. This plan must contain “reasonable standards” to achieve the objectives and requirements of Title XIX. 42 U.S.C. § 1396a(a)(17).
105. One of Title XIX’s primary objectives is “to help such families and individuals attain or retain capability for independence or self-care …” 42 U.S.C. § 1396.
106. Certain services under Title XIX are “mandatory” and must be provided to all eligible individuals. 42 U.S.C. § 1396a(a)(10)(A) (incorporating 42 U.S.C. §§ 1396d(a)(1-5), (17), (21)). States may additionally provide “optional” services, including ICF-DD (referred to as “intermediate care facility for the mentally retarded [ICF/MR]” in Title XIX). Id. § 1396d(a)(15).
107. Once a state elects to provide an optional service, that service becomes part of the state’s Medicaid plan and is subject to all requirements of Title XIX. Id. § 1396a(a)(1).
108. Illinois participates in Medicaid and its plan, approved by the United States Department of Health and Human Services, includes ICF-DD services.
B. Medicaid Home and Community Based Services Waivers 109. Title XIX also allows states to “waive” certain Medicaid requirements in order to enable people with disabilities to receive services in integrated community settings as opposed to institutions. 42 U.S.C. § 1396n(c). These are known as “Medicaid Home and Community Based Services waivers” (“HCBS waiver”); 42 C.F.R. § 441.300. States can receive Medicaid reimbursement for waiver services up to the average per capita cost of institutional care, including the cost of care in an ICF-DD. 42 U.S.C. § 1396n(c)(2)(D).
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110. Illinois has an HCBS waiver for people with developmental disabilities. This waiver allows some people who would otherwise be institutionalized to receive services in integrated community settings, including their own home, their family home, or a community or other small residential arrangement providing necessary care and services.
111. An ICF-DD with nine or more sleeping beds is not a community setting. ICFDDs do not qualify as community settings under the Illinois Community Integrated Living Arrangement Licensure Act (“Act”), 210 ILCS § 135. The Act defines community-integrated living arrangement (“CILA”) as a “living arrangement certified by a community mental health or developmental services agency under this Act where 8 or fewer recipients with [] a developmental disability [] reside under the supervision of the agency.” 210 ILCS § 135/3(d). CILAs are “intended to promote independence in daily living and economic self-sufficiency.” 210 ILCS § 135/2. CILAs “shall be located so as to enable residents to participate in and be integrated into their community or neighborhood.” 210 ILCS § 135/10.
112. Although states must apply for a specific number of slots for their HCBS waiver programs, there is no limit on how many slots a state may apply for. Illinois has only 14,000 waiver slots. Illinois ranks 47th among the states in waiver use per capita.
113. Historically, the federal government encourages states to apply for waiver slots. A state is not absolved from complying with the integration mandates under the ADA, Section 504 and Title XIX simply because it failed to apply for more waiver slots. Since the Olmstead decision, the federal government has encouraged and provided financial incentives to states to transfer people from institutions to the community.
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C. Title XIX’s Requirements 114. Title XIX requires that individuals eligible for an ICF-DD level of care be given the opportunity to choose alternatives to institutional care, and that such individuals be afforded their choice of placement options and services. 42 U.S.C. § 1396n(c)(2)(C). 115. Title XIX additionally requires states to “provide that all individuals wishing to make an application for medical assistance under the plan shall have the opportunity to do so, and that such assistance shall be furnished with reasonable promptness to all eligible individuals.” 42 U.S.C. § 1396a(a)(8) (emphasis added). 116. Title XIX requires states to ensure against “unnecessary utilization” of ICF-DD services, 42 U.S.C. § 1396a(a)(30)(A). Title XIX ensures that residents are screened and assessed prior to admission to determine whether their needs can be met in community settings. 42 U.S.C. § 1396a(a)(30)(B); 42 C.F.R. §§ 456.370-71. D. Defendants’ Unnecessary Segregation of Certain People with Developmental
Disabilities in ICF-DDs 117. In Illinois, approximately 6,000 people live in 246 private ICF-DDs with nine or more people, with some facilities housing hundreds of people. As state officials have acknowledged, these ICF-DDs do not qualify as community settings. 118. Many ICF-DD residents who could handle and benefit from living in community settings with appropriate supports and services have affirmatively indicated to Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) that they wish to receive long-term care services in a community setting. For most, if not all, of these individuals, segregation in ICF-DDs is unnecessary. Rather, the community is the most integrated setting appropriate to their needs, but Defendants have not provided
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sufficient community alternatives or provided any indication of when such alternatives might become available.
119. Many persons with developmental disabilities who are eligible for Medicaid services currently live at home with parents or other family members but are in danger of institutionalization because he or she is at imminent risk of abuse, neglect or homelessness, or has not reached that stage of crisis yet, but, without interventions, is likely to within one year. Many of these individuals have affirmatively indicated to Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) that they wish to receive long-term care services in a community setting, but Defendants have not provided sufficient community alternatives or provided any indication of when such alternatives might become available.
120. Defendants do not provide Plaintiffs or Class members the choice between receiving services in an institutional or community setting.
121. Defendants do not systematically evaluate persons already residing in ICF-DDs who have expressed an interest in receiving services in a more integrated or community setting to ascertain if they could handle and benefit from such settings.
122. Defendants also deny community-based services to persons already evaluated and determined able to handle and benefit from living in the community or other integrated setting.
123. Defendants do not maintain a waiting list for community-based services. Defendants allocate community residential services in an arbitrary and capricious fashion, often ignoring the recommendations of the PAS agencies, the requirements of the State’s own Medicaid Plan, and federal law.
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124. By arbitrarily denying placement in community settings, Defendants have caused substantial, irreparable harm and prejudice to Plaintiffs, as well as all similarly situated Class members, including the unnecessary institutionalization or risk thereof, segregation, loss of life skills, loss of opportunities to develop to their fullest potential, and aggravation of their physical, mental, and emotional conditions.
LEGAL CLAIMS COUNT I: VIOLATIONS OF THE AMERICANS WITH DISABILITIES ACT
125. Plaintiffs reallege paragraphs 1 through 124 as though fully set forth herein. 126. Plaintiffs and the members of the Class are qualified individuals with disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2). 127. Title II of the ADA requires that “a public entity shall administer services, programs and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” 28 C.F.R. § 35.130(d) 128. Regulations implementing Title II of the ADA provide that “a public entity may not, directly or through contractual or other arrangements, utilize criteria or other methods of administration: (i) that have the effect of subjecting qualified individuals with disabilities to discrimination on the basis of disability; [or] (ii) that have the purpose or effect of defeating or substantially impairing accomplishment of the objectives of the entity’s program with respect to individuals with disabilities …” 28 C.F.R. § 35.130(b)(3). 129. Defendants have systematically failed, and continue to fail, to evaluate many of the named Plaintiffs and Class members to ascertain whether they could handle and benefit from, and fail to place or provide services to such persons in, community-based or other more integrated settings appropriate to meet their needs. ICF-DDs do not qualify as community settings.
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130. Defendants have discriminated, and continue to discriminate, against the named Plaintiffs and the Class, and have violated, and continue to violate, the ADA and implementing regulations, by denying Plaintiffs and the Class access to community settings and by requiring them to be unnecessarily segregated in ICF-DDs in order to receive necessary services.
131. Defendants do not have a comprehensive, effectively working plan to serve the named Plaintiffs and the Class, all of whom are people with developmental disabilities, in the most integrated setting appropriate for their needs.
132. With reasonable modifications to its system for providing long term care services to people with developmental disabilities, Defendants could provide services to the named Plaintiffs and the Class in community settings.
COUNT II: VIOLATIONS OF SECTION 504 OF THE REHABILITATION ACT 133. Plaintiffs reallege paragraphs 1 through 132 as though fully set forth herein. 134. Section 504 of the Rehabilitation Act provides that: “No otherwise qualified
individual with a disability . . . shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance . . . .” 29 U.S.C. § 794(a).
135. Regulations promulgated pursuant to Section 504 of the Rehabilitation Act provide that: “Recipients shall administer programs and activities in the most integrated setting appropriate to the needs of qualified handicapped persons.” 28 C.F.R. § 41.51(d).
136. Named Plaintiffs and the Class are qualified individuals with disabilities within the meaning of the Rehabilitation Act. 29 U.S.C. § 794(a).
137. The regulations promulgated under Section 504 of the Rehabilitation Act further prohibit recipients of federal financial assistance from “utiliz[ing] criteria or methods of administration . . . (i) that have the effect of subjecting handicapped persons to discrimination on
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the basis of handicap; [or] (ii) that have the purpose or effect of defeating or substantially impairing accomplishment of the objectives of the recipient’s program with respect to handicapped persons.” 28 C.F.R. § 41.5(b)(3); 45 C.F.R. §84.4(b).
138. The programs and activities maintained by Defendants and their agencies, DHFS and DHS, at issue in this case, including institutional and community services for people with developmental disabilities, receive substantial federal financial assistance, and therefore, Defendants are subject to the provisions of Section 504 of the Rehabilitation Act.
139. Placement in a community setting, rather than an ICF-DD, is the most integrated setting appropriate to meet the needs of the named Plaintiffs and the Class.
140. Defendants have discriminated, and continue to discriminate, against the named Plaintiffs and the Class, and have violated, and continue to violate, the Rehabilitation Act and its implementing regulations, by denying named Plaintiffs and the Class access to community settings and by effectively requiring them to be confined unnecessarily in ICF-DDs in order to receive necessary services.
141. Defendants do not have a comprehensive, effectively working plan to serve people with developmental disabilities in the most integrated setting appropriate for their needs.
142. With reasonable modifications to its system for providing long term care services to people with developmental disabilities, Defendants could provide services to the named Plaintiffs and the Class in community settings.
COUNT III: VIOLATIONS OF TITLE XIX OF THE SOCIAL SECURITY ACT 143. Plaintiffs reallege paragraphs 1 through 142 as though fully set forth herein. 144. Illinois participates in the federal Medicaid program and has chosen to provide
long term care services under its Medicaid plan to eligible people with developmental disabilities in ICF-DDs and through HCBS waivers.
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145. Because Illinois participates in the federal Medicaid program, it must comply with the requirements of Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v.
146. Named Plaintiffs and the Class are recipients of, or are eligible for, Medicaid. 147. Defendants have failed, and continue to fail, to comply with Title XIX of the Social Security Act. A. Failure to Provide Choice between ICF-DD and HCBS Waiver Services 148. Named Plaintiffs and the Class require the level of care provided in an ICF-DD. Title XIX requires that when persons with disabilities are determined to be likely to require the level of care provided in an ICF-DD, states must inform them of feasible alternatives under the HCBS waiver and give them a choice of either ICF-DD or waiver services. 42 U.S.C. § 1396n(c)(2)(C), 42 C.F.R § 441.302(d). 149. Defendants have failed to give Plaintiffs and the Class the choice of community services available under the HCBS waiver. B. Failure to Provide Services with Reasonable Promptness 150. Title XIX requires states to provide Medicaid benefits to all eligible persons with reasonable promptness. 42 U.S.C. § 1396a(a)(8). Provision of services must not be delayed by the agencies’ administrative procedures. 42 C.F.R § 435.930(a). 151. Named Plaintiffs and the Class qualify for both ICF-DD services and HCBS waiver services. 152. Defendants have failed to provide HCBS waiver services with reasonable promptness. C. Unnecessary Utilization of ICF-DD Services 153. Title XIX requires participating states to implement any “methods and procedures … as may be necessary to safeguard against unnecessary utilization” of institutional care,
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including ICF-DDs. 42 U.S.C. § 1396a(a)(30)(A). In accordance with this requirement, states must ensure that “each admission to a[n] … intermediate care facility for the mentally retarded … is reviewed or screened in accordance with criteria established by medical and other professional personnel….” Id. § 1396a(a)(30)(B).
154. Regulations implementing this requirement provide that, prior to admission to an ICF-DD, “an interdisciplinary team of health professionals must make a comprehensive medical and social evaluation and, where appropriate, a psychological evaluation of each applicant’s or recipient’s need for care in the ICF.” 42 C.F.R. § 456.370(a).
155. The regulations further require that if an ICF resident’s “needs could be met by alternative services that are currently unavailable, the facility must enter this fact in the recipient’s record and begin to look for alternative services.” 42 C.F.R. § 456.371.
156. Defendants’ methods and procedures cause unnecessary utilization of ICF-DD services for Plaintiffs and Class members. Defendants fail to ensure that named Plaintiffs and the Class are adequately evaluated to determine whether their needs could be met by alternative services. Additionally, Defendants fail to ensure the provision of community services for persons found not to require institutional care and who have affirmatively indicated their desire for community services.
PRAYER FOR RELIEF WHEREFORE, Plaintiffs, individually and on behalf of the Class, respectfully request that the Court: A. Enter an order certifying named Plaintiffs David Cicarelli and Stanley Ligas as representatives of a sub-class of ICF-DD Residents Who Have Requested Community Placements, consisting of adult individuals in Illinois who:
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(1) have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid services;
(2) reside in a private ICF-DDs with nine or more residents; and
(3) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a record reflecting that the individual has affirmatively indicated that he or she seeks to receive services in a community setting.
B. Enter an order certifying named Plaintiffs Isaiah Fair, Jamie McElroy and Jennifer Wilson as representatives of a sub-class of Individuals At Risk of Institutionalization Who Have Requested Community Placements, consisting of adult individuals in Illinois who:
(1) have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid services;
(2) are living in a home-based setting and are at risk of institutionalization because Defendants have determined that the individual is either (i) at imminent risk of abuse, neglect or homelessness or (ii) likely (without
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Case 1:05-cv-04331 Document 436 Filed 08/31/2009 Page 27 of 30
interventions) to be at imminent risk of abuse, neglect or homelessness within a year; and (3) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a record reflecting that the individual has affirmatively indicated that he or she seeks to receive services in a community setting. C. Declare that Defendants’ failure to provide the named Plaintiffs and the Class with services in the most integrated setting appropriate to their needs violates Title II of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and Title XIX of the Social Security Act.
D. Declare that Defendants do not have a comprehensive, effectively working plan for placing the named Plaintiffs and the Class in less restrictive settings as required by Title II of the Americans with Disabilities Act.
E. Issue a permanent injunction:
(1) requiring Defendants to identify those individuals who are members of the sub-class of ICF-DD Residents Who Have Requested Community Placements, and those individuals who are members of the sub-class of Individuals At Risk of Institutionalization Who Have Requested Community Placements, and to maintain lists of these individuals;
(2) requiring Defendants promptly to offer to evaluate the named Plaintiffs and Class members to determine whether, in the view of qualified
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treatment professionals, they could handle and benefit from placement in a community setting;

(3) requiring Defendants promptly to offer those named Plaintiffs and Class members who could handle and benefit from placement in a community setting the option (which they are under no obligation to accept) to receive appropriate supports and services sufficient to allow them to live in the most integrated setting appropriate to their needs.

F. Grant such other and further relief as this Court deems just and proper, including an award of reasonable attorneys’ fees, litigation expenses and costs.

Respectfully submitted:

Dated: August 31, 2009

By: /s Kendra K. Hartman One of the attorneys for Plaintiffs

Barry G. Lowy (ARDC No. 6196719) Laura J. Miller (ARDC No. 6202721) Barry C. Taylor (ARDC No. 6199045) John W. Whitcomb (ARDC No. 6204744) EQUIP FOR EQUALITY 20 North Michigan Avenue, Suite 300 Chicago, Illinois 60602 Tel: (312) 341-0022 Fax: (312) 341-0295

John Grossbart (ARDC No. 3126133 ) Kendra K. Hartman (ARDC No. 6257264) Wendy Enerson (ARDC No. 6272377 ) Corey Shapiro (ARDC No. 6291974) SONNENSCHEIN NATH & ROSENTHAL LLP 233 S. Wacker Drive, Suite 7800 Chicago, Illinois 60606 Tel: (312) 876-8000 Fax: (312) 876-7934

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Case 1:05-cv-04331 Document 436 Filed 08/31/2009 Page 29 of 30
Edward B. Mullen III (ARDC No. 6286924) ACCESS LIVING OF METROPOLITAN CHICAGO 115 West Chicago Ave. Chicago, Illinois 60610 Tel: (312) 640-2131 Fax: (312) 640-2101 Benjamin S. Wolf (ARDC No. 3125607) AMERICAN CIVIL LIBERTIES UNION OF ILLINOIS 180 North Michigan Avenue, Suite 2300 Chicago, Illinois 60601 Tel: (312) 201-9740 Fax: (312) 201-9760 Judith A. Gran PUBLIC INTEREST LAW CENTER OF PHILADELPHIA 125 S. Ninth Street, Suite 700 Philadelphia, Pennsylvania 19107 Tel: (215) 627-7100 Fax: (215) 627-3183
12623919
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Case 1:05-cv-04331 Document 436 Filed 08/31/2009 Page 30 of 30 CERTIFICATE OF SERVICE
The undersigned, an attorney for the plaintiffs, certifies that on August 31, 2009, she electronically filed the foregoing document with the Clerk of the Court using the CM/ECF system which will send notification of such filing to the counsel of record.
s/ Kendra K. Hartman
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 Order Form (01/2005)

Case 1:05-cv-04331 Document 420 Filed 07/07/2009 Page 1 of 3
United States District Court, Northern District of Illinois

Name of Assigned Judge or Magistrate Judge
CASE NUMBER
CASE TITLE

James F. Holderman

Sitting Judge if Other than Assigned Judge

05 C 4331

DATE

7/7/2009

Stanley Ligas, et al. vs. Barry S. Maram, et al.

DOCKET ENTRY TEXT
For the reasons set forth in the Statement section below, the class certification order [85] is vacated and approval of the proposed consent decree is denied. Plaintiffs' counsel are to notify the class members as efficiently and inexpensively as possible of the change in status of this lawsuit. See Culver v. City of Milwaukee, 277 F.3d 908 (7th Cir. 2002) (requiring notice to class members when class is decertified). The case is set for a status report as to the continued litigation of the individual plaintiffs' claims on July 30, 2009, at 9:00 a.m.

O[ For further details see text below.]

Notices mailed.

STATEMENT
Stanley Ligas and eight other individually named plaintiffs (the "plaintiffs") filed this lawsuit on behalf of themselves and other similarly situated individuals against the State of Illinois officials who administer state programs that provide long-term care services for people with developmental disabilities (the "defendants"). In their complaint, the plaintiffs alleged that the defendants failed to provide developmentally disabled people with long-term care services in the most integrated setting appropriate for their needs in violation of Title II of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and Title XIX of the Social Security Act. The plaintiffs' lawsuit relies heavily on Olmstead v. L.C., 527 U.S. 581 (1999). In Olmstead, the Supreme Court held that developmentally disabled individuals should be placed in community settings when (1) the state's treatment professionals have determined that community placement is appropriate, (2) the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and (3) the placement can be reasonably accommodated considering the available state resources and the needs of other people with disabilities. Olmstead, 527 U.S. at 587. The plaintiffs allege that, despite their requests that they be placed in a community-based setting and the fact that the plaintiffs meet the criteria set forth in Olmstead, the State of Illinois has refused to place them in the least restrictive setting appropriate to their needs. The plaintiffs therefore request injunctive relief on behalf of themselves and class members, requiring the defendants to place eligible developmentally disabled individuals in community-based settings with appropriate services and support or Community-Integrated Living Arrangements ("CILAs") rather than in intermediate care facilities ("ICF-DD"). On March 7, 2006, the court granted plaintiffs' motion for class certification [85].

On November 13, 2009, the plaintiffs filed with the court a Proposed Consent Decree on behalf of the class [295], setting forth the terms of the settlement entered into between the plaintiffs and the defendants. The Proposed Consent Decree defined the class as:

All persons in Illinois 18 years of age or older who:

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Case 1:05-cv-04331 Document 420 Filed 07/07/2009 Page 2 of 3 (a) have mental retardation and/or other Developmental Disabilities and who are
eligible for Medicaid ICF/MR services;
(b) with appropriate supports and services, could live in the community; and
(c) either: (i) are, or will in the future be, institutionalized in private ICF-DDs with nine or more residents or (ii) are, or will in the future be, living in a homebased setting and are at risk of institutionalization because of their need for services.
(Proposed Consent Decree ¶ 2.) A "Notice of Proposed Class Action Settlement and Hearing" was sent to the class on March 31, 2009 [327].
On July 1, 2009, the court held a hearing to determine the fairness, adequacy and reasonableness of the Proposed Consent Decree and to consider any objections by class members to the Decree. In preparation for the hearing, class members submitted more than 2,500 written objections to the Proposed Consent Decree. Approximately 240 people attended the fairness hearing, and thirty-four individual class members or their legal guardians spoke at the hearing. Many more objectors were represented at the hearing by counsel. A common theme among the objectors was the concern that many developmentally disabled individuals, who are within the class definition, would be adversely affected by provisions of the Proposed Consent Decree even though the individual neither met the Olmstead criteria nor desired placement in a community-based setting.
The class definition included in the Proposed Consent Decree is considerably broader than the class contemplated by the plaintiffs' lawsuit and, because of the highly individualized needs of the developmentally disabled as demonstrated at the fairness hearing, is unlikely to be rectified by modification of the class definition. To proceed as a class action, the potential class must satisfy the following criteria: (1) numerosity; (2) commonality of facts and law; (3) typicality between the class claims and those of the named parties; and (4) adequacy of the representation by the named parties and class counsel. Fed R. Civ. P. 23(a). The court may review its class certification "any time before a decision on the merits." Movement for Opportunity & Equal. v. Gen. Motors Corp., 622 F.2d 1235, 1278 (7th Cir. 1980). "If the certification of the class is later deemed to be improvident, the court may decertify" the class. Eggleston v. Chi. Journeymen Plumbers' Local Union No. 130, 657 F.2d 890, 896 (7th Cir. 1981).
The named plaintiffs assert that they meet the criteria set forth in Olmstead, but the class definition fails to restrict the class to developmentally disabled individuals that are eligible for, and desire, community placement. Indeed, many of the objections received by the court concerned class members that were neither eligible for, nor desired, community placement. And based on the objections raised at the fairness hearing, it appears that sufficient commonality does not exist among the highly specialized needs and desires of the class members and their legal guardians. Similarly, because the named plaintiffs meet the conditions set forth in Olmstead insofar as they have been adjudged eligible for, and desirous of, community placement, the named plaintiffs' claims are not typical of class members who may or may not satisfy the Olmstead criteria. It therefore became clear to the court at the fairness hearing that commonality and typicality among class members are lacking in this case. See Keele v. Wexler, 149 F.3d 589, 595 (7th Cir. 1998) (explaining that commonality is closely related to typicality). Consequently, decertification of the class is appropriate.
In addition, briefing and arguments by the various parties' counsel as well as the statements of the individual objectors, both at the July 1, 2009 hearing and in writing, establish that the settlement negotiated by the plaintiffs and the defendants is considerably broader than was necessary to address the needs of the

05C4331 Stanley Ligas, et al. vs. Barry S. Maram, et al.

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Case 1:05-cv-04331 Document 420 Filed 07/07/2009 Page 3 of 3 class contemplated by the plaintiffs' lawsuit. For example, the Proposed Consent Decree attempts to establish annual evaluations for developmentally disabled individuals that are neither required by Olmstead or necessary to secure the rights of individual class members. (See Proposed Consent Decree ¶ 7.) The Decree also attempts to restructure the administrative process through which the State of Illinois receives applications and assesses eligibility for services available to developmentally disabled individuals. (See Proposed Consent Decree ¶ 6.) Moreover, on June 11, 2009, the court struck paragraph ten of the Proposed Consent Decree after receiving confirmation from the plaintiffs and the defendants that paragraph ten was not a "deal breaker," and plaintiffs' counsel indicated in a letter to this court dated July 2, 2009, that the plaintiffs were amenable to revision of paragraph seven of the Proposed Consent Decree consistent with the language proposed by the Misericordia Resident Objectors at the fairness hearing [415]. Such broad drafting of the Proposed Consent Decree overreaches the objective of the plaintiffs' lawsuit, which plaintiffs' counsel described as ensuring the plaintiffs' "right to choose" to reside in the most integrated setting appropriate to their needs.
Because commonality and typicality do not exist among class members, class certification is vacated and approval of the proposed consent decree is denied. The case will proceed as an individual lawsuit rather than as a class action. The plaintiffs are directed to notify class members of the change in status of this lawsuit. See Culver v. City of Milwaukee, 277 F.3d 908 (7th Cir. 2002) (requiring notice to class members when class is decertified).
Courtroom Deputy Initials:

05C4331 Stanley Ligas, et al. vs. Barry S. Maram, et al.

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 Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 1 of 39 PageID #:10794

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs, vs.
BARRY S. MARAM, et al., Defendants.

)

)

)

No. 05 C 4331

)

)

Chief Judge Holderman

)

)

)

)

MEMORANDUM IN SUPPORT OF JOINT MOTION FOR SETTLEMENT CLASS CERTIFICATION, PRELIMINARY APPROVAL
OF CONSENT DECREE, AND APPROVAL OF NOTICE PLAN

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 2 of 39 PageID #:10795
TABLE OF CONTENTS Page
BACKGROUND ............................................................................................................................ 1 CLASS CERTIFICATION IS APPROPRIATE ............................................................................ 6
A. PLAINTIFFS MEET THE REQUIREMENTS OF RULE 23(a)........................... 7 1. Joinder Would Be Impracticable ................................................................ 9 2. There Are Questions of Law and Fact Common to the Class................... 10 3. The Named Plaintiffs’ Claims Are Typical of Those of the Class. .......... 13 4. The Named Plaintiffs and their Counsel Will Fairly and Adequately Protect the Interests of the Class ........................................... 14 a) The Named Plaintiffs’ Interests are Not Antagonistic to Those of the Class......................................................................... 14 b) Plaintiffs’ Counsel Are Qualified to Maintain This Action.......... 15 5. The Class Is Readily Identifiable.............................................................. 15 6. Plaintiffs Are Members of the Class......................................................... 16
B. PLAINTIFFS MEET THE REQUIREMENTS OF RULE 23(b)(2).................... 16 THE COURT SHOULD PRELIMINARILY APPROVE THE CONSENT DECREE............... 18
A. THE PRINCIPAL TERMS OF THE DECREE PROVIDE FAIR AND REASONABLE RELIEF THAT IS LIMITED TO INDIVIDUALS WHO WANT RELIEF .................................................................................................... 18 1. Development of Community Capacity ..................................................... 18 2. Relief Affects Private ICF-DD Residents Who Affirmatively Request Community-Based Services or Placement in A Community-Based Setting ....................................................................... 18 3. Relief Afforded to Class Members Who Reside at Home........................ 19 4. Monitoring and Compliance ..................................................................... 20 5. Implementation Plan ................................................................................. 21 6. Attorneys’ Fees and Costs ........................................................................ 21
i

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 3 of 39 PageID #:10796 7. Jurisdiction and Termination of Consent Decree...................................... 21
B. THE PROPOSED CONSENT DECREE MERITS PRELIMINARY APPROVAL ......................................................................................................... 22 1. Strength of the Plaintiffs’ Case on the Merits Balanced Against the Terms of the Consent Decree.................................................................... 23 2. Complexity, Length and Expense of Continued Litigation ...................... 24 3. Opposition to the Settlement..................................................................... 25 4. Lack of Collusion...................................................................................... 25 5. Opinion of Competent Counsel as to the Reasonableness of the Settlement ................................................................................................. 26 6. Stage of the Proceeding and Amount of Discovery Completed ............... 26
THE PROPOSED NOTICE PLAN SATISFIES THE REQUIREMENT OF RULE 23 AND DUE PROCESS .................................................................................................................. 27 CONCLUSION............................................................................................................................. 29
ii

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 4 of 39 PageID #:10797
TABLE OF AUTHORITIES Page
Cases Alliance to End Repression v. Rochford,
565 F.2d 975 (7th Cir. 1977) ................................................................................................ 8, 15 Amchem Products, Inc., v. Windsor,
521 U.S. 591 (1997).............................................................................................................. 7, 16 Arenson v. Whitehall Convalescent & Nursing Home,
164 F.R.D. 659 (N.D. Ill. 1996)............................................................................................ 9, 10 Armstrong v. Board of School Directors of the City of Milwaukee,
616 F.2d 305 (7th Cir. 1980) ........................................................................................ 22, 25, 26 Baby Neal v. Casey,
43 F.3d 48 (3d Cir. 1994) ......................................................................................................... 10 Benjamin H. v. Ohl, No. 3:99-0338, 1999 U.S. Dist. LEXIS 22454 (S.D.W.V. Oct. 8, 1999).... 17 Biekert v. Maram,
388 Ill. App. 3d 1114, 905 N.E.2d 357 (Ill. App. Ct. 2009)....................................................... 5 Boulet v. Cellucci,
107 F. Supp. 2d 61 (D. Mass. 2001) ......................................................................................... 17 Bzdawka v. Milwaukee County,
238 F.R.D. 469 (E.D. Wis. 2006) ............................................................................................. 17 City of New York v. Maul,
59 A.D. 3d 187 (N.Y. App. 1st Dept. Feb. 10, 2009)................................................................ 13 Colbert v. Blagojevich,
2008 WL 4442597 (N.D. Ill. Sept. 29, 2008) ............................................................................. 8 De La Fuente v. Stokely-Van Camp,
713 F.2d 225 (7th Cir. 1983) .................................................................................................... 13 Donovan v. Estate of Fitzsimmons,
778 F.2d 298 (7th Cir. 1985) .................................................................................................... 23 Edmondson v. Simon,
86 F.R.D. 375 (N.D. Ill. 1980).................................................................................................. 10 Eisen v. Carlisle & Jacquelin, 417 U.S. 156 (1974)....................................................................... 7
iii

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 5 of 39 PageID #:10798
Fields v. Maram, No. 04-C-0174, 2004 U.S. Dist. LEXIS 16291 (N.D. Ill. Aug. 16, 2004) ........................ passim
Fontana v. Elrod, 826 F.2d 729 (7th Cir. 1987) .................................................................................................... 27
Fowler v. Birmingham News Co., 608 F.2d 1055 (5th Cir. 1979) .................................................................................................. 27
Fresco v. Auto Data Direct, Inc., 2007 WL 2330895 (S.D. Fla. May 14, 2007) ........................................................................... 27
GE Capital Corp. v. Lease Resolution Corp., 128 F.3d 1074 (7th Cir. 1997) .................................................................................................. 23
Gen. Tel. Co. v. Falcon, 457 U.S. 147 (1982).............................................................................................................. 7, 13
Gomez v. Ill. State Bd. of Educ., 117 F.R.D. 394 (N.D. Ill. 1987)........................................................................................ 7, 8, 15
Haldeman v. Pennhurst State Sch. & Hosp., 995 F. Supp. 534 (E.D. Pa. 1998) ............................................................................................. 17
Hawker v. Consovoy, 198 F.R.D. 619 (D.N.J. 2001)................................................................................................... 28
Hawkins v. Comm’r, No. 99-143-JD, 2004 U.S. Dist. LEXIS 807, (D.N.H. Jan. 23, 2004)...................................... 17
Hendrix v. Faulkner, 525 F. Supp. 435 (N.D. Ind. 1980) ........................................................................................... 16
Hispanics United v. Vill. of Addison, 160 F.R.D. 681 (N.D. Ill. 1995).................................................................................... 10, 12, 14
In re Asbestos Litigation, 90 Fed.3d 35, Fed.R.Serv. 3d 1360 (5th Cir. 1996).................................................................... 7
Isby v. Bahy, 75 F.3d 1191 (7th Cir. 1996) .................................................................................................... 23
Kaplan v. Chertoff, 2008 WL 200108 (E.D. Pa. Jan. 24, 2008)............................................................................... 28
Lightbourn v. County of El Paso, 118 F.3d 421 (5th Cir. 1997) .................................................................................................... 10
iv

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 6 of 39 PageID #:10799
Long v. Thornton Township High Sch., 82 F.R.D. 186 (N.D. Ill. 1979).................................................................................................... 9
Makin v. Hawaii, 114 F. Supp. 2d 1017 (D. Haw. 1999) ....................................................... 16, 17 Maley v. Del Global Techs. Corp.,
186 F.Supp.2d 358 (S.D.N.Y. 2002) ........................................................................................ 26 Marisol A. v. Guiliani,
126 F.3d 372 (2d Cir. 1997) ............................................................................................... 10, 11 Mars Steel v. Continental Ill. Nat’l Bank & Trust,
834 F.2d 677 (7th Cir. 1987) .................................................................................................... 25 Martin v. Taft,
222 F. Supp. 2d 940 (S.D. Ohio 2002) ..................................................................................... 17 Midwest Cmty. Council v. Chicago Park Dist.,
87 F.R.D. 457 (N.D. Ill. 1980).................................................................................................. 12 Olmstead v. L.C.,
527 U.S. 591 (1999).............................................................................................................. 2, 23 Patterson v. Gen. Motors Corp.,
631 F.2d 476 (7th Cir.), cert. denied, 451 U.S. 914 (1980)...................................................... 11 Rancourt v. Concannon, 207 F.R.D. 14 (D. Me. 2002)................................................................ 12 Riordan v. Smith Barney,
113 F.R.D. 60 (N.D. Ill. 1986).............................................................................................. 9, 14 Robert E. v. Lane, 530 F. Supp. 930 (N.D. Ill. 1980) ..................................................................... 7 Rolland v. Cellucci,
52 F. Supp. 2d 231 (D. Mass. 1999) ......................................................................................... 17 Rosario v. Livaditis,
963 F.2d 1013 (7th Cir. 1992) ................................................................................ 10, 11, 13, 14 Small v. Sullivan,
820 F. Supp. 1098 (S.D. Ill. 1992).............................................................................................. 9 Swanson v. Am. Consumer Indus.,
415 F.2d 1326 (7th Cir. 1969) .................................................................................................... 9 Van Horn v. Trickey,
840 F.2d 604 (8th Cir. 1987) .................................................................................................... 23
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Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 7 of 39 PageID #:10800
Wal-Mart Stores, Inc. v. Visa U.S.A., Inc., 396 F.3d 96 (2d Cir. 2005) ....................................................................................................... 26
Walsh v. Great Atlantic & Pacific Tea Co., 726 F.2d 956 (3d Cir. 1983) ..................................................................................................... 27
Wellman v. Faulkner, 715 F.2d 269 (7th Cir. 1983), cert. denied, 468 U.S. 1217 (1984)........................................... 16
Williams v. Blagojevich, 2006 WL 3332844 (N.D. Ill. Nov. 13, 2006) ....................................................................... 8, 17
Wyatt v. Poundstone, 169 F.R.D. 155 (M.D. Ala. 1995)................................................................................... 9, 11, 17
Statutes 28 U.S.C. App., p 697..................................................................................................................... 7 59 Ill. Adm. Code §120.50.............................................................................................................. 5 Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a)................................................. 2, 11, 23 Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132................................... 2, 11, 23 Other Authorities 4 Robert Newberg, NEWBERG ON CLASS ACTIONS § 11:25 at 38 (4th ed. 2002).................... 22, 25 David F. Herr, MANUAL FOR COMPLEX LITIGATION, FOURTH (“MANUAL FOURTH”), § 30.41
(2005).................................................................................................................................. 22, 29 Rules Fed. R. Civ. P. 23................................................................................................................ 7, 27, 29 Fed. R. Civ. P. 23(a) .............................................................................................................. passim Fed. R. Civ. P. 23(a)(2)................................................................................................................. 10 Fed. R. Civ. P. 23(a)(3)................................................................................................................. 13 Fed. R. Civ. P. 23(b) ................................................................................................................. 7, 16 Fed. R. Civ. P. 23(b)(2)............................................................................................... 16, 17, 27, 28 Fed. R. Civ. P. 23(b)(3)................................................................................................................... 7 Fed. R. Civ. P. 23(c)(2)................................................................................................................. 27
vi

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 8 of 39 PageID #:10801 Fed. R. Civ. P. 23(e) ..................................................................................................................... 22 Fed. R. Civ. P. 23(e)(1)................................................................................................................. 27
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Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 9 of 39 PageID #:10802
Plaintiffs Stanley Ligas, Jamie McElroy, David Cicarelli, Isaiah Fair, and Jennifer Wilson, on behalf of themselves and all others similarly situated (“Plaintiffs”), and Defendants Barry Maram1 and Michelle R.B. Saddler, submit this joint memorandum in support of their Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan (“Motion”). For the reasons explained below, certification of the narrowly defined settlement class addressed by the recently executed proposed Consent Decree (“Decree,” attached as Exhibit A) entered into between the Plaintiffs, Defendants and Intervenors is appropriate.2 The proposed Decree is fair, reasonable, and provides substantial benefits to those individuals who affirmatively seek Community-Based Services and/or placement in a Community-Based Setting3, while protecting the interests of individuals who are happy with the care they currently receive and/or have no interest in receiving such services. This Court should certify the proposed class, grant preliminary approval of the Decree, adopt the Notice Plan and related proposed forms of notice (attached hereto as Exhibit B) and proceed to consider any objections to the Decree and final approval.
BACKGROUND
1 Since this lawsuit was filed, Julie Hamos has succeeded Mr. Maram as the Director of the Illinois Department of Healthcare and Family Services. Pursuant to Fed. R. Civ. P. 25(d), Ms. Hamos, as the successor to Mr. Maram, is deemed “automatically substituted as a party.” The Parties respectfully request that this Court enter an Order consistent therewith. 2 As set forth in the Decree, Intervenors, with the exception of the Mt. St. Joseph’s Intervenors, join in the Motion to approve the Decree, and have represented to Plaintiffs’ counsel that they do not oppose certification of the proposed class and approval of the proposed Notice Plan. Counsel for the Mt. St. Joseph Intervenors represented to Plaintiffs’ counsel that he does not anticipate any objections from his clients to the proposed Decree, as well as the relief sought in the Motion, but simply was not able to obtain client consent prior to filing. 3 The terms “Community-Based Services” and “Community-Based Setting” are defined in the Decree at page 4.

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 10 of 39 PageID #:10803
This action, as originally filed on July 28, 2005, and as the Second Amended Complaint continued to set forth, seeks to provide the choice of community placement to adults with developmental disabilities in compliance with Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v, and the Supreme Court’s integration mandate in Olmstead v. L.C., 527 U.S. 591 (1999). Among other things, the Olmstead decision requires the State to develop a comprehensive, effectively working plan to offer individuals with developmental disabilities services in the most integrated setting appropriate to their needs. The named Plaintiffs are five adults with developmental disabilities who currently reside in Intermediate Care Facilities for individuals with Developmental Disabilities (“ICFs-DD”), or who reside in a Family Home and are in need of community-based services or placement, and who have affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting. Defendants, named in their official capacities, operate the Illinois Department of Healthcare and Family Services (“HFS”) and the Illinois Department of Human Services (“DHS”).4 Those agencies are responsible for administering Illinois’ programs for providing services to persons with developmental disabilities. Intervenors are Illinois residents with developmental disabilities who have intervened in this lawsuit to ensure that the State of Illinois continues to meet its obligations to provide ICF-DD services. Plaintiffs, Defendants and Intervenors have agreed to all of the terms and relief set forth in the Decree.
The Class encompassed within the scope of the previously proposed consent decree agreed to by the Plaintiffs and Defendants in their first attempt to settle this matter included all developmentally disabled adults who either reside in ICFs-DD with nine or more beds or are at 4 As stated above, Defendant Barry Maram has been succeeded by Julie Hamos and therefore no longer operates HFS.
2

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risk of being placed in an ICF-DD. (CM/ECF Doc. Nos. 326, 327.) Due to the concern expressed by a large number of guardians and/or family members of persons within that group -who either had no interest in, or objected to even being considered for Community-Based Services or a placement in a Community-Based Setting -- about the potential impact of the broadly applicable provisions of that earlier proposed decree, on July 7, 2009, the Court entered an Order denying approval of that decree and vacating its prior Order certifying the class. (CM/ECF Doc. No. 420.) In its decertification Order, the Court explained that “the class definition fails to restrict the class to developmentally disabled individuals that are eligible for, and desire, community placement.” (Id. at p. 2.) All of the concerns previously expressed by the Court have been rectified by the Decree now presented.
Following the Court’s July 7, 2009 Order, Plaintiffs filed their Second Amended Complaint on August 31, 2009, in which Plaintiffs sought relief for a significantly revised class specifically limited to those individuals who are expressly seeking Community-Based Services and/or placement in a Community-Based Setting. (CM/ECF Doc. No. 485). On or about January 11, 2010, Plaintiffs and Defendants agreed to settle this matter and entered into a second proposed consent decree. (CM/ECF Doc. No. 462-1.) On January 25, 2010, Plaintiffs and Defendants jointly moved for class certification and preliminary approval of the second proposed consent decree. (CM/ECF Doc. No. 455.) On February 11, 2010, approximately 2,000 individuals with developmental disabilities (through their guardians) who reside at, or wish to reside at, ICFs-DD, (collectively, the “Intervenors”), sought to intervene as Defendants for the limited purpose of participating in the Court’s consideration of class certification and preliminary and final approval of that proposed consent decree. (CM/ECF Doc. No. 465.)
3

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The Court granted the Intervenors’ motion on April 7, 2010, denied the Plaintiffs’ and Defendants’ joint motion without prejudice, and instructed the Parties to work together to seek a mutually agreeable resolution of the case. (CM/ECF Doc. No. 479.) Since that time, those parties have met on numerous occasions to negotiate and draft the terms of a proposed agreement that will provide substantial benefits to those individuals who affirmatively seek CommunityBased Services and/or placement in a Community-Based Setting, while protecting the interests of individuals who are happy with the care they currently receive and/or have no interest in receiving such services. Those efforts were successfully concluded with the completion of a new, more focused and limited Decree and a Notice Plan. Indeed, both the class and the proposed relief granted to that class are significantly revised and squarely address the concerns previously expressed by the Court and the Intervenors.
First and foremost, with respect to the “desire” and “choice” of individuals, the class is expressly defined to include only those individuals who have actually requested community services or placements. To that end, Plaintiffs and Defendants jointly move this Court to certify a class consisting of individuals with developmental disabilities for whom Defendants have a “Current Record” (as defined in the Decree) reflecting that the individual has affirmatively requested Community-Based Services and/or placement in a Community-Based Setting. The proposed class expressly does not include any individual who objected to the proposed consent decree that was the subject of the July 1, 2009 Fairness Hearing. Nor will the relief provided in the Decree impact or impair the rights of individuals who wish to remain in an ICF-DD and/or oppose Community-Based Services or placement in a Community-Based Setting.5
5 The Decree gives those individuals multiple opportunities to change their minds and affirmatively request such services, thus allowing them to join the class, if and when they choose to do so.
4

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Second, with respect to “eligibility,” as a matter of law, all individuals who are “eligible” to receive services in an ICF-DD are “eligible” to be considered for community services because the eligibility criteria for community services under both Illinois and federal law are virtually identical to the criteria for placement in an ICF-DD. Biekert v. Maram, 388 Ill. App. 3d 1114, 1121, 905 N.E.2d 357, 364 (Ill. App. Ct. 2009) (“Pursuant to federal and state law and its own documentation, the [Home and Community-Based Services for the Developmentally Disabled] waiver program is available only to recipients who, in the absence of the waiver services, would require the Medicaid-covered level of care provided in an ICF/MR,6 in that the waiver services are an alternative to an ICF/MR placement”); 59 Ill. Adm. Code §120.50 (“The target population to be served under [Illinois’ Waiver Program] is Medicaid-eligible Illinois adults with developmental disabilities who otherwise would require services in a State-operated developmental center or a community ICF/MR.”). Thus, the members of the proposed class -those individuals who (i) currently live in ICFs-DD or who otherwise are eligible to live in ICFsDD, and (ii) who have expressly requested Community-Based Services and/or placement in a Community-Based Setting -- are all indisputably “eligible” to be considered for such services by the State of Illinois should they affirmatively request them.
Third, the Decree resolves the concerns previously raised by the Intervenors. In particular, and as stated above, the Decree in no way affects the rights of individuals who choose to reside in ICFs-DD or otherwise do not wish to receive Community-Based Services or placement in a Community-Based Setting. Resources necessary to meet the needs of those individuals who choose to reside in ICFs-DD will continue to be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree.
6 ICF/MR is the federal term for the facilities that Illinois refers to as ICFs-DD.
5

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In addition, the Decree affords Intervenors’ and their counsel a role in creating and implementing
an Implementation Plan (as defined in the Decree) to accomplish the obligations and objectives
set forth in the Decree.
CLASS CERTIFICATION IS APPROPRIATE
In connection with the agreement set forth in the Decree, Plaintiffs, Defendants and
Intervenors have stipulated to certifying the following two sub-classes for purposes of
settlement:
1) Adult individuals in Illinois: (a) who have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid Waiver services; (b) who reside in private ICFs-DD with nine or more residents; and (c) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a Current Record reflecting that the individual has affirmatively requested to receive CommunityBased Services or placement in a CommunityBased Setting; or
2) Adult individuals in Illinois: (a) who have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid Waiver services; (b) who reside in a Family Home and are in need of Community-Based Services or placement in a Community-Based Setting; and
6

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(c) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a Current Record reflecting that the individual has affirmatively requested to receive CommunityBased Services or placement in a CommunityBased Setting.7 For the reasons discussed below, this class meets the requirements of both Rules 23(a) and (b).
A. PLAINTIFFS MEET THE REQUIREMENTS OF RULE 23(a) The overriding objective of class certification pursuant to Federal Rule 23 is to obtain “economies of time, effort and expense.” Advisory Committee’s Notes on Fed.R.Civ.P. 23(b)(3), 28 U.S.C. App., p 697. It is entirely proper for Plaintiffs, Defendants and Intervenors to negotiate a proposed settlement prior to certification. Although a court should consider the settlement agreement when deciding certification issues, In re Asbestos Litigation, 90 Fed.3d 35, Fed.R.Serv. 3d 1360 (5th Cir. 1996), it is settled that a class action must meet the requirements of Fed.R.Civ.P. 23 when certified for settlement purposes. Amchem Products, Inc., v. Windsor, 521 U.S. 591, 614 (1997).
When determining a class under Rule 23(a), the Court may not consider the merits of Plaintiffs’ claims and must take all factual allegations in the complaint as true. Eisen v. Carlisle & Jacquelin, 417 U.S. 156, 177 (1974); Gomez v. Ill. State Bd. of Educ., 117 F.R.D. 394, 398 (N.D. Ill. 1987). Additionally, civil rights cases alleging discriminatory policies or practices are “by definition” class actions, provided they meet the other requirements of Rule 23(a). Gen. Tel. Co. v. Falcon, 457 U.S. 147, 157 (1982); see also Amchem, 521 U.S. at 614; Robert E. v. Lane, 530 F. Supp. 930, 944 (N.D. Ill. 1980) (a case alleging civil rights violations in an institutional 7 The terms “Current Record”, “Developmental Disabilities”, “ICFs-DD”, are defined in the Decree at pages 3-7.
7

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setting represents a “prototypical candidate” for class certification). In particular, class certification is routinely allowed in civil rights cases alleging states’ violations of the community integration mandates of the Americans with Disabilities Act. See Colbert v. Blagojevich, 2008 WL 4442597, *10 (N.D. Ill. Sept. 29, 2008) (J. Lefkow) (certifying class consisting of “all Medicaid-eligible adults with disabilities in Cook County, Illinois, who are being, or may in the future be, unnecessarily confined to nursing facilities and who, with appropriate supports and services, may be able to live in a community setting”); Williams v. Blagojevich, 2006 WL 3332844, *5 (N.D. Ill. Nov. 13, 2006) (J. Hart) (certifying class consisting of Illinois residents who “(a) have a mental illness; (b) are institutionalized in a privately owned Institution for Mental Diseases; and (c) with appropriate supports and services may be able to live in an integrated community setting”).8
Under Rule 23(a), courts may certify a class when 1) its members are so numerous that joinder of all claims is impracticable, 2) there are questions of law or fact common to the class, 3) the claims of the representative parties are typical of the class claims, and 4) the representative parties and their counsel will fairly and adequately protect the interests of the class. Fed. R. Civ. P. 23(a); Alliance to End Repression v. Rochford, 565 F.2d 975, 977 (7th Cir. 1977); Fields v. Maram, No. 04-C-0174, 2004 U.S. Dist. LEXIS 16291 at *8-*9 (N.D. Ill. Aug. 16, 2004). Additionally, courts have recognized two implied requirements under Rule 23(a): the class must be readily identifiable and the named plaintiffs must be part of the class. Alliance to End Repression, 565 F.2d at 977-78; Gomez, 117 F.R.D. at 397-98. As shown below, the proposed class here easily meets all of these requirements.
8 Most recently, Judge Hart granted preliminary approval of the proposed Consent Decree in that action which was largely modeled on the Decree that Plaintiffs and Defendants seek approval of here. See Williams v. Quinn, 2010 WL 3894359 (N.D. Ill. Sept. 29, 2010).
8

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1. Joinder Would Be Impracticable Although commonly referred to as the “numerosity” requirement, “the crux of the numerosity requirement is not the number of interested persons per se, but the practicality of their joinder into a single suit.” Arenson v. Whitehall Convalescent & Nursing Home, 164 F.R.D. 659, 663 (N.D. Ill. 1996) (quoting Small v. Sullivan, 820 F. Supp. 1098, 1109 (S.D. Ill. 1992)). While the number of class members is an important factor, others include “judicial economy, geographic diversity of class members, and the ability of individual class members to institute individual lawsuits ….” Id.; see also Riordan v. Smith Barney, 113 F.R.D. 60, 61 (N.D. Ill. 1986) (“[T]he test for impracticability of joinder is not simply a test for the number of class members”). Under these guidelines, this Court has certified classes with as few as 29 members. Riordan, 113 F.R.D. at 61; see also Swanson v. Am. Consumer Indus., 415 F.2d 1326, 1333 (7th Cir. 1969) (40 members sufficient). In this case, there is no question joinder is impracticable. Defendants have previously acknowledged that just through their Prioritization of Urgency of Need for Services (PUNS) database, at least 300 current ICF-DD residents and more than 4,000 individuals with developmental disabilities who live at home had requested placement in Community-Based Settings or Community-Based Services. See Second Am. Compl. ¶89. Based on these numbers alone, joinder is impracticable. See Long v. Thornton Township High Sch., 82 F.R.D. 186, 189 (N.D. Ill. 1979) (plaintiff not required to specify exact size of class as long as good-faith estimate is provided); Fields, 2004 U.S. Dist. LEXIS 16291 at *13 (“[I]t is appropriate for the Court to make such common sense assumptions in determining whether the numerosity requirement is met”); Wyatt v. Poundstone, 169 F.R.D. 155, 164 (M.D. Ala. 1995) (in case on behalf of
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institutionalized persons with mental retardation, numerosity was met because “[t]here are approximately 1,000 mentally retarded individuals in the defendants’ institutions …”).
Other circumstances also point to impracticability of joinder. As Medicaid recipients, class members are located throughout the state and do not have the financial means to bring individual lawsuits. Fields, 2004 U.S. Dist. LEXIS 16291 at *18 (“Because the class members reside throughout the state, and because they are disabled and therefore are often of limited financial resources, joinder would be particularly difficult in this case.”); Arenson, 164 F.R.D. at 663 (“Class members who are residents of a nursing home may also lack the ability to pursue their claims individually.”). Finally, judicial economy plainly would be served by consolidating the actions of all similarly-situated persons rather than having them litigate individually. Arenson, 164 F.R.D. at 663.
2. There Are Questions of Law and Fact Common to the Class Rule 23(a) requires that there “need be only a single issue common to all members of the class.” Edmondson v. Simon, 86 F.R.D. 375, 380 (N.D. Ill. 1980); Hispanics United v. Vill. of Addison, 160 F.R.D. 681, 688 (N.D. Ill. 1995). “A common nucleus of operative fact is usually enough to satisfy the commonality requirement of Rule 23(a)(2).” Rosario v. Livaditis, 963 F.2d 1013, 1018 (7th Cir. 1992). See also Lightbourn v. County of El Paso, 118 F.3d 421, 425 (5th Cir. 1997) (“The commonality test is met when there is at least one issue, the resolution of which will affect all or a significant number of the putative class members.”) (citations omitted); Baby Neal v. Casey, 43 F.3d 48, 55 (3d Cir. 1994) (commonality met where “named plaintiffs share at least one question of fact or law with the grievances of the prospective class”); Marisol A. v. Guiliani, 126 F.3d 372, 375 (2d Cir. 1997) (class must “share a common question of law or fact”).
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Even when the effect on each class member differs, an allegation that the defendant’s discriminatory policy or practice affects the class as a whole will suffice to prove commonality of claims. Rosario, 963 F.2d at 1017 (“The fact that there is some factual variation among class grievances will not defeat a class action.”) (citing Patterson v. Gen. Motors Corp., 631 F.2d 476, 481 (7th Cir.), cert. denied, 451 U.S. 914 (1980)). Thus, even if each class member’s remedy differs, there is commonality if the injury flows from the same discriminatory acts or omissions. See Marisol A., 126 F.3d at 376 (in class action involving foster children, “[t]he unique circumstances of each child do not compromise the common question of whether, as plaintiffs allege, defendants have failed to meet their federal and state law obligations”).
In this action, Plaintiffs have challenged the systematic failure of Defendants to provide them with services in integrated community settings after they specifically requested such services. This is a “common nucleus of operative fact” that affects all members of the class. Indeed, unlike the previously certified class, this class consists solely of those individuals who have specifically requested Community-Based Services or placement in a Community-Based Setting. Additionally, the class members share overriding questions of law: whether Defendants’ conduct violates the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v. Class actions routinely are certified in civil rights cases presenting common questions of this nature. See Wyatt, 169 F.R.D. at 164-65 (commonality and typicality existed where “[t]he named plaintiffs share multiple interests and claims identical to the class members’ claims”). As this Court has recognized, “[w]here ‘broad discriminatory policies and practices constitute the gravamen of a class suit, common questions of law or fact are necessarily
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presumed.’” Hispanics United, 160 F.R.D. at 688 (quoting Midwest Cmty. Council v. Chicago Park Dist., 87 F.R.D. 457, 460 (N.D. Ill. 1980)).
Courts have found commonality exists in classes of adults with developmental disabilities. In M.A.C., et al. v. Betit, the court certified a class similar to the class proposed here, where the class consisted of individuals who had affirmatively requested community services. M.A.C., et al. v. Betit,284 F. Supp. 2d 1298 (D. Utah 2003). The court, finding that commonality existed, noted that the facts shared by each class member, all of whom were adults with developmental disabilities, were nearly identical in that each proposed class member “is being denied a meaningful choice between the receipt of HCBS waiver services and institutionalization in violation of the Medicaid Act; and each is threatened with unnecessary institutionalization in violation of the ADA and § 504.” Id. Similarly, in Rancourt v. Concannon, 207 F.R.D. 14 (D. Me. 2002)), the court found commonality existed in a class comprised of developmentally disabled individuals who were eligible for, but were not receiving community-based services, stating “[w]hile there is variation in the specifics of their individual medical circumstances, Plaintiffs do not allege that they have suffered isolated difficulties, but rather, that they face systemic barriers to receiving services” and that therefore “this common fact pattern gives rise to common legal issues, alleging violations of the Medicaid Act and its implementing regulations. Id. at 16; see also Boulet v. Celluci, 107 F. Supp.2d 61, 81 (D. Mass. 2000) (limiting class only to include adults with developmental disabilities who are eligible for and requested community services and finding that “the claims of the plaintiffs and the proposed class as amended share a common legal theory that adults eligible for waiver services are not being provided such services with reasonable promptness and, therefore, satisfy the commonality and typicality requirements of Rule 23(a)”). Thus, this Court should find that commonality exists here.
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3. The Named Plaintiffs’ Claims Are Typical of Those of the Class. The “typicality” requirement is met when the named Plaintiffs’ claims “arise[] from the same event or practice or course of conduct that gives rise to the claims of other class members and … are based on the same legal theory.” De La Fuente v. Stokely-Van Camp, 713 F.2d 225, 232 (7th Cir. 1983). This question is “closely related to the preceding question of commonality.” Rosario, 963 F.2d at 1018; see also Falcon, 457 U.S. at 157 n.13 (“the commonality and typicality requirements of Rule 23(a) tend to merge…”). As with commonality, typicality does not require that all class members suffer the same injury as the named plaintiffs. “Instead, we look to the defendant’s conduct and the plaintiffs’ legal theory to satisfy Rule 23(a)(3).” Id.; see also De La Fuente, 713 F.2d at 232 (typicality satisfied regardless of whether “there are factual distinctions between the claims of the named plaintiffs and those of other class members. Thus, similarity of legal theory may control even in the face of differences of fact.”); M.A.C., et al. v. Betit, 284 F. Supp. 2d at 1303 (finding typicality exists among class of individuals with developmental disabilities who had affirmatively requested community services); City of New York v. Maul, 59 A.D. 3d 187 (N.Y. App. 1st Dept. Feb. 10, 2009). In City of New York v. Maul, defendants argued that a class of children with developmental disabilities lacked commonality because “to determine the appropriateness of a particular facility requires an individualized inquiry into that individual's needs”. Id. at 190. The court rejected this argument finding that “it ignores all of the other alleged harmful results of [defendants’] conduct which do not require specific factual inquiry.” Id. Here, the named Plaintiffs have affirmatively requested and been denied CommunityBased Services or placement in a Community-Based Setting by Defendants. Therefore, their claims are identical to those of the putative class, which consists of other persons with
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developmental disabilities who have also requested and been denied Community-Based Services or placement in a Community-Based Setting from Defendants. Because the named Plaintiffs and the class share the same deprivations of federal rights, typicality is met here.
4. The Named Plaintiffs and their Counsel Will Fairly and Adequately Protect the Interests of the Class
The question of whether the named Plaintiffs will adequately protect the interests of the class is twofold. The first inquiry is the adequacy of the named Plaintiffs’ representation of the interests of the class; the second is the adequacy of the named Plaintiffs’ counsel. Hispanics United, 160 F.R.D. at 689. As shown below, those requirements are met here.
a) The Named Plaintiffs’ Interests are Not Antagonistic to Those of the Class
The ability of the named Plaintiffs to represent the class goes to whether they have “sufficient interest in the outcome to ensure vigorous advocacy”, Rosario, 963 F.2d at 1018, as well as any interests “antagonistic to the interests of the class.” Riordan, 113 F.R.D. at 64. Courts may deny certification based on grounds of antagonism only if that antagonism “goes to the subject matter of the litigation.” Id. Potential conflicts that are remote or speculative will not defeat class certification. Hispanics United, 160 F.R.D. at 689.
In this case, the named Plaintiffs’ interests are entirely coextensive with those of the class. The named Plaintiffs who are currently residing in private ICFs-DD have requested placement in Community-Based Settings just like the rest of the class members residing in ICFsDD who have made similar requests. Similarly, the named Plaintiffs who are currently residing in a Family Home have requested Community-Based Services or placement in a CommunityBased Setting just like the rest of the class members residing at home. They share the same claims as the class members as well as a strong interest in securing the declaratory and injunctive
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relief they seek. This relief will benefit all members of each of the two sub classes. There are no conflicts or antagonism, whether actual or apparent, between the named Plaintiffs and the class.
b) Plaintiffs’ Counsel Are Qualified to Maintain This Action This Court has already determined Plaintiffs’ counsel are qualified. (CM/ECF Doc. No. 86.) Nothing has happened that should lead to a different result here. Plaintiffs’ counsel are personally experienced in disability civil rights and class action litigation and are well qualified to prosecute this action. The fact that counsel have been found adequate to represent classes of plaintiffs in the past constitutes “persuasive evidence” that they will serve as adequate counsel in this case. Gomez, 117 F.R.D. at 401.9
5. The Class Is Readily Identifiable A class under Rule 23(a) must be “readily identifiable.” Specifically, “the description of the class must be sufficiently definite to permit ascertainment of the class members….” Alliance to End Repression, 565 F.2d at 977. A class description is sufficiently definite when its “scope is defined by the activities of the defendants.” Id. at 978.
Here, the proposed definition expressly identifies class members as adults with developmental disabilities who either reside in ICFs-DD or in a Family Home and have affirmatively requested Community-Based Services or placement in a Community-Based Setting. This definition properly relies on objective, readily identifiable criteria. Moreover, the proposed class is significantly more identifiable than the previously certified class because here the individual must have affirmatively requested such services. Whether a person is a class
9 The depth of Class Counsel’ class action experience was previously set forth in detail in Plaintiffs’ and Defendants’ February 1, 2010 Memorandum in Support of Joint Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan (Doc. No. 462), which is adopted and incorporated by reference herein. Their experience and expertise has not been challenged in these proceedings.
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member is dependent upon both an individual’s affirmative request and Defendants’ actions or inactions, and therefore the Court can feasibly determine whether an individual is a class member. See Makin v. Hawaii, 114 F. Supp. 2d 1017, 1020 (D. Haw. 1999) (in case under ADA integration mandate, court certified class of “mentally retarded people living at home who are on a wait list for services …”); Fields, 2004 U.S. Dist. LEXIS 16291 at *40.
6. Plaintiffs Are Members of the Class Finally, the named Plaintiffs must show they are part of the class they seek to represent. Hendrix v. Faulkner, 525 F. Supp. 435, 442 (N.D. Ind. 1980), aff’d in relevant part, Wellman v. Faulkner, 715 F.2d 269 (7th Cir. 1983), cert. denied, 468 U.S. 1217 (1984). Here, each of the named Plaintiffs resides in an ICF-DD or in a Family Home and have affirmatively requested placement in a Community-Based Setting; therefore, they meet the criteria for class membership. B. PLAINTIFFS MEET THE REQUIREMENTS OF RULE 23(b)(2) In addition to meeting the requirements of Rule 23(a), Plaintiffs must meet one of the requirements of Rule 23(b). Plaintiffs move here under Rule 23(b)(2), which allows courts to certify a class if the defendant “has acted or refused to act on grounds generally applicable to the class, thereby making appropriate final injunctive relief or corresponding declaratory relief with respect to the class as a whole.” FED. R. CIV. P. 23(b)(2). Civil rights cases against parties charged with broad-based discrimination are “prime examples” of actions under Rule 23(b)(2). Amchem Prods v. Windsor, 521 U.S. 591, 613 (1997). This case is exemplary of a Rule 23(b)(2) action because Defendants’ policies and practices affect all members of the proposed class as well as the named Plaintiffs, the remediation of which is well-suited for and requires declaratory and injunctive relief. Plaintiffs do not seek monetary damages for themselves or the class. Indeed, it is common for class
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actions to proceed under Rule 23(b)(2) where people with disabilities seek to enforce their rights to community integration and services. See Bzdawka v. Milwaukee County, 238 F.R.D. 469, 476 (E.D. Wis. 2006) (class of elderly disabled persons in claim under ADA integration mandate); Williams v. Blagojevich, 2006 WL 3332844, *5 (N.D. Ill. Nov. 13, 2006) (J. Hart) (certifying class consisting of Illinois residents who “(a) have a mental illness; (b) are institutionalized in a privately owned Institution for Mental Diseases; and (c) with appropriate supports and services may be able to live in an integrated community setting”); M.A.C., 284 F. Supp. 2d at 1301-04 (D. Utah 2003) (certifying class of “all current and future Medicaid-eligible individuals residing in Utah who, because of their developmental disabilities or mental retardation have or will be determined to be eligible for, and are or will be on the waiting list to receive, services under the HCBS waiver by the Division of Services for People with Disabilities”); Fields, 2004 U.S. Dist. LEXIS 16291, at *39-*42; Hawkins v. Comm’r, No. 99-143-JD, 2004 U.S. Dist. LEXIS 807, at *11-*12 (D.N.H. Jan. 23, 2004); Boulet v. Cellucci, 107 F. Supp. 2d 61, 81 (D. Mass. 2001); Benjamin H. v. Ohl, No. 3:99-0338, 1999 U.S. Dist. LEXIS 22454, at *11-*12 (S.D.W.V. Oct. 8, 1999); Makin, 114 F. Supp. at 1020 (class of persons living at home certified in claim under ADA integration mandate); Martin v. Taft, 222 F. Supp. 2d 940, 947 (S.D. Ohio 2002); Rolland v. Cellucci, 52 F. Supp. 2d 231, 233 (D. Mass. 1999); Haldeman v. Pennhurst State Sch. & Hosp., 995 F. Supp. 534, 536 (E.D. Pa. 1998); Wyatt, 169 F.R.D. at 164-68 (certifying class of “all current and future mentally-retarded and mentally-ill residents of any facility, hospital, center, or home, public or private, to which they are assigned or transferred for residence by the Alabama Department of Mental Health and Mental Retardation”).
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THE COURT SHOULD PRELIMINARILY APPROVE THE CONSENT DECREE
A. THE PRINCIPAL TERMS OF THE DECREE PROVIDE FAIR AND REASONABLE RELIEF THAT IS LIMITED TO INDIVIDUALS WHO WANT RELIEF
The Decree fairly, reasonably and adequately affords relief to all class members. The essence of Plaintiffs’ Complaint is that all individuals with developmental disabilities who want Community-Based Services must be afforded opportunities to make meaningful, informed choices regarding where they live, and that Defendants must ensure that supports and services are available, where appropriate, in Community-Based Settings. The relief afforded under the Decree fully addresses and achieves that goal and addresses the concerns of those individuals who previously objected to the terms of the earlier, proposed consent decree. A brief description of the key provisions and features of the Decree follows:
1. Development of Community Capacity The Decree requires Defendants to ensure the availability of services, supports and other resources necessary to meet their obligations under the Decree, and, in particular, to increase the choices and opportunities for people with developmental disabilities who want CommunityBased Services and/or placement in a Community-Based Setting.
2. Relief Affects Private ICF-DD Residents Who Affirmatively Request Community-Based Services or Placement in A Community-Based Setting
The Decree ensures that individuals currently residing in ICFs-DD who affirmatively request placement in a Community-Based Setting will receive such services in the most integrated setting appropriate to their needs. Defendants will then develop a Transition Service Plan (as defined in the Decree) specific to each individual who requests such services. The Transition Service Plan will describe the services required; where and how such services will be
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developed and obtained; and a timetable for promptly completing that transition. The Transition Service Plan will be developed by a Qualified Professional (as defined in the Decree) in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member. For those individuals who have never requested Community-Based Services or who inform Defendants that they no longer wish to receive Community-Based Services, a Transition Service Plan will not be developed. The Transition Service Plan process is for only those who have affirmatively indicated that they want placement in a Community-Based Setting.
Within six years, all persons residing in ICFs-DD who have affirmatively requested placement in Community-Based Settings will transition to such Settings consistent with their Transition Service Plans and consistent with their ongoing desire for such placement. The Decree sets forth interim benchmarks as well, with not less than one-third of such persons transitioning within two and a half years, and not less than two-thirds transitioning within four and a half years of approval of the Decree. Individuals residing in ICF-DDs can request placement in a Community-Based Setting, and therefore join the class, at any time during the six-year implementation period.
3. Relief Afforded to Class Members Who Reside at Home The relief afforded by the Decree is not limited to private ICF-DD residents. Individuals with developmental disabilities who reside in a Family Home also benefit from the Decree. Under the Decree, Defendants must maintain a Statewide database in which all individuals with developmental disabilities who reside in a Family Home and have been identified as expressly having requested either Community-Based Services or placement in a Community-Based Setting
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are enrolled. These individuals will be placed on a waiting list for community services with selection prioritized by the individual’s urgency of need for such services, the length of time that has passed since the individual enrolled, geographical considerations and other factors. As each individual is selected to receive community services, Defendants will develop a Transition Service Plan (as defined in the Decree) specific to each person, and as described above. Within two years following approval of the Decree, Defendants shall provide such services to at least 1,000 individuals on the waiting list who are not in Crisis situations, and in each of the third, fourth, fifth and sixth years following approval of the Decree, defendants shall provide such services to at least 500 additional individuals each year.
The Decree provides that individuals in “Crisis” situations (as defined in the Decree) will receive necessary and appropriate Community-Based Services and/or placement in a Community-Based Setting expeditiously. The Decree places no limit to, or cap upon, the number of individuals in Crisis situations whom Defendants are obligated to serve.
4. Monitoring and Compliance Under the Decree, the Court will appoint an independent and impartial Monitor who is knowledgeable concerning the management and oversight of programs serving individuals with developmental disabilities. The Monitor will be responsible for gauging Defendants’ compliance with the Decree, identifying actual and potential areas of non-compliance with the Decree, and recommending appropriate action by the Court in the event any issues cannot be resolved by discussion and negotiation among the Monitor and the Parties. The Monitor will file annual, publicly available reports with the Court to provide information sufficient for the Court to evaluate Defendants’ compliance or non-compliance with the Decree.
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5. Implementation Plan The Decree requires Defendants (with assistance from the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel) to develop an “Implementation Plan” to accomplish the obligations and objectives set forth in the Decree. The Implementation Plan will set forth specific tasks, timetables, and protocols to ensure that Defendants fulfill the requirements of each provision of the Decree; describe the hiring, training and supervision of the personnel necessary to implement the Decree; describe necessary resource development activities; identify any services or supports required in Transition Service Plans that are not currently available; and identify any services and supports which, based on demographic or other data, are expected to be required to meet defendants’ obligations under the Decree.
6. Attorneys’ Fees and Costs In full settlement of attorneys’ fees incurred in connection with the litigation, Defendants will pay $1,740,000.00 to Class Counsel and $500,000.00 to Intervenors’ Counsel, all of which will be donated to charitable 501(c)(3) organizations that serve individuals with developmental disabilities. Additionally, Defendants will pay costs and expenses incurred by Class Counsel through and including the approval of the Decree and any appeal thereof.
7. Jurisdiction and Termination of Consent Decree Under the Decree, the Court shall retain exclusive jurisdiction to oversee, supervise, modify and enforce the terms of the Decree. The Court shall retain such jurisdiction for at least nine years following the approval of the Decree; after that time period, termination of jurisdiction can be accomplished through a specific procedure set forth in the Decree.
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B. THE PROPOSED CONSENT DECREE MERITS PRELIMINARY APPROVAL
Preliminary approval of a proposed settlement or, as is the case here, a proposed consent decree, is the first in a two-step process required before a class action may be settled. David F. Herr, MANUAL FOR COMPLEX LITIGATION, FOURTH (“MANUAL FOURTH”), § 30.41 (2005). In considering preliminary approval, the court must first determine whether the proposed settlement is within the range of reasonableness that ultimately could be given final approval. See Armstrong v. Board of School Directors of the City of Milwaukee, 616 F.2d 305, 312 (7th Cir. 1980). The court must review the settlement for fairness, adequacy, and reasonableness. Id. (“The courts of appeals have required that district court approval of a settlement pursuant to Rule 23(e) be given only where the district court finds the settlement fair, reasonable and adequate.”). If the court finds that a settlement is “within the range of possible approval,” it then proceeds to the second step in the review process, the fairness hearing. Id.; see also 4 Robert Newberg, NEWBERG ON CLASS ACTIONS § 11:25 at 38 (4th ed. 2002) (“NEWBERG”) (“If the preliminary evaluation of the proposed settlement does not disclose grounds to doubt its fairness or other obvious deficiencies … and appears to fall within the range of possible approval, the court should direct that notice under Rule 23(e) be given to the class members of a formal fairness hearing…”). The purpose of the fairness hearing is to “provide class members an opportunity to present their views on the proposed settlement and to hear arguments and evidence for and against the terms.” MANUAL FOURTH, supra, § 21.633.
The Seventh Circuit has identified six factors for analyzing whether a class action settlement or consent decree should be given final approval. These factors are equally germane in deciding whether to grant preliminary approval:
1. the strength of the plaintiff’s case on the merits balanced against the settlement;
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2. the complexity, length and expense of continued litigation;

3. the amount of opposition to the settlement;

4. the presence of collusion in gaining a settlement;

5. and

the opinion of competent counsel regarding the reasonableness of the settlement;

6. the stage of the proceedings and the amount of discovery completed.

See GE Capital Corp. v. Lease Resolution Corp., 128 F.3d 1074, 1082 (7th Cir. 1997); Donovan v. Estate of Fitzsimmons, 778 F.2d 298, 308 (7th Cir. 1985). Because the object of settlement is to avoid, not confront, the determination of contested issues, the approval process should not be converted into an abbreviated trial on the merits. Van Horn v. Trickey, 840 F.2d 604,607 (8th Cir. 1987) (“the district court need not undertake the type of detailed investigation that trying the case would involve”). Instead, the court’s inquiry should be “limited to the consideration of whether the proposed settlement is lawful, fair, reasonable, and adequate.” Isby v. Bahy, 75 F.3d 1191, 1196 (7th Cir. 1996). As set forth in the following sections, application of these six factors in the context of this litigation merits preliminary approval of the Decree.

1. Strength of the Plaintiffs’ Case on the Merits Balanced Against the Terms of the Consent Decree
The terms of the Decree are fair, reasonable and adequate when balanced against the strength of the Plaintiffs’ case on the merits. Plaintiffs allege that Defendants have failed to comply with the integration mandates required by the ADA, Section 504 and Title XIX, and specifically allege that Illinois does not have “a comprehensive, effectively working plan for placing qualified persons with [ ] disabilities in less restrictive settings” as required by Olmstead, 527 U.S. at 605-06. Plaintiffs have developed the necessary proof to support these claims,

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including the retention of four experts who would testify, among other things, that Illinois does not have a comprehensive, effectively working plan; that Illinois ranks last or near last among the states in the percentage of people with developmental disabilities living in small CommunityBased Settings; that depriving persons with developmental disabilities with meaningful opportunities to live in such settings can cause a diminution in overall quality of life; and that persons who currently reside in ICFs-DD and have made a record wanting placements in Community-Based Settings, are eligible for Community-Based Settings, and that such placements should be made where appropriate.
Despite the strengths of Plaintiffs’ case, Plaintiffs are mindful of the hurdles to establish Defendants’ liability and overcome any affirmative defenses. Plaintiffs also are mindful of the possibility of an adverse ruling on appeal if they prevail at trial. Importantly, however, because the Decree ensures that persons with developmental disabilities are offered the opportunity to make informed, meaningful choices as to whether or not their needs can best be met in Community-Based Settings or ICFs-DD, and ensures the availability of Community-Based options for those who choose them, the Decree fully implements the relief sought in Plaintiffs’ Complaint, which Defendants acknowledge is appropriate for the persons who their agencies are intended to serve. Defendants, without conceding the merits of the Plaintiffs’ allegations, believe that the services and supports required by the Decree are consistent with their goals for the future direction of the developmental disabilities system in Illinois.
2. Complexity, Length and Expense of Continued Litigation If the Decree were not approved, expensive and protracted litigation will ensue. Any trial will be complex, contentious and cumbersome. Such a proceeding would likely involve over thirty witnesses, including four expert witnesses who reside outside Illinois, and numerous State
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employees who reside in Springfield, Illinois. The costs and expenses of preparing these witnesses, and for trial in general, would be enormous.
In addition, both Plaintiffs and Defendants submit that if they were not to prevail at trial, they would likely appeal the matter to the Seventh Circuit Court of Appeals. An appeal would all but guarantee that this litigation would drag on for several more years without resolution or the implementation of any relief for members of the proposed class, many of whom have been waiting years for Community-Based Services. These factors strongly weigh in favor of preliminary and final approval of the Decree.
3. Opposition to the Settlement Plaintiffs and Defendants believe there will be few, if any, objections to the Decree. Importantly, Intervenors are parties to the Decree and the Decree resolves all concerns raised by the Intervenors. In particular, the Decree affords substantial benefits to members of the proposed class, while protecting the rights of individuals who choose to reside in ICFs-DD or who otherwise do not wish to receive Community-Based Services or placement. Further, the Decree obligates Defendants to make available the resources necessary to meet the needs of individuals who choose to reside in ICFs-DD. Those resources will not be affected by Defendants’ fulfillment of their obligations under the Decree.
4. Lack of Collusion As a matter of law, a court should presume that negotiations were conducted in good faith and that the resulting agreement was reached without collusion in the absence of evidence to the contrary. Mars Steel v. Continental Ill. Nat’l Bank & Trust, 834 F.2d 677, 681-81 (7th Cir. 1987); Armstrong, 616 2d at 325; Newberg at § 11.41. Nothing supports a different result here. Plaintiffs, Defendants and Intervenors, with the assistance of Magistrate Judge Cole, have
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participated in numerous meetings and conferences to discuss and negotiate the terms of the Decree. See, e.g., Maley v. Del Global Techs. Corp., 186 F.Supp.2d 358, 366 (S.D.N.Y. 2002) (finding negotiations leading to class action settlement were arm’s length in part because they had occurred over several months and had involved several in-person meetings). Because the Decree resulted from arm’s length negotiations between experienced counsel, and no evidence exists to the contrary, the Decree should be presumed to have been reached without collusion. See, e.g., Wal-Mart Stores, Inc. v. Visa U.S.A., Inc., 396 F.3d 96, 116 (2d Cir. 2005) (“presumption of fairness, adequacy, and reasonableness may attach to a class settlement reached in arm’s-length negotiations between experienced, capable counsel after meaningful discovery”).
5. Opinion of Competent Counsel as to the Reasonableness of the Settlement
The court is “entitled to rely heavily on the opinion of competent counsel.” Armstrong, 616 F.2d at 325. Counsel for Plaintiffs, Defendants and Intervenors, who are competent and experienced in class action and civil rights litigation, all recommend acceptance of the Decree. The Decree provides a fair, reasonable, and adequate disposition of the lawsuit.
6. Stage of the Proceeding and Amount of Discovery Completed Another factor strongly supporting approval of the Decree is the extent of written, oral, fact and expert discovery and fact finding which had been completed in this case before settlement was reached. Plaintiffs and Defendants have thoroughly explored the factual and legal underpinnings, as well as the merits, of this case. They have produced and reviewed hundreds of thousands of pages of documents, conducted over thirty depositions on the merits, and worked extensively with five experts in related fields. Considerable third-party discovery was also conducted. Plaintiffs and Defendants spent considerable time getting the matter ready for the original trial date of October 20, 2008, all of which would have been used in a trial based
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on the allegations in the Second Amended Complaint. Thus, there was a complete factual record upon which experienced Class Counsel could evaluate what would be a fair resolution for Plaintiffs and the Class. THE PROPOSED NOTICE PLAN SATISFIES THE REQUIREMENT OF RULE 23 AND
DUE PROCESS Rule 23(e)(1) requires the court to direct notice of a proposed settlement in a “reasonable manner to all class members who would be bound by the proposal.” Although notice is mandatory to satisfy due process considerations, the extent of the notice is discretionary, particularly with a Rule 23(b)(2) class with no right of opt-out. See Walsh v. Great Atlantic & Pacific Tea Co., 726 F.2d 956, 962 (3d Cir. 1983) (Rule 23(c)(2)’s requirement of “the best notice practicable” is inapplicable for notice of settlement of a Rule 23(b)(2) class); Fontana v. Elrod, 826 F.2d 729, 732 (7th Cir. 1987) (notice not required after certification of a Rule 23(b)(2) class). In a Rule 23(b)(2) class action, “mechanics of the notice process are left to the discretion of the court subject only to the broad ‘reasonableness standards imposed by due process.’” Fowler v. Birmingham News Co., 608 F.2d 1055, 1059 (5th Cir. 1979). In determining what type of notice is reasonable, courts consider whether the notice is sufficient to “bring the proposed settlement to the attention of representative class members who may alert the court to inadequacies in class representation, or conflicts among subclasses, which might bear upon fairness of settlement.” Walsh, 726 F.2d at 963-64 (upholding notice by publication and mail to representative members in Rule 23(b)(2) class). Courts have routinely approved notice plans in Rule 23(b)(2) cases, such as this one, where notice consisted of publication and/or other reasonable forms of direct or indirect notice. Fresco v. Auto Data Direct, Inc., 2007 WL 2330895, at *8 (S.D. Fla. May 14, 2007) (approving a notice plan that included a combination of publication and Internet notice but did not require individual notice);
27

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 36 of 39 PageID #:10829
Hawker v. Consovoy, 198 F.R.D. 619, 621 (D.N.J. 2001) (publication notice in two newspapers as well as in all relevant prisons and jails was sufficient). For example, in Kaplan v. Chertoff, 2008 WL 200108, *13 (E.D. Pa. Jan. 24, 2008), the court approved a notice plan where a Rule 23(b)(2) class of approximately 50,000 non-US citizens seeking injunctive relief from the government settled the case, and the proposed notice included posting the notice on the appropriate governmental websites, and providing notice to a network of community-based and non-profit immigration organizations. Id. at *13. Of particular relevance here is the court’s finding that “the organizations that receive[d] the notice are well-positioned to spread information regarding the settlement to their clients by posting the notice in their facilities or on their websites.” Id.
The Notice Plan (Exhibit B) proposed here provides for the most reasonable notice under the circumstances. The Notice Plan includes: (1) publication notice in nine newspapers throughout Illinois with a collective circulation of over one million readers; (2) posting notice on the websites of the Illinois Department of Human Services, Division of Developmental Disabilities and Equip for Equality, the not-for-profit corporation appointed by the State of Illinois to implement the federally-mandated Protection and Advocacy System in Illinois for persons with, among other things, developmental disabilities; (3) mailed notice to all eighteen preadmission screening (“PAS”) agencies throughout Illinois, which are responsible, by contract with the State of Illinois, for determining an individual’s eligibility for developmental disabilities services; (4) mailed notice to numerous disability rights-related organizations; (5) mailed notice to all adults with developmental disabilities (and their guardians) for whom Defendants have a Current Record containing an affirmative request for Community-Based Services or placement in a Community-Based Setting; and (6) mailed notice to all 240 private ICFs-DD in Illinois with
28

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 37 of 39 PageID #:10830
nine beds or more. The cost of the Notice Plan will be fully borne by Defendants. The Notice Plan is reasonable and clearly satisfies due process.
In conjunction with the proposed Notice Plan, the undersigned request that the Court approve the form and content of the proposed Notices. (See Exhibit B.) The Notices are written in simple terminology and include (i) a description of the class; (ii) a description of the Decree; (iii) an explanation of the rights of Class Members; (iv) the names of class counsel; (v) the fairness hearing date; (vi) a statement regarding attorneys’ fees and expenses; (vii) a statement of the deadline for filing objections to the Decree; and (viii) instructions for obtaining further information. Those Notices satisfy the content requirements of Rule 23 of the Federal Rules of Civil Procedure. See MANUAL FOURTH, supra § 21.633.
CONCLUSION
For the foregoing reasons, and pursuant to Rule 23, Plaintiffs and Defendants respectfully request that the Court enter an Order (1) certifying the settlement class as described; (2) granting preliminary approval of the Decree; (3) commanding notice in the form and method of the Parties’ proposed Notice Plan; and (4) setting a date for a Fairness Hearing on the Decree.

Dated: January 11, 2011
For Plaintiffs
By: /s/ Wendy N. Enerson
John Grossbart Wendy N. Enerson Corey Shapiro SNR Denton US LLP 233 S. Wacker Dr., Suite 7800

Respectfully submitted,
For Defendants By: /s/ (with consent of) Brent D. Stratton_ Brent D. Stratton Thomas A. Ioppolo Kathleen Kreisel Flahaven Office of the Illinois Attorney General 100 W. Randolph Street, 12th Floor
29

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 38 of 39 PageID #:10831

Chicago, Illinois 60606
Barry C. Taylor Laura J. Miller John W. Whitcomb Barry G. Lowy Kendra K. Hartman Equip for Equality 20 North Michigan Avenue, Suite 300 Chicago, Illinois 60602

Chicago, Illinois 60601
Karen Konieczny John E. Huston Christopher S. Gange Office of the Illinois Attorney General 160 North LaSalle Street, Suite N-1000 Chicago, Illinois 60601

Ed Mullen Access Living of Metropolitan Chicago 115 West Chicago Avenue Chicago, IL 60610
Benjamin S. Wolf Roger Baldwin Foundation of ACLU, Inc. 180 North Michigan Avenue, Suite 2300 Chicago, Illinois 60601

30

Case: 1:05-cv-04331 Document #: 522-1 Filed: 01/11/11 Page 39 of 39 PageID #:10832 CERTIFICATE OF SERVICE
The undersigned, an attorney for the Plaintiffs, certifies that on January 11, 2011, he electronically filed the foregoing document with the Clerk of the Court using the CM/ECF system which will send notification of such filing to the counsel of record.
/s/ Wendy N. Enerson
31

 
 Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 1 of 11 PageID #:10915

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, by his sister and next friend, Gina )

Foster; DAVID CICARELLI, by his guardians James and )

Julianne Cicarelli; ISAIAH FAIR, by his guardian,

)

Lutricia Fair; JAMIE McELROY, by his guardian,

)

Patricia McElroy; and JENNIFER WILSON, by her

)

guardians, Nancy and Richard Wilson, on behalf of

)

themselves and all others similarly situated,

)

)

)

Plaintiffs,

)

)

vs.

)

)

JULIE HAMOS, in her official capacity as Director of )

the Illinois Department of Healthcare and Family

)

Services, and MICHELLE R.B. SADDLER, in her

)

official capacity as Secretary of the Illinois Department )

of Human Services,

)

)

Defendants.

)

No. 05-4331 Chief Judge Holderman

NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING
PLEASE READ THIS NOTICE CAREFULLY AND IN ITS ENTIRETY
A SETTLEMENT HAS BEEN PROPOSED THAT MAY AFFECT THE RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES WHO HAVE REQUESTED COMMUNITY-BASED SERVICES OR PLACEMENT IN A COMMUNITY-BASED SETTING.

BASIC INFORMATION
1. WHY DID YOU GET THIS NOTICE?
You were sent this Notice to inform you about the proposed settlement of the class action lawsuit, as set forth in the Consent Decree (“Consent Decree”) proposed in this case, which may affect the rights of individuals with developmental disabilities who have requested communitybased services or placement in a community-based setting. This Notice was sent to you and other people (and/or their parents, guardians or legal representatives) in Illinois who have been identified as being eighteen (18) years of age or older with a developmental disability and who have previously requested community services or residential placement, as well as individuals and entities who care for and work with them.

Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 2 of 11 PageID #:10916
This Notice explains the lawsuit and the key terms of the Consent Decree, tells you how to obtain more information, explains how to determine whether an individual with a developmental disability is a Class Member in the lawsuit, and explains how Class Members (and/or their legal representatives) can tell the Court whether they disagree with the Consent Decree or some part of it.
The Consent Decree described in this Notice is subject to Court approval, and thus has not yet been made final. The Court has scheduled a hearing to determine the fairness, adequacy and reasonableness of the Consent Decree and to consider any objections Class Members may have to the Decree.
The Consent Decree may affect the rights of individuals with developmental disabilities who have affirmatively requested community-based services or placement in a community-based setting and: (1) reside in a private Intermediate Care Facility for individuals with Developmental Disabilities (“ICF-DD”) with nine or more residents; or (2) live in a family home and are in need of community-based services or placement in a community-based setting. As defined in the Decree, an ICF-DD is a residential facility where nine or more adults with developmental disabilities live together. If you currently live in an ICF-DD and want to stay there, or you want to live in an ICF-DD, then you are not a Class Member and you do not need to do anything.
2. WHAT IS THIS LAWSUIT ABOUT?
The Court in charge of the lawsuit is the United States District Court for the Northern District of Illinois, and the case is known as Ligas v. Hamos, Case No. 05-4331. The people who sued are called the Plaintiffs, and the people they sued are called the Defendants.
Plaintiffs filed this lawsuit on July 28, 2005, on behalf of themselves and a class of similarly situated Illinois residents, seeking to prevent what they allege is their unnecessary segregation in ICFs-DD by Defendants. The named Plaintiffs are five adults with developmental disabilities who have requested and been denied placements in community-based settings. The named Defendants are Julie Hamos, who is the Director of the Illinois Department of Healthcare and Family Services, and Michelle R.B. Saddler, who is the Secretary of the Illinois Department of Human Services. The Defendants are responsible for administering the State of Illinois’ programs for people with developmental disabilities. The lawsuit seeks to compel the State of Illinois (through the Defendants) to comply with federal law and rulings of the United States Supreme Court, and to bring Illinois in line with prevailing national practices, by offering individuals with developmental disabilities the opportunity to make meaningful, informed choices about whether to live in community-based settings, in addition to the ICF-DD choice.
3. WHAT IS A CONSENT DECREE AND WHY IS IT BEING PROPOSED HERE?
A Consent Decree is a final order of the court in a case that is agreed to by all Plaintiffs and Defendants. The Court in this case did not decide in favor of either Plaintiffs or Defendants. There was not a trial. Instead, all of the Plaintiffs and Defendants agreed to settle the case according to certain terms that are stated in the Consent Decree. In addition to all of the Plaintiffs and Defendants, the Consent Decree was entered into on behalf of certain Illinois residents with developmental disabilities who have intervened in this case to ensure that the State of Illinois continues to meet its obligations to provide ICF-DD services. These individuals
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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 3 of 11 PageID #:10917

are referred to as Intervenors. The Plaintiffs, Defendants and Intervenors have jointly asked the Court to enter the Consent Decree as an official order of the Court. That way, the cost of a trial is avoided, and the people affected will get relief. The Plaintiffs who filed the lawsuit and their attorneys think the Consent Decree is best for the people who are Class Members.

4.

WHO IS A CLASS MEMBER?

The Court has certified the lawsuit as a class action and decided that everyone who fits this description is a Class Member: Adults in Illinois who have a Developmental Disability (as defined below) and who qualify for Medicaid Waiver services and who either: (i) reside in private ICFs-DD with nine or more residents or (ii) live in a family home and are in need of community-based services or placement in a community-based setting; and for whom Defendants have a current record reflecting that the individual has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting (both defined below). If you currently live in an ICF-DD and want to stay there, or you want to live in an ICFDD, then you are not a Class Member and you do not need to do anything.

5. WHAT IS CONSIDERED A “DEVELOPMENTAL DISABILITY”?

In the Consent Decree, “Developmental Disability” means: a disability that is attributable to a diagnosis of mental retardation (mild, moderate, severe, profound), or a related condition. A related condition is attributable to: cerebral palsy or epilepsy, or any other condition, other than mental illness, found to be closely related to mental retardation because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons with mental retardation, and requires treatment or services similar to those required for persons with mental retardation. In addition, this condition is manifested before the age of 22; is likely to continue indefinitely; and results in substantial functional limitations in three or more of the following areas of major life activity: self-care; understanding and use of language; learning; mobility; self-direction; capacity for independent living.

6. WHAT IF YOU WANT TO RECEIVE COMMUNITY-BASED SERVICES OR PLACEMENT IN A COMMUNITY-BASED SETTING BUT HAVE NOT MADE SUCH A REQUEST?
If you otherwise meet the definition of a Class Member, but have not made a request to receive Community-Based Services or placement in a Community-Based Setting, or are not sure if you made such a request, you may request those services at any time. For your convenience, attached as Exhibit 1 to this Notice is a form letter that you may send to Brent D. Stratton at the Office of the Illinois Attorney General indicating your request for such services. If you sent Mr. Stratton a request, like the one attached as Exhibit 1, you do not need to send him another request. If you choose not to request such services now, you will not be precluded from requesting and receiving such services at a later time. Additionally, if you currently reside in an ICF-DD, requesting such services will not require you to give up any rights to remain in an ICFDD.

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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 4 of 11 PageID #:10918
7. WHAT IF YOU DON’T WANT TO RECEIVE COMMUNITY-BASED SERVICES OR PLACEMENT IN A COMMUNITY-BASED SETTING?
If you have not requested to receive Community-Based Services or placement in a Community-Based Setting, and do not to wish to receive such services, you need not do anything because you are not a Class Member. If you currently live in an ICF-DD and want to stay there, or if you want to live in an ICF-DD, then you are not a Class Member and you do not need to do anything. If you previously requested to receive Community-Based Services or placement in a Community-Based Setting, or are not sure if you made such a request, but you no longer wish to receive such services, you may let Defendants know of your choice now or at any time. For your convenience, attached as Exhibit 2 to this Notice is a form letter that you may, at your option, send to Brent D. Stratton at the Office of the Illinois Attorney General indicating that you no longer wish to receive such services, at which point you will no longer be a Class Member. Whether you choose to use the letter or not, you may always later change your choice should you decide later that you do not wish to receive such services. Also, if you objected (either personally, or through your legal guardian) to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing in this Litigation because you do not wish to receive Community-Based Services or placement in a Community-Based Setting, you shall be considered to have retracted any request for services that you have made in the past and you do not need to send a letter to Mr. Stratton.
THE SETTLEMENT
8. WHAT DOES THE CONSENT DECREE IN THIS CASE PROVIDE?
The Consent Decree in this case that the Plaintiffs and Defendants have asked the Court to enter, if approved by the Court, would provide certain rights and benefits (as more fully described in the Consent Decree) to eligible Class Members as defined above, as well as provide certain protections to Intervenors. If the Consent Decree is not approved, it will be withdrawn and the lawsuit will continue. A copy of the entire Consent Decree is available on the website of the Illinois Department of Human Services, Division of Developmental Disabilities: www.dhs.state.il.us/page.aspx, and on the website of Equip for Equality: www.equipforequality.org.
All Plaintiffs and Defendants in this case believe that the Consent Decree is fair, reasonable and adequately affords relief to all eligible Class Members. The Consent Decree establishes procedures to allow individuals with developmental disabilities to choose Community-Based Services or placements in Community-Based Settings, while still maintaining the choice of private ICFs-DD; and requires Defendants to make those services or placements available to those eligible individuals who have requested them.
The following is a brief summary of key terms in the Consent Decree.
 Development of Community Capacity. The Consent Decree requires Defendants to ensure the availability of services, supports and other resources to meet their obligations under the Decree and in particular to provide community residential settings and community-based services.
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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 5 of 11 PageID #:10919
 Benefits for Class Members Currently Residing in ICFs-DD. The Consent Decree ensures that for individuals currently residing in ICFs-DD who indicate that they desire to move to a Community-Based Setting and otherwise qualify for Medicaid Waiver services, Defendants will develop a transition service plan specific to each person. The transition service plan will describe the services required, where and how such services will be developed and obtained, and a timetable for promptly completing that transition. The transition service plan will be developed by a qualified professional in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member.
Within six years, all persons residing in ICFs-DD who request placement in Community-Based Settings will transition to such settings. The Consent Decree sets forth interim benchmarks as well, with not less than one-third of such persons transitioning within two and a half years, and not less than two-thirds transitioning within four and a half years of approval of the Consent Decree.
The Consent Decree does not require or force anyone to receive a transition service plan or to move out of an ICF-DD unless he or she affirmatively indicates that he or she wants placement in a Community-Based Setting.
 Benefits for Eligible Class Members Who Reside In A Family Home. Eligible individuals with developmental disabilities who reside in a family home (as defined in the Consent Decree) and have requested either Community-Based Services or placement in a Community-Based Setting also benefit from the Consent Decree. Under the Consent Decree, Defendants must maintain a Statewide database in which all individuals with developmental disabilities who reside in a family home and have been identified as requesting either Community-Based Services or placement in a Community-Based Setting are enrolled. These individuals will be placed on a waiting list for community services with selection prioritized by the individual’s urgency of need for such services, the length of time that has passed since the individual enrolled, geographical considerations and other factors. As each individual is selected to receive community services, Defendants will develop a transition service plan specific to each person. The service plan will describe the services required, where and how such services will be developed and obtained, and a timetable for promptly completing that transition. The transition service plan will be developed by a qualified professional in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member.
The Consent Decree provides that individuals in Crisis who affirmatively request Community-Based Services and/or placement in a Community-Based Setting will receive such necessary and appropriate services or placement expeditiously. There is no limit to, or cap upon, the number of Crisis situations that Defendants are obligated to handle.
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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 6 of 11 PageID #:10920
Within two years, Defendants shall provide Community-Based Services and/or placement in a Community-Based Setting, in accordance with their transition plan, to at least 1,000 individuals on the waiting list who are not in Crisis situations, with these individuals served in order of priority. In each of the third, fourth, fifth, and sixth years following approval of the Consent Decree, Defendants shall provide such services to at least 500 additional individuals on the waiting list, again in order of priority.
Before any individual is placed in a Community-Based Setting, Defendants will ensure that he or she is provided with objective information regarding residential options, and that he or she continues to request placement in a Community-Based Setting.
 Implementation Plan. The Consent Decree requires Defendants to develop an Implementation Plan to establish specific tasks, timetables, and protocols to ensure that Defendants fulfill the requirements of each provision of the Consent Decree.
 Monitoring and Compliance. Under the Consent Decree, the Court will appoint an independent and impartial Monitor who is knowledgeable concerning the management and oversight of programs serving individuals with developmental disabilities. The Monitor will be responsible for assisting the Court in evaluating Defendants’ compliance or non-compliance with the Consent Decree.
 Attorneys’ Fees and Costs. Under the Consent Decree, Defendants will pay $1,740,000.00 to Class Counsel and $500,000.00 to Intervenors’ Counsel in full settlement of attorneys’ fees incurred in connection with the lawsuit, all of which will be donated to charitable 501(c)(3) organizations that serve individuals with developmental disabilities. Additionally, Defendants will pay all costs and expenses incurred by Class Counsel through and including the approval of the Consent Decree and any appeal thereof. Class Members do not have to pay anything to Class Counsel.
 Termination. Under the Consent Decree, the Court shall retain exclusive jurisdiction to fully oversee, supervise, modify and enforce the terms of the Consent Decree for at least nine years following the approval of the Consent Decree.
9. WHAT IS CONSIDERED A “COMMUNITY-BASED SETTING” AND WHAT ARE CONSIDERED “COMMUNITY-BASED SERVICES”?
In the Consent Decree, “Community-Based Setting” means a residential setting with a maximum of eight (8) beds, but does not include an ICF-DD, that is the most integrated residential setting appropriate for an individual with developmental disabilities, where the setting is designed to promote independence in daily living, community integration, and economic selfsufficiency and enables the individual to interact with non-disabled persons to the fullest extent possible.
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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 7 of 11 PageID #:10921
In the Consent Decree, “Community-Based Services” means those services (other than a placement in a Community-Based Setting) available under the Illinois Home and CommunityBased Services Waiver for Adults with Developmental Disabilities.
10. WILL CLASS MEMBERS RECEIVE MONEY FROM THE CONSENT DECREE?
No. The lawsuit did not seek money damages on behalf of any Class Members, and there is no money awarded to any Class Members as part of the Consent Decree.
CLASS MEMBERS’ RIGHTS
Class Members (and/or their parents, guardians or legal representatives) can tell the Court whether they disagree with the Consent Decree or some part of it.
11. HOW DO YOU TELL THE COURT THAT YOU OBJECT TO THE CONSENT DECREE?
All Class Members have the right to object to the Consent Decree and to give reasons why they believe the Court should not approve it. The Court will consider those views. Any objection must include the name and number of the case (Ligas v. Hamos, Case No. 05-4331), as well as a statement of the reasons (in no more than 15 pages) why the Court should not approve the Consent Decree. Be sure to include your name, address, telephone number, and your signature. Please note that it is not sufficient to simply state that you object. Objections must state reasons why the Decree should not be approved.
All objections must be sent by U.S. Mail and postmarked no later than May 13, 2011, to John Grossbart, SNR Denton US LLP, 233 S. Wacker Dr., Suite 7800, Chicago, Illinois 60606. Attorney John Grossbart, the lead counsel, will inform the Court and other counsel for the Plaintiffs and Defendants of the objections that he receives and that Class Members want presented to the Court.
THE COURT’S FAIRNESS HEARING
The Court will hold a Fairness Hearing to decide whether to approve the Consent Decree.
12. WHEN AND WHERE WILL THE COURT DECIDE WHETHER TO APPROVE THE CONSENT DECREE?
The Fairness Hearing will be held before the Honorable James F. Holderman, United States District Judge, in the Dirksen Federal Building, 219 S. Dearborn Street, Room 2541, Chicago, Illinois 60604 on June 10, 2011 at 9:30 a.m. At this hearing, the Court will consider whether the Consent Decree is fair, reasonable and adequate to the Class. The Court will consider any objections made according to the procedures described above.
13. DO YOU HAVE TO COME TO THE HEARING?
All Class Members are entitled to attend the Fairness Hearing if they choose to do so, but no one is required to attend the Fairness Hearing. Plaintiffs’ and Defendants’ lawyers will answer questions Chief Judge Holderman may have. If you mail an objection in accordance with
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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 8 of 11 PageID #:10922
the procedures described in Section 11, above, of this Notice, you do not have to come to Court to talk about it. As long as you mailed your written objection in accordance with the procedures described in Section 11, above, of this Notice, the Court will consider it. 14. WHO CAN SPEAK AT THE HEARING?
You may ask the Court for permission to speak at the Fairness Hearing. The Judge will decide whether you are permitted to do so. To request permission, you must send a “Notice of Intention to Appear in Ligas v. Hamos, Case No. 05-4331” to the Court and the parties. Be sure to include your name, address, telephone number, and your signature.
You must send your Notice of Intention to Appear to the Clerk of the Court, Dirksen Federal Building, 219 South Dearborn Street, Chicago, Illinois 60604. The Notice must be received by the Clerk of the Court no later than May 13, 2011. (If you file an objection and also want to ask for permission to speak at the Fairness Hearing, you can include the Notice of Intention to Appear in the same document as the objection.)
Your Notice of Intention to Appear must be mailed to the parties by sending a copy of the objection, postmarked no later than May 13, 2011, to John Grossbart, SNR Denton US LLP, 233 S. Wacker Dr., Suite 7800, Chicago, Illinois 60606.
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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 9 of 11 PageID #:10923

LAWYERS REPRESENTING THE CLASS

15. WHO ARE THE CLASS MEMBERS’ LAWYERS IN THE CASE?

The Court ordered that the following attorneys represent the Class Members. These lawyers are called “Class Counsel.”

John Grossbart Wendy N. Enerson Corey M. Shapiro SNR Denton US LLP 233 S. Wacker Drive, Suite 7800 Chicago, Illinois 60606 Telephone: 312-876-8000

Barry C. Taylor Kendra K. Hartman Laura J. Miller John W. Whitcomb Barry G. Lowy Equip for Equality 20 North Michigan Avenue, Suite 300 Chicago, Illinois 60602 Telephone: 312-341-0022

Ed Mullen Access Living of Metropolitan Chicago 115 West Chicago Avenue Chicago, IL 60610 Telephone: 312-640-2100

Benjamin S. Wolf Roger Baldwin Foundation of ACLU, Inc. 180 North Michigan Avenue, Suite 2300 Chicago, Illinois 60601 Telephone: 312-201-9740

Class Members will not be charged for these lawyers’ fees or expenses.

GETTING MORE INFORMATION

16. HOW DO YOU GET MORE INFORMATION ABOUT THE CONSENT DECREE?

A copy of the entire Consent Decree is available on the website of the Illinois Department of Human Services, Division of Developmental Disabilities: www.dhs.state.il.us/page.aspx, and on the website of Equip for Equality: www.equipforequality.org.

If you have any questions for Plaintiffs’ lawyers or want to request that a copy of the Consent Decree be mailed to you, you may write to Barry Taylor at Equip for Equality, 20 North Michigan Avenue, Suite 300, Chicago, Illinois 60602, call Barry Taylor at 312-895-7317, or email Barry Taylor at barryt@equipforequality.org.

DATED: January 13, 2011

__________________________________ The Honorable James F. Holderman United States District Court Judge

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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 10 of 11 PageID #:10924

REQUEST FOR COMMUNITY-BASED SERVICES OR PLACEMENT IN A COMMUNITY-BASED SETTING
To: Illinois Department of Human Services Division of Developmental Disabilities c/o Mr. Brent D. Stratton Office of Illinois Attorney General 100 W. Randolph St., 12th Floor Chicago, IL 60601
This request is on behalf of _________________________________________, an adult with a
developmental disability, who currently lives:
_____ at home OR at __________________________________________________________ (an Intermediate Care Facility for the Developmentally Disabled).

This is a request for Community-Based Services or placement in a Community-Based Setting under the Illinois Home and Community-Based Services Waiver for Adults with Developmental Disabilities.

I understand that, by completing this form, I am NOT getting myself/my family member on a waiting list for services or placement.

I understand that, in order to be placed on a waiting list, I need to enroll myself/my family member on PUNS.

I understand that I can get more information about PUNS by calling 1-888-DD-PLANS (or 1866-376-8446 (TTY)) or by going to http://www.dd.illinois.gov/SignUp.cfm.

I understand that this request is NOT a request for a determination of eligibility for services or placement. Eligibility determinations are completed upon selection from PUNS.

Signature:

________________________________________________

Printed Name:

________________________________________________

Address:

________________________________________________

________________________________________________

Phone:

________________________________________________

Date:

________________________________________________

Relationship to person requesting services: ___ Self ___ Guardian

___ Family member ___ Other

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Case: 1:05-cv-04331 Document #: 527 Filed: 01/13/11 Page 11 of 11 PageID #:10925
CONFIRMATION OF NON-REQUEST To: Illinois Department of Human Services
Division of Developmental Disabilities c/o Mr. Brent D. Stratton Office of Illinois Attorney General 100 W. Randolph St., 12th Floor Chicago, IL 60601 This letter is written by or on behalf of the person listed below, who currently resides at (circle A or B): A: an Intermediate Care Facility for the Developmentally Disabled; OR B. his/her place of residence. The person listed below wishes to confirm that he/she does not request at this time any Community-Based Services or placement in a Community-Based Setting.
Name: _________________________________ Address: ________________________________
________________________________ Legal Guardian (if any): ___________________
Sincerely,
_____________________________ Date: ________________________

12839666

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 IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs, vs.
BARRY S. MARAM, et al., Defendants.

)

)

)

No. 05 C 4331

)

)

Chief Judge Holderman

)

Magistrate Judge Ashman

)

)

)

[PROPOSED] CONSENT DECREE

TABLE OF CONTENTS INTRODUCTION......................................................................................................................... 1 DECREE........................................................................................................................................ 2 I. JURISDICTION ................................................................................................................. 2 II. CLASS DEFINITION ........................................................................................................ 2 III. DEFINITION OF TERMS ................................................................................................. 2 IV. THE DEVELOPMENTAL DISABILITY SERVICES SYSTEM..................................... 6 V. INDIVIDUALIZED EVALUATION AND PLANNING FOR INDIVIDUALS
RESIDING IN ICF-DDs..................................................................................................... 8 VI. INDIVIDUALIZED EVALUATION AND PLANNING FOR INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES WHO ARE CURRENTLY RESIDING AT HOME............................................................................................................................... 12 VII. DISPUTE RESOLUTION ................................................................................................ 15 VIII. OUTREACH..................................................................................................................... 15 IX. IMPLEMENTATION....................................................................................................... 16 X. MONITORING AND COMPLIANCE ............................................................................ 17 XI. NAMED PLAINTIFFS..................................................................................................... 22 XII. ATTORNEYS’ FEES AND COSTS ................................................................................ 22 XIII. MISCELLANEOUS PROVISIONS................................................................................. 23 XIV. TERMINATION............................................................................................................... 24
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INTRODUCTION AND BACKGROUND Plaintiffs1, who are Illinois residents with Developmental Disabilities, filed this class action lawsuit on July 28, 2005, seeking declaratory and injunctive relief to redress violations of the community integration mandates of Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132; Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a); and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v. Plaintiffs allege that those federal statutes require Defendants to: (a) provide services, programs and activities in the most integrated setting appropriate to the needs of Individuals with Developmental Disabilities; (b) implement procedures to avoid unjustified institutional isolation of Individuals with Developmental Disabilities; and (c) offer Individuals with Developmental Disabilities a choice between institutional-based services, supports and programs, and services, supports and programs that are integrated into the community. Defendants have denied liability. In the interest of compromise and settlement, Plaintiffs and Defendants have entered into a Stipulation agreeing to the form, and jointly moved for preliminary and final approval, of a proposed consent decree. On November ___, 2008, the Court entered an Order preliminarily approving the Decree set forth below in accordance with Parties’ proposal. (Doc. No. ___.) Thereafter, pursuant to that Order, the Parties provided notice in accordance therewith, which the Court previously found, and hereby affirms, constitutes reasonable notice under the circumstances, and is in full compliance with the requirements of due process and governing law. On ______, 20__, the Court conducted a fairness hearing, at which it considered the written submissions of all interested persons and the presentations made in open court; and assessed the fairness and reasonableness of the Decree set forth below, taking into account the benefits of litigation to the Plaintiffs as compared with the benefits offered by the Decree. As set 1 Certain capitalized terms set forth herein are defined in Section III, below.
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forth in its Order dated _____, 20__ (Doc. No. __), the Court is of the opinion that the Decree set forth below represents a fair resolution of the competing interests of Plaintiffs and Defendants; that it is fair, reasonable and adequate; and that it should be and is approved pursuant to Rule 23 of the Federal Rules of Civil Procedure.
Therefore, upon all of the foregoing, and the Court being otherwise fully advised, the Court hereby ORDERS, ADJUDGES and DECREES as follows:
DECREE I. JURISDICTION
1. The Court has jurisdiction over this Litigation pursuant to 28 U.S.C. § 1331 and 28 U.S.C. § 1343.
II. CLASS DEFINITION 2. The Class is defined as: All persons in Illinois 18 years of age or older who: (a) have mental retardation and/or other Developmental Disabilities and who are eligible for Medicaid ICF/MR services; (b) with appropriate supports and services, could live in the community; and (c) either: (i) are, or will in the future be, institutionalized in private ICF-DDs with nine or more residents or (ii) are, or will in the future be, living in a home-based setting and are at risk of institutionalization because of their need for services.
III. DEFINITION OF TERMS 3. As used herein, the following terms have the following meanings: a) “Approval of the Decree” means the date defined in Paragraph 38, below.
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b) “Class Counsel” means all of the attorneys that have appearances on behalf of Plaintiffs in effect as of the Approval of the Decree, and each of the following organizations: Equip for Equality; Sonnenschein Nath & Rosenthal LLP; Access Living of Metropolitan Chicago; Roger Baldwin Foundation of ACLU, Inc.; and Public Interest Law Center of Philadelphia.
c) “Class” and “Class Members” means the persons who meet the definition set forth in Section II, above.
d) “Community Based Services” means those services (other than a placement in a Community Based Setting) available under the Waiver.
e) “Community Based Setting” means the most integrated residential setting appropriate for an Individual with Developmental Disabilities, where the setting is designed to promote independence in daily living, community integration, and economic self-sufficiency and enables the Individual to interact with non-disabled persons to the fullest extent possible.
f) “Community Service Provider” means a provider of Waiver-funded services, but does not include ICF-DDs or State Operated Developmental Centers.
g) “Court” means the United States District Court for the Northern District of Illinois, Eastern Division.
h) “Crisis” has the meaning set forth in Paragraph 15, below. i) “Decree” means this Consent Decree.
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j) “Defendants” means the Director of the Illinois Department of Healthcare and Family Services; the Secretary of the Illinois Department of Human Services, and any of their successors.
k) “Developmental Disability” means a disability that is attributable to a diagnosis of mental retardation (mild, moderate, severe, profound), or a related condition. A related condition is attributable to: cerebral palsy or epilepsy, or any other condition, other than mental illness, found to be closely related to mental retardation because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons with mental retardation, and requires treatment or services similar to those required for persons with mental retardation. In addition, this condition is manifested before the age of 22; is likely to continue indefinitely; and results in substantial functional limitations in three or more of the following areas of major life activity: self-care; understanding and use of language; learning; mobility; self-direction; capacity for independent living.
l) “Emerging Crisis” has the meaning set forth in Paragraph 16, below. m) “Evaluation” means an Initial Evaluation and an Updated Evaluation,
collectively. n) “ICF-DD” means any privately-owned long term care facility licensed by
the Illinois Department of Public Health as an Intermediate Care Facility for the Developmentally Disabled, as defined at 77 Ill.Adm.Code §300.330.
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o) “ICF-DD System” means the aggregate bed capacity of all ICF-DDs in operation as of the Approval of the Decree.
p) “ICF/MR services” has the meaning set forth in 42 C.F.R. § 440.150. q) “Implementation Plan” has the meaning set forth in Section IX, below. r) “Individual” or “Individual with Developmental Disabilities” means a
person in Illinois 18 years of age or older who has one or more Developmental Disabilities and who is Medicaid-eligible. s) “Initial Evaluation” has the meaning set forth in Paragraph 7(a), below. t) “Litigation” means the matter Ligas v. Maram, Case No. 05-4331, filed in the United States District Court for the Northern District of Illinois, Eastern Division. u) “Monitor” means the person or entity appointed by the Court pursuant to Section X, below, to perform the functions more fully described therein. v) “Named Plaintiffs” means the following people, each of whom the Court certified as a class representative in the Litigation: Lorene Bierman, David Cicarelli, Isaiah Fair, Adam Kulig, Stanley Ligas, Jamie McElroy, and Jennifer Wilson. w) “Parties” means Plaintiffs and Defendants, collectively. x) “Plaintiffs” means the Named Plaintiffs and Class Members, collectively. y) “Protective Order” means the Protective Order entered by the Court in the Litigation on May 15, 2006 (CM/ECF Doc. No. 98). z) “Qualified Professional” has the meaning set forth in Paragraph 7(c), below.
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aa) “Service Plan” has the meaning set forth in Paragraph 8, below. bb) “Single Point of Entry” has the meaning set forth in Paragraph 6, below. cc) “State Plan” means the plan that was submitted by the State of Illinois to
the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, in accordance with Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v, in effect as of the date of Approval of the Decree, including any amendments thereto, but only to the extent such amendments expand the range and/or amount of services available to Individuals with Developmental Disabilities, or their families or caregivers. dd) “Updated Evaluations” has the meaning set forth in Paragraph 7(b), below. ee) “Waiver” means the Illinois Home and Community Based Services Waiver for Adults with Developmental Disabilities, as approved by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, in effect as of the date of Approval of the Decree, or any amendments thereto or similar waivers subsequently approved by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, but only to the extent such amendments or subsequent waivers expand the range and/or amount of services available to Individuals with Developmental Disabilities.
IV. THE DEVELOPMENTAL DISABILITY SERVICES SYSTEM 4. Development of Community Capacity. Defendants shall ensure the availability
of services, supports and other resources of sufficient quality, scope and variety to meet their
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obligations under the Decree and the Implementation Plan. Defendants shall implement sufficient measures, consistent with the choices of Individuals with Developmental Disabilities, to provide Community Based Settings and Community Based Services pursuant to the Decree.
5. Resources and Budget Requests. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings, including but not limited to combining appropriations. Nothing contained in this Paragraph 5 shall be deemed to create or operate as (i) a condition or contingency upon which any term of the Decree depends; or (ii) a circumstance entitling Defendants to alter, amend or modify the implementation or timing of Defendants’ obligations under the Decree.
6. Single Point of Entry. a) Defendants shall develop and implement a “Single Point of Entry” system, which means a coordinated administrative system that receives applications and assesses eligibility for all forms of supports and services for Individuals with Developmental Disabilities; develops plans that are consistent with the Individual’s choice for appropriate supports and services; and identifies and locates appropriate service providers. b) Within three (3) years of Approval of the Decree, Defendants shall coordinate all Evaluations through a Single Point of Entry system. c) Within three (3) years of Approval of the Decree, no Individual with a Developmental Disability shall be admitted to an ICF-DD or enrolled in a Waiver-funded program without an Evaluation having first been
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conducted through the Single Point of Entry system and a Service Plan completed, except where exigent circumstances require otherwise.
V. INDIVIDUALIZED EVALUATION AND PLANNING FOR INDIVIDUALS RESIDING IN ICF-DDs 7. Evaluations. a) Within two (2) years of Approval of the Decree, all Individuals with Developmental Disabilities living in ICF-DDs will receive independent, professionally appropriate and person-centered evaluations of their strengths and needs in order to determine the supports and services required to live in a Community Based Setting (“Initial Evaluations”). b) Each year thereafter, for those Individuals living in ICF-DDs who oppose placement in a Community Based Setting, Initial Evaluations will be reviewed and updated as part of that Individual’s annual service planning (“Updated Evaluations”). c) Evaluations shall be conducted by appropriately trained and qualified professionals who are independent of the ICF-DD in which the Individuals live (the “Qualified Professional” or “Qualified Professionals”). Evaluations shall include, among other materials, all documents used to determine eligibility for services. d) The Evaluation process must address the Individual’s own vision of, and desires for, the future, and his or her medical, behavioral, vocational and social needs. Evaluations must draw upon communications with the Individual; discussions with family members, guardians, friends, support
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staff and professionals familiar with the Individual; and the history and experience of the Individual. e) Before an Evaluation is completed, a Qualified Professional must offer to show (and, upon request, show) the Individual, the Individual’s guardian, and/or any interested family members or others requested by the Individual, an example of a Community Based Setting in or around a locale desired by the Individual. f) Evaluations shall identify the types of Community Based Settings and/or Community Based Services that would best fulfill the preferences and serve the needs of the Individual. g) If an Evaluation indicates that the Individual will remain in an ICF-DD placement, such Evaluation must either (i) explain why the Individual cannot benefit from a Community Based Setting, or (ii) indicate that the Individual opposes placement in a Community Based Setting. h) After an Evaluation is completed, an Individual currently residing in an ICF-DD may (i) indicate that he or she desires to move or does not oppose moving to a Community Based Setting, or (ii) oppose placement in a Community Based Setting, opting to remain in the ICF-DD. 8. Service Plans. a) When, pursuant to Paragraph 7(h), an Individual residing in an ICF-DD indicates that he or she desires to move to, or does not oppose moving to, a Community Based Setting, Defendants shall develop a Service Plan specific to, and centered on, that Individual.
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b) The Service Plan shall be dated as of the date completed and, at a minimum, describe the services the Individual requires in a Community Based Setting; where and how such services can be developed and obtained; the supports and services the Individual will need during his or her transition to a Community Based Setting; and a timetable for promptly completing that transition.
c) The Service Plan shall be developed by a Qualified Professional in conjunction with the Individual and the Individual’s family members, guardians, friends and support staff who are familiar with the Individual.
d) The process for developing a Service Plan shall focus on the Individual’s personal vision, preferences, strengths and needs in home, community and work environments and shall reflect the value of supporting the Individual with relationships, productive work, participation in community life, and personal decision-making.
e) All services and supports in the Service Plan must be integrated into the community to the maximum extent possible.
f) The Service Plan shall not be limited by the current availability of services, provided, however, that nothing in this sub-paragraph obligates Defendants to provide the types of services beyond those included in the Waiver and/or the State Plan.
g) The Service Plan shall be completed within sufficient time to provide appropriate and sufficient transitions for Individuals in accordance with the deadlines set forth in the Decree.
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9. Individuals shall be entitled to their choice of Community Service Providers, as required by the Social Security Act, 42 U.S.C. 1396a(a)(23).
10. ICF-DD Capacity. Within six (6) years of Approval of the Decree, Defendants shall, to the extent consistent with governing law, reduce the use or aggregate licensed capacity of the ICF-DD System by an amount equivalent to the number of Individuals who, in aggregate and consistent with their Evaluations, Service Plans and choices, have transitioned to Community Based Settings from ICF-DDs. Nothing contained in this Paragraph 10 shall be deemed to create or operate as (i) a condition or contingency upon which any term of the Decree depends; or (ii) a circumstance entitling Defendants to alter, amend or modify the implementation or timing of Defendants’ obligations under the Decree.
11. Benchmarks for Evaluation and Planning for Individuals Residing in ICFDDs.
a) Subject to the interim requirements set forth below, within six (6) years of Approval of the Decree, all Class Members residing in ICF-DDs at the time of Approval of the Decree who do not oppose placement in Community Based Settings will transition to Community Based Settings consistent with their Service Plans.
b) Not less than one-third of the total number of Class Members residing in ICF-DDs at the time of Approval of the Decree who do not oppose placements in Community Based Settings will receive appropriate services in Community Based Settings consistent with their Service Plans within two (2) years of Approval of the Decree.
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c) Not less than two-thirds of the total number of Class Members residing in ICF-DDs at the time of Approval of the Decree who do not oppose placements in Community Based Settings will receive appropriate services in Community Based Settings consistent with their Service Plans within four (4) years of Approval of the Decree.
d) Individuals residing in ICF-DDs who have Service Plans prepared after the end of the sixth year following Approval of the Decree, which Service Plans provide for placement in a Community Based Setting, shall receive appropriate services consistent with their Service Plans within ninety (90) days of the date of the Service Plan.
e) Within three (3) years of Approval of the Decree, no Individual shall be placed in an ICF-DD without an Evaluation having first been conducted through the Single Point of Entry system.
VI. INDIVIDUALIZED EVALUATION AND PLANNING FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES WHO ARE CURRENTLY RESIDING AT HOME 12. Within two (2) years of Approval of the Decree, Defendants shall maintain a
statewide database in which all Individuals with Developmental Disabilities who reside at home and have been identified as in need of Community Based Services or placement in a Community Based Setting are enrolled. Enrollment shall be done through the Single Point of Entry system.
13. Defendants must screen all Individuals enrolled pursuant to Paragraph 12 regarding the Individual’s potential eligibility and need for developmental disabilities services, including a determination of whether such Individual meets the Crisis or Emerging Crisis criteria set forth in Paragraphs 15 and 16. For Individuals who are already, as of the date of the
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Approval of the Decree, enrolled in such database, Defendants must complete screenings in accordance with this Paragraph 13 within one year of Approval of the Decree. For Individuals who were not, as of the date of the Approval of the Decree, enrolled in such database, Defendants must complete screenings in accordance with this Paragraph 13 within thirty (30) days of enrollment. Defendants must update all screenings conducted pursuant to this Paragraph 13 on an annual basis.
14. Individuals who are determined to be in a situation of Crisis or Emerging Crisis will receive an Initial Evaluation and a Service Plan promptly. Initial Evaluations and Service Plans for these Individuals shall be conducted and completed as set forth in Paragraphs 7 and 8, above.
15. For purposes of the Decree, an Individual is in a situation of “Crisis” if he or she is at imminent risk of abuse, neglect, or homelessness. Some examples of circumstances that constitute Crisis include, but are not limited to circumstances:
a) where the Individual’s caregiver(s) are deceased; b) where the Individual’s caregiver is unable to address the support needs of
the Individual, thereby jeopardizing the Individual’s health, well-being, and/or safety; c) where physical and/or mental injury and/or sexual abuse is being inflicted on the Individual; d) where the Individual is homeless or without domicile; or e) where the Individual’s behaviors (e.g., verbal and /or physical aggression, bodily harm to self and/or others) put the Individual and/or family member(s) at risk of serious harm.
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16. For purposes of the Decree, an Individual is in a situation of “Emerging Crisis” if he or she has not yet reached a stage of “Crisis” but, without interventions, is likely to be in Crisis within a year. Emerging Crisis includes situations where the Individual is expected to continue to deteriorate, require long-term supports, or is in a temporary situation unlikely to be resolved, including, for example:
a) where the Individual has an ill caregiver who will be unable to continue providing care within the coming year; or
b) where the Individual’s personal care or medical needs cannot be met by the current caregiver(s) within the coming year.
17. If, following an Evaluation, the Individual who is determined to be in Crisis or Emerging Crisis indicates that he or she wishes to remain in the family home with appropriate Community Based Services or seeks placement in a Community Based Setting, Defendants will develop, in conjunction with the Individual, a Service Plan. Service Plans for such Individuals shall be conducted as set forth in Paragraph 8, above.
18. Defendants shall ensure that all Individuals who are determined to be in a situation of Crisis receive necessary and appropriate Community Based Services and/or placement in a Community Based Setting expeditiously. There is no limit to, or cap upon, the number of Individuals in Crisis who shall be served pursuant to the Decree.
19. Defendants shall ensure that all Individuals who are determined to be in a situation of Emerging Crisis receive necessary and appropriate Community Based Services and/or placement in a Community Based Setting within ninety (90) days of the issuance of a Service Plan, subject to limitations described in Paragraph 20, below.
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20. Within two (2) years of Approval of the Decree, Defendants must provide necessary and appropriate Community Based Services and/or placement in Community Based Settings for at least 1,000 Individuals who meet the Emerging Crisis criteria. In each of the third, fourth, fifth and sixth years following Approval of the Decree, Defendants shall serve at least 500 additional Individuals who meet the Emerging Crisis criteria each year. The obligations set forth in this Paragraph 20 do not obligate Defendants to serve more than 500 additional Individuals who meet the Emerging Crisis criteria each year.
VII. DISPUTE RESOLUTION 21. Any Individual who disputes a decision by Defendants or a Community Service
Provider regarding eligibility for, or delivery of, Community Based Services or placement in a Community Based Setting shall, pursuant to governing law, have the right to appeal or seek administrative or judicial review of such decisions through Defendants’ existing Fair Hearings process (as set forth in 89 Ill.Adm.Code Part 120) or as otherwise provided by law. Individuals also may avail themselves of any informal appeal process that currently exists.
VIII. OUTREACH 22. Defendants shall ensure that Individuals with Developmental Disabilities, and
their guardians and/or families, receive complete and accurate information regarding the rights of those Individuals to live in Community Based Settings and/or to receive Community Based Services, and available options and opportunities for doing so. The Implementation Plan shall describe the methods and mechanisms by which such information will be disseminated. All costs for outreach shall be borne by Defendants.
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IX. IMPLEMENTATION 23. Overview and Contents of the Implementation Plan. Defendants, with the
input of the Monitor, Plaintiffs and Class Counsel, shall create and implement an Implementation Plan to accomplish the obligations and objectives set forth in the Decree. The Implementation Plan must, at a minimum:
a) establish specific tasks, timetables, goals, programs, plans, strategies and protocols to assure that Defendants fulfill the requirements of each provision of the Decree;
b) describe the hiring, training and supervision of the personnel necessary to implement the Decree;
c) describe necessary resource development activities, including actions, inter-agency agreements, requests for proposals and the development of other resources necessary to implement the Decree;
d) identify, based on information known at the time the Implementation Plan is prepared, any services or supports required in Service Plans formulated pursuant to the Decree that are not currently available in the appropriate quantity, quality or geographic location; and
e) identify, based on information known at the time the Implementation Plan is prepared, any services and supports which, based on demographic or other data, are expected to be required in the following six months to meet the obligations of the Decree.
24. Within ninety (90) days of Approval of the Decree, Defendants shall provide the Monitor, Plaintiffs and Class Counsel with a draft Implementation Plan. The Monitor, Plaintiffs and Class Counsel will participate in developing and finalizing the Implementation Plan, which
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shall be finalized within six (6) months following Approval of the Decree. In the event the Monitor or Plaintiffs disagree with the Defendants’ proposed Implementation Plan, the matter shall be submitted to the Court for resolution.
25. The Implementation Plan shall be updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate. The Monitor, Plaintiffs and Class Counsel may review and comment upon any such updates or amendments. In the event the Monitor or Plaintiffs disagree with the Defendants’ proposed updates or amendments, the matter may be submitted to the Court for resolution.
26. The Implementation Plan, and all amendments or updates thereto, shall be incorporated into, and become enforceable as part of the Decree.
X. MONITORING AND COMPLIANCE 27. Appointment of a Monitor. The Court shall appoint an independent and
impartial Monitor who is knowledgeable concerning the management and oversight of programs serving Individuals with Developmental Disabilities. Within twenty-one (21) days of Approval of the Decree, the Parties shall submit to the Court their joint recommendation or separate nominations for a Monitor. The Parties shall endeavor to agree on a single candidate for Monitor. If the Parties cannot agree, Plaintiffs and Defendants shall each submit to the Court the names of no more than two qualified professionals or organizations who are experienced in the design and development of community programs for Individuals with Developmental Disabilities, and experienced in the administration and monitoring of specialized services for Individuals with Developmental Disabilities. Each Party will have seven (7) days to comment on the qualifications of the other Party’s candidate(s), following which the Court shall then select the Monitor from the names submitted by the Parties. In the event the Monitor resigns or
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otherwise becomes unavailable, and the Parties cannot agree on a replacement Monitor to recommend to the Court, the process described above will be used to select a replacement Monitor.
28. Role of the Monitor. The duties of the Monitor shall include gauging Defendants’ compliance with the Decree, identifying actual and potential areas of noncompliance with the Decree, facilitating the resolution of compliance issues without Court intervention, and recommending appropriate action by the Court in the event an issue cannot be resolved by discussion and negotiation among the Monitor and the Parties. The Monitor may retain such staff and/or consultants as appropriate to assist in the performance of his or her duties.
29. Development of Measurable Standards for Evaluation. a) Within 90 days of the Monitor’s appointment, the Monitor shall submit to the Parties a set of objective standards to guide the Monitor in evaluating Defendants’ compliance with the Decree. In the event any of the Parties believe that such standards are insufficient or inappropriate, they shall first meet and confer with the Monitor in an effort to revise the standards in a manner acceptable to the Monitor and the Parties. In the event that the Monitor and the Parties are unable to agree on such standards, they may seek appropriate relief from the Court. b) Appropriate standards by which the Monitor evaluates Defendants’ compliance with the Decree shall include, but are not limited to, the following:
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i) whether the Defendants are operating a Single Point of Entry system pursuant to the guidelines set forth in Paragraph 6;
ii) whether person-centered Evaluations have been completed for all Class Members living in ICF-DDs within two years of Approval of the Decree;
iii) whether Evaluations are being conducted by Qualified Professionals and whether Evaluations contain appropriate documentation;
iv) whether Service Plans meet the criteria set forth in Paragraph 9;
v) whether the benchmarks set forth in Paragraph 11 have been satisfied;
vi) whether Individuals who are determined to be in Crisis receive services expeditiously in accordance with Paragraph 18;
vii) whether Individuals who are determined to be in Emerging Crisis are being served in accordance with Paragraph 19;
viii) whether the benchmarks set forth in Paragraph 20 have been satisfied;
ix) the extent to which, at periodic intervals, Individuals are being placed in Community Based Settings; and
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x) the extent to which, at periodic intervals, Individuals are receiving Community Based Services.
c) None of the standards adopted by the Monitor pursuant to this Paragraph 29 shall in any way modify, change or otherwise abrogate any of the terms of the Decree or Defendants’ obligations under the Decree.
30. Review and Evaluation of Data and Information. The Monitor shall review and evaluate Defendants’ compliance with the terms of the Decree. Not less than every six (6) months, Defendants shall provide the Monitor, Plaintiffs and Class Counsel with a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress towards achieving compliance, with the Parties and Monitor agreeing in advance of the first report of the data and information that must be included in such report. Defendants will not refuse any request by the Monitor for documents or other information that are reasonably related to the Monitor’s review and evaluation of Defendants’ compliance with the Decree, and Defendants will, upon reasonable notice, permit confidential interviews of Defendants’ staff or consultants, except their attorneys. The Monitor will have access to all Class Members and their records and files, as well as to those service providers, facilities, buildings and premises that serve, or are otherwise pertinent to, Class Members, where such access is reasonably related to the Monitor’s review and evaluation of Defendants’ compliance with the Decree. The Defendants shall comply with Plaintiffs’ requests for information that are reasonably related to Defendants’ compliance with the Decree, including without limitation requests for records and other relevant documents pertinent to implementation of the Decree or to Class Members. Plaintiffs and Class Counsel also shall be permitted to
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review the information provided to the Monitor. All information provided to the Monitor and/or Plaintiffs pursuant to the Decree shall be subject to the Protective Order.
31. Reporting. The Monitor shall file annual reports with the Court. Such reports shall include the information necessary, in the Monitor’s professional judgment, for the Court and Plaintiffs to evaluate Defendants’ compliance or non-compliance with the terms of the Decree. The Monitor may file additional reports as necessary. Reports of the Monitor shall be served on all Parties.
32. Compliance. In the event the Monitor finds Defendants not in compliance with the Decree, the Monitor shall promptly meet and confer with the Parties in an effort to agree on steps necessary to achieve compliance. In the event that Plaintiffs believe that Defendants are not complying with the terms of the Decree, Plaintiffs shall notify the Monitor and Defendants of Defendants’ potential non-compliance. The Monitor then shall review Plaintiffs’ claims of actual or potential non-compliance and, as the Monitor deems appropriate in its professional judgment, meet and confer with Defendants and Plaintiffs in an effort to agree on steps necessary to achieve compliance with the Decree. If the Monitor and Parties agree, such steps shall be memorialized in writing and incorporated into, and become enforceable as part of, the Decree. In the event that the Monitor is unable to reach agreement with Defendants and Plaintiffs, the Monitor may seek appropriate relief from the Court. In the event that Plaintiffs believe that Defendants are not in compliance with the Decree and that the Monitor refuses or fails to act, Plaintiffs may seek appropriate relief from the Court. The Monitor will not communicate with the Court without advance notice to the Parties.
33. Compensation of the Monitor. Defendants shall compensate the Monitor and his or her staff and consultants at their usual and customary rate. Defendants shall reimburse all
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reasonable expenses of the Monitor and the Monitor’s staff, consistent with the guidelines set forth in the “Governor’s Travel Control Board Travel Guide for State Employees.” Defendants reserve their right to seek relief from the Court if Defendants believe that any of the Monitor’s charges is inappropriate or unreasonable.
XI. NAMED PLAINTIFFS 34. As part of the settlement of the Litigation, within sixty (60) days of Approval of
the Decree, Defendants shall offer each of the Named Plaintiffs the opportunity to receive appropriate Community Based Services or placement in a Community Based Setting. Provision of services to the Named Plaintiffs pursuant to this provision shall not be used to determine any other particular Individual’s eligibility for services under the terms of the Decree.
XII. ATTORNEYS’ FEES AND COSTS 35. In full settlement of all attorneys’ fees incurred in connection with the Litigation,
Defendants shall pay $1,990,000.00 to Class Counsel. In full settlement of all out-of-pocket costs and expenses (not to include attorneys’ fees) incurred by Class Counsel, Defendants shall pay to Class Counsel such costs and expenses incurred by Class Counsel through and including the Approval of the Decree and any appeal thereof. Such amounts shall be distributed to Class Counsel in the manner set forth in written instructions provided by Class Counsel. Furthermore, such amounts shall be set forth in a Judgment Order to be entered by the Court within fourteen (14) days of Approval of the Decree. Defendants shall complete and submit all paperwork necessary for payment of such amounts, plus applicable statutory post-judgment interest, within five (5) business days after expiration of the time to appeal the Decree without the filing of a Notice to Appeal or after the issuance of the mandate by the highest reviewing court, whichever is later.
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36. Current Class Counsel agree not to seek fees and expenses beyond the amounts described in Paragraph 35, above.
37. Nothing herein shall preclude the Court from imposing sanctions or other relief for non-compliance with the Decree.
XIII. MISCELLANEOUS PROVISIONS 38. Approval of the Decree. “Approval of the Decree” shall be deemed to occur on
the date the Court enters the Decree. 39. Costs of Notices. The cost of all notices hereunder or otherwise ordered by the
Court shall be borne by Defendants. 40. Signatories. Each undersigned representative of a Defendant to this Litigation
and the Attorney General for the State of Illinois certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally such Defendant to this document. Each undersigned representative of Plaintiffs and Class Counsel certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally the Plaintiffs and Class Counsel to this document.
41. Delivery of Notices or Mailings. a) Delivery of notices or mailings to Plaintiffs shall be made to: Equip for Equality, Attn.: Barry Taylor (or his successor), 20 North Michigan Avenue, Suite 300, Chicago, Illinois 60602; and Sonnenschein Nath & Rosenthal LLP, Attn.: John Grossbart, 7800 Sears Tower, Chicago, Illinois 60606. b) Delivery of notices or mailings to Defendants shall be made to: Office of the Illinois Attorney General, Attn: Brent D. Stratton, 100 W.
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Randolph Street, Chicago, Illinois 60601 and Office of the Illinois Attorney General, Attn: Karen Konieczny, 160 N. LaSalle St., Suite N1000, Chicago, Illinois 60601. c) The Parties may modify the instructions for delivery of notices or mailings contained in this Paragraph 41 without Court approval. 42. Waiver. Defendants have waived their right to oppose entry of the Decree by this Court or to challenge any provision of the Decree. Defendants have waived their right to appeal the Decree or any other matter that has occurred to date in connection with the Litigation.
XIV. TERMINATION 43. The Court shall retain exclusive jurisdiction to fully oversee, supervise, modify
and enforce the terms of the Decree. The Court shall retain such jurisdiction for at least nine (9) years following the Approval of the Decree.
44. The Parties, jointly or separately, may request termination of the monitoring process described in Section X at any time after nine (9) years from Approval of the Decree. If, after nine years from Approval of the Decree or any time thereafter, Defendants and the Monitor agree that Defendants have substantially complied with the terms of the Decree, Defendants shall notify Plaintiffs in writing of their desire to terminate the monitoring process (“Termination Request”). Plaintiffs shall have not less than 120 days from receipt of the Termination Request to respond. During those 120 days, Plaintiffs shall have the opportunity to conduct reasonable discovery concerning factual issues relevant to the determination of compliance. If Plaintiffs oppose the Termination Request, Plaintiffs must file a motion within 120 days from the date Plaintiffs received Defendants’ Termination Request.
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45. The Court will grant Defendants’ Termination Request and terminate the monitoring process if the Court finds that Defendants have substantially complied with the terms of the Decree and the Court determines that Defendants have implemented and are maintaining a system that complies with the Decree.
46. Termination of the Court’s jurisdiction over the Decree may occur only in the event of a successful request to terminate the monitoring process pursuant to Section XIV. The Decree shall remain in effect, and the Court shall retain its jurisdiction over the Decree, until a final order is entered granting the Termination Request and all appellate rights and/or appeals have been exhausted.
SO ORDERED THIS _____ DAY OF ______________, 20____. ________________________________________ United States District Judge
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 IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs, vs.
BARRY S. MARAM, et al., Defendants.

) ) ) No. 05 C 4331 ) ) Chief Judge Holderman ) Magistrate Judge Cole ) ) ) )

CONSENT DECREE

TABLE OF CONTENTS
INTRODUCTION AND BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 DECREE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I. JURISDICTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 II. CLASS DEFINITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 III. DEFINITION OF TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 IV. THE DEVELOPMENTAL DISABILITY SERVICES SYSTEM . . . . . . . . . . . . . . . . . . 7 V. DETERMINATION OF CLASS MEMBERSHIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 VI. STATEWIDE DATABASE AND WAITING LIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 VII. TRANSITION SERVICE PLANS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 VIII. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS RESIDING IN
ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE . . . . . . . . . . . . . . . 10 IX. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS NOT RESIDING
IN ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE . . . . . . . . . . . . . 11 X. PROVISION OF SERVICES AFTER THE END OF THE SIXTH YEAR
FOLLOWING APPROVAL OF THE DECREE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 XI. DISPUTE RESOLUTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 XII. OUTREACH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 XIII. IMPLEMENTATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 XIV. MONITORING AND COMPLIANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 XV. NAMED PLAINTIFFS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 XVI. ATTORNEYS’ FEES AND COSTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 XVII. MISCELLANEOUS PROVISIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 XVIII. TERMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
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INTRODUCTION AND BACKGROUND Plaintiffs1, who are Illinois residents with Developmental Disabilities, filed this class action lawsuit on July 28, 2005, seeking declaratory and injunctive relief to redress violations of the community integration mandates of Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132; Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a); and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v. Plaintiffs allege that those federal statutes require Defendants to: (a) provide services, programs and activities in the most integrated setting appropriate to the needs of Individuals with Developmental Disabilities; (b) implement procedures to provide such services, programs and activities; and (c) offer Individuals with Developmental Disabilities a choice between services, supports and programs provided in ICFsDD, and services, supports and programs that are integrated into the community. Defendants have denied liability. Intervenors are Illinois residents with Developmental Disabilities who have intervened to ensure that the State of Illinois continues to meet its obligations to also provide ICF-DD services. In the interest of compromise and settlement, Plaintiffs, Intervenors, and Defendants have entered into a Stipulation agreeing to the form, and jointly moved for preliminary and final approval, of a proposed consent decree. On ____________, 20__, the Court entered an Order preliminarily approving the Decree set forth below in accordance with Parties’ proposal. (Doc. No. ___.) Thereafter, pursuant to that Order, the Parties provided notice in accordance therewith, which the Court previously found, and hereby affirms, constitutes reasonable notice under the circumstances, and is in full compliance with the requirements of due process and governing law. On _______, 20 ___, the Court conducted a fairness hearing, at which it considered the written submissions of all interested persons and the presentations made in open court; and assessed the fairness and reasonableness of the Decree set forth below, taking into account the
1 Certain capitalized terms set forth herein are defined in Section III, below. 1

benefits of litigation to the Plaintiffs as compared with the benefits offered by the Decree, the resources of the State of Illinois, and the needs of the Intervenors and other Individuals with Developmental Disabilities. As set forth in its Order dated _____, 20__ (Doc. No. __), the Court is of the opinion that the Decree set forth below represents a fair resolution of the competing interests of Plaintiffs, Intervenors, and Defendants; that it is fair, reasonable and adequate; and that it should be and is approved pursuant to Rule 23 of the Federal Rules of Civil Procedure.
Therefore, upon all of the foregoing, and the Court being otherwise fully advised, the Court hereby ORDERS, ADJUDGES and DECREES as follows:
DECREE I. JURISDICTION
1. The Court has jurisdiction over this Litigation pursuant to 28 U.S.C. § 1331 and 28 U.S.C. § 1343. II. CLASS DEFINITION
2. The Class is defined as those individuals in one of two sub-classes: (a) adult individuals in Illinois: (i) who have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid Waiver services; (ii) who reside in private ICFs-DD with nine or more residents; and (iii) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a Current Record reflecting that the individual has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting; or (b) adult individuals in Illinois: (i) who have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2)
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and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid Waiver services; (ii) who reside in a Family Home and are in need of CommunityBased Services or placement in a Community-Based Setting; and (iii) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a Current Record reflecting that the individual has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting. III. DEFINITION OF TERMS 3. As used herein, the following terms have the following meanings: (a) “Approval of the Decree” means the date defined in Paragraph 40, below. (b) “Class Counsel” means all of the attorneys that have appearances on behalf of the Named Plaintiffs in effect as of the Approval of the Decree, and each of the following organizations: Equip for Equality; SNR Denton; Access Living of Metropolitan Chicago; and Roger Baldwin Foundation of ACLU, Inc. (c) “Class” and “Class Members” mean the persons who meet the definition set forth in Section II, above. (d) “Community-Based Services” means those services (other than a placement in a Community-Based Setting) available under the Waiver. (e) “Community-Based Setting” means a Waiver-funded residential setting with a maximum of eight (8) beds, but does not include an ICF-DD, that is the most integrated residential setting appropriate for an Individual where the setting is designed to promote independence in daily living, community integration, and economic self-sufficiency and enables the Individual to interact with non-disabled persons to the fullest extent possible.
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(f) “Community Service Provider” means a provider of Waiver-funded services, but does not include an ICF-DD or a State Operated Developmental Centers.
(g) “Court” means the United States District Court for the Northern District of Illinois, Eastern Division.
(h) “Crisis” has the meaning set forth in Paragraph 21(a), below. (i) “Current Record” means an accurate record reflecting that the Individual,
or the Individual’s legal guardian, has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting, and, to the best of Defendants’ knowledge, that record has not been withdrawn or retracted by the Individual or the Individual’s legal guardian. All Individuals who objected (either personally, or through the Individual’s legal guardian) to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing in this Litigation, on the grounds that they do not wish to receive Community-Based Services or placement in a Community-Based Setting shall be deemed to have retracted any record reflecting that, prior to such objection, he or she had affirmatively indicated that he or she seeks to receive Community-Based Services or placement in a Community-Based Setting. (j) “Decree” means this Consent Decree. (k) “Defendants” means the Director of the Illinois Department of Healthcare and Family Services; the Secretary of the Illinois Department of Human Services; and any of their successors. (l) “Developmental Disability” means a disability that is attributable to a diagnosis of mental retardation (mild, moderate, severe, profound), or a related condition. A related condition is attributable to: cerebral palsy or epilepsy, or any other condition, other than mental illness, found to be closely related to mental retardation because this condition results in impairment of general intellectual functioning or adaptive behavior similar
4

to that of persons with mental retardation, and requires treatment or services similar to those required for persons with mental retardation. In addition, this condition is manifested before the age of 22; is likely to continue indefinitely; and results in substantial functional limitations in three or more of the following areas of major life activity: self-care; understanding and use of language; learning; mobility; self-direction; capacity for independent living. (m) Family Home means a family home and does not include a CommunityIntegrated Living Arrangement, as defined at 210 ILCS §135/3(d), or an ICF-DD. (n) “ICF-DD” means any privately-owned long term care facility licensed by the Illinois Department of Public Health as an Intermediate Care Facility for the Developmentally Disabled, as defined at 77 Ill.Adm.Code §300.330. (o) “ICF/MR services” shall have the meaning set forth in 42 C.F.R. § 440.150. (p) “Implementation Plan” has the meaning set forth in Section XIII, below. (q) “Individual” means a person in Illinois 18 years of age or older who has one or more Developmental Disabilities and who is Medicaid-eligible. (r) “Intervenors” mean those individuals granted leave to intervene pursuant to the Court’s Memorandum Opinion and Order entered on April 7, 2010. (Doc. No. 479) (s) “Intervenors’ Counsel” means all of the attorneys who have appearances on behalf of the Intervenors in effect as of the Approval of the Decree. (t) “Litigation” means the matter Ligas v. Maram, Case No. 05-4331, filed in the United States District Court for the Northern District of Illinois, Eastern Division. (u) “Monitor” means the person or entity appointed by the Court pursuant to Section XIV, below, to perform the functions more fully described therein.
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(v) “Named Plaintiffs” means the following people, each of whom the Court certified as a class representative in the Litigation: David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, and Jennifer Wilson.
(w) “Parties” means Plaintiffs and Defendants, collectively. (x) “Plaintiffs” means the Named Plaintiffs and Class Members, collectively. (y) “Protective Order” means the Protective Order entered by the Court in the
Litigation on May 15, 2006 (CM/ECF Doc. No. 98). (z) “Qualified Professional” means an appropriately trained and qualified
professional. (aa) “State Plan” means the plan that was submitted by the State of Illinois to
the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, in accordance with Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v, in effect as of the date of Approval of the Decree, including any amendments thereto. (bb) “Transition Service Plan” has the meaning set forth in Section VII, below. (cc) “Waiting List” has the meaning set forth in Paragraph 9, below. (dd) “Waiting List Class Members” has the meaning set forth in Paragraph 22(c), below. (ee) “Waiver” means the Illinois Home and Community-Based Services Waiver for Adults with Developmental Disabilities, as approved by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, in effect as of the date of Approval of the Decree, or any amendments thereto or similar waivers subsequently approved by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, but only to the extent such amendments or subsequent waivers expand the range and/or amount of services available to Individuals with Developmental Disabilities.
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IV. THE DEVELOPMENTAL DISABILITY SERVICES SYSTEM 4. Development of Resource Capacity. The choices of Individuals with
Developmental Disabilities, including Class Members, to receive Community-Based Services or placement in a Community-Based Setting or to receive ICF/MR services in an ICF-DD will be honored; provided, however, that this commitment to honoring choice does not alter Defendants’ current obligations under existing law regarding licensed ICF-DD capacity system-wide or at any specific ICF-DD, and provided that, under current applicable law, this commitment does not entitle an Individual with Developmental Disabilities to receive ICF/MR services in a specific ICF-DD. Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such Individuals under the Decree and the Implementation Plan consistent with such choices. While the Decree remains in effect, any amendment to the State Plan submitted by the State pursuant to 42 U.S.C. § 1396, et seq. will continue to include ICF-DD services as an alternative choice for long-term care services for eligible Individuals with Developmental Disabilities. Nothing in this Decree shall impair Defendants’ ability to make changes in their provision of supports and services to Individuals with Developmental Disabilities, including Class Members, regardless of setting, provided that Defendants continue to honor Individuals’ choices and fulfill Defendants’ obligations under the Decree and Implementation Plan. Resources necessary to meet the needs of Individuals with Developmental Disabilities who choose to receive services in ICFs-DD shall be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree, including the obligations under Paragraphs 17 through 19 and 21 through 23. Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs using federally approved objective criteria regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based Setting; provided, however, nothing in this Decree shall require Defendants to change their current method for establishing funding or from adopting new methods based upon federally approved objective criteria.
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5. Resources and Budget Requests. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings. Nothing contained in this Paragraph 5 shall be deemed to create or operate as (i) a condition or contingency upon which any term of the Decree depends; or (ii) a circumstance entitling Defendants to alter, amend or modify the implementation or timing of Defendants’ obligations under the Decree. V. DETERMINATION OF CLASS MEMBERSHIP
6. Within thirty (30) days after Approval of the Decree, Defendants shall compile an initial list of Class Members by taking the list of Individuals to whom notice of Preliminary Approval of this Decree was sent, adding those Individuals from whom any of the Parties received a written, affirmative request to receive Community-Based Services or placement in a Community-Based Setting after notice of Preliminary Approval of this Decree was sent, but excluding (i) those individuals who filed objections to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing as described in Paragraph 3(i) above, and (ii) those Individuals from whom Defendants receive written requests that the Individuals do not wish to receive Community-Based Services or placement in a Community-Based Setting.
7. Within thirty (30) days after compiling the initial list described in Paragraph 6 above, Defendants shall confirm whether all Class Members on the initial list are included in the statewide database described in Paragraph 8 below and shall add – to the extent possible with available information – those Class Members not already included. VI. STATEWIDE DATABASE AND WAITING LIST
8. Defendants shall maintain a statewide database in which all Class Members are enrolled. Defendants must promptly and regularly add Individuals to this database as they become Class Members. If Defendants receive written requests from Individuals that the Individuals would not wish to receive Community-Based Services or placement in a Community-Based Setting, Defendants shall promptly revise the database to reflect the fact that
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such Individuals are no longer Class Members. Defendants must update all enrollment information on an annual basis.
9. Class Members not residing in ICFs-DD as of the date of Approval of the Decree who are enrolled in the statewide database described in Paragraph 8 above shall be placed on a Waiting List with selection prioritized by the Class Member’s urgency of need for CommunityBased Services or placement in a Community-Based Setting, the length of time that has passed since the Class Member enrolled, geographical considerations and other factors. Defendants must promptly and regularly update the Waiting List as Class Members are added to the database described in paragraph 8, above. VII. TRANSITION SERVICE PLANS
10. Within no more than twelve months prior to the development of a Transition Service Plan, Defendants shall present to the Class Member, in an objective manner, all of his or her service alternatives under the State Plan and any applicable Waiver, determine whether, after such presentation, the Class Member requests Community-Based Services or placement in a Community-Based Setting and obtain from the Class Member a completed and executed DDPAS-10 Form and a DMHDD-1238 Form (the “Request Forms”) evidencing Class Member’s request. Upon receipt of the Request Forms from the Class Member, Defendants shall develop a Transition Service Plan specific to, and centered on, each Class Member as each Class Member is selected from the statewide database to receive Community-Based Services or placement in Community-Based Settings under this Decree.
11. The Transition Service Plan shall describe the services the Class Member requires in a Community-Based Setting or through Community-Based Services; where and how such services can be developed and obtained; the supports and services the Class Member will need during his or her transition to a Community-Based Setting; and a timetable for completing that transition.
12. The Transition Service Plan shall be developed by a Qualified Professional in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member.
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13. The process for developing a Transition Service Plan shall focus on the Class Member’s personal vision, preferences, strengths and needs in home, community and work environments and shall reflect the value of supporting the Class Member with relationships, productive work, participation in community life, and personal decision-making.
14. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent possible, consistent with the choices of the Class Member and the Class Member’s legal guardian.
15. The Transition Service Plan shall not be limited by the current availability of services, provided, however, that nothing in this paragraph obligates Defendants to provide the types of services beyond those included in the Waiver and/or the State Plan.
16. The Transition Service Plan shall be completed within sufficient time to provide appropriate and sufficient transitions of Class Members in accordance with the deadlines set forth in the Decree. VIII. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS RESIDING IN
ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE 17. Subject to the interim requirements set forth below, within six (6) years after Approval of the Decree, all Class Members residing in ICFs-DD as of the date of Approval of the Decree (regardless of when in this timeframe the Class Member affirmatively requested placement in a Community-Based Setting) will transition to Community-Based Settings consistent with their Transition Service Plans, if, at the time of transition, the Class Member requests placement in a Community-Based Setting, as confirmed and documented in accordance with Paragraph 10. 18. Within two and a half years after Approval of the Decree: not less than one-third of the total number of those Class Members residing in ICFs-DD as of the date of Approval of the Decree who have, within two (2) years after the date of Approval of the Decree, affirmatively requested placement in a Community-Based Setting will be transitioned to Community-Based Settings consistent with their Transition Service Plans. 19. Within four and a half years after Approval of the Decree: not less than twothirds of the total number of those Class Members residing in ICFs-DD as of the date of Approval of the Decree who have, within four (4) years after the date of Approval of the Decree,
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affirmatively requested placement in a Community-Based Setting will be transitioned to Community-Based Settings consistent with their Transition Service Plans. IX. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS NOT RESIDING
IN ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE 20. Within one (1) year after Approval of the Decree, Defendants shall screen all Class Members residing in a Family Home who are enrolled in the database described in Paragraph 8 as of the date of Approval of the Decree regarding the Class Members’ potential eligibility and need for developmental disabilities services, including (i) a determination of whether such Class Members meet the Crisis criteria set forth in Paragraph 21(a) and, (ii) after presenting to the Class Member, in an objective manner, all of his or her service alternatives under the State Plan and any applicable Waiver, a determination of whether the Class Member requests Community-Based Services or placement in a Community-Based Setting, as confirmed and documented in accordance with Paragraph 10. 21. Class Members Who Reside in a Family Home and Are Determined to be in
a Situation of Crisis. (a) For purposes of the Decree, an Individual is in a situation of “Crisis” if he
or she is at imminent risk of abuse, neglect, or homelessness. The provision of interim emergency services (including interim placement in an ICF-DD where no placement in a Community-Based Setting was immediately available) will not necessarily exclude the Individual from being deemed to be in a situation of Crisis. Some examples of circumstances that constitute Crisis include, but are not limited to circumstances: (i) where the Individual’s caregiver(s) are deceased; (ii) where the Individual’s caregiver is unable to address the support
needs of the Individual, thereby jeopardizing the Individual’s health, well-being, and/or safety; (iii) where physical and/or mental injury and/or sexual abuse is being inflicted on the Individual; (iv) where the Individual is homeless or without domicile; or
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(v) where the Individual’s behaviors (e.g., verbal and /or physical aggression, bodily harm to self and/or others) put the Individual and/or family member(s) at risk of serious harm.
(b) If, following a screening, the Individual who is determined to be in Crisis requests appropriate Community-Based Services to be provided in the Family Home or requests placement in a Community-Based Setting, Defendants will promptly develop, in conjunction with the Class Member, a Transition Service Plan. Transition Service Plans for such Class Members shall be developed as set forth in Section VII, above.
(c) Defendants shall ensure that all Class Members who are determined to be in a situation of Crisis, and who request to receive Community-Based Services and/or placement in a Community-Based Setting, receive such services and/or placement in such setting expeditiously. If a Class Member is determined to be in Crisis and then moves into an ICF-DD before Defendants are able to provide a placement in a Community-Based Setting, that change in the Class Member’s residential status will not in itself change the determination of Crisis or change the Defendants’ obligation to place the Class Member in a Community-Based Setting expeditiously, provided that, at the time of transition to a CommunityBased Setting, the Class Member requests placement in a CommunityBased Setting, as confirmed and documented at that time. There is no limit to, or cap upon, the number of Class Members in Crisis who shall be served pursuant to the Decree.
22. Benchmarks for Transitions of “Waiting List Class Members” (a) Class Members who become residents of ICFs-DD after the date of Approval of the Decree, but who did not reside in ICFs-DD as of the date of Approval of the Decree, shall be enrolled in the database described in Paragraph 8, placed on the Waiting List described in Paragraph 9 and served in accordance with this Paragraph 22, provided that the Class
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Member requests Community-Based Services or placement in a Community-Based Setting, as confirmed and documented in accordance with Paragraph 10. (b) Class Members residing at a Family Home who, as a result of the screening described in Paragraphs 20 and 21(a), are not determined to be in a situation of Crisis but who have requested and been identified as appropriate for Community-Based Services or placement in a CommunityBased Setting will be placed on the Waiting List described in Paragraph 9 and served in accordance with this Paragraph 22. (c) Collectively, the Class Members identified in sub-Paragraphs 22(a) and 22(b), above, shall be referred to as “Waiting List Class Members.” (d) Within two (2) years after Approval of the Decree, Defendants shall provide, in accordance with the Class Members’ Transition Service Plans, appropriate Community-Based Services and/or placement in CommunityBased Settings for at least 1,000 Waiting List Class Members who are selected from the Waiting List described in Paragraph 9 above, with these Class Members served in order of priority. In each of the third, fourth, fifth and sixth years following Approval of the Decree, Defendants shall serve at least 500 additional Waiting List Class Members who are selected from the Waiting List, again in order of priority. The obligations set forth in this Paragraph 22(d) do not obligate Defendants to serve more than 500 additional Waiting List Class Members who are selected from the Waiting List in each of the third, fourth, fifth, and sixth years following Approval of the Decree. X. PROVISION OF SERVICES AFTER THE END OF THE SIXTH YEAR FOLLOWING APPROVAL OF THE DECREE 23. All Class Members who are on the Waiting List after the end of the sixth year following Approval of the Decree shall receive appropriate Community-Based Services and/or placement in a Community-Based Setting, such that they move off the Waiting List at a reasonable pace, provided that the Class Members have requested such services and/or settings at
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the point when they are to move off the Waiting List and that the requests are confirmed and documented in accordance with Paragraph 10. XI. DISPUTE RESOLUTION
24. Any Class Member who disputes a decision by Defendants or a Community Service Provider regarding eligibility for, or delivery of, Community-Based Services or placement in a Community-Based Setting shall, pursuant to governing law, have the right to appeal or seek administrative or judicial review of such decisions through Defendants’ existing Fair Hearings process (as set forth in 89 Ill.Adm.Code Part 120) or as otherwise provided by law. Class Members also may avail themselves of any informal appeal process that currently exists. XII. OUTREACH
25. Defendants shall maintain a fair and accessible process by which Individuals with Developmental Disabilities or their legal guardians can affirmatively request in writing to receive Community-Based Services and/or placement in a Community-Based Setting or to receive ICF-MR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests. Defendants, in conjunction with Class Counsel, also shall ensure that Individuals with Developmental Disabilities, and their guardians and/or families, have the opportunity to receive complete, accurate, and objective information regarding all alternative choices for longterm care services for eligible Individuals with Developmental Disabilities. Nothing in this Paragraph, or any other provision of this Decree, requires Defendants to provide this information to Individuals or their guardians or families who are not interested in changing their current placement. All costs for outreach shall be borne by Defendants. Details about how Defendants shall conduct the obligations set forth in this Paragraph 25 will be set forth in the Implementation Plan described below. XIII. IMPLEMENTATION
26. Overview and Contents of the Implementation Plan. Defendants, with the input of the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel shall create and implement an Implementation Plan to accomplish the obligations and objectives set forth in the Decree. Intervenors and Intervenors’ Counsel’s input shall be limited to those portions of the
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Implementation Plan which relate to Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD. The Implementation Plan must, at a minimum:
(a) establish specific tasks, timetables, goals, programs, plans, strategies and protocols to assure that Defendants fulfill the requirements of each provision of the Decree;
(b) describe the hiring, training and supervision of the personnel necessary to implement the Decree;
(c) describe necessary resource development activities, including actions, inter-agency agreements, requests for proposals and the development of other resources necessary to implement the Decree;
(d) describe the methods and mechanisms by which Defendants shall comply with the obligations set forth in Paragraph 25, above;
(e) identify, based on information known at the time the Implementation Plan is prepared, any services or supports required in Transition Service Plans formulated pursuant to the Decree that are not currently available in the appropriate quantity, quality or geographic location; and
(f) identify, based on information known at the time the Implementation Plan is prepared, any services and supports which, based on demographic or other data, are expected to be required in the following six months to meet the obligations of the Decree.
27. Within ninety (90) days after Approval of the Decree, Defendants shall provide the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel with a draft Implementation Plan. The Monitor, Plaintiffs and Class Counsel will participate in developing and finalizing the Implementation Plan, which shall be finalized and filed with the Court within six (6) months following Approval of the Decree. Intervenors may provide input to the Parties and the Monitor on the Implementation Plan. In the event the Monitor or Plaintiffs disagree with the Defendants’ proposed Implementation Plan, the matter shall be submitted to the Court for resolution. If Intervenors disagree with the Defendants’ proposed Implementation Plan with
15

respect to provisions in Paragraphs 4-10, 25 and 45 regarding Individuals who choose to receive ICF/MR services in an ICF-DD, Intervenors may submit any such issue to the Court for resolution. The Monitor, Plaintiffs, or Intervenors shall submit such issues within fourteen (14) days after the filing of the Implementation Plan.
28. The Implementation Plan shall be updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate. The Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel may review and comment upon any such updates or amendments. Intervenors’ and Intervenors’ Counsel’s comments shall be limited to those updates or amendments which relate to provisions in Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD. In the event the Monitor or Plaintiffs disagree with the Defendants’ proposed updates or amendments, the matter may be submitted to the Court for resolution. If Intervenors disagree with the Defendants’ proposed updates or amendments relating to provisions in Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, Intervenors may submit such issue to the Court for resolution.
29. The Implementation Plan, and any amendments or updates thereto, shall be set forth in a separate Court Order supplemental to the Decree. XIV. MONITORING AND COMPLIANCE
30. Appointment of a Monitor. The Court shall appoint an independent and impartial Monitor who is knowledgeable concerning the management and oversight of programs serving Individuals with Developmental Disabilities. The Parties shall endeavor to agree on a single candidate for Monitor, after obtaining input rom Class Members. Intervenors may provide input to the Parties on the Monitor. Within twenty-one (21) days after Approval of the Decree, the Parties shall submit to the Court their joint recommendation or separate nominations for a Monitor. If the Parties cannot agree, Plaintiffs and Defendants shall each submit to the Court the names of no more than two qualified professionals or organizations who are experienced in the design and development of community programs for Individuals with Developmental Disabilities, and experienced in the administration and monitoring of specialized services for Individuals with Developmental Disabilities. Each Party will have seven (7) days to
16

comment on the qualifications of the other Party’s candidate(s). Intervenors may, within the same seven (7) days, comment on the qualifications of any one or more of the Parties’ candidates. The Court then shall select the Monitor from the names submitted by the Parties. In the event the Monitor resigns or otherwise becomes unavailable, and the Parties cannot agree on a replacement Monitor to recommend to the Court, the process described above will be used to select a replacement Monitor.
31. Role of the Monitor. The duties of the Monitor shall include gauging Defendants’ compliance with the Decree, identifying actual and potential areas of noncompliance with the Decree, facilitating the resolution of compliance issues without Court intervention, and recommending appropriate action by the Court in the event an issue cannot be resolved by discussion and negotiation among the Monitor, the Parties, and, with respect to provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, the Intervenors. The Monitor may retain such staff and/or consultants as appropriate to assist in the performance of his or her duties.
32. Development of Measurable Standards for Evaluation. (a) Within 90 days after the Monitor’s appointment, the Monitor shall submit to the Parties and the Intervenors a set of objective standards to guide the Monitor in evaluating Defendants’ compliance with the Decree. Intervenors may provide input to the Parties and the Monitor on the standards. In the event any of the Parties believe that such standards are insufficient or inappropriate, they shall first meet and confer with the Monitor in an effort to revise the standards in a manner acceptable to the Monitor and the Parties. In the event the Intervenors believe that such standards are insufficient or inappropriate with respect to Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, they shall first meet and confer with the Monitor and the Parties in an effort to revise the standards in a manner acceptable to the Monitor, the Parties, and the Intervenors. In the event that following any such meet and confer, the Monitor, the Parties, and the
17

Intervenors are unable to agree on such standards, any of the Parties or the Intervenors may seek appropriate relief from the Court within 14 days after they meet and confer. Once finalized, the objective standards will be made publicly available. (b) Appropriate standards by which the Monitor evaluates Defendants’ compliance with the Decree shall include, but are not limited to, the following: (i) whether Transition Service Plans meet the criteria set forth in
Section VII; (ii) whether the benchmarks set forth in Sections VIII and IX and X
have been satisfied; (iii) whether Class Members who are determined to be in Crisis receive
services expeditiously in accordance with Paragraph 21; (iv) the extent to which, at periodic intervals, Class Members are being
placed in Community-Based Settings; and (v) the extent to which, at periodic intervals, Class Members are
receiving Community-Based Services. (c) None of the standards adopted by the Monitor pursuant to this Paragraph
32 shall in any way modify, change or otherwise abrogate any of the terms of the Decree or Defendants’ obligations under the Decree. 33. Review and Evaluation of Data and Information. The Monitor shall review and evaluate Defendants’ compliance with the terms of the Decree. Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress towards achieving compliance. Prior to the first report, the Parties and the Monitor will agree on the data and information that must be included in such reports. The Intervenors may provide input to the Parties and the Monitor on the proposed data and information. Defendants will not refuse any request by the Monitor for documents or other information that are
18

reasonably related to the Monitor’s review and evaluation of Defendants’ compliance with the Decree, and Defendants will, upon reasonable notice, permit confidential interviews of Defendants’ staff or consultants, except their attorneys. The Monitor will have access to all Class Members and their records and files, as well as to those service providers, facilities, buildings and premises that serve, or are otherwise pertinent to, Class Members, where such access is reasonably related to the Monitor’s review and evaluation of Defendants’ compliance with the Decree. The Defendants shall comply with Plaintiffs’ requests for information that are reasonably related to Defendants’ compliance with the Decree, including without limitation requests for records and other relevant documents pertinent to implementation of the Decree or to Class Members. Class Counsel also shall be permitted to review the information provided to the Monitor. All information provided to the Monitor and/or Class Counsel pursuant to the Decree shall be subject to the Protective Order.
34. Reporting. The Monitor shall file annual reports with the Court, which shall be served on all Parties and Intervenors and be made publicly available. Such reports shall include the information necessary, in the Monitor’s professional judgment, for the Court, Plaintiffs, and Intervenors to evaluate Defendants’ compliance or non-compliance with the terms of the Decree. The Monitor may file additional reports as necessary.
35. Compliance. In the event the Monitor finds Defendants not in compliance with the Decree, the Monitor shall promptly meet and confer with the Parties in an effort to agree on steps necessary to achieve compliance. In the event the Monitor finds Defendants not in compliance with the Decree relating to provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, the Monitor shall promptly meet and confer with the Parties and the Intervenors in an effort to agree on steps necessary to achieve compliance. In the event that Plaintiffs believe that Defendants are not complying with the terms of the Decree, Plaintiffs shall notify the Monitor and Defendants of Defendants’ potential non-compliance. The Monitor then shall review Plaintiffs’ claims of actual or potential non-compliance and, as the Monitor deems appropriate in his or her professional judgment, meet and confer with Defendants and Plaintiffs in an effort to agree on steps necessary to achieve compliance with the Decree. If the Monitor and Parties agree, such
19

steps shall be memorialized in writing and set forth in a separate Court Order supplemental to the Decree. In the event that the Monitor is unable to reach agreement with Defendants and Plaintiffs, the Monitor may seek appropriate relief from the Court. In the event that Plaintiffs believe that Defendants are not in compliance with the Decree and that the Monitor refuses or fails to act, Plaintiffs may seek appropriate relief from the Court.
In the event that Intervenors believe that Defendants are not complying with the terms of the Decree relating to provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, Intervenors shall notify the Monitor and Parties of Defendants’ potential non-compliance. The Monitor then shall review Intervenors’ claims of actual or potential non-compliance and, as the Monitor deems appropriate in his or her professional judgment, meet and confer with the Parties and Intervenors in an effort to agree on steps necessary to achieve compliance with the Decree. If the Monitor, the Intervenors and Parties agree, such steps shall be memorialized in writing and set forth in a separate Court Order supplemental to the Decree. In the event that the Monitor is unable to reach agreement with Intervenors, Defendants and Plaintiffs, the Monitor may seek appropriate relief from the Court. In the event that the Intervenors believe that Defendants are not in compliance with the Decree and that the Monitor refuses or fails to act, Intervenors may seek appropriate relief from the Court.
The Monitor will not communicate with the Court without advance notice to the Parties and the Intervenors. Individuals who choose to receive ICF/MR services in an ICF-DD shall have the same rights as Class Members to enforce this Decree, provided however that such Individuals’ rights to enforce this Decree shall be limited to enforcement of provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD.
36. Compensation of the Monitor. Defendants shall compensate the Monitor and his or her staff and consultants at their usual and customary rate. Defendants shall reimburse all reasonable expenses of the Monitor and the Monitor’s staff, consistent with the guidelines set forth in the “Governor’s Travel Control Board Travel Guide for State Employees.” Defendants
20

reserve their right to seek relief from the Court if Defendants believe that any of the Monitor’s charges are inappropriate or unreasonable. XV. NAMED PLAINTIFFS
37. As part of the settlement of the Litigation, within sixty (60) days after Approval of the Decree, Defendants shall offer each of the Named Plaintiffs the opportunity to receive appropriate Community-Based Services or placement in a Community-Based Setting. Provision of services to the Named Plaintiffs pursuant to this provision shall not be used to determine any other particular Class Member’s eligibility for services under the terms of the Decree. XVI. ATTORNEYS’ FEES AND COSTS
38. In full settlement of all attorneys’ fees incurred in connection with the Litigation, Defendants shall pay $1,740,000.00 to Class Counsel and $500,000.00 to Intervenors’ Counsel. In addition, in full settlement of all out-of-pocket costs and expenses (not to include attorneys’ fees) incurred by Class Counsel, Defendants shall pay to Class Counsel reasonable costs and expenses incurred by Class Counsel through and including the Approval of the Decree and any appeal thereof. Class Counsel shall provide Defendants with their out-of-pocket costs and expenses and appropriate supporting documentation so that Defendants have an opportunity to review them and, if necessary, meet and confer with Class Counsel and bring any disputes before the Court. Defendants shall pay one-half of the aforesaid amounts due Class Counsel and onehalf of the aforesaid amount due Intervenors’ Counsel in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of the aforesaid amounts due Class Counsel and one-half of the aforesaid amount due Intervenors’ Counsel in State Fiscal Year 2013 (which begins July 1, 2012). All of the aforesaid amounts shall be distributed to Class Counsel and Intervenors’ Counsel in the manner set forth in written instructions provided by Class Counsel and Intervenors’ Counsel, respectively. Furthermore, such amounts shall be set forth in one or more Judgment Orders to be entered by the Court within fourteen (14) days after Approval of the Decree. Defendants shall complete and submit all paperwork necessary for payment of the first half of the aforesaid amounts, plus applicable statutory post-judgment interest, within (a) five (5) business days after expiration of the time to appeal the Decree without the filing of a Notice of Appeal, or after the issuance of the mandate by the highest reviewing court, whichever is later,
21

or (b) July 1, 2011, whichever is later. Defendants shall complete and submit all paperwork necessary for payment of the second half of the aforesaid amounts, plus applicable statutory post-judgment interest, on July 2, 2012.
39. Nothing herein shall preclude the Court from imposing sanctions or other relief for non-compliance with the Decree. XVII. MISCELLANEOUS PROVISIONS
40. Approval of the Decree. “Approval of the Decree” shall be deemed to occur on the date the Court enters the Decree.
41. Costs of Notices. The cost of all notices hereunder or otherwise ordered by the Court shall be borne by Defendants.
42. Signatories. Each undersigned representative of a Defendant to this Litigation and the Attorney General for the State of Illinois certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally such Defendant to this document. Each undersigned representative of Plaintiffs and Class Counsel certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally the Plaintiffs and Class Counsel to this document. Each undersigned representative of the Intervenors certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally those individuals whom he or she represents to this document.
43. Delivery of Notices or Mailings. (a) Delivery of notices or mailings to Plaintiffs shall be made to: Equip for Equality, Attn.: Barry Taylor (or his successor), 20 North Michigan Avenue, Suite 300, Chicago, Illinois 60602; and SNR Denton US LLP, Attn.: John Grossbart, 233 South Wacker Drive, Suite 7800, Chicago, Illinois 60606. (b) Delivery of notices or mailings to Defendants shall be made to: Office of the Illinois Attorney General, Attn: Brent D. Stratton, 100 W. Randolph Street, Chicago, Illinois 60601 and Office of the Illinois Attorney General,
22

Attn: Karen Konieczny, 160 N. LaSalle St., Suite N-1000, Chicago, Illinois 60601. (c) Delivery of notices or mailings to Intervenors shall be made to: Scott M. Mendel, K&L Gates LLP, 70 W. Madison St., Suite 3100, Chicago, IL 60602, William Choslovsky, Neal, Gerber & Eisenberg, LLP, Two N. LaSalle St., Suite 1700, Chicago, IL 60602, James W. Ducayet, Sidley Austin LLP, One S. Dearborn, Chicago, IL 60603. (d) The Parties and Intervenors may modify the instructions for delivery of notices or mailings contained in this Paragraph 43 without Court approval. 44. Waiver. Defendants have waived their right to oppose entry of the Decree by this Court or to challenge any provision of the Decree. Defendants have waived their right to appeal the Decree or any other matter that has occurred to date in connection with the Litigation. 45. Nothing in this Decree alters the legal rights that Individuals with Developmental Disabilities, including Class Members, otherwise may have, including the right to choose to receive ICF/MR services in an ICF-DD. Nothing in this Decree alters the legal rights that an Individual with Developmental Disabilities otherwise may have to work directly (i) with the State-identified point of entry for developmental disability services and/or (ii) with an ICF-DD to be approved to move into a then-existing licensed vacancy in an ICF-DD, including a vacancy created by a departing resident. 46. Nothing in this Decree alters the legal rights, authority, or responsibilities of the legal guardian(s) of any Individual with Developmental Disabilities under state or federal law or regulations. XVIII. TERMINATION 47. The Court shall retain exclusive jurisdiction to fully oversee, supervise, modify and enforce the terms of the Decree. The Court shall retain such jurisdiction for at least nine (9) years following the Approval of the Decree. 48. The Parties, jointly or separately, may request termination of the monitoring process described in Section XIV at any time after nine (9) years from Approval of the Decree. If, after nine years from Approval of the Decree or any time thereafter, Defendants and the
23

Monitor agree that Defendants have substantially complied with the terms of the Decree, Defendants shall notify Plaintiffs and Intervenors in writing of their desire to terminate the monitoring process (“Termination Request”). Plaintiffs shall have not less than 120 days from receipt of the Termination Request to respond. Intervenors may provide input to the Parties and the Monitor on the Termination Request. During those 120 days, Plaintiffs shall have the opportunity to conduct reasonable discovery concerning factual issues relevant to the determination of compliance. If Plaintiffs oppose the Termination Request, Plaintiffs must file a motion within 120 days from the date of receipt of Defendants’ Termination Request.
49. The Court will grant Defendants’ Termination Request and terminate the monitoring process if the Court finds that Defendants have substantially complied with the terms of the Decree and the Court determines that Defendants have implemented and are maintaining a system that complies with the Decree.
50. Termination of the Court’s jurisdiction over the Decree may occur only in the event of a successful request to terminate the monitoring process pursuant to Section XVIII. The Decree shall remain in effect, and the Court shall retain its jurisdiction over the Decree, until a final order is entered granting the Termination Request and all appellate rights and/or appeals have been exhausted.
SO ORDERED THIS _____ DAY OF ______________, 20____. ________________________________________ United States District Judge
[SIGNATURE PAGE FOLLOWS]
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.:
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 Case: 1:05-cv-04331 Document #: 555 Filed: 07/05/11 Page 1 of 2 PageID #:11172
IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs, vs.
JULIE HAMOS, et al., Defendants.

)

)

)

No. 05 C 4331

)

)

Chief Judge Holderman

)

)

)

)

JUDGMENT ORDER

This cause coming on to be heard pursuant to the Agreed Motion for Entry of Judgment

Order, and the Court being fully advised,

IT IS HEREBY ORDERED that:

1. Plaintiffs’ Agreed Motion for Entry of Judgment Order (Doc. No. 550) is granted; and

2. In accordance with this Court’s Consent Decree entered June 15, 2011 (Doc. No. 549), judgment is entered against the Defendants, and the Defendants are ordered to pay:

(i) $188,318.69 in costs and expenses incurred by Plaintiffs, to be paid to SNR Denton US LLP, with one-half of that amount due in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of that amount due in State Fiscal Year 2013 (which begins July 1, 2012);

(ii) $186,254.67 in costs and expenses incurred by Plaintiffs, to be paid to Equip for Equality, with one-half of that amount due in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of that amount due in State Fiscal Year 2013 (which begins July 1, 2012);

(iii) $59,557.18 in costs and expenses incurred by Plaintiffs, to be paid to Roger Baldwin Foundation of ACLU, Inc., with one-half of that amount due in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of that amount due in State Fiscal Year 2013 (which begins July 1, 2012);

(iv) $29,790.09 in costs and expenses incurred by Plaintiffs, to be paid to Access Living of Metropolitan Chicago, with one-half of that amount due in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of that amount due in State Fiscal Year 2013 (which begins July 1, 2012);

(v) $1,740,000.00 in attorneys’ fees incurred by Plaintiffs, to be paid to Class Counsel, with one-half of that amount due in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of that amount due in State Fiscal Year 2013 (which begins July 1, 2012); and

Case: 1:05-cv-04331 Document #: 555 Filed: 07/05/11 Page 2 of 2 PageID #:11173 (vi) $500,000.00 in attorneys’ fees incurred by the Intervenors, to be paid to Intervenors’ Counsel, with one-half of that amount due in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of that amount due in State Fiscal Year 2013 (which begins July 1, 2012). Dated: July 5, 2011 Chief Judge Holderman
- 2 -

 
 Case: 1:05-cv-04331 Document #: 564 Filed: 02/15/12 Page 1 of 1 PageID #:11214

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al.,
Plaintiffs, vs. JULIE HAMOS, in her official capacity as Director of the Illinois Department of Healthcare and Family Services, et al.,
Defendants.

) ) ) ) ) No. 05 C 4331 ) ) Chief Judge Holderman ) ) Magistrate Judge Cole ) )

ORDER This matter coming before the Court on the Agreed Motion to Enter Order Regarding Implementation Plan, the Plaintiffs, Defendants, Intervenors and Monitor having all approved the Implementation Plan and the Court being fully advised in the premises, IT IS HEREBY ORDERED THAT the Implementation Plan, attached hereto and previously filed by Defendants on December 15, 2011 (Doc. No. 559), is hereby filed as a supplement to the Consent Decree (Doc. No. 549).

Dated: February 15, 2012

_____________________________ Chief Judge James F Holderman

 
 Case: 1:05-cv-04331 Document #: 569 Filed: 03/05/13 Page 1 of 1 PageID #:11289

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al.,
Plaintiffs, vs.
JULIE HAMOS, in her official capacity as Director of the Illinois Department of Healthcare and Family Services, et al.,
Defendants.

) ) ) ) ) No. 05 C 4331 ) ) Chief Judge Holderman ) ) Magistrate Judge Cole ) )

ORDER This matter coming before the Court on the Agreed Motion to Approve Amendments to Implementation Plan, the Defendants having prepared and circulated for comment draft amendments to the Plan, and after providing input to Defendants, the Plaintiffs and Intervenors not raising any objections to the final version of Amended Implementation Plan and the Court being fully advised in the premises, IT IS HEREBY ORDERED THAT the Amended Implementation Plan, previously filed on February 22, 2013 (Doc. No. 566, Ex. 1), is hereby approved and filed as a supplement to the Consent Decree (Doc. No. 549).

Dated: March 5, 2013

___________________________________ Chief Judge James F. Holderman

 
 Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 1 of 41 PageID #:11108

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs, vs.
JULIE HAMOS, et al., Defendants.

) ) ) No. 05 C 4331 ) ) Chief Judge Holderman ) Magistrate Judge Cole ) ) ) )

CONSENT DECREE

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 2 of 41 PageID #:11109 TABLE OF CONTENTS
INTRODUCTION AND BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 DECREE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 I. JURISDICTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 II. CLASS DEFINITION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 III. DEFINITION OF TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 IV. THE DEVELOPMENTAL DISABILITY SERVICES SYSTEM . . . . . . . . . . . . . . . . . . 7 V. DETERMINATION OF CLASS MEMBERSHIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 VI. STATEWIDE DATABASE AND WAITING LIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 VII. TRANSITION SERVICE PLANS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 VIII. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS RESIDING IN
ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE . . . . . . . . . . . . . . . 10 IX. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS NOT RESIDING
IN ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE . . . . . . . . . . . . . 11 X. PROVISION OF SERVICES AFTER THE END OF THE SIXTH YEAR
FOLLOWING APPROVAL OF THE DECREE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 XI. DISPUTE RESOLUTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 XII. OUTREACH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 XIII. IMPLEMENTATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 XIV. MONITORING AND COMPLIANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 XV. NAMED PLAINTIFFS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 XVI. ATTORNEYS’ FEES AND COSTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 XVII. MISCELLANEOUS PROVISIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 XVIII. TERMINATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
i

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 3 of 41 PageID #:11110
INTRODUCTION AND BACKGROUND Plaintiffs1, who are Illinois residents with Developmental Disabilities, filed this class action lawsuit on July 28, 2005, seeking declaratory and injunctive relief to redress violations of the community integration mandates of Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132; Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a); and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v. Plaintiffs allege that those federal statutes require Defendants to: (a) provide services, programs and activities in the most integrated setting appropriate to the needs of Individuals with Developmental Disabilities; (b) implement procedures to provide such services, programs and activities; and (c) offer Individuals with Developmental Disabilities a choice between services, supports and programs provided in ICFsDD, and services, supports and programs that are integrated into the community. Defendants have denied liability. Intervenors are Illinois residents with Developmental Disabilities who have intervened to ensure that the State of Illinois continues to meet its obligations to also provide ICF-DD services. In the interest of compromise and settlement, Plaintiffs, Intervenors, and Defendants have entered into a Stipulation agreeing to the form, and jointly moved for preliminary and final approval, of a proposed consent decree. On January 13, 2011, the Court entered an Order preliminarily approving the Decree set forth below in accordance with Parties’ proposal. (Doc. No. 525.) Thereafter, pursuant to that Order, the Parties provided notice in accordance therewith, which the Court previously found, and hereby affirms, constitutes reasonable notice under the circumstances, and is in full compliance with the requirements of due process and governing law. On June 15, 2011, the Court conducted a fairness hearing, at which it considered the written submissions of all interested persons and the presentations made in open court; and assessed the fairness and reasonableness of the Decree set forth below, taking into account the
1 Certain capitalized terms set forth herein are defined in Section III, below. 1

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 4 of 41 PageID #:11111 benefits of litigation to the Plaintiffs as compared with the benefits offered by the Decree, the resources of the State of Illinois, and the needs of the Intervenors and other Individuals with Developmental Disabilities. As set forth in its Order dated June 15, 2011 (Doc. No. 547), the Court is of the opinion that the Decree set forth below represents a fair resolution of the competing interests of Plaintiffs, Intervenors, and Defendants; that it is fair, reasonable and adequate; and that it should be and is approved pursuant to Rule 23 of the Federal Rules of Civil Procedure.
Therefore, upon all of the foregoing, and the Court being otherwise fully advised, the Court hereby ORDERS, ADJUDGES and DECREES as follows:
DECREE I. JURISDICTION
1. The Court has jurisdiction over this Litigation pursuant to 28 U.S.C. § 1331 and 28 U.S.C. § 1343. II. CLASS DEFINITION
2. The Class is defined as those individuals in one of two sub-classes: (a) adult individuals in Illinois: (i) who have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2) and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid Waiver services; (ii) who reside in private ICFs-DD with nine or more residents; and (iii) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a Current Record reflecting that the individual has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting; or (b) adult individuals in Illinois: (i) who have mental retardation and/or other developmental disabilities within the meaning of the ADA, 42 U.S.C. § 12131(2)
2

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 5 of 41 PageID #:11112 and the Rehabilitation Act, 29 U.S.C. § 794(a), and who qualify for Medicaid Waiver services;
(ii) who reside in a Family Home and are in need of CommunityBased Services or placement in a Community-Based Setting; and
(iii) for whom Defendants (including Defendants’ agencies, employees, contractors and agents, and those acting in concert with them) have a Current Record reflecting that the individual has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting.
III. DEFINITION OF TERMS 3. As used herein, the following terms have the following meanings: (a) “Approval of the Decree” means the date defined in Paragraph 40, below. (b) “Class Counsel” means all of the attorneys that have appearances on behalf of the Named Plaintiffs in effect as of the Approval of the Decree, and each of the following organizations: Equip for Equality; SNR Denton; Access Living of Metropolitan Chicago; and Roger Baldwin Foundation of ACLU, Inc. (c) “Class” and “Class Members” mean the persons who meet the definition set forth in Section II, above. (d) “Community-Based Services” means those services (other than a placement in a Community-Based Setting) available under the Waiver. (e) “Community-Based Setting” means a Waiver-funded residential setting with a maximum of eight (8) beds, but does not include an ICF-DD, that is the most integrated residential setting appropriate for an Individual where the setting is designed to promote independence in daily living, community integration, and economic self-sufficiency and enables the Individual to interact with non-disabled persons to the fullest extent possible.
3

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 6 of 41 PageID #:11113 (f) “Community Service Provider” means a provider of Waiver-funded services, but does not include an ICF-DD or a State Operated Developmental Center. (g) “Court” means the United States District Court for the Northern District of Illinois, Eastern Division. (h) “Crisis” has the meaning set forth in Paragraph 21(a), below. (i) “Current Record” means an accurate record reflecting that the Individual, or the Individual’s legal guardian, has affirmatively requested to receive Community-Based Services or placement in a Community-Based Setting, and, to the best of Defendants’ knowledge, that record has not been withdrawn or retracted by the Individual or the Individual’s legal guardian. All Individuals who objected (either personally, or through the Individual’s legal guardian) to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing in this Litigation, on the grounds that they do not wish to receive Community-Based Services or placement in a Community-Based Setting shall be deemed to have retracted any record reflecting that, prior to such objection, he or she had affirmatively indicated that he or she seeks to receive Community-Based Services or placement in a Community-Based Setting. (j) “Decree” means this Consent Decree. (k) “Defendants” means the Director of the Illinois Department of Healthcare and Family Services; the Secretary of the Illinois Department of Human Services; and any of their successors. (l) “Developmental Disability” means a disability that is attributable to a diagnosis of mental retardation (mild, moderate, severe, profound), or a related condition. A related condition is attributable to: cerebral palsy or epilepsy, or any other condition, other than mental illness, found to be closely related to mental retardation because this condition results in impairment of general intellectual functioning or adaptive behavior similar
4

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 7 of 41 PageID #:11114 to that of persons with mental retardation, and requires treatment or services similar to those required for persons with mental retardation. In addition, this condition is manifested before the age of 22; is likely to continue indefinitely; and results in substantial functional limitations in three or more of the following areas of major life activity: self-care; understanding and use of language; learning; mobility; self-direction; capacity for independent living.
(m) “Family Home” means a family home and does not include a CommunityIntegrated Living Arrangement, as defined at 210 ILCS §135/3(d), or an ICF-DD.
(n) “ICF-DD” means any privately-owned long term care facility licensed by the Illinois Department of Public Health as an Intermediate Care Facility for the Developmentally Disabled, as defined at 77 Ill.Adm.Code §300.330.
(o) “ICF/MR services” shall have the meaning set forth in 42 C.F.R. § 440.150.
(p) “Implementation Plan” has the meaning set forth in Section XIII, below. (q) “Individual” means a person in Illinois 18 years of age or older who has
one or more Developmental Disabilities and who is Medicaid-eligible. (r) “Intervenors” mean those individuals granted leave to intervene pursuant
to the Court’s Memorandum Opinion and Order entered on April 7, 2010. (Doc. No. 479) (s) “Intervenors’ Counsel” means all of the attorneys who have appearances on behalf of the Intervenors in effect as of the Approval of the Decree. (t) “Litigation” means the matter Ligas v. Hamos, Case No. 05-4331, filed in the United States District Court for the Northern District of Illinois, Eastern Division. (u) “Monitor” means the person or entity appointed by the Court pursuant to Section XIV, below, to perform the functions more fully described therein.
5

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 8 of 41 PageID #:11115 (v) “Named Plaintiffs” means the following people, each of whom the Court certified as a class representative in the Litigation: David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, and Jennifer Wilson. (w) “Parties” means Plaintiffs and Defendants, collectively. (x) “Plaintiffs” means the Named Plaintiffs and Class Members, collectively. (y) “Protective Order” means the Protective Order entered by the Court in the Litigation on May 15, 2006 (Doc. No. 98). (z) “Qualified Professional” means an appropriately trained and qualified professional. (aa) “State Plan” means the plan that was submitted by the State of Illinois to the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, in accordance with Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v, in effect as of the date of Approval of the Decree, including any amendments thereto. (bb) “Transition Service Plan” has the meaning set forth in Section VII, below. (cc) “Waiting List” has the meaning set forth in Paragraph 9, below. (dd) “Waiting List Class Members” has the meaning set forth in Paragraph 22(c), below. (ee) “Waiver” means the Illinois Home and Community-Based Services Waiver for Adults with Developmental Disabilities, as approved by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, in effect as of the date of Approval of the Decree, or any amendments thereto or similar waivers subsequently approved by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, but only to the extent such amendments or subsequent waivers expand the range and/or amount of services available to Individuals with Developmental Disabilities.
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 9 of 41 PageID #:11116 IV. THE DEVELOPMENTAL DISABILITY SERVICES SYSTEM
4. Development of Resource Capacity. The choices of Individuals with Developmental Disabilities, including Class Members, to receive Community-Based Services or placement in a Community-Based Setting or to receive ICF/MR services in an ICF-DD will be honored; provided, however, that this commitment to honoring choice does not alter Defendants’ current obligations under existing law regarding licensed ICF-DD capacity system-wide or at any specific ICF-DD, and provided that, under current applicable law, this commitment does not entitle an Individual with Developmental Disabilities to receive ICF/MR services in a specific ICF-DD. Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such Individuals under the Decree and the Implementation Plan consistent with such choices. While the Decree remains in effect, any amendment to the State Plan submitted by the State pursuant to 42 U.S.C. § 1396, et seq. will continue to include ICF-DD services as an alternative choice for long-term care services for eligible Individuals with Developmental Disabilities. Nothing in this Decree shall impair Defendants’ ability to make changes in their provision of supports and services to Individuals with Developmental Disabilities, including Class Members, regardless of setting, provided that Defendants continue to honor Individuals’ choices and fulfill Defendants’ obligations under the Decree and Implementation Plan. Resources necessary to meet the needs of Individuals with Developmental Disabilities who choose to receive services in ICFs-DD shall be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree, including the obligations under Paragraphs 17 through 19 and 21 through 23. Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs using federally approved objective criteria regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based Setting; provided, however, nothing in this Decree shall require Defendants to change their current method for establishing funding or from adopting new methods based upon federally approved objective criteria.
5. Resources and Budget Requests. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the
7

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 10 of 41 PageID #:11117 services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings. Nothing contained in this Paragraph 5 shall be deemed to create or operate as (i) a condition or contingency upon which any term of the Decree depends; or (ii) a circumstance entitling Defendants to alter, amend or modify the implementation or timing of Defendants’ obligations under the Decree. V. DETERMINATION OF CLASS MEMBERSHIP
6. Within thirty (30) days after Approval of the Decree, Defendants shall compile an initial list of Class Members by taking the list of Individuals to whom notice of Preliminary Approval of this Decree was sent, adding those Individuals from whom any of the Parties received a written, affirmative request to receive Community-Based Services or placement in a Community-Based Setting after notice of Preliminary Approval of this Decree was sent, but excluding (i) those individuals who filed objections to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing as described in Paragraph 3(i) above, and (ii) those Individuals from whom Defendants receive written requests that the Individuals do not wish to receive Community-Based Services or placement in a Community-Based Setting.
7. Within thirty (30) days after compiling the initial list described in Paragraph 6 above, Defendants shall confirm whether all Class Members on the initial list are included in the statewide database described in Paragraph 8 below and shall add – to the extent possible with available information – those Class Members not already included. VI. STATEWIDE DATABASE AND WAITING LIST
8. Defendants shall maintain a statewide database in which all Class Members are enrolled. Defendants must promptly and regularly add Individuals to this database as they become Class Members. If Defendants receive written requests from Individuals that the Individuals would not wish to receive Community-Based Services or placement in a Community-Based Setting, Defendants shall promptly revise the database to reflect the fact that such Individuals are no longer Class Members. Defendants must update all enrollment information on an annual basis.
8

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 11 of 41 PageID #:11118 9. Class Members not residing in ICFs-DD as of the date of Approval of the Decree
who are enrolled in the statewide database described in Paragraph 8 above shall be placed on a Waiting List with selection prioritized by the Class Member’s urgency of need for CommunityBased Services or placement in a Community-Based Setting, the length of time that has passed since the Class Member enrolled, geographical considerations and other factors. Defendants must promptly and regularly update the Waiting List as Class Members are added to the database described in paragraph 8, above. VII. TRANSITION SERVICE PLANS
10. Within no more than twelve months prior to the development of a Transition Service Plan, Defendants shall present to the Class Member, in an objective manner, all of his or her service alternatives under the State Plan and any applicable Waiver, determine whether, after such presentation, the Class Member requests Community-Based Services or placement in a Community-Based Setting and obtain from the Class Member a completed and executed DDPAS-10 Form and a DMHDD-1238 Form (the “Request Forms”) evidencing Class Member’s request. Upon receipt of the Request Forms from the Class Member, Defendants shall develop a Transition Service Plan specific to, and centered on, each Class Member as each Class Member is selected from the statewide database to receive Community-Based Services or placement in Community-Based Settings under this Decree.
11. The Transition Service Plan shall describe the services the Class Member requires in a Community-Based Setting or through Community-Based Services; where and how such services can be developed and obtained; the supports and services the Class Member will need during his or her transition to a Community-Based Setting; and a timetable for completing that transition.
12. The Transition Service Plan shall be developed by a Qualified Professional in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member.
13. The process for developing a Transition Service Plan shall focus on the Class Member’s personal vision, preferences, strengths and needs in home, community and work
9

Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 12 of 41 PageID #:11119 environments and shall reflect the value of supporting the Class Member with relationships, productive work, participation in community life, and personal decision-making.
14. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent possible, consistent with the choices of the Class Member and the Class Member’s legal guardian.
15. The Transition Service Plan shall not be limited by the current availability of services, provided, however, that nothing in this paragraph obligates Defendants to provide the types of services beyond those included in the Waiver and/or the State Plan.
16. The Transition Service Plan shall be completed within sufficient time to provide appropriate and sufficient transitions of Class Members in accordance with the deadlines set forth in the Decree. VIII. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS RESIDING IN
ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE 17. Subject to the interim requirements set forth below, within six (6) years after Approval of the Decree, all Class Members residing in ICFs-DD as of the date of Approval of the Decree (regardless of when in this timeframe the Class Member affirmatively requested placement in a Community-Based Setting) will transition to Community-Based Settings consistent with their Transition Service Plans, if, at the time of transition, the Class Member requests placement in a Community-Based Setting, as confirmed and documented in accordance with Paragraph 10. 18. Within two and a half years after Approval of the Decree: not less than one-third of the total number of those Class Members residing in ICFs-DD as of the date of Approval of the Decree who have, within two (2) years after the date of Approval of the Decree, affirmatively requested placement in a Community-Based Setting will be transitioned to Community-Based Settings consistent with their Transition Service Plans. 19. Within four and a half years after Approval of the Decree: not less than twothirds of the total number of those Class Members residing in ICFs-DD as of the date of Approval of the Decree who have, within four (4) years after the date of Approval of the Decree, affirmatively requested placement in a Community-Based Setting will be transitioned to Community-Based Settings consistent with their Transition Service Plans.
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 13 of 41 PageID #:11120 IX. BENCHMARKS FOR TRANSITIONS OF CLASS MEMBERS NOT RESIDING
IN ICFs-DD AS OF THE DATE OF APPROVAL OF THE DECREE 20. Within one (1) year after Approval of the Decree, Defendants shall screen all Class Members residing in a Family Home who are enrolled in the database described in Paragraph 8 as of the date of Approval of the Decree regarding the Class Members’ potential eligibility and need for developmental disabilities services, including (i) a determination of whether such Class Members meet the Crisis criteria set forth in Paragraph 21(a) and, (ii) after presenting to the Class Member, in an objective manner, all of his or her service alternatives under the State Plan and any applicable Waiver, a determination of whether the Class Member requests Community-Based Services or placement in a Community-Based Setting, as confirmed and documented in accordance with Paragraph 10. 21. Class Members Who Reside in a Family Home and Are Determined to be in
a Situation of Crisis. (a) For purposes of the Decree, an Individual is in a situation of “Crisis” if he
or she is at imminent risk of abuse, neglect, or homelessness. The provision of interim emergency services (including interim placement in an ICF-DD where no placement in a Community-Based Setting was immediately available) will not necessarily exclude the Individual from being deemed to be in a situation of Crisis. Some examples of circumstances that constitute Crisis include, but are not limited to circumstances: (i) where the Individual’s caregiver(s) are deceased; (ii) where the Individual’s caregiver is unable to address the support
needs of the Individual, thereby jeopardizing the Individual’s health, well-being, and/or safety; (iii) where physical and/or mental injury and/or sexual abuse is being inflicted on the Individual; (iv) where the Individual is homeless or without domicile; or
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 14 of 41 PageID #:11121 (v) where the Individual’s behaviors (e.g., verbal and /or physical aggression, bodily harm to self and/or others) put the Individual and/or family member(s) at risk of serious harm.
(b) If, following a screening, the Individual who is determined to be in Crisis requests appropriate Community-Based Services to be provided in the Family Home or requests placement in a Community-Based Setting, Defendants will promptly develop, in conjunction with the Class Member, a Transition Service Plan. Transition Service Plans for such Class Members shall be developed as set forth in Section VII, above.
(c) Defendants shall ensure that all Class Members who are determined to be in a situation of Crisis, and who request to receive Community-Based Services and/or placement in a Community-Based Setting, receive such services and/or placement in such setting expeditiously. If a Class Member is determined to be in Crisis and then moves into an ICF-DD before Defendants are able to provide a placement in a Community-Based Setting, that change in the Class Member’s residential status will not in itself change the determination of Crisis or change the Defendants’ obligation to place the Class Member in a Community-Based Setting expeditiously, provided that, at the time of transition to a CommunityBased Setting, the Class Member requests placement in a CommunityBased Setting, as confirmed and documented at that time. There is no limit to, or cap upon, the number of Class Members in Crisis who shall be served pursuant to the Decree.
22. Benchmarks for Transitions of “Waiting List Class Members” (a) Class Members who become residents of ICFs-DD after the date of Approval of the Decree, but who did not reside in ICFs-DD as of the date of Approval of the Decree, shall be enrolled in the database described in Paragraph 8, placed on the Waiting List described in Paragraph 9 and served in accordance with this Paragraph 22, provided that the Class
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 15 of 41 PageID #:11122 Member requests Community-Based Services or placement in a Community-Based Setting, as confirmed and documented in accordance with Paragraph 10.
(b) Class Members residing at a Family Home who, as a result of the screening described in Paragraphs 20 and 21(a), are not determined to be in a situation of Crisis but who have requested and been identified as appropriate for Community-Based Services or placement in a CommunityBased Setting will be placed on the Waiting List described in Paragraph 9 and served in accordance with this Paragraph 22.
(c) Collectively, the Class Members identified in sub-Paragraphs 22(a) and 22(b), above, shall be referred to as “Waiting List Class Members.”
(d) Within two (2) years after Approval of the Decree, Defendants shall provide, in accordance with the Class Members’ Transition Service Plans, appropriate Community-Based Services and/or placement in CommunityBased Settings for at least 1,000 Waiting List Class Members who are selected from the Waiting List described in Paragraph 9 above, with these Class Members served in order of priority. In each of the third, fourth, fifth and sixth years following Approval of the Decree, Defendants shall serve at least 500 additional Waiting List Class Members who are selected from the Waiting List, again in order of priority. The obligations set forth in this Paragraph 22(d) do not obligate Defendants to serve more than 500 additional Waiting List Class Members who are selected from the Waiting List in each of the third, fourth, fifth, and sixth years following Approval of the Decree.
X. PROVISION OF SERVICES AFTER THE END OF THE SIXTH YEAR FOLLOWING APPROVAL OF THE DECREE 23. All Class Members who are on the Waiting List after the end of the sixth year
following Approval of the Decree shall receive appropriate Community-Based Services and/or placement in a Community-Based Setting, such that they move off the Waiting List at a reasonable pace, provided that the Class Members have requested such services and/or settings at
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 16 of 41 PageID #:11123 the point when they are to move off the Waiting List and that the requests are confirmed and documented in accordance with Paragraph 10. XI. DISPUTE RESOLUTION
24. Any Class Member who disputes a decision by Defendants or a Community Service Provider regarding eligibility for, or delivery of, Community-Based Services or placement in a Community-Based Setting shall, pursuant to governing law, have the right to appeal or seek administrative or judicial review of such decisions through Defendants’ existing Fair Hearings process (as set forth in 89 Ill.Adm.Code Part 120) or as otherwise provided by law. Class Members also may avail themselves of any informal appeal process that currently exists. XII. OUTREACH
25. Defendants shall maintain a fair and accessible process by which Individuals with Developmental Disabilities or their legal guardians can affirmatively request in writing to receive Community-Based Services and/or placement in a Community-Based Setting or to receive ICF-MR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests. Defendants, in conjunction with Class Counsel, also shall ensure that Individuals with Developmental Disabilities, and their guardians and/or families, have the opportunity to receive complete, accurate, and objective information regarding all alternative choices for longterm care services for eligible Individuals with Developmental Disabilities. Nothing in this Paragraph, or any other provision of this Decree, requires Defendants to provide this information to Individuals or their guardians or families who are not interested in changing their current placement. All costs for outreach shall be borne by Defendants. Details about how Defendants shall conduct the obligations set forth in this Paragraph 25 will be set forth in the Implementation Plan described below. XIII. IMPLEMENTATION
26. Overview and Contents of the Implementation Plan. Defendants, with the input of the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel shall create and implement an Implementation Plan to accomplish the obligations and objectives set forth in the Decree. Intervenors and Intervenors’ Counsel’s input shall be limited to those portions of the
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 17 of 41 PageID #:11124 Implementation Plan which relate to Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD. The Implementation Plan must, at a minimum:
(a) establish specific tasks, timetables, goals, programs, plans, strategies and protocols to assure that Defendants fulfill the requirements of each provision of the Decree;
(b) describe the hiring, training and supervision of the personnel necessary to implement the Decree;
(c) describe necessary resource development activities, including actions, inter-agency agreements, requests for proposals and the development of other resources necessary to implement the Decree;
(d) describe the methods and mechanisms by which Defendants shall comply with the obligations set forth in Paragraph 25, above;
(e) identify, based on information known at the time the Implementation Plan is prepared, any services or supports required in Transition Service Plans formulated pursuant to the Decree that are not currently available in the appropriate quantity, quality or geographic location; and
(f) identify, based on information known at the time the Implementation Plan is prepared, any services and supports which, based on demographic or other data, are expected to be required in the following six months to meet the obligations of the Decree.
27. Within ninety (90) days after Approval of the Decree, Defendants shall provide the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel with a draft Implementation Plan. The Monitor, Plaintiffs and Class Counsel will participate in developing and finalizing the Implementation Plan, which shall be finalized and filed with the Court within six (6) months following Approval of the Decree. Intervenors may provide input to the Parties and the Monitor on the Implementation Plan. In the event the Monitor or Plaintiffs disagree with the Defendants’ proposed Implementation Plan, the matter shall be submitted to the Court for resolution. If Intervenors disagree with the Defendants’ proposed Implementation Plan with
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 18 of 41 PageID #:11125 respect to provisions in Paragraphs 4-10, 25 and 45 regarding Individuals who choose to receive ICF/MR services in an ICF-DD, Intervenors may submit any such issue to the Court for resolution. The Monitor, Plaintiffs, or Intervenors shall submit such issues within fourteen (14) days after the filing of the Implementation Plan.
28. The Implementation Plan shall be updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate. The Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel may review and comment upon any such updates or amendments. Intervenors’ and Intervenors’ Counsel’s comments shall be limited to those updates or amendments which relate to provisions in Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD. In the event the Monitor or Plaintiffs disagree with the Defendants’ proposed updates or amendments, the matter may be submitted to the Court for resolution. If Intervenors disagree with the Defendants’ proposed updates or amendments relating to provisions in Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, Intervenors may submit such issue to the Court for resolution.
29. The Implementation Plan, and any amendments or updates thereto, shall be set forth in a separate Court Order supplemental to the Decree. XIV. MONITORING AND COMPLIANCE
30. Appointment of a Monitor. The Court shall appoint an independent and impartial Monitor who is knowledgeable concerning the management and oversight of programs serving Individuals with Developmental Disabilities. The Parties shall endeavor to agree on a single candidate for Monitor, after obtaining input from Class Members. Intervenors may provide input to the Parties on the Monitor. Within twenty-one (21) days after Approval of the Decree, the Parties shall submit to the Court their joint recommendation or separate nominations for a Monitor. If the Parties cannot agree, Plaintiffs and Defendants shall each submit to the Court the names of no more than two qualified professionals or organizations who are experienced in the design and development of community programs for Individuals with Developmental Disabilities, and experienced in the administration and monitoring of specialized services for Individuals with Developmental Disabilities. Each Party will have seven (7) days to
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 19 of 41 PageID #:11126 comment on the qualifications of the other Party’s candidate(s). Intervenors may, within the same seven (7) days, comment on the qualifications of any one or more of the Parties’ candidates. The Court then shall select the Monitor from the names submitted by the Parties. In the event the Monitor resigns or otherwise becomes unavailable, and the Parties cannot agree on a replacement Monitor to recommend to the Court, the process described above will be used to select a replacement Monitor.
31. Role of the Monitor. The duties of the Monitor shall include gauging Defendants’ compliance with the Decree, identifying actual and potential areas of noncompliance with the Decree, facilitating the resolution of compliance issues without Court intervention, and recommending appropriate action by the Court in the event an issue cannot be resolved by discussion and negotiation among the Monitor, the Parties, and, with respect to provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, the Intervenors. The Monitor may retain such staff and/or consultants as appropriate to assist in the performance of his or her duties.
32. Development of Measurable Standards for Evaluation. (a) Within 90 days after the Monitor’s appointment, the Monitor shall submit to the Parties and the Intervenors a set of objective standards to guide the Monitor in evaluating Defendants’ compliance with the Decree. Intervenors may provide input to the Parties and the Monitor on the standards. In the event any of the Parties believe that such standards are insufficient or inappropriate, they shall first meet and confer with the Monitor in an effort to revise the standards in a manner acceptable to the Monitor and the Parties. In the event the Intervenors believe that such standards are insufficient or inappropriate with respect to Paragraphs 4-10, 25 and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, they shall first meet and confer with the Monitor and the Parties in an effort to revise the standards in a manner acceptable to the Monitor, the Parties, and the Intervenors. In the event that following any such meet and confer, the Monitor, the Parties, and the
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 20 of 41 PageID #:11127 Intervenors are unable to agree on such standards, any of the Parties or the Intervenors may seek appropriate relief from the Court within 14 days after they meet and confer. Once finalized, the objective standards will be made publicly available.
(b) Appropriate standards by which the Monitor evaluates Defendants’ compliance with the Decree shall include, but are not limited to, the following: (i) whether Transition Service Plans meet the criteria set forth in Section VII; (ii) whether the benchmarks set forth in Sections VIII and IX and X have been satisfied; (iii) whether Class Members who are determined to be in Crisis receive services expeditiously in accordance with Paragraph 21; (iv) the extent to which, at periodic intervals, Class Members are being placed in Community-Based Settings; and (v) the extent to which, at periodic intervals, Class Members are receiving Community-Based Services.
(c) None of the standards adopted by the Monitor pursuant to this Paragraph 32 shall in any way modify, change or otherwise abrogate any of the terms of the Decree or Defendants’ obligations under the Decree.
33. Review and Evaluation of Data and Information. The Monitor shall review and evaluate Defendants’ compliance with the terms of the Decree. Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress towards achieving compliance. Prior to the first report, the Parties and the Monitor will agree on the data and information that must be included in such reports. The Intervenors may provide input to the Parties and the Monitor on the proposed data and information. Defendants will not refuse any request by the Monitor for documents or other information that are
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 21 of 41 PageID #:11128 reasonably related to the Monitor’s review and evaluation of Defendants’ compliance with the Decree, and Defendants will, upon reasonable notice, permit confidential interviews of Defendants’ staff or consultants, except their attorneys. The Monitor will have access to all Class Members and their records and files, as well as to those service providers, facilities, buildings and premises that serve, or are otherwise pertinent to, Class Members, where such access is reasonably related to the Monitor’s review and evaluation of Defendants’ compliance with the Decree. The Defendants shall comply with Plaintiffs’ requests for information that are reasonably related to Defendants’ compliance with the Decree, including without limitation requests for records and other relevant documents pertinent to implementation of the Decree or to Class Members. Class Counsel also shall be permitted to review the information provided to the Monitor. All information provided to the Monitor and/or Class Counsel pursuant to the Decree shall be subject to the Protective Order.
34. Reporting. The Monitor shall file annual reports with the Court, which shall be served on all Parties and Intervenors and be made publicly available. Such reports shall include the information necessary, in the Monitor’s professional judgment, for the Court, Plaintiffs, and Intervenors to evaluate Defendants’ compliance or non-compliance with the terms of the Decree. The Monitor may file additional reports as necessary.
35. Compliance. In the event the Monitor finds Defendants not in compliance with the Decree, the Monitor shall promptly meet and confer with the Parties in an effort to agree on steps necessary to achieve compliance. In the event the Monitor finds Defendants not in compliance with the Decree relating to provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, the Monitor shall promptly meet and confer with the Parties and the Intervenors in an effort to agree on steps necessary to achieve compliance. In the event that Plaintiffs believe that Defendants are not complying with the terms of the Decree, Plaintiffs shall notify the Monitor and Defendants of Defendants’ potential non-compliance. The Monitor then shall review Plaintiffs’ claims of actual or potential non-compliance and, as the Monitor deems appropriate in his or her professional judgment, meet and confer with Defendants and Plaintiffs in an effort to agree on steps necessary to achieve compliance with the Decree. If the Monitor and Parties agree, such
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 22 of 41 PageID #:11129 steps shall be memorialized in writing and set forth in a separate Court Order supplemental to the Decree. In the event that the Monitor is unable to reach agreement with Defendants and Plaintiffs, the Monitor may seek appropriate relief from the Court. In the event that Plaintiffs believe that Defendants are not in compliance with the Decree and that the Monitor refuses or fails to act, Plaintiffs may seek appropriate relief from the Court.
In the event that Intervenors believe that Defendants are not complying with the terms of the Decree relating to provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD, Intervenors shall notify the Monitor and Parties of Defendants’ potential non-compliance. The Monitor then shall review Intervenors’ claims of actual or potential non-compliance and, as the Monitor deems appropriate in his or her professional judgment, meet and confer with the Parties and Intervenors in an effort to agree on steps necessary to achieve compliance with the Decree. If the Monitor, the Intervenors and Parties agree, such steps shall be memorialized in writing and set forth in a separate Court Order supplemental to the Decree. In the event that the Monitor is unable to reach agreement with Intervenors, Defendants and Plaintiffs, the Monitor may seek appropriate relief from the Court. In the event that the Intervenors believe that Defendants are not in compliance with the Decree and that the Monitor refuses or fails to act, Intervenors may seek appropriate relief from the Court.
The Monitor will not communicate with the Court without advance notice to the Parties and the Intervenors. Individuals who choose to receive ICF/MR services in an ICF-DD shall have the same rights as Class Members to enforce this Decree, provided however that such Individuals’ rights to enforce this Decree shall be limited to enforcement of provisions in Paragraphs 4-10, 25, and 45 of this Decree regarding Individuals who choose to receive ICF/MR services in an ICF-DD.
36. Compensation of the Monitor. Defendants shall compensate the Monitor and his or her staff and consultants at their usual and customary rate. Defendants shall reimburse all reasonable expenses of the Monitor and the Monitor’s staff, consistent with the guidelines set forth in the “Governor’s Travel Control Board Travel Guide for State Employees.” Defendants
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 23 of 41 PageID #:11130 reserve their right to seek relief from the Court if Defendants believe that any of the Monitor’s charges are inappropriate or unreasonable. XV. NAMED PLAINTIFFS
37. As part of the settlement of the Litigation, within sixty (60) days after Approval of the Decree, Defendants shall offer each of the Named Plaintiffs the opportunity to receive appropriate Community-Based Services or placement in a Community-Based Setting. Provision of services to the Named Plaintiffs pursuant to this provision shall not be used to determine any other particular Class Member’s eligibility for services under the terms of the Decree. XVI. ATTORNEYS’ FEES AND COSTS
38. In full settlement of all attorneys’ fees incurred in connection with the Litigation, Defendants shall pay $1,740,000.00 to Class Counsel and $500,000.00 to Intervenors’ Counsel. In addition, in full settlement of all out-of-pocket costs and expenses (not to include attorneys’ fees) incurred by Class Counsel, Defendants shall pay to Class Counsel reasonable costs and expenses incurred by Class Counsel through and including the Approval of the Decree and any appeal thereof. Class Counsel shall provide Defendants with their out-of-pocket costs and expenses and appropriate supporting documentation so that Defendants have an opportunity to review them and, if necessary, meet and confer with Class Counsel and bring any disputes before the Court. Defendants shall pay one-half of the aforesaid amounts due Class Counsel and onehalf of the aforesaid amount due Intervenors’ Counsel in State Fiscal Year 2012 (which begins July 1, 2011) and one-half of the aforesaid amounts due Class Counsel and one-half of the aforesaid amount due Intervenors’ Counsel in State Fiscal Year 2013 (which begins July 1, 2012). All of the aforesaid amounts shall be distributed to Class Counsel and Intervenors’ Counsel in the manner set forth in written instructions provided by Class Counsel and Intervenors’ Counsel, respectively. Furthermore, such amounts shall be set forth in one or more Judgment Orders to be entered by the Court within fourteen (14) days after Approval of the Decree. Defendants shall complete and submit all paperwork necessary for payment of the first half of the aforesaid amounts, plus applicable statutory post-judgment interest, within (a) five (5) business days after expiration of the time to appeal the Decree without the filing of a Notice of Appeal, or after the issuance of the mandate by the highest reviewing court, whichever is later,
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 24 of 41 PageID #:11131 or (b) July 1, 2011, whichever is later. Defendants shall complete and submit all paperwork necessary for payment of the second half of the aforesaid amounts, plus applicable statutory post-judgment interest, on July 2, 2012.
39. Nothing herein shall preclude the Court from imposing sanctions or other relief for non-compliance with the Decree. XVII. MISCELLANEOUS PROVISIONS
40. Approval of the Decree. “Approval of the Decree” shall be deemed to occur on the date the Court enters the Decree.
41. Costs of Notices. The cost of all notices hereunder or otherwise ordered by the Court shall be borne by Defendants.
42. Signatories. Each undersigned representative of a Defendant to this Litigation and the Attorney General for the State of Illinois certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally such Defendant to this document. Each undersigned representative of Plaintiffs and Class Counsel certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally the Plaintiffs and Class Counsel to this document. Each undersigned representative of the Intervenors certifies that he or she is authorized to enter into the terms and conditions of the Decree and to execute and bind legally those individuals whom he or she represents to this document.
43. Delivery of Notices or Mailings. (a) Delivery of notices or mailings to Plaintiffs shall be made to: Equip for Equality, Attn.: Barry Taylor (or his successor), 20 North Michigan Avenue, Suite 300, Chicago, Illinois 60602; and SNR Denton US LLP, Attn.: John Grossbart, 233 South Wacker Drive, Suite 7800, Chicago, Illinois 60606. (b) Delivery of notices or mailings to Defendants shall be made to: Office of the Illinois Attorney General, Attn: Brent D. Stratton, 100 W. Randolph Street, Chicago, Illinois 60601 and Office of the Illinois Attorney General,
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 25 of 41 PageID #:11132 Attn: Karen Konieczny, 160 N. LaSalle St., Suite N-1000, Chicago, Illinois 60601.
(c) Delivery of notices or mailings to Intervenors shall be made to: Scott M. Mendel, K&L Gates LLP, 70 W. Madison St., Suite 3100, Chicago, IL 60602, William Choslovsky, Neal, Gerber & Eisenberg, LLP, Two N. LaSalle St., Suite 1700, Chicago, IL 60602, James W. Ducayet, Sidley Austin LLP, One S. Dearborn, Chicago, IL 60603.
(d) The Parties and Intervenors may modify the instructions for delivery of notices or mailings contained in this Paragraph 43 without Court approval.
44. Waiver. Defendants have waived their right to oppose entry of the Decree by this Court or to challenge any provision of the Decree. Defendants have waived their right to appeal the Decree or any other matter that has occurred to date in connection with the Litigation.
45. Nothing in this Decree alters the legal rights that Individuals with Developmental Disabilities, including Class Members, otherwise may have, including the right to choose to receive ICF/MR services in an ICF-DD. Nothing in this Decree alters the legal rights that an Individual with Developmental Disabilities otherwise may have to work directly (i) with the State-identified point of entry for developmental disability services and/or (ii) with an ICF-DD to be approved to move into a then-existing licensed vacancy in an ICF-DD, including a vacancy created by a departing resident.
46. Nothing in this Decree alters the legal rights, authority, or responsibilities of the legal guardian(s) of any Individual with Developmental Disabilities under state or federal law or regulations. XVIII. TERMINATION
47. The Court shall retain exclusive jurisdiction to fully oversee, supervise, modify and enforce the terms of the Decree. The Court shall retain such jurisdiction for at least nine (9) years following the Approval of the Decree.
48. The Parties, jointly or separately, may request termination of the monitoring process described in Section XIV at any time after nine (9) years from Approval of the Decree. If, after nine years from Approval of the Decree or any time thereafter, Defendants and the
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Case: 1:05-cv-04331 Document #: 549 Filed: 06/15/11 Page 26 of 41 PageID #:11133 Monitor agree that Defendants have substantially complied with the terms of the Decree, Defendants shall notify Plaintiffs and Intervenors in writing of their desire to terminate the monitoring process (“Termination Request”). Plaintiffs shall have not less than 120 days from receipt of the Termination Request to respond. Intervenors may provide input to the Parties and the Monitor on the Termination Request. During those 120 days, Plaintiffs shall have the opportunity to conduct reasonable discovery concerning factual issues relevant to the determination of compliance. If Plaintiffs oppose the Termination Request, Plaintiffs must file a motion within 120 days from the date of receipt of Defendants’ Termination Request.
49. The Court will grant Defendants’ Termination Request and terminate the monitoring process if the Court finds that Defendants have substantially complied with the terms of the Decree and the Court determines that Defendants have implemented and are maintaining a system that complies with the Decree.
50. Termination of the Court’s jurisdiction over the Decree may occur only in the event of a successful request to terminate the monitoring process pursuant to Section XVIII. The Decree shall remain in effect, and the Court shall retain its jurisdiction over the Decree, until a final order is entered granting the Termination Request and all appellate rights and/or appeals have been exhausted.
SO ORDERED THIS 15th DAY OF JUNE, 2011.
_______________________________ JAMES F. HOLDERMAN Chief Judge, United States District Court
[SIGNATURE PAGE FOLLOWS]
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 Case: 1:05-cv-04331 Document #: 559 Filed: 12/15/11 Page 1 of 26 PageID #:11178
Ligas v. Hamos Implementation Plan
State of Illinois
Department of Human Services, Division of Developmental Disabilities 12/15/2011
The Division of Developmental Disabilities has developed this Implementation Plan to accomplish the obligations and objectives set forth in the Ligas v. Hamos Consent Decree. (Case: 1:05-cv-04331; Document No. 549)

Case: 1:05-cv-04331 Document #: 559 Filed: 12/15/11 Page 2 of 26 PageID #:11179
LIGAS IMPLEMENTATION PLAN
December 15, 2011
Section I. Executive Summary
Background of Litigation and Overview of Consent Decree On June 15, 2011, the State entered into a Consent Decree settling the Ligas v. Hamos lawsuit, filed on July 28, 2005 on behalf of individuals with developmental disabilities who were residing in private, State-funded facilities (Intermediate Care Facilities for Persons with Developmental Disabilities or ICFs/DD) of nine or more persons or who were at risk of being placed in such facilities. Plaintiffs sought placement in Community-Based Settingsi and receipt of community-based services. The Consent Decree, which is available on the Division of Developmental Disabilities’ (DDD) website,ii identifies two groups of Class Members:
 Adult individuals in Illinois with developmental disabilities who qualify for Medicaid Waiver services, who reside in ICFs/DD with nine or more residents, and who affirmatively request to receive Community-Based Services or placement in a Community-Based Setting.
 Adult individuals in Illinois with developmental disabilities who qualify for Medicaid Waiver services, who reside in a Family Home, who are in need of Community-Based Services or placement in a Community-Based Setting, and who affirmatively request Community-Based Services or placement in a Community-Based Setting.
The Decree does not force individuals who do not want community-based services or placement to move. Nor does it force providers to close beds or enter into downsizing agreements with the State against their will. The tenets of the Decree will assist the DDD in expanding its community-based system to meet the growing demand for those services, while continuing to honor an individual's choice in deciding on the types of services and settings he or she prefers in order to live a personally fulfilling and productive life. The Decree includes the following provisions:
Services for Individuals Currently Residing in ICFs/DD Within six years of approval of the Decree, all individuals living in ICFs/DD as of the effective date of the Decree who have affirmatively requested CommunityBased Settings will move to Community-Based Settings. Placements must be implemented for one-third of all such individuals every two years of this six-year period. For those individuals who wish to continue living in an ICF/DD, the Decree requires the State to honor that choice and to continue to provide adequate funding to meet the needs of such individuals.
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Services for Individuals Currently Residing in the Family Home The DDD will continue to expeditiously serve all people who meet the established crisis criteria. There will be no limit to the number of people served who meet the crisis criteria. The DDD will serve 3,000 individuals on the Waiting List for Community-Based Services or placement in a Community-Based Setting, as defined in the Decree, over the next six years (1,000 within the first two years and 500 each year the next four years) with home-based support services or in community-based residential settings. After the end of the six year period, all Class members on the Waiting List shall move off the Waiting List at a reasonable pace.
Other General Provisions
 Evaluations and Transition Service Plans will focus on individual desires and goals and will not be limited by existing services. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent appropriate and consistent with the choices of the class member and his or her legal guardian. The State, however, will not be required to develop or offer services that are not part of the approved Waiver or Medicaid State Plan.
 The Department of Human Services (DHS) will seek sufficient funds in annual budget requests to develop and maintain the services described in the Decree. Implementation of the Decree is not, however, dependent on legislative appropriation of new funds.
 A monitor has been appointed by the Court to oversee compliance with the Decree and report on progress to the Court on an annual basis. After nine years of the approval of the Decree, the State may petition the Court to terminate the monitoring process.
The Implementation Plan
This document sets forth the State’s plans to implement the provisions of the Consent Decree. It is being developed consistent with Paragraph 26 of the Consent Decree. The DDD has sought and incorporated input received from the Plaintiffs, Intervenors, and other advocates throughout the system. The final Implementation Plan is being filed with the Court on December 15, 2011.
References to paragraph numbers in each of the sections below refer to paragraphs within the Consent Decree from which language is excerpted. For full context, readers should refer to the Consent Decree. Should any language in the Implementation Plan unintentionally conflict with that of the Consent Decree, the Consent Decree governs.
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Section II, Development and Maintenance of the Class Member List, describes the compilation of an initial list of class members and the DDD’s further development and maintenance of that list. These efforts will be on-going as additional individuals request to be added to or removed from Class Membership as a result of outreach activity.
Section III, Outreach, provides information regarding the DDD’s efforts to identify individuals in need of residential or in-home supports, as well as those Potential Class Members who wish to move from ICFs/DD. It is the intention of the DDD to partner with the Plaintiffs and other advocates to ensure individuals and their guardians are given accurate and complete information about their options.
Section IV, Development of Community Capacity, discusses the need to expand and develop new service capacity to meet the requirements of the Decree for Class Members seeking services. The DDD intends to work with both existing providers and recruit new providers to fill the growth in service delivery.
Section V, Community-Based Services/Placement for Individuals Residing in ICFs/DD, addresses the opportunity for Class Members residing in ICFs/DD to move to community-based services. At 2 ½, 4 ½, and 6 years from the approval of the Consent Decree (June 15, 2011), the DDD will have implemented services to one-third of these Class Members. Monitoring activities will be underway to achieve the goal of successful transitions.
Section VI, Transition Planning, outlines a plan and time frame for implementing the use of Transition Service Plans for Class Members. This new process will present a system change for the entire service delivery system. The Transition Service Plans will be developed prior to the selection of service providers to describe the services a Class Member needs. The goal of this process is to ensure service delivery focused on and tailored to the individual.
Section VII, Waiting List for Community Services and Placement, details the process for Class Members living at home to be selected for the 3,000 new community capacities. Individuals will be selected each year from the DDD’s waiting list.
Section VIII, Community Crises, confirms the DDD will continue its current practices in serving individuals in crisis situations. These services will be above the 3,000 capacities being developed for Class Members residing at home.
Section IX, Appeal Process, refers to the right to appeal any denial, suspension, termination, or reduction of services, as well as the process for informing Class Members of this right. Section X, Resources Necessary for Implementation, outlines additional resources required by the DDD to implement the provisions of the Consent Decree. These resources include contractual services for administrative
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functions, additional staff, and direct services for Class Members. Also discussed in this section is the budget development to both maintain existing services and implement the new provisions of the Decree.
Section XI, Interagency Agreements, lists the two agreements currently in place among State governmental entities to secure matching Medicaid funds for developmental disabilities services. It is believed these agreements are sufficient to implement the provisions of the Decree.
Section XII, Process for Plan Reporting and Modification, provides for the annual review and update of this Implementation Plan. Reports will be produced every six months by the DDD containing data and information regarding compliance activities.
Section XIII, Acronyms, lists the acronyms used in this document.
Section II. Development and Maintenance of the Class Member List
Paragraph 6. Within thirty (30) days after Approval of the Decree, Defendants shall compile an initial list of Class Members by taking the list of Individuals to whom notice of Preliminary Approval of this Decree was sent, adding those Individuals from whom any of the Parties received a written, affirmative request to receive Community-Based Services or placement in a Community-Based Setting after notice of Preliminary Approval of this Decree was sent, but excluding (i) those individuals who filed objections to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing as described in Paragraph 3(i) above, and (ii) those Individuals from whom Defendants receive written requests that the Individuals do not wish to receive Community-Based Services or placement in a Community-Based Setting.
Paragraph 8. Defendants shall maintain a statewide database in which all Class Members are enrolled.
Consistent with Paragraph 6 of the Consent Decree, the Attorney General’s Office provided to the Monitor and Plaintiffs on July 15, 2011, an initial list of Class Members. Intervenors were also given a copy of the initial list. The list includes:
 Adults (age 18 and above) enrolled in the State’s Prioritization of Urgency of Need for Services (PUNS) database as of June 15, 2011, who were not already living in a 24-hour Community-Based Setting or State-Operated Developmental Center (SODC); and
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 Individuals who had submitted written requests to be included in the Class to the Attorney General’s Office;
 But not those excluded from the class, as set out immediately below and in Paragraph 6 of the Decree.
The Parties have agreed that, for those individuals who live in ICF/DD settings, they are a Class Member if they have completed an Illinois Form 1238iii or its predecessor, DMHDD Form 1243; or the DDPAS-10 Formiv; or the Request Form disseminated through Plaintiffs’ counsel; and checked the box indicating he or she chooses Home and Community-Based Services. An individual will not be a Class Member if he or she completed one of the above forms and checked the box choosing services in an ICF/DD or if he or she otherwise objected to the terms of the Consent Decree at the Court’s fairness hearing or objected otherwise in writing per Paragraph 6 of the Decree, unless a subsequent communication to DDD requests Community-Based Services or placement in a Community-Based Setting.
With the assistance of the Monitor, the DDD will further scrutinize the initial list, including comparing it to the list of objectors to the Consent Decree, to ensure that only individuals for whom the State has a current record affirmatively requesting Community-Based Services or Settings are included on the list.
This initial list of Class Members will be compared with the State’s PUNS database of individuals waiting for services and the following actions will be taken:
 The record for Class Member will be marked as a Ligas Class Member, along with the date the person was added to the Class Member listing. Records for those in the initial list will show this date as June 15, 2011. The record will also reflect whether the Class Member is living in the Family Home, an ICF/DD on June 15, 2011, or an ICF/DD after June 15, 2011.
 If an individual is included in the initial listing but is not enrolled in PUNS, the State will instruct the PAS/ISC agencies to meet with the individual and his or her guardian to complete a PUNS enrollment.
 The State will add individuals to the class list as they request CommunityBased Services or placement through the normal PUNS process, per the existing PUNS manual.v It will also add those individuals who inform the State they choose to move from ICFs/DD through the completion of Form 1238, Choice of Supports and Services, or the DDPAS-10 Form. Efforts to identify additional Class Members are discussed in the Outreach section of this plan.
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 If a person requests to be removed from the class at any point during the time of the Consent Decree, their record will be so marked, along with the date and reason. Reasons for leaving the class include: o Individual chose to stay in ICF/DD o Individual chose to move to ICF/DD o Individual is deceased o Individual moved out of State o Individual was determined by DDD to be ineligible for the Medicaid Waiver o Individual withdrew from the class without giving a reason o Other
Thus, the individual’s record will be marked as “removed” but the record itself will not be deleted. Prior to marking an individual’s record as “removed”, the DDD will ensure the individual was informed of his or her rights as a Class Member by a PAS/ISC agency or an independent contractor.
The State will use its PUNS database to maintain the list of Class Members. Each Class Member will have a PUNS enrollment and his or her record will be marked with the data elements described above.
In order for these efforts to be successful, enrollments on the PUNS database must be kept current. The DDD will work with the existing 18 PAS/ISC agencies to ensure records are updated at least annually. The DDD will require each agency to develop a plan of action to update all records presently out-of-date.
The DDD will maintain the class list. The Monitor and Class Counsel will have access to the class list, including contact information, on an on-going basis. The DDD also will provide to Intervenors’ Counsel the class list that DDD will use to compare with the listing of all ICF/DD residents to determine which ICF/DD residents will be contacted by the Outreach contractors as provided in Section III of this Implementation Plan, subject to Intervenors’ Counsel’s agreement to: (1) maintain the list as “attorneys’ eyes only”; (2) not disseminate any name on the list beyond Intervenors’ Counsel; and (3) not contact any individual on the list, the individuals’ guardians or the ICFs/DD in which those individuals reside. The DDD will produce for the Monitor, Class Counsel, and Intervenors’ Counsel semiannual summary reports of additions to and removals from the list.
As part of the annual reviews of the Implementation Plan (see Section XII), the DDD will review the adequacy of the PUNS database in capturing the information needed for implementation of the Decree.
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Section III. Outreach
Paragraph 25. Defendants shall maintain a fair and accessible process by which Individuals with Developmental Disabilities or their legal guardians can affirmatively request in writing to receive Community-Based Services and/or placement in a Community-Based Setting or to receive ICF-MR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests.
The DDD’s outreach efforts will be directed to:
 identifying individuals with developmental disabilities throughout the State who are or will be in need of residential or in-home supports funded through DDD Medicaid services; and
 Identifying individuals residing in ICFs/DD on or before June 15, 2011, who may choose to transition to Community-Based Settings and services. Objectors to the Consent Decree will not be contacted. The DDD will work in conjunction with Class Counsel to coordinate efforts on outreach.
Community Outreach
DDD will use the existing PUNS database, enrollment form, and manual as tools to identify, record, and track information regarding individuals newly identified as in need of services. The DDD will continue to complete PUNS enrollments through contracted entities. As the Implementation Plan is being written, there are 18 local PAS/ISC agencies with contracts through the DDD for PUNS enrollments.
Outreach efforts shall include:
 Training of PAS/ISC agencies on the requirements of the Consent Decree and the provisions of the Implementation Plan;
 Development and maintenance of special brochures, flyers, and posters, which can be downloaded from the DDD website;vi
 Coordination with trade associations, local schools, special recreation associations, and other advocacy organizations to publicize PUNS;
 Distribution of information regarding PUNS and Ligas to Medicaid-enrolled health care providers via the State Medicaid agency’s list serve;
 Distribution of materials at special events such as conferences, seminars, etc.;
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 Inclusion of culturally appropriate materials, alternative means of communication, and easily understandable language in efforts to publicize PUNS, including targeting communities identified as under-reported;
 Maintenance of the PAS/ISC office locator function on the DDD website; and
 Maintenance of the 1-888-DDPLANS toll free number to connect families with their local PAS/ISC office.
Outreach to Persons in ICFs/DD
In addition to the efforts to inform and identify individuals throughout the population as a whole, the DDD will focus outreach efforts to identify Potential Class Members residing in ICFs/DD. (Potential Class Members residing in ICFs/DD are those ICF/DD residents who (1) are not Class Members and (2) did not exclude themselves from the class by having objected to the Decree prior to its approval or by submitting a written request to be excluded prior to compilation of the initial class list per Paragraph 6 of the Decree.) The DDD will issue a Request for Proposals (RFP) to secure the services of a contractor or multiple contractors to contact all Potential Class Members residing in ICFs/DD. The contractor(s) selected will be independent of direct service and service coordination for persons with developmental disabilities in Illinois. The Monitor, Class Counsel, and Intervenors will provide input into the development of the RFP.
Once the contract (or contracts) is in place, the DDD will issue notice that the contracted entities (or entity) will be working in the facilities for the next two to three years. The DDD will require the ICFs/DD providers to confirm the list of individuals residing in their facilities and to provide the DDD with the addresses and phone numbers for all guardians. The DDD will then compare the listing of all ICF/DD residents to the list of known Class Members and the list of those individuals who excluded themselves from the class by objecting or submitting a written request per Paragraph 6 of the Decree. Once that comparison is finished, the DDD will provide the contractor(s) with a list of ICFs/DD and Potential Class Members. The contractor(s) will then call the guardian and ask if the guardian is willing to meet to discuss having the Potential Class Member move to a community-based setting and, if so, inform them that the Potential Class Member’s records will be reviewed as part of the next steps. Thereafter, the ICFs/DD will provide the contractor(s) with full access to records only for those individuals who indicate they wish to consider moving, and, upon reasonable notice (i.e., at least seven calendar days), provide the contractor(s) with full access to and private meeting space with Potential Class Members at times and in a manner that are convenient for the Potential Class Members and their guardians and do not unreasonably interfere with the operations of the facility. (For those individuals without guardians, the first contact will be through record
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reviews and face-to-face meetings.) The DDD will inform ICF/DD administrators that they and facility staff cannot interfere with the outreach process or seek to intimidate, persuade, or otherwise influence residents to stay in their facilities. No individual or their guardian will be required to meet with the contractor(s) if they choose not to do so.
DDD, with the participation of the Monitor, will develop written guidelines and provide training for the contractor(s). Such guidelines and training will ensure the contractor(s) provide complete and objective information regarding all alternative choices for long-term care services for Potential Class Members and do not attempt to steer Potential Class Members toward any particular service alternative. The goal is to enable the individual and his or her guardian, if applicable, to choose the service alternative that they feel best meets their needs.
Where Potential Class Members have indicated that they wish to consider moving to a Community-Based Setting, the contractor will meet with those individuals, and their guardians and family members, to inform the individuals of their rights under the Consent Decree and to provide them with complete and objective information regarding all alternative choices for long-term care services. As part of the information regarding alternative choices, prior to making choices about moving, the contractor will provide Potential Class Members the opportunity to visit community-based settings and to meet with people with disabilities and their families who already have transitioned to another setting. The contractor will document the date and time of the meeting with the individual, guardian, and/or family members and record on a form provided by the DDD the individual’s decision to remain in the ICF/DD or to consider moving to an alternative setting. The contractor will give copies of these completed forms to the DDD.
The contractor will inform the individual of his or her options through the PUNS intake form, complete the PUNS enrollment for those individuals who wish to receive community-based services, and report that information to the DDD using the Reporting of Community Services (ROCS) software.
If an individual indicates that he or she would like to consider moving to an alternative setting, whether that alternative setting be community-based services or another ICF/DD, the contractor will refer the individual to the appropriate PAS agency to work with the individual regarding his or her options. The PAS agency will facilitate visits to potential alternative settings to assist the individual and guardian in evaluating and/or selecting types of services and providers.
If a Potential Class Member chooses to move to a Community-Based Setting and that choice is documented in accordance with Paragraph 10 of the Consent Decree, the individual shall become a Class Member. If a Potential Class Member chooses to remain in his or her ICF/DD or move to another ICF/DD, the
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individual will not be a Class Member. However, Potential Class Members are not required to make a decision about whether to join the class during the initial outreach visit and can maintain their status as a Potential Class Member until they are ready to make a decision.
Much of the contractor(s) work should be completed by July 31, 2015, including initial meetings with individuals, guardians, and family members. In order to provide individuals’ guardians, and family members sufficient time to explore options and make decisions, outreach efforts will continue beyond that date.
General Information Sharing
In order to better inform individuals and family members, the DDD will expand and maintain the Ligas page on its website. It will develop materials for this page with input from the Monitor, Plaintiffs, and family representatives. It will also make presentations about the Consent Decree around the State at conferences, annual meetings, and other events hosted by other organizations and agencies. If there are an insufficient number of such events to enable DDD to educate the public about the Consent Decree, DDD will create and host its own events. The DDD will post a schedule on its website of all events in which it will present information about the Consent Decree.
Section IV. Development of Community Capacity
Paragraph 4. The choices of Individuals with Developmental Disabilities, including Class Members, to receive Community-Based Services or placement in a Community-Based Setting or to receive ICF/MR services in an ICF-DD will be honored; provided, however, that this commitment to honoring choice does not alter Defendants’ current obligations under existing law regarding licensed ICF-DD capacity system-wide or at any specific ICF-DD, and provided that, under current applicable law, this commitment does not entitle an Individual with Developmental Disabilities to receive ICF/MR services in a specific ICF-DD. Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such individuals under the Decree and the Implementation Plan consistent with such choices. While the Decree remains in effect, any amendment to the State Plan submitted by the State pursuant to 42 U.S.C.§ 1396, et seq. will continue to include ICF-DD services as an alternative choice for long-term care services for eligible Individuals with Developmental Disabilities. Nothing in this Decree shall impair Defendants’ ability to make changes in their provision of supports and services to Individuals with Developmental Disabilities, including Class Members, regardless of setting, provided that Defendants continue to honor Individuals’ choices and fulfill Defendants’ obligations under the
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Decree and Implementation Plan. Resources necessary to meet the needs of Individuals with Developmental Disabilities who choose to receive services in ICFs-DD shall be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree, including the obligations under Paragraphs 17 through 19 and 21 through 23. Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs using federally approved objective criteria regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based Setting; provided, however, nothing in this Decree shall require Defendants to change their current method for establishing funding or from adoption new methods based upon federally approved objective criteria.
Paragraph 5. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings.
Within the first six years of the Consent Decree, the DDD will provide services to 3,000 individuals currently living at home with their families or in another community arrangement. These services will include both Home-Based Support Services (HBS) and Community Integrated Living Arrangement (CILA) services, inclusive of day programs, therapies, assistive technology, and other support services, In addition, an unidentified number of individuals will be moving from ICFs/DD to HBS or CILA services. This will require at least an estimated 20% expansion of Waiver capacity. (The exact amount cannot be known until the individuals in ICFs/DD are identified.) Individuals selected to receive services under this Consent Decree may choose from any qualified and willing providers as defined in the Waiver.
Illinois has a substantial base of qualified HBS, CILA, and day program providers. There are approximately 190 licensed CILA providers, 125 HBS service facilitation agencies, 150 developmental training providers, and 65 supported employment providers, as well as providers of therapies, assistive technology, and other support services. In order to meet the required expansion, current providers will be called upon to increase the size of their operations and new providers may be needed.
As part of the annual reviews of the Implementation Plan (see Section XII), the DDD will review progress toward this needed expansion and modify the Implementation Plan as necessary to implement the provisions of the Decree.
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New Providers
Any existing providers interested in implementing new programs or any entities interested in becoming providers through the DDD are directed to visit the DDD’s web page about becoming a new providervii. This web page informs potential providers about the qualification process, regulations, compliance issues, staff training requirements, DDD contact persons, etc. In addition, for potential new CILA or developmental training providers, prior to the acceptance of a license or certification application, the DDD mandates attendance at one of the orientation sessions provided by the DDD approximately twice per year. Information about these sessions is posted on the DDD website. At these sessions, community services, quality assurance, and rates staff give joint presentations about provider regulations and processes and are available to answer questions from potential providers.
Conversion of ICF/DD Capacity
The DDD will work with the Department of Healthcare and Family Services (HFS) to propose rule language to allow the DDD to enter into voluntary closure agreements with providers of ICFs/DD of 16 and fewer beds. These closure agreements would provide for rates during the closure period that recognize the need for coverage of fixed costs while individuals are transitioning to new residential settings of their choice, whether operated by the same or a different provider. The DDD, through regulatory language, has for over a decade been able to enter into such agreements with larger ICFs/DD; however, the option is not available for 16-bed facilities as of the writing of this plan. This new proposed option could assist ICF/DD providers that choose to eliminate ICF/DD capacity and create or expand community-based settings. The DDD and HFS will work together to submit the proposed rule language to the Joint Committee on Administrative Rules (JCAR) and respond to comments during the public comment periods. The DDD’s goal is to submit the proposed rule language to JCAR by July 31, 2012.
In order to provide more detail about the downsizing/closure process, a sample agreement is available for reference on the DDD’s website.viii
Provider Qualifications and Training
The qualifications for each type of Waiver provider are specified in Appendix C of the Waiver.ix Training requirements are listed and described in the DDD’s training catalogue available on the DDD’s website.x
The quality improvement system for the Waiver is described in Appendix H of the Waiver. Performance measures are outlined throughout the Waiver itself.
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Section V. Community-Based Services/Placement for Individuals Residing in ICFs/DD
Paragraph 17. …within six (6) years after Approval of the Decree, all Class Members residing in ICFs-DD as of the date of Approval of the Decree (regardless of when in this timeframe the Class Member affirmatively requested placement in a Community-Based Setting) will transition to Community-Based Settings consistent with their Transition Service Plan, if, at the time of transition, the Class Member requests placement in a Community-Based Setting…
Per the Consent Decree, at 2 ½, 4 ½, and 6 years, the DDD will have implemented services to one-third of the individuals who were residing in ICFs/DD as of June 15, 2011 who inform the DDD they choose to move to Community-Based Placements. The number requesting to move will be calculated at 24 months following the approval of the Consent Decree, i.e., June 15, 2013. Any of the individuals who were residing in ICFs/DD as of June 15, 2011, who are newly identified as choosing to move to community-based services after June 15, 2013, will be offered services over the course of Years three through six.
As this Implementation Plan is being drafted, there are over 450 confirmed class members residing in ICFs/DD. The DDD is instructing the PAS agencies to work with these individuals to submit applications for Waiver services. Applications will be processed as they are received by the DDD. In the event the number of individuals seeking to move requires the DDD to manage the flow of requests and time frames for authorization, the DDD will select individuals for services based on the length of time they have resided in an ICF/DD. That is, those residing in an ICF/DD the longest amount of time will be selected first. Three factors may cause individuals to be selected sooner, at the DDD’s discretion, than their class list date would indicate: (1) a request from the individual or the ICF/DD due to the inability of the ICF/DD to meet the individual’s medical or behavioral needs, (2) a request from roommates or friends who wish to move together at the same time, and (3) a voluntary downsizing or closure agreement.
As individuals are identified as choosing to move, via the process described in the Outreach section above, pre-admission screening entities will be instructed to complete Medicaid Waiver eligibility assessments for them per the DD PreAdmission Screening Manualxi and to report the results to the DDD via the ROCS software.xii Service options will be presented, per the same manual, to those individuals determined eligible. These options will be recorded on the DDPAS-10 Form. Transition Service Plans, as described below in the Transition Planning section, will be developed for those who choose to move.
The DDD will build upon processes it has developed for persons transitioning from State-Operated Developmental Centers (SODCs) to monitor the transitions
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of individuals from ICFs/DD to Community-Based Settings or Services. Staff within the DDD’s Bureau of Transition Services will be assigned to each individual, contacting them or their guardians and service providers monthly during the first year following transition. Monitoring activities will be tracked through an internal database that is currently in use for SODC transitions.
In addition to the activities by State staff, the PAS/ISSA will monitor the individual’s successful adjustment to the new services by completing four weekly visits with the Class Member during the first month and quarterly visits thereafter. In the event the ISSA identifies problems, it shall take steps to resolve issues locally and refer matters as needed to the DDD per the Problem Resolution Protocol within the ISSA Guidelines.xiii It may also request more hours for additional visits per the Guidelines.
Section VI. Transition Planning
Paragraph 11. The Transition Service Plan shall describe the services the Class Member requires in a Community-Based Setting or through Community-Based Services; where and how such services can be developed and obtained; the supports and services the Class Member will need during his or her transition to a Community-Based Setting; and a timetable for completing that transition.
Paragraph 12. The Transition Service Plan shall be developed by a Qualified Professional in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member.
Paragraph 13. The process for developing a Transition Service Plan shall focus on the Class member’s personal vision, preferences, strengths and needs in home, community and work environments and shall reflect the value of supporting the Class Member with relationships, productive work, participation in community life, and personal decision-making.
Paragraph 14. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent possible, consistent with the choices of the Class Member and the Class Member’s legal guardian.
Paragraph 15. The Transition Service Plan shall not be limited by the current availability of services, provided, however, that nothing in this paragraph obligates Defendants to provide the types of services beyond those included in the Waiver and/or the State Plan.
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Implementation of the use of Transition Service Plans will be a system change for the entire service delivery system. Time will be needed in order to affect this change.
The DDD will develop a process for completion of a Transition Service Plan for each class member seeking services in a Community-Based Setting. A standardized format will be developed and required. As the Implementation Plan is being written, it is envisioned that the PAS/ISC agencies will complete the Transition Service Plans with the Class Member and his or her guardian. The DDD will seek input from the Monitor, Plaintiffs Counsel, PAS/ISC agencies, selfadvocates, providers, and other advocates throughout the system in the development of the standard form and accompanying processes.
In order to complete this work, the DDD will:
 By March 31, 2012, seek initial input,  By April 30, 2012, draft initial version of standard form and accompanying
instructions,  By May 31, 2012, seek comments from stakeholders on draft materials,  By June 30, 2012, finalize the standard form and accompanying
instructions and draft implementation processes,  By September 30, 2012, pilot the new materials and processes,  By November 30, 2012, review results of the pilot and make necessary
revisions,  By May 31, 2013, provide training to PAS/ISC agencies, direct service
providers, and DDD staff,  By July 1, 2013, implement the new process statewide for all Class
Members,  By January 31, 2014, evaluate the new process, and  On an on-going basis, modify the new process as necessary to implement
the provisions of the Decree.
The new process will be consistent with Paragraphs 11 through 15 of the Decree quoted above at the beginning of this Section.
The process will address the coordination required between PAS/ISC agencies when a Class Member is moving from one geographic location to another. The training for the PAS/ISC agencies will emphasize their respective responsibilities in such situations.
Once implementation is complete, Transition Service Plans will be completed for each individual leaving an ICF/DD or the Family Home. In no more than 12 months prior to the development of the Transition Service Plan, the Class Member must be presented with all of his or her service alternatives. Transition Plans are not required for those individuals who will be receiving Home-Based Support Services (HBS) in their own or family’s home. An individual service plan
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is still required for each individual in the HBS Program as described in the Waiver.
In the meantime, no individuals will be required to wait for the development and implementation of this process in order to move to a Community-Based Setting. PAS/ISC agencies will follow the processes described in the DD PAS Manual to assist individuals in obtaining needed services. Once the Transition Service Plan process is implemented, the Plans shall be completed within sufficient time to provide appropriate and sufficient transitions of Class Members in accordance with the deadlines set forth in the Decree.
This Transition Service Plan is separate from the Individual Service Plans completed for all individuals enrolling in the Waiver. The Individual Service Plans will be completed prior to the individual transitioning to community-based services and are inclusive of risk assessments to ensure the health and general well-being of the individuals.
Section VII. Waiting List for Community Services and Placement
Paragraph 22(d). Within two (2) years after Approval of the Decree, Defendants shall provide, in accordance with the Class Members’ Transition Service Plans, appropriate Community-Based Services and/or placement in Community-Based Settings for at least 1,000 Waiting List Class Members who are selected from the Waiting List…with these Class Members served in order of priority. In each of the third, fourth, fifth and sixth years following Approval of the Decree, Defendants shall serve at least 500 additional Waiting List Class Members who are selected from the Waiting List, again in order of priority.
Paragraph 23. All Class Members who are on the Waiting List after the end of the sixth year following Approval of the Decree shall receive appropriate Community-Based Services and/or placement in a Community-Based Setting, such that they move off the Waiting List at a reasonable pace…
Over the first six years of the Decree, the DDD is to serve under the Medicaid Waiver an additional 3,000 individuals from the waiting list. The addition of these 3,000 capacities will be accomplished by adding people to both the CILA and HBS programs. The DDD will use the following process for selecting individuals to be served from the Class Member waiting list:
Exclude anyone whose record is not labeled as a Ligas class member. As secondary edits to double check for accuracy of the list and selection, exclude the following records in all cases:
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 Persons previously selected in PUNS selections [These individuals have already been chosen and offered services.],
 Persons in the Planning category [These individuals are not seeking services within the year, but are anticipating the need for services within five years.],
 Persons who are under the age of 18 [These individuals are not Class Members.],
 Persons residing in Child Care Institutions (Program Code 19D) and Community Living Facilities (Program Code 67D) [These individuals are already receiving residential services.],
 Persons already enrolled in the Children’s Support and Residential Waivers (Waiver Codes D1 or D2) [These individuals already have a funding path for entrance into the adult Waiver.],
 Persons who are client type [These individuals are not Class Members.]: o B, Bogard Class Members, o C, CILA participants, o F, Family Assistance Program developmental disabilities participants, o K, Family Assistance Program mental health participants, o S, State-Operated Developmental Center residents, and o W, Mental Health Home-Based Support Services participants, and
 Persons who are client type [These individuals already have a funding path for entrance into the adult Waiver.]: o G, Children’s Support Waiver participants, and o R, Children’s Residential Waiver participants.
When selecting adults for HBS, exclude anyone already in the HBS program.
Selections will include individuals enrolled in the adult Waiver who indicate a need for more services. For example, persons receiving day program services but who may request in-home supports, or persons receiving HBS services but who may request CILA services, will be included in the selection process for the 3,000 capacities. Individuals admitted to ICFs/DD after June 15, 2011 who choose to move will also be included in the selections.
For every 100 individuals selected, include for residential services criteria:
25 individuals who are recorded on the PUNS database as being in an emergency situation (i.e., needing services immediately)xiv and needing out-ofhome supports
25 individuals residing at home with a primary caregiver age 75 or over
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For every 100 individuals selected, include for Home-Based Support Services:
20 individuals who are recorded on the PUNS database as being in an emergency (i.e., needing services immediately) or critical (i.e., needing services within the year) situation and needing in-home or day supports
15 individuals leaving the Public School System in the last 5 years (use age 22 as selection criteria)
15 individuals residing at home with a primary caregiver age 60 or over
Within each category, selections will be made by length of time on the database.
The DDD will select sufficient numbers to enroll in the Waiver 1,000 individuals in the first two years of the Decree and 500 in each of Years three through six.
With the expansion envisioned under the Decree, it is believed the waiting list will move at a faster pace after Year Six. The DDD will track and post on its website the average length of time individuals wait on the PUNS database.
At the end of July of 2011, of the individuals actively enrolled in PUNS, 16% were recorded as being in the emergency category (i.e., needing services immediately), 54% in the critical category (i.e., needing services within the year), and 30% in the planning category (i.e., needing services within the next five years). Summary information regarding the PUNS enrollments can be found on the DDD’s website.xv
Section VIII. Community Crises
Paragraph 21(c). Defendants shall ensure that all Class Members who are determined to be in a situation of Crisis, and who request to receive Community-Based Services and/or placement in a Community-Based Setting, receive such services and/or placement in such setting expeditiously.
The PAS/ISC agencies will continue to submit requests for services from individuals in crisis situations, and the DDD will continue to process these requests, using existing criteria available on the DDD website.xvi These requests are not part of the 3,000 capacities to be provided under Section VII, Waiting List for Community Services and Placement. The DDD will ensure individuals are served expeditiously.
As the Implementation Plan is being written, the DDD has provided the Monitor with baseline information regarding crisis requests approved and denied during FY10, FY11, and FY12 (year to date). As part of its compliance reports, the DDD
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will continue to provide to the Monitor data regarding the crisis requests approved and denied. The Monitor will review a sample of these requests and will be given access to the individual files.
Section IX. Appeal Process
Paragraph 24. Any Class Member who disputes a decision by Defendants or a Community Service Provider regarding eligibility for, or delivery of, Community-Based Services or placement in a Community-Based Setting shall, pursuant to governing law, have the right to appeal or seek administrative or judicial review of such decisions through Defendants’ existing Fair Hearings process (as set forth in 89 Ill.Adm.Code Part 120) or as otherwise provided by law. Class Members also may avail themselves of any informal appeal process that currently exists.
Individuals may appeal any denial, suspension, termination, or reduction of Home and Community-Based Waiver Services. The appeal process, including time frames, is described in Title 59, Chapter 1, Part 120.xvii Individuals are informed of this right to appeal through the use of Form IL462-1202, Notice of Individual’s Right to Appeal, available on the DDD website.xviii Individuals are also informed of their right to appeal a determination of ineligibility via the DDPAS-10 Form, available on the DDD website.xix
The DDD will hire another individual to assist in processing the anticipated increase in the number of appeals. The DDD will also work with staff from HFS to identify potential ways to streamline the appeal process.
Section X. Resources Necessary for Implementation
Paragraph 5. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members.
Each year of the Consent Decree, the DDD and the DHS Budget Office will prepare annual proposals for inclusion in the Governor’s Introduced Budget for the funds necessary to carry out the provisions of the Decree. These proposals will include items that are currently funded and must be maintained as well as items that require new funding. As implementation is underway, the known resource needs include:
 Contractual agreements o Request for Proposals for Outreach to ICFs/DD Residents,
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o Pre-Admission Screening, both on-going maintenance and new funds for increased volume of eligibility determinations,
o Increased PUNS enrollments, o Transition Service Plan development, o Increased ISSA enrollments, o Consultant to work within the Bureau of Transition Services during
the first two years of the Decree to review Transition Plans and train PAS/ISC agencies and providers on their development, o Consultant to work within the Bureau of Transition Services during the first two years of the Decree to serve as a family liaison during the outreach to individuals residing in ICFs/DD, and o Central Office assistance with coordination and implementation until new staff can be hired;
 Additional DDD staff to be hired (with the hiring beginning in FY12 and continuing through mid FY13) o (1) Strategic Planning Unit, for a Ligas Compliance Coordinator to oversee implementation activities and prepare required compliance reports, o (1) Program and Data Support Bureau, for maintenance and management of the class list, o (7) Bureau of Quality Management, for monitoring of communitybased services, including intake and management of complaints, trend analysis of complaints and investigations, targeted site visits to new providers, and increased volume of follow-up activity as concerns are identified and addressed, o (4) Bureau of Transition Services, for facilitating and overseeing transition activity for the individuals moving from ICFs/DD and the 3000 individuals starting services from the community, o (1) Appeals Unit, for increased volume of appeals, o (1) Rates Section, for increased volume of application and rate packets, and o (3) Medicaid Waiver Unit, for increased activity regarding Waiver oversight;
 Direct Services o Services for 1000 individuals in the first two years and 500 each year thereafter, and o Services for individuals who choose to move from ICFs/DD.
The above implementation items are in addition to the on-going maintenance items included in the DDD’s budget. These maintenance items include:
 Services for persons residing in ICFs/DD,  Services for persons enrolled in the Waiver,  Base Pre-Admission Screening grants,
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 Base grants for PUNS enrollments, and  Administrative staff within the DDD.
The DDD will make every effort to maximize federal Medicaid match for the direct services and administrative activities. The DDD reviews rejected claims and works with providers to correct or complete data for claims submissions. The DDD needs to increase those efforts and account for the anticipated growth in volume as Waiver capacity expands. Additional staff is being requested. Where applicable, the Money Follows the Person grant will be used to secure enhanced match during the first year of community-based services for those individuals who leave ICFs/DD for eligible settings under the grant. Existing interagency agreements describe the coordination between DDD and HFS regarding Medicaid match. See the following Section XI.
Appropriations
As implementation is underway, the DDD’s budget for Fiscal Year 12 has combined the major appropriation line for community-based services and ICF/DD services into one line. This will enable the DDD to redirect resources, if appropriate, as individuals and providers make future choices regarding service provision. The DDD will request that this practice continue in each subsequent year of the Consent Decree. However, the DDD will maintain sufficient records to enable the Monitor to determine whether the State is fulfilling its obligations under Paragraph 4 of the Decree, including its obligation to provide funding sufficient to meet the needs of those who choose to live in ICFs/DD and to ensure that such resources are not affected by the State’s fulfillment of its obligation to provide Community-Based Services or Settings to those who choose those service options.
Annually, per the deadline established by the Governor’s Office of Management and Budget, the DDD will calculate and submit details of needed resources for consideration for inclusion in the Governor’s Introduced Budget for the following fiscal year. Each year the needed resources for implementation of the Consent Decree, separate and apart from the maintenance items specified above, will include, at a minimum, funding for:
 Community-Based Services and Community-Based Settings, both new funds for those beginning services and annualized funds for those who began services in the prior year;
 Assessments and outreach;  Special rates for ICFs/DD voluntary closure agreements; and  Contractual consultants and staff.
As implementation is underway, the DDD and the DHS Budget Office are informing the Governor’s Office of Management and Budget of anticipated resources needed yet in Fiscal Year 2012. These include:
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 Capacities for 100 ICF/DD residents to move to Waiver services;  Capacities for an additional 300 individuals who live in the Family Home at
one-half year phase;  Eligibility assessments for 400 individuals;  Contractor(s) for outreach to ICF/DD residents;  Closure rates for ICFs/DD agreements covering an estimated 50
individuals;  Contractual consultants as necessary to oversee compliance until new
staff are hired; and  Eight new staff.xx
The proposed budget for Ligas implementation will be annually presented to the Parties and Intervenors.
Federal Approval of Waiver Capacity
Each year, as new enrollment opportunities are made available for individuals, the DDD will work with HFS to submit an amendment increasing the capacity of the adult Waiver.xxi
Federal approval for the current adult Waiver expires on June 30, 2012. The renewal process is underway as the Implementation Plan is being written. During the development of the renewal application, the DDD and HFS will ensure consistency and compliance with the Ligas Consent Decree. The DDD and HFS are being assisted during the renewal process by technical assistance provided by the federal government through its quality assurance contractor.
Section XI. Interagency Agreements
Interagency agreements, necessary to carry out the provisions of the Decree, are in place among the Departments. Specifically, there is an interagency agreement among the Departments of Children and Family Services, Healthcare and Family Services, Human Services, and Public Health that addresses the interactions involving developmental disabilities Medicaid programs. In addition, there is an interagency agreement specific to the implementation of the Money Follows the Person grant. These agreements are available upon request from the DDD. At this point, the DDD does not anticipate the need for any new interagency agreements to implement the Decree.
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Section XII. Process for Plan Reporting and Modification
Paragraph 28. The Implementation Plan shall be updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate…
Paragraph 33. …Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress toward achieving compliance. Prior to the first report, the Parties and the Monitor will agree on the data and information that must be included in such reports…
Pursuant to Paragraph 28 of the Decree, the DDD will review the Implementation Plan on an annual basis. Changes will be made, as needed, with the assistance of the Monitor. The proposed modifications will be submitted to the Monitor. The Plaintiffs and, if applicable, the Intervenors, will be given the opportunity for input.
Per Paragraph 33 of the Decree, the DDD will report data and information regarding its progress toward compliance with the provisions of the Decree. These reports will be posted on the DDD’s website. As the draft Implementation Plan is being developed, the DDD is discussing with the Parties and Monitor the data and information to be included in these reports. These discussions will be concluded by December 15, 2011, so the data and information will be listed in the final Plan.
Section XIII. Acronyms
The following, for reference, is a list of acronyms used throughout this document:
CILA – Community Integrated Living Arrangement DDD – Division of Developmental Disabilities DHS – Illinois Department of Human Services HBS – Home-Based Support Services HFS – Illinois Department of Healthcare and Family Services ICF/DD – Intermediate Care Facility for Persons with Developmental Disabilities ICF/MR – Intermediate Care Facility for Persons with Mental Retardation ISC – Independent Service Coordination ISSA – Individual Service and Support Advocacy JCAR – Joint Committee on Administrative Rules PAS – Pre-Admission Screening PUNS – Prioritization of Urgency of Need for Services RFP – Request for Proposals ROCS – Reporting of Community Services
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i Capitalized terms in the Implementation Plan are defined in the Implementation Plan are defined in the Consent Decree.
ii The link for the Ligas Consent Decree is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/Li gasConsentDecree061511.pdf.
iii The link to Form IL1238, Choice of Supports and Services, is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Forms/IL462-1238.pdf.
iv The link to the DDPAS-10 Form is http://www.dhs.state.il.us/OneNetLibrary/4/documents/PAS/DDPAS100111.pdf.
v The link to the PUNS Manual is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Manuals/DD%20Manuals/Illinois%20PUNS% 20Manual.pdf.
vi The link to the PUNS brochures, flyers, and posters is http://www.dhs.state.il.us/page.aspx?item=31104.
vii The link to the new provider page is http://www.dhs.state.il.us/page.aspx?item=47336.
viii The link to the sample downsizing agreement is http://www.dhs.state.il.us/page.aspx?item=50038.
ix The link to the adult DD Waiver is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/Adult%2 0DD%20Waiver.pdf.
x The link to the DDD’s training information is http://www.dhs.state.il.us/page.aspx?item=45209.
xi The link to the DD Pre-Admission Screening Manual is http://www.dhs.state.il.us/page.aspx?item=53018.
xii The link to the ROCS Software is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/MentalHealth/DHSCRSManual.p df.
xiii The link to the ISSA Problem Resolution Protocol is http://www.dhs.state.il.us/page.aspx?item=56642.
xiv The PUNS database categorizes individuals into emergency, critical, and planning needs. See the PUNS Manual for definitions of these categories. The link to the PUNS Manual is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Manuals/DD%20Manuals/Illinois%20PUNS% 20Manual.pdf.
xv The link to the PUNS summary reports is http://www.dhs.state.il.us/page.aspx?item=51905.
xvi The link to the crisis criteria is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/DD%20Reports/Community%20Emer gency%20Criteria%20-%20Adults.pdf.
xvii The link to Rule 120 is http://www.ilga.gov/commission/jcar/admincode/059/05900120sections.html.
xviii The link to Form IL462-1202, Notice of Individual’s Right to Appeal is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Forms/IL462-1202.pdf.
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xix The link to the DDPAS-10 Form is http://www.dhs.state.il.us/OneNetLibrary/4/documents/PAS/DDPAS100111.pdf. xx The first eight staff to be hired will be the compliance coordinator, the class list person, three quality assurance staff, two transition services staff, and one appeals unit staff. xxi The link to the adult DD Waiver is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/Adult%2 0DD%20Waiver.pdf.
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 Case: 1:05-cv-04331 Document #: 566-1 Filed: 02/22/13 Page 1 of 29 PageID #:11255 Ligas, et al. v. Hamos, et al., Case No. 05 cv 04331
EXHIBIT 1

Case: 1:05-cv-04331 Document #: 566-1 Filed: 02/22/13 Page 2 of 29 PageID #:11256
Ligas Implementation Plan
2013 Revisions
State of Illinois
Department of Human Services, Division of Developmental Disabilities 02/15/13
This Implementation Plan has been developed by the Division of Developmental Disabilities, with input from the Plaintiffs, Intervenors, and Monitor to accomplish the obligations and objectives set forth in the Ligas v. Hamos Consent Decree. (Case: 1:05-cv-04331 Document #: 549)
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LIGAS IMPLEMENTATION PLAN 2013 Revisions
February 15, 2013
Section I. Executive Summary
Background of Litigation and Overview of Consent Decree On June 15, 2011, the State entered into a Consent Decree settling the Ligas v. Hamos lawsuit, filed on July 28, 2005 on behalf of individuals with developmental disabilities who were residing in private, State-funded facilities (Intermediate Care Facilities for Persons with Developmental Disabilities or ICFs/DD) of nine or more persons or who were at risk of being placed in such facilities. Plaintiffs sought placement in Community-Based Settingsi and receipt of CommunityBased Services. The Consent Decree, which is available on the Division of Developmental Disabilities’ (DDD) website,ii identifies two groups of Class Members:
 Adult individuals in Illinois with developmental disabilities who qualify for Medicaid Waiver services, who reside in ICFs/DD with nine or more residents, and who affirmatively request to receive Community-Based Services or placement in a Community-Based Setting.
 Adult individuals in Illinois with developmental disabilities who qualify for Medicaid Waiver services, who reside in a Family Home, who are in need of Community-Based Services or placement in a Community-Based Setting, and who affirmatively request Community-Based Services or placement in a Community-Based Setting.
The Decree does not force individuals who do not want Community-Based Services or placement to move. Nor does it force providers to close beds or enter into downsizing agreements with the State against their will. The tenets of the Decree will assist the DDD in expanding its community-based system to meet the growing demand for those services, while continuing to honor an individual's choice in deciding on the types of services and settings he or she prefers in order to live a personally fulfilling and productive life. The Decree includes the following provisions:
 Services for Individuals Currently Residing in ICFs/DD Within six years of approval of the Decree, all individuals living in ICFs/DD as of the effective date of the Decree who have affirmatively requested CommunityBased Settings will move to Community-Based Settings. Placements must be
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implemented for one-third of all such individuals every two years of this six-year period. For those individuals who wish to continue living in an ICF/DD, the Decree requires the State to honor that choice and to continue to provide adequate funding to meet the needs of such individuals.
 Services for Individuals Currently Residing in the Family Home The DDD will continue to expeditiously serve all people who meet the established crisis criteria. There will be no limit to the number of people served who meet the crisis criteria. The DDD will serve 3000 individuals on the Waiting List for Community-Based Services or placement in a Community-Based Setting, as defined in the Decree, over the next six years (1,000 within the first two years and 500 each year the next four years) with home-based support services or in community-based residential settings. After the end of the six year period, all Class members on the Waiting List shall move off the Waiting List at a reasonable pace.
 Other General Provisions
 Evaluations and Transition Service Plans will focus on individual desires and goals and will not be limited by existing services. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent appropriate and consistent with the choices of the class member and his or her legal guardian. The State, however, will not be required to develop or offer services that are not part of the approved Waiver or Medicaid State Plan.
 The Department of Human Services (DHS) will seek sufficient funds in annual budget requests to develop and maintain the services described in the Decree. Implementation of the Decree is not, however, dependent on legislative appropriation of new funds.
 A monitor has been appointed by the Court to oversee compliance with the Decree and report on progress to the Court on an annual basis. After nine years of the approval of the Decree, the State may petition the Court to terminate the monitoring process.
The Implementation Plan
This document sets forth the State’s plans to implement the provisions of the Consent Decree. It is being developed consistent with Paragraph 26 of the Consent Decree and has incorporated input received from the Plaintiffs, Intervenors, and other advocates throughout the system.
References to paragraph numbers in each of the sections below refer to paragraphs within the Consent Decree from which language is excerpted. For full context, readers should refer to the Consent Decree. Should any language in
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the Implementation Plan unintentionally conflict with that of the Consent Decree, the Consent Decree governs.
Section II, Development and Maintenance of the Class Member List, describes the compilation of an initial list of class members and the DDD’s further development and maintenance of that list. These efforts will be on-going as additional individuals request to be added to or removed from Class Membership as a result of outreach activity.
Section III, Outreach, provides information regarding the DDD’s efforts to identify individuals in need of residential or in-home supports, as well as those Potential Class Members who wish to move from ICFs/DD. It is the intention of the DDD to partner with the Plaintiffs and other advocates to ensure individuals and their guardians are given accurate and complete information about their options.
Section IV, Development of Community Capacity, discusses the need to expand and develop new service capacity to meet the requirements of the Decree for Class Members seeking services. The DDD intends to work with both existing providers and recruit new providers to fill the growth in service delivery.
Section V, Community-Based Services/Placement for Individuals Residing in ICFs/DD, addresses the opportunity for Class Members residing in ICFs/DD to move to community-based services. At 2 ½, 4 ½, and 6 years from the approval of the Consent Decree (June 15, 2011), the DDD will have implemented services to one-third of these Class Members. Monitoring activities will be underway to achieve the goal of successful transitions.
Section VI, Transition Planning, outlines a plan and time frame for implementing the use of Transition Service Plans for Class Members. This new process will present a system change for the entire service delivery system. The Transition Service Plans will be developed prior to the selection of service providers to describe the services a Class Member needs. The goal of this process is to ensure service delivery focused on and tailored to the individual.
Section VII, Waiting List for Community Services and Placement, details the process for Class Members living at home to be selected for the 3,000 new community capacities. Individuals will be selected each year from the DDD’s waiting list.
Section VIII, Community Crises, confirms the DDD will continue its current practices in serving individuals in crisis situations. These services will be above the 3,000 capacities being developed for Class Members residing at home.
Section IX, Appeal Process, refers to the right to appeal any denial, suspension, termination, or reduction of services, as well as the process for informing Class Members of this right.
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Section X, Resources Necessary for Implementation, outlines additional resources required by the DDD to implement the provisions of the Consent Decree. These resources include contractual services for administrative functions, additional staff, and direct services for Class Members. Also discussed in this section is the budget development to both maintain existing services and implement the new provisions of the Decree.
Section XI, Interagency Agreements, lists the two agreements currently in place among State governmental entities to secure matching Medicaid funds for developmental disabilities services. It is believed these agreements are sufficient to implement the provisions of the Decree.
Section XII, Process for Plan Reporting and Modification, provides for the annual review and update of this Implementation Plan. Reports will be produced every six months by the DDD containing data and information regarding compliance activities.
Section XIII, Acronyms, lists the acronyms used in this document.
Section II. Development and Maintenance of the Class Member List
Paragraph 6. Within thirty (30) days after Approval of the Decree, Defendants shall compile an initial list of Class Members by taking the list of Individuals to whom notice of Preliminary Approval of this Decree was sent, adding those Individuals from whom any of the Parties received a written, affirmative request to receive Community-Based Services or placement in a Community-Based Setting after notice of Preliminary Approval of this Decree was sent, but excluding (i) those individuals who filed objections to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing as described in Paragraph 3(i) above, and (ii) those Individuals from whom Defendants receive written requests that the Individuals do not wish to receive Community-Based Services or placement in a Community-Based Setting.
Paragraph 8. Defendants shall maintain a statewide database in which all Class Members are enrolled.
Consistent with Paragraph 6 of the Consent Decree, the Attorney General’s Office provided to the Monitor and Plaintiffs on July 15, 2011, an initial list of Class Members. Intervenors were also given a copy of the initial list. The list includes:
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 Adults (age 18 and above) enrolled in the State’s Prioritization of Urgency of Need for Services (PUNS) database as of June 15, 2011, who were not already living in a 24-hour Community-Based Setting or State-Operated Developmental Center (SODC); and
 Individuals who had submitted written requests to be included in the Class to the Attorney General’s Office;
 But not those excluded from the class, as set out immediately below and in Paragraph 6 of the Decree.
The Parties have agreed that, for those individuals who live in ICF/DD settings, they are a Class Member if they have completed an Illinois Form 1238iii or its predecessor, DMHDD Form 1243; or the DDPAS-10 Formiv; or the Request Form disseminated through Plaintiffs’ counsel; and checked the box indicating he or she chooses Home and Community-Based Services. An individual will not be a Class Member if he or she completed one of the above forms and checked the box choosing services in an ICF/DD or if he or she otherwise objected to the terms of the Consent Decree at the Court’s fairness hearing or objected otherwise in writing per Paragraph 6 of the Decree, unless a subsequent communication to DDD requests Community-Based Services or placement in a Community-Based Setting.
With the assistance of the Monitor, the DDD will further scrutinize the initial list, including comparing it to the list of objectors to the Consent Decree, to ensure that only individuals for whom the State has a current record affirmatively requesting Community-Based Services or Settings are included on the list.
This initial list of Class Members will be compared with the State’s PUNS database of individuals waiting for services and the following actions will be taken:
 The record for Class Member will be marked as a Ligas Class Member, along with the date the person was added to the Class Member listing. Records for those in the initial list will show this date as June 15, 2011. The record will also reflect whether the Class Member is living in the Family Home, an ICF/DD on June 15, 2011, or an ICF/DD after June 15, 2011.
 If an individual is included in the initial listing but is not enrolled in PUNS, the State will instruct the PAS/ISC agencies to meet with the individual and his or her guardian to complete a PUNS enrollment.
 The State will add individuals to the class list as they request CommunityBased Services or placement through the normal PUNS process, per the existing PUNS manual.v It will also add those individuals who inform the State they choose to move from ICFs/DD through the completion of Form 1238, Choice of Supports and Services, or the DDPAS-10 Form. Efforts
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to identify additional Class Members are discussed in the Outreach section of this plan.  If a person requests to be removed from the class at any point during the time of the Consent Decree, their record will be so marked, along with the date and reason. Reasons for leaving the class include:
o Individual chose to stay in ICF/DD o Individual chose to move to ICF/DD o Individual is deceased o Individual moved out of State o Individual was determined by DDD to be ineligible for the Medicaid
Waiver o Individual withdrew from the class without giving a reason o Other
Thus, the individual’s record will be marked as “removed” but the record itself will not be deleted. Prior to marking an individual’s record as “removed”, the DDD will ensure the individual was informed of his or her rights as a Class Member by a PAS/ISC agency or an independent contractor. For people found to be ineligible, the DDD will refer these individuals to the appropriate state agency in which they may be eligible (e.g. the Division of Mental Health or the Division of Rehabilitation Services). For people found to be ineligible, if such individuals are later found eligible (as a result of an appeal or otherwise), those individuals will be added back to the class.
The State will use its PUNS database to maintain the list of Class Members. Each Class Member will have a PUNS enrollment and his or her record will be marked with the data elements described above.
In order for these efforts to be successful, enrollments on the PUNS database must be kept current. The DDD will work with the existing 18 PAS/ISC agencies to ensure records are updated at least annually. The DDD will require each agency to develop a plan of action to update all records presently out-of-date.
The DDD will maintain the class list. The Monitor and Class Counsel will have access to the class list, including contact information, on an on-going basis. The DDD also will provide to Intervenors’ Counsel the class list that DDD will use to compare with the listing of all ICF/DD residents to determine which ICF/DD residents will be contacted by the Outreach contractors as provided in Section III of this Implementation Plan, subject to Intervenors’ Counsel’s agreement to: (1) maintain the list as “attorneys’ eyes only”; (2) not disseminate any name on the list beyond Intervenors’ Counsel; and (3) not contact any individual on the list, the individuals’ guardians or the ICFs/DD in which those individuals reside. The DDD will produce for the Monitor, Class Counsel, and Intervenors’ Counsel semiannual summary reports of additions to and removals from the list.
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As part of the annual reviews of the Implementation Plan (see Section XII), the DDD will review the adequacy of the PUNS database in capturing the information needed for implementation of the Decree.
Section III. Outreach
Paragraph 25. Defendants shall maintain a fair and accessible process by which Individuals with Developmental Disabilities or their legal guardians can affirmatively request in writing to receive Community-Based Services and/or placement in a Community-Based Setting or to receive ICF-MR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests.
The DDD’s outreach efforts will be directed to:
 identifying individuals with developmental disabilities throughout the State who are or will be in need of residential or in-home supports funded through DDD Medicaid services; and
 Identifying individuals residing in ICFs/DD on or before June 15, 2011, who may choose to transition to Community-Based Settings and services. Objectors to the Consent Decree will not be contacted. The DDD will work in conjunction with Class Counsel to coordinate efforts on outreach.
Community Outreach
DDD will use the existing PUNS database, enrollment form, and manual as tools to identify, record, and track information regarding individuals newly identified as in need of services. The DDD will continue to complete PUNS enrollments through contracted entities. As the Implementation Plan is being written, there are 18 local PAS/ISC agencies with contracts through the DDD for PUNS enrollments.
Outreach efforts shall include:
 Training of PAS/ISC agencies on the requirements of the Consent Decree and the provisions of the Implementation Plan;
 Development and maintenance of special brochures, flyers, and posters, which can be downloaded from the DDD website;vi
 Coordination with trade associations, local schools, special recreation associations, and other advocacy organizations to publicize PUNS;
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 Distribution of information regarding PUNS and Ligas to Medicaid-enrolled health care providers via the State Medicaid agency’s list serve;
 Distribution of materials at special events such as conferences, seminars, etc.;
 Inclusion of culturally appropriate materials, alternative means of communication, and easily understandable language in efforts to publicize PUNS, including targeting communities identified as under-reported;
 Maintenance of the PAS/ISC office locator function on the DDD website; and
 Maintenance of the 1-888-DDPLANS toll free number to connect families with their local PAS/ISC office.
Outreach to Persons in ICFs/DD
In addition to the efforts to inform and identify individuals throughout the population as a whole, the DDD will focus outreach efforts to identify Potential Class Members residing in ICFs/DD. (Potential Class Members residing in ICFs/DD are those ICF/DD residents who (1) are not Class Members and (2) did not exclude themselves from the class by having objected to the Decree prior to its approval or by submitting a written request to be excluded prior to compilation of the initial class list per Paragraph 6 of the Decree.) With input from the Monitor, Class Counsel, and Intervenors, the DDD issued a Request for Proposals (RFP) to secure the services of a contractor or multiple contractors to contact all Potential Class Members residing in ICFs/DD; however, the DDD did not receive any bids in response to the RFP. After consultation with the State’s procurement staff to ensure all regulations are appropriately followed, the DDD is now in discussions with a potential vendor. The DDD’s goal is to have a contract in place by April 1, 2013. The contractor(s) selected will be independent of direct service and service coordination for persons with developmental disabilities in Illinois.
Once the contract (or contracts) is in place, the DDD will issue notice that the contracted entity (or entities) will be working in the facilities for the next two to three years. The DDD will require the ICFs/DD providers to confirm the list of individuals residing in their facilities and to provide the DDD with the addresses and phone numbers for all guardians. The DDD will then compare the listing of all ICF/DD residents to the list of known Class Members and the list of those individuals who excluded themselves from the class by objecting or submitting a written request per Paragraph 6 of the Decree. Once that comparison is finished, the DDD will provide the contractor(s) with a list of ICFs/DD and Potential Class Members. The contractor(s) will then call the guardian and ask if the guardian is willing to meet to discuss having the Potential Class Member move to a
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community-based setting and, if so, inform them that the Potential Class Member’s records will be reviewed as part of the next steps. Thereafter, the ICFs/DD will provide the contractor(s) with full access to records only for those individuals who indicate they wish to consider moving, and, upon reasonable notice (i.e., at least seven calendar days), provide the contractor(s) with full access to and private meeting space with Potential Class Members at times and in a manner that are convenient for the Potential Class Members and their guardians and do not unreasonably interfere with the operations of the facility. [For those individuals without guardians, the first contact will be through record reviews and face-to-face meetings.] The DDD will inform ICF/DD administrators that they and facility staff cannot interfere with the outreach process or seek to intimidate, persuade, or otherwise influence residents to stay in their facilities. No individual or their guardian will be required to meet with the contractor(s) if they choose not to do so.
DDD, with the participation of the Monitor, will develop written guidelines and provide training for the contractor(s). Such guidelines and training will ensure the contractor(s) provide complete and objective information regarding all alternative choices for long-term care services for Potential Class Members and do not attempt to steer Potential Class Members toward any particular service alternative. The goal is to enable the individual and his or her guardian, if applicable, to choose the service alternative that they feel best meets their needs.
Where Potential Class Members have indicated that they wish to consider moving to a Community-Based Setting, the contractor will meet with those individuals, and their guardians and family members, to inform the individuals of their rights under the Consent Decree and to provide them with complete and objective information regarding all alternative choices for long-term care services. As part of the information regarding alternative choices, prior to making choices about moving, the contractor will provide Potential Class Members the opportunity to visit community-based settings and to meet with people with disabilities and their families who already have transitioned to another setting. The contractor will document the date and time of the meeting with the individual, guardian, and/or family members and record on a form provided by the DDD the individual’s decision to remain in the ICF/DD or to consider moving to an alternative setting. The contractor will give copies of these completed forms to the DDD.
The contractor will inform the individual of his or her options through the PUNS intake form, complete the PUNS enrollment for those individuals who wish to receive community-based services, and report that information to the DDD using the Reporting of Community Services (ROCS) software.
If an individual indicates that he or she would like to consider moving to an alternative setting, whether that alternative setting be community-based services
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or another ICF/DD, the contractor will refer the individual to the appropriate PAS agency to work with the individual regarding his or her options. The PAS agency will facilitate visits to potential alternative settings to assist the individual and guardian in evaluating and/or selecting types of services and providers.
If a Potential Class Member chooses to move to a Community-Based Setting and that choice is documented in accordance with Paragraph 10 of the Consent Decree, the individual shall become a Class Member. If a Potential Class Member chooses to remain in his or her ICF/DD or move to another ICF/DD, the individual will not be a Class Member. However, Potential Class Members are not required to make a decision about whether to join the class during the initial outreach visit and can maintain their status as a Potential Class Member until they are ready to make a decision.
Much of the contractor(s) work should be completed by June 30, 2016, including initial meetings with individuals, guardians, and family members. In order to provide individuals’ guardians, and family members sufficient time to explore options and make decisions, outreach efforts will continue beyond that date.
General Information Sharing
In order to better inform individuals and family members, the DDD will expand and maintain the Ligas page on its website. It will develop materials for this page with input from the Monitor, Plaintiffs, and family representatives. It will also make presentations about the Consent Decree around the State at conferences, annual meetings, and other events hosted by other organizations and agencies. If there are an insufficient number of such events to enable DDD to educate the public about the Consent Decree, DDD will create and host its own events. The DDD will post a schedule on its website of all events in which it will present information about the Consent Decree.
Ligas Class Member/Family Advisory Committee (CMAC)
The Defendants, in conjunction with the Monitor and with input from the Parties, will establish and support a Ligas Class Member/Family Advisory Committee (CMAC) by June 30, 2013. This committee will provide ongoing consultation and advice to the Defendants, Monitor and Parties regarding implementation of Ligas activities from the perspective of Class Members and their families. Members of the CMAC will be selected by the Defendants with input from the Parties. The Defendants will provide administrative support to the CMAC and, when necessary, reimburse approved costs associated with Class Member/family travel. Summaries of CMAC meetings and any written recommendations will be provided to the Parties for review and comment. Meetings of the CMAC will be open to the public.
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Section IV. Development of Community Capacity
Paragraph 4. The choices of Individuals with Developmental Disabilities, including Class Members, to receive Community-Based Services or placement in a Community-Based Setting or to receive ICF/MR services in an ICF-DD will be honored; provided, however, that this commitment to honoring choice does not alter Defendants’ current obligations under existing law regarding licensed ICF-DD capacity system-wide or at any specific ICF-DD, and provided that, under current applicable law, this commitment does not entitle an Individual with Developmental Disabilities to receive ICF/MR services in a specific ICF-DD. Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such individuals under the Decree and the Implementation Plan consistent with such choices. While the Decree remains in effect, any amendment to the State Plan submitted by the State pursuant to 42 U.S.C.§ 1396, et seq. will continue to include ICF-DD services as an alternative choice for long-term care services for eligible Individuals with Developmental Disabilities. Nothing in this Decree shall impair Defendants’ ability to make changes in their provision of supports and services to Individuals with Developmental Disabilities, including Class Members, regardless of setting, provided that Defendants continue to honor Individuals’ choices and fulfill Defendants’ obligations under the Decree and Implementation Plan. Resources necessary to meet the needs of Individuals with Developmental Disabilities who choose to receive services in ICFs-DD shall be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree, including the obligations under Paragraphs 17 through 19 and 21 through 23. Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs using federally approved objective criteria regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based Setting; provided, however, nothing in this Decree shall require Defendants to change their current method for establishing funding or from adopting new methods based upon federally approved objective criteria.
Paragraph 5. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings.
Within the first six years of the Consent Decree, the DDD will provide services to 3,000 individuals currently living at home with their families or in another
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community arrangement. These services will include both Home-Based Support Services (HBS) and Community Integrated Living Arrangement (CILA) services, inclusive of all support services provided under the Waiver. In addition, an unidentified number of individuals will be moving from ICFs/DD to HBS or CILA services. This will require at least an estimated 20% expansion of Waiver capacity. (The exact amount cannot be known until the individuals in ICFs/DD are identified.) Individuals selected to receive services under this Consent Decree may choose from any qualified and willing providers as defined in the Waiver.
Illinois has a substantial base of qualified HBS, CILA, and day program providers. There are approximately 190 licensed CILA providers, 125 HBS service facilitation agencies, 150 developmental training providers, and 65 supported employment providers, as well as providers of therapies, assistive technology, and other support services as provided under the Waiver. In order to meet the required expansion, current providers will be called upon to increase the size of their operations and new providers may be needed.
As part of the annual reviews of the Implementation Plan (see Section XII), the DDD will review progress toward this needed expansion and modify the Implementation Plan as necessary to implement the provisions of the Decree.
New Providers
Any existing providers interested in implementing new programs or any entities interested in becoming providers through the DDD are directed to visit the DDD’s web page about becoming a new providervii. This web page informs potential providers about the qualification process, regulations, compliance issues, staff training requirements, DDD contact persons, etc. In addition, for potential new CILA or developmental training providers, prior to the acceptance of a license or certification application, the DDD mandates attendance at one of the orientation sessions provided by the DDD approximately twice per year. Information about these sessions is posted on the DDD website. At these sessions, community services, quality assurance, and rates staff give joint presentations about provider regulations and processes and are available to answer questions from potential providers. The DDD will encourage providers of day services to develop options that reflect the value of supporting the Class Member with relationships, productive work, participation in community life, and personal decision-making.
Conversion of ICF/DD Capacity
The DDD will work with the Department of Healthcare and Family Services (HFS) to propose rule language to allow the DDD to enter into voluntary closure agreements with providers of ICFs/DD of 16 and fewer beds. These closure agreements would provide for rates during the closure period that recognize the
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need for coverage of fixed costs while individuals are transitioning to new residential settings of their choice, whether operated by the same or a different provider. The DDD shall ensure that ICF/DD residents transitioning to a new residential setting are provided with a Transition Service Plan, as called for in Paragraph 13 of the Consent Decree, are informed of their right to explore options among any qualified provider, and are given a choice of qualified residential providers if they choose to explore those options. The DDD, through regulatory language, has for over a decade been able to enter into such agreements with larger ICFs/DD; however, the option is not available for 16-bed facilities as of the writing of this plan. This new proposed option could assist ICF/DD providers that choose to eliminate ICF/DD capacity and create or expand community-based settings. The DDD and HFS will work together to submit the proposed rule language to the Joint Committee on Administrative Rules (JCAR) and respond to comments during the public comment periods. The DDD’s goal is to submit the proposed rule language to JCAR by October 31, 2013.
In order to provide more detail about the downsizing/closure process, a sample agreement is available for reference on the DDD’s website.viii
Provider Qualifications and Training
The qualifications for each type of Waiver provider are specified in Appendix C of the Waiver.ix Training requirements are listed and described in the DDD’s training catalogue available on the DDD’s website.x
The quality improvement system for the Waiver is described in Appendix H of the Waiver. Performance measures are outlined throughout the Waiver itself.
Section V. Community-Based Services/Placement for Individuals Residing in ICFs/DD
Paragraph 17. …within six (6) years after Approval of the Decree, all Class Members residing in ICFs-DD as of the date of Approval of the Decree (regardless of when in this timeframe the Class Member affirmatively requested placement in a Community-Based Setting) will transition to Community-Based Settings consistent with their Transition Service Plan, if, at the time of transition, the Class Member requests placement in a Community-Based Setting…
Per the Consent Decree, at 2 ½, 4 ½, and 6 years respectively, the DDD will have implemented services to one-third of the individuals who were residing in ICFs/DD as of June 15, 2011 who inform the DDD they choose to move to Community-Based Placements. The number requesting to move will be calculated at 24 months following the approval of the Consent Decree, i.e., June 15, 2013. Any of the individuals who were residing in ICFs/DD as of June 15,
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2011, who are newly identified as choosing to move to community-based services after June 15, 2013, will be offered services over the course of Years three through six.
At the time of this revision to the Implementation Plan, there are 770 confirmed class members residing in ICFs/DD. The DDD is instructing the PAS agencies to work with these individuals to submit applications for Waiver services. Applications will be processed as they are received by the DDD. In the event the number of individuals seeking to move requires the DDD to manage the flow of requests and time frames for authorization, the DDD will select individuals for services based on the length of time they have resided in an ICF/DD. That is, those residing in an ICF/DD the longest amount of time will be selected first. Three factors may cause individuals to be selected sooner, at the DDD’s discretion, than their class list date would indicate: (1) a request from the individual or the ICF/DD due to the inability of the ICF/DD to meet the individual’s medical or behavioral needs, (2) a request from roommates or friends who wish to move together at the same time, and (3) a voluntary downsizing or closure agreement.
As individuals are identified as choosing to move, via the process described in the Outreach section above, pre-admission screening entities will be instructed to complete Medicaid Waiver eligibility assessments for them per the DD PreAdmission Screening Manualxi and to report the results to the DDD via the ROCS software.xii Service options will be presented, per the same manual, to those individuals determined eligible. These options will be recorded on the DDPAS-10 Form. Transition Service Plans, as described below in the Transition Planning section, will be developed for those who choose to move.
The DDD will build upon processes it has developed for persons transitioning from State-Operated Developmental Centers (SODCs) to monitor the transitions of individuals from ICFs/DD to Community-Based Settings or Services. Staff within the DDD’s Bureau of Transition Services will be assigned to each individual, contacting them or their guardians and service providers monthly during the first year following transition. Monitoring activities will be tracked through an internal database that is currently in use for SODC transitions.
In addition to the activities by State staff, the PAS/ISSA will monitor the individual’s successful adjustment to the new services by completing four weekly visits with the Class Member during the first month and quarterly visits thereafter. In the event the ISSA identifies problems, it shall take steps to resolve issues locally and refer matters as needed to the DDD per the Problem Resolution Protocol within the ISSA Guidelines.xiii It may also request more hours for additional visits per the Guidelines.
Section VI. Transition Planning
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Paragraph 11. The Transition Service Plan shall describe the services the Class Member requires in a Community-Based Setting or through Community-Based Services; where and how such services can be developed and obtained; the supports and services the Class Member will need during his or her transition to a Community-Based Setting; and a timetable for completing that transition.
Paragraph 12. The Transition Service Plan shall be developed by a Qualified Professional in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member.
Paragraph 13. The process for developing a Transition Service Plan shall focus on the Class member’s personal vision, preferences, strengths and needs in home, community and work environments and shall reflect the value of supporting the Class Member with relationships, productive work, participation in community life, and personal decision-making.
Paragraph 14. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent possible, consistent with the choices of the Class Member and the Class Member’s legal guardian.
Paragraph 15. The Transition Service Plan shall not be limited by the current availability of services, provided, however, that nothing in this paragraph obligates Defendants to provide the types of services beyond those included in the Waiver and/or the State Plan.
Implementation of the use of Transition Service Plans will be a system change for the entire service delivery system. Time will be needed in order to affect this change.
The DDD is finalizing the development of its process for completion of a Transition Service Plan for each class member seeking services in a CommunityBased Setting. An initial version of a standardized format and accompanying instructions was developed with input from the Monitor, Plaintiffs Counsel, PAS/ISC agencies, and other advocates throughout the system. Two PAS/ISC agencies are piloting the draft process and materials with Class Members and providers in their areas. These two PAS/ISC agencies participated in a planning/training meeting with the Monitor and DDD staff on August 23, 2012 in order to begin the pilot.
As the Implementation Plan is being revised, 41 Transition Service Plans have been developed and submitted for review by the DDD and Monitor. Monthly
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conference calls have been held among the two PAS/ISC agencies, Monitor, and DDD staff throughout the pilot. The standardized format and accompanying instructions are now undergoing final revisions, based on the experience of the pilot, for Statewide implementation.
Training for all PAS/ISC agencies is scheduled for April 16, 2013. Local training sessions for small groups of PAS/ISC agencies will be held throughout the rest of April and May. A webinar session will also be made available. These training opportunities are being conducted by DDD staff and the Monitor.
In order to complete this work, the DDD will:
 By March 31, 2013, finalize the standard form and accompanying instructions and implementation processes,
 On April 16, 2013, provide training to PAS/ISC agencies and DDD staff,  By May 31, 2013, host a second opportunity for training for all PAS/ISC
agencies in small groups of agencies,  By May 31, 2013, make a webinar training session available for viewing by
interested parties,  By July 1, 2013, implement the new process statewide for all Class
Members,  By January 31, 2014, evaluate the new process, and  On an on-going basis, modify the new process as necessary to implement
the provisions of the Decree.
The new process will be consistent with Paragraphs 11 through 15 of the Decree quoted above at the beginning of this Section.
The process will address the coordination required between PAS/ISC agencies when a Class Member is moving from one geographic location to another. The training for the PAS/ISC agencies will emphasize their respective responsibilities in such situations.
Once implementation is complete, Transition Service Plans will be completed for each individual leaving an ICF/DD or the Family Home. In no more than 12 months prior to the development of the Transition Service Plan, the Class Member must be presented with all of his or her service alternatives. Transition Plans are not required for those individuals who will be receiving Home-Based Support Services (HBS) in their own or family’s home. An individual service plan is still required for each individual in the HBS Program as described in the Waiver.
In the meantime, no individuals will be required to wait for the development and implementation of this process in order to move to a Community-Based Setting. PAS/ISC agencies will follow the processes described in the DD PAS Manual to assist individuals in obtaining needed services. Once the Transition Service Plan
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process is implemented, the Plans shall be completed within sufficient time to provide appropriate and sufficient transitions of Class Members in accordance with the deadlines set forth in the Decree. For those Class Members who moved to a Community-Based Setting without a Transition Service Plan, the ISSA will work with the Class Member and guardian to ensure needed modifications are made to the Individual Service Plan to address the Class Member’s personal vision, preferences, strengths and needs in home, community and work environments. The DDD will have a process to ensure this work is completed by December 31, 2013.
This Transition Service Plan is separate from the Individual Service Plans completed for all individuals enrolling in the Waiver. The Individual Service Plans will be completed prior to the individual transitioning to community-based services and are inclusive of risk assessments to ensure the health and general well-being of the individuals.
Section VII. Waiting List for Community Services and Placement
Paragraph 22(d). Within two (2) years after Approval of the Decree, Defendants shall provide, in accordance with the Class Members’ Transition Service Plans, appropriate Community-Based Services and/or placement in Community-Based Settings for at least 1,000 Waiting List Class Members who are selected from the Waiting List…with these Class Members served in order of priority. In each of the third, fourth, fifth and sixth years following Approval of the Decree, Defendants shall serve at least 500 additional Waiting List Class Members who are selected from the Waiting List, again in order of priority.
Paragraph 23. All Class Members who are on the Waiting List after the end of the sixth year following Approval of the Decree shall receive appropriate Community-Based Services and/or placement in a Community-Based Setting, such that they move off the Waiting List at a reasonable pace…
Over the first six years of the Decree, the DDD is to serve under the Medicaid Waiver an additional 3,000 individuals from the waiting list. The addition of these 3,000 capacities will be accomplished by adding people to both the CILA and HBS programs.
The provision of community-based services and/or placement in a communitybased setting for waiting list class members pursuant to Paragraph 22(d) of the Consent Decree will be based on an annual compliance date of 1000 class members by June 30, 2013 and 500 class members per year by June 30 for the next four years thereafter. This annual compliance date is consistent with the
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State of Illinois fiscal year as well as the semi-annual date for information provided in the required data reports.
The DDD will use the following process for selecting individuals to be served from the Class Member waiting list:
Exclude anyone whose record is not labeled as a Ligas class member. As secondary edits to double check for accuracy of the list and selection, exclude the following records in all cases:
 Persons previously selected in PUNS selections [These individuals have already been chosen and offered services.],
 Persons in the Planning category [These individuals are not seeking services within the year, but are anticipating the need for services within five years.],
 Persons who are under the age of 18 [These individuals are not Class Members.],
 Persons residing in Child Care Institutions (Program Code 19D) and Community Living Facilities (Program Code 67D) [These individuals are already receiving residential services.],
 Persons already enrolled in the Children’s Support and Residential Waivers (Waiver Codes D1 or D2) [These individuals already have a funding path for entrance into the adult Waiver.],
 Persons who are client type [These individuals are not Class Members.]: o B, Bogard Class Members, o C, CILA participants, o F, Family Assistance Program developmental disabilities participants, o K, Family Assistance Program mental health participants, o S, State-Operated Developmental Center residents, and o W, Mental Health Home-Based Support Services participants, and
 Persons who are client type [These individuals already have a funding path for entrance into the adult Waiver.]: o G, Children’s Support Waiver participants, and o R, Children’s Residential Waiver participants.
When selecting adults for HBS, exclude anyone already in the HBS program.
Selections will include individuals enrolled in the adult Waiver who indicate a need for more services. For example, persons receiving day program services who may request in-home supports, or persons receiving HBS services who may request CILA services, will be included in the selection process for the 3,000 capacities. Individuals admitted to ICFs/DD after June 15, 2011 who choose to move will also be included in the selections.
Per the original Implementation Plan, the selections were to include the following:
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For every 100 individuals selected, include for residential services criteria:
25 individuals who are recorded on the PUNS database as being in an emergency situation (i.e., needing services immediately)xiv and needing out-ofhome supports
25 individuals residing at home with a primary caregiver age 75 or over
For every 100 individuals selected, include for Home-Based Support Services:
20 individuals who are recorded on the PUNS database as being in an emergency (i.e., needing services immediately) or critical (i.e., needing services within the year) situation and needing in-home or day supports
15 individuals leaving the Public School System in the last 5 years (use age 22 as selection criteria)
15 individuals residing at home with a primary caregiver age 60 or over
Within each category, selections will be made by length of time on the database.
The DDD will select sufficient numbers to enroll in the Waiver 1,000 individuals in the first two years of the Decree and 500 in each of Years three through six.
With the expansion envisioned under the Decree, it is believed the waiting list will move at a faster pace after Year Six. The DDD will track and post on its website the average length of time individuals wait on the PUNS database.
At the end of July of 2011, of the individuals actively enrolled in PUNS, 16% were recorded as being in the emergency category (i.e., needing services immediately), 54% in the critical category (i.e., needing services within the year), and 30% in the planning category (i.e., needing services within the next five years). Summary information regarding the PUNS enrollments can be found on the DDD’s website.xv
Selections from the PUNS Waiting List during Calendar Year 2012 indicated insufficient numbers to complete the selection process identified above in two of the selection categories: individuals waiting for CILA services in emergency situations and individuals waiting for CILA services with aging caregivers. In order to meet selection goals, to date, the DDD has expanded the selection criteria to include individuals waiting for CILA services in the critical category. During the first quarter of Calendar Year 2013, the DDD will evaluate the number of individuals in the selection categories and modify the selection process
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originally put forward in this section. The DDD will seek input from the Plaintiffs’ Counsel and Monitor during the course of this evaluation.
Section VIII. Community Crises
Paragraph 21(c). Defendants shall ensure that all Class Members who are determined to be in a situation of Crisis, and who request to receive Community-Based Services and/or placement in a Community-Based Setting, receive such services and/or placement in such setting expeditiously.
The PAS/ISC agencies will continue to submit requests for services from individuals in crisis situations, and the DDD will continue to process these requests, using existing criteria available on the DDD website.xvi These requests are not part of the 3,000 capacities to be provided under Section VII, Waiting List for Community Services and Placement. The DDD will ensure individuals are served expeditiously.
The DDD provided the Monitor with baseline information regarding crisis requests approved and denied during FY10, FY11, and FY12 (year to date). As part of its compliance reports, the DDD continues to provide to the Monitor data regarding the crisis requests approved and denied. The Monitor reviewed a sample of these requests and was given additional information upon request.
On May 1, 2012, the Monitor notified the Parties of non-compliance in that crisis services were not being provided expeditiously as called for in Paragraph 21(c) of the Decree. With input from the Monitor and Parties, the DDD developed a corrective action plan. Since the corrective action plan was implemented, the Monitor reviewed the crisis requests from June 15, 2012, through September 7, 2012. There had been 70 crisis service requests during that period. The DDD provided a status report to the Monitor showing the activities and outcomes of each one of these requests. The results of this review show significant progress.
The Monitor began the next review on January 31, 2013.
Section IX. Appeal Process
Paragraph 24. Any Class Member who disputes a decision by Defendants or a Community Service Provider regarding eligibility for, or delivery of, Community-Based Services or placement in a Community-Based Setting shall, pursuant to governing law, have the right to appeal or seek administrative or judicial review of such decisions through Defendants’ existing Fair Hearings process (as set forth in 89 Ill.Adm.Code Part 120)
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or as otherwise provided by law. Class Members also may avail themselves of any informal appeal process that currently exists.
Individuals may appeal any denial, suspension, termination, or reduction of Home and Community-Based Waiver Services. The appeal process, including time frames, is described in Title 59, Chapter 1, Part 120.xvii Individuals are informed of this right to appeal through the use of Form IL462-1202, Notice of Individual’s Right to Appeal, available on the DDD website.xviii Individuals are also informed of their right to appeal a determination of ineligibility via the DDPAS-10 Form, available on the DDD website.xix
Due to inconsistencies among various regulatory documents as to the proper submission of an appeal request, the DDD will make appropriate revisions to these documents over the course of Calendar Year 2013. In the meantime, by March 15, 2013, the DDD will ensure through an Information Notice to be posted on the DDD’s website that all PAS/ISC agencies are aware of the correct process. The PAS/ISC agencies are charged with assisting Class Members and Potential Class Members in submitting appeal requests.
The Monitor reviewed the appeal data with DDD staff in April of 2012. On May 1, 2012, the Monitor notified the Parties of non-compliance of the handling of appeals as called for by Paragraph 24 of the Decree. In his first annual report, the Monitor stated that a number of problems with the appeal process were identified, including that scheduling of appeal hearings and obtaining written hearing determinations were taking an inordinately long time. The DDD, with input from the Monitor and Class Counsel, developed a corrective action plan.
As part of this action plan, the DDD hired an additional individual to assist in processing appeals, and HFS hired an additional three new Administrative Law Judges as hearing officers and one additional attorney to support the hearing process. The process has been streamlined and PAS/ISC agencies have been trained on the revised process.
Over the next year, the Monitor will review appeals data with the DDD and provide the Parties with findings and recommendations for improvement.
Section X. Resources Necessary for Implementation
Paragraph 5. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members.
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Each year of the Consent Decree, the DDD and the DHS Budget Office will prepare annual proposals for inclusion in the Governor’s Introduced Budget for the funds necessary to carry out the provisions of the Decree. These proposals will include items that are currently funded and must be maintained as well as items that require new funding. The known resource needs include:
 Contractual agreements o Outreach to ICFs/DD Residents [Funding for ICF/DD Outreach was included in the FY13 Budget. Vendor identification is pending.], o Pre-Admission Screening, both on-going maintenance and new funds for increased volume of eligibility determinations [PreAdmission Screening allocations for the 18 PAS/ISC agencies were increased by 10% in the FY13 Community Service Agreements.], o Increased PUNS enrollments [At this writing, we are not yet experiencing the anticipated volume of new requests; however, we expect a higher volume may still occur as additional selections are made.], o Transition Service Plan development [With the assistance of the Monitor, this work is being done within the DDD by staff hired for Ligas activities.], o Increased ISSA enrollments [These are being funded as individuals enroll in the Waiver.], o Consultant to work within the Bureau of Transition Services during the first two years of the Decree to review Transition Plans and train PAS/ISC agencies and providers on their development [The DDD has approval to contract for this assistance and will be posting the contract opportunity by the end of FY13.], and o Consultant to work within the Bureau of Transition Services during the first two years of the Decree to serve as a family liaison during the outreach to individuals residing in ICFs/DD [The DDD is currently considering a proposal from a potential vendor for this work, rather than seek an individual consultant.];
 Additional DDD staff to be hired (with the hiring beginning in FY12 and continuing through mid FY13) o (1) Strategic Planning Unit, for a Ligas Compliance Coordinator to oversee implementation activities and prepare required compliance reports [This position has not yet been filled and is pending revisions to the official job description.], o (1) Program and Data Support Bureau, for maintenance and management of the class list [This position has not been filled. The DDD is considering redirecting the headcount to other Ligas activities.], o (7) Bureau of Quality Management, for monitoring of communitybased services, including intake and management of complaints, trend analysis of complaints and investigations, targeted site visits to new providers, and increased volume of follow-up activity as
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concerns are identified and addressed [These positions have been filled.], o (4) Bureau of Transition Services, for facilitating and overseeing transition activity for the individuals moving from ICFs/DD and the 3000 individuals starting services from the community [Three of these positions have been filled. The remaining position is posted for hiring at the time of this writing.], o (1) Appeals Unit, for increased volume of appeals [This position has been filled.], o (1) Rates Section, for increased volume of application and rate packets [This position has been filled.], and o (3) Medicaid Waiver Unit, for increased activity regarding Waiver oversight [These positions have been filled.];  Direct Services o Services for 1000 individuals in the first two years and 500 each year thereafter, and o Services for individuals who choose to move from ICFs/DD.
The above implementation items are in addition to the on-going maintenance items included in the DDD’s budget. These maintenance items include:
 Services for persons residing in ICFs/DD,  Services for persons enrolled in the Waiver,  Base Pre-Admission Screening grants,  Base grants for PUNS enrollments, and  Administrative staff within the DDD.
The DDD will make every effort to maximize federal Medicaid match for the direct services and administrative activities. The DDD reviews rejected claims and works with providers to correct or complete data for claims submissions. The DDD needs to increase those efforts and account for the anticipated growth in volume as Waiver capacity expands. An additional staff person has been hired to assist with these efforts. Where applicable, the Money Follows the Person grant will be used to secure enhanced match during the first year of communitybased services for those individuals who leave ICFs/DD for eligible settings under the grant. Existing interagency agreements describe the coordination between DDD and HFS regarding Medicaid match. See the following Section XI.
Appropriations
The DDD’s budgets for Fiscal Years 12 and 13 combined the major appropriation line for community-based services and ICF/DD services into one line. This enables the DDD to redirect resources, if appropriate, as individuals and providers make future choices regarding service provision. The DDD will request that this practice continue in each subsequent year of the Consent Decree. However, the DDD will maintain sufficient records to enable the Monitor to
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determine whether the State is fulfilling its obligations under Paragraph 4 of the Decree, including its obligation to provide funding sufficient to meet the needs of those who choose to live in ICFs/DD and to ensure that such resources are not affected by the State’s fulfillment of its obligation to provide Community-Based Services or Settings to those who choose those service options.
Annually, per the deadline established by the Governor’s Office of Management and Budget, the DDD will calculate and submit details of needed resources for consideration for inclusion in the Governor’s Introduced Budget for the following fiscal year. Each year the needed resources for implementation of the Consent Decree, separate and apart from the maintenance items specified above, will include, at a minimum, funding for:
 Community-Based Services and Community-Based Settings, both new funds for those beginning services and annualized funds for those who began services in the prior year;
 Assessments and outreach;  Special rates for ICFs/DD voluntary closure agreements; and  Contractual consultants and staff.
The proposed budget for Ligas implementation will be annually presented to the Parties and Intervenors. Budget information is included in the data reports.
Federal Approval of Waiver Capacity
Each year, as new enrollment opportunities are made available for individuals, the DDD will work with HFS to submit an amendment increasing the capacity of the adult Waiverxx, as needed.
The adult Waiver was renewed by the federal government effective July 1, 2012. As part of that renewal, the total capacity of the Waiver was increased to 19,000 in anticipation of the expected growth during FYs 13 and 14. The next amendment will probably be submitted near the end of FY14. Waiver capacity had been set at 17,600 in FY11 and 18,200 in FY12.
Section XI. Interagency Agreements
Interagency agreements, necessary to carry out the provisions of the Decree, are in place among the Departments. Specifically, there is an interagency agreement among the Departments of Children and Family Services, Healthcare and Family Services, Human Services, and Public Health that addresses the interactions involving developmental disabilities Medicaid programs. In addition, there is an interagency agreement specific to the implementation of the Money Follows the Person grant. These agreements are available upon request from
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the DDD. At this point, the DDD does not anticipate the need for any new interagency agreements to implement the Decree.
Section XII. Process for Plan Reporting and Modification
Paragraph 28. The Implementation Plan shall be updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate…
Paragraph 33. …Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress toward achieving compliance. Prior to the first report, the Parties and the Monitor will agree on the data and information that must be included in such reports…
Pursuant to Paragraph 28 of the Decree, the DDD will review the Implementation Plan on an annual basis. Changes will be made, as needed, with the assistance of the Monitor. The proposed modifications will be submitted to the Monitor. The Plaintiffs and, if applicable, the Intervenors, will be given the opportunity for input.
Per Paragraph 33 of the Decree, the DDD will report data and information regarding its progress toward compliance with the provisions of the Decree. The Parties, Intervenors, and Monitor agreed to a standard format for these data reports, which are now being produced twice per year by February 15th and August 15th. [By mutual agreement, the deadline for the first report was extended so the DDD could incorporate information regarding the Governor’s proposed budget for FY13.] These reports are being posted on the DDD’s website as they are available.
Section XIII. Acronyms
The following, for reference, is a list of acronyms used throughout this document:
CILA – Community Integrated Living Arrangement DDD – Division of Developmental Disabilities DHS – Illinois Department of Human Services HBS – Home-Based Support Services HFS – Illinois Department of Healthcare and Family Services ICF/DD – Intermediate Care Facility for Persons with Developmental Disabilities ICF/MR – Intermediate Care Facility for Persons with Mental Retardation ISC – Independent Service Coordination
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ISSA – Individual Service and Support Advocacy JCAR – Joint Committee on Administrative Rules PAS – Pre-Admission Screening PUNS – Prioritization of Urgency of Need for Services RFP – Request for Proposals ROCS – Reporting of Community Services
i Capitalized terms in the Implementation Plan are defined in the Implementation Plan are defined in the Consent Decree. ii The link for the Ligas Consent Decree is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/LigasCo nsentDecree061511.pdf. iii The link to Form IL1238, Choice of Supports and Services, is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Forms/IL462-1238.pdf. iv The link to the DDPAS-10 Form is http://www.dhs.state.il.us/OneNetLibrary/4/documents/PAS/DDPAS100111.pdf. v The link to the PUNS Manual is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Manuals/DD%20Manuals/Illinois%20PUNS% 20Manual.pdf. vi The link to the PUNS brochures, flyers, and posters is http://www.dhs.state.il.us/page.aspx?item=31104. vii The link to the new provider page is http://www.dhs.state.il.us/page.aspx?item=47336. viii The link to the sample downsizing agreement is http://www.dhs.state.il.us/page.aspx?item=50038. ix The link to the adult DD Waiver is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/Adult%2 0DD%20Waiver.pdf. x The link to the DDD’s training information is http://www.dhs.state.il.us/page.aspx?item=45209. xi The link to the DD Pre-Admission Screening Manual is http://www.dhs.state.il.us/page.aspx?item=53018. xii The link to the ROCS Software is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/MentalHealth/DHSCRSManual.p df. xiii The link to the ISSA Problem Resolution Protocol is http://www.dhs.state.il.us/page.aspx?item=56642. xiv The PUNS database categorizes individuals into emergency, critical, and planning needs. See the PUNS Manual for definitions of these categories. The link to the PUNS Manual is
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http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Manuals/DD%20Manuals/Illinois%20PUNS% 20Manual.pdf. xv The link to the PUNS summary reports is http://www.dhs.state.il.us/page.aspx?item=51905. xvi The link to the crisis criteria is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/DD%20Reports/Community%20Emergency% 20Criteria%20-%20Adults.pdf. xvii The link to Rule 120 is http://www.ilga.gov/commission/jcar/admincode/059/05900120sections.html. xviii The link to Form IL462-1202, Notice of Individual’s Right to Appeal is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Forms/IL462-1202.pdf. xix The link to the DDPAS-10 Form is http://www.dhs.state.il.us/OneNetLibrary/4/documents/PAS/DDPAS100111.pdf. xx The link to the adult DD Waiver is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/Adult%2 0DD%20Waiver.pdf.
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 Case: 1:05-cv-04331 Document #: 565 Filed: 09/27/12 Page 1 of 36 PageID #:11215

STANLEY LIGAS, et al. v. JULIE HAMOS, et al.

First Annual Report of the Monitor

September 27, 2012

Submitted by:

Tony Records, Monitor 7109 Exeter Road Bethesda, MD 20814 301-529-9510 traconsult@mindspring.com

Section 1 – Introduction This report is respectfully submitted to the Court, the Parties and the Intervenors in accordance with the Consent Decree (Decree) approved and filed by the Court on June 15, 2011. Specifically, the Decree requires that:

The Monitor shall file annual reports to the Court, which shall be served on all Parties and Intervenors and be made publicly available. Such reports shall include the information necessary, in the Monitor’s professional judgment, for the Court, Plaintiffs and Intervenors to evaluate Defendants’ compliance or non-compliance with the terms of the Decree.1
The Monitor has engaged in numerous activities consistent with Section XIV (Monitoring and Compliance) of the Decree. There have been seven parties’ meetings since the approval of the Decree. During each of these meetings, the
Monitor has given a verbal report of progress and concerns regarding compliance
as well as a review of activities. The Monitor has also met with and talked to
counsel and representatives of the parties and intervenors separately on an ongoing
basis. No prior drafts of this report or any part of this report have been submitted

1 Consent Decree, Section XIV, ¶34, at Page 19.

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to the parties, intervenors or anyone else. This report was served by hand to the Parties and Intervenors at the scheduled Parties’ meeting of September 27, 2012.
This report is organized in five sections. Following the introduction is a section describing the activities of the Monitor during the past year and anticipated activities for the next year. This is followed by a brief and general description of actions taken by the Defendants during this period. The next section is the primary section, which includes a sequential description of activities and findings listed in order of requirements of the Decree and as listed in the established Compliance Standards developed by the Monitor in accordance with the Decree.2 Finally, the Monitor has included some overall comments designed to communicate a broad description of progress and successes thus far, as well as anticipated possible roadblocks to compliance in the future.
There has been one instance, on May 1, 2012 when the Monitor notified the Defendants and Plaintiffs’ counsel of non-compliance with ¶21. (c) of the Decree (Crisis Services). In accordance with the Compliance provisions of the Decree,3 the Monitor met and conferred with the parties to discuss the necessary actions to achieve compliance. The defendants are now implementing the action steps that were developed as the result of this process. (See section on Crisis Services on page 22-23 for further details). Other than this one instance, there have been no other notices or written findings of non-compliance.

2 Consent Decree, Section XIV, ¶32, at pages 17 and 18. 3 Consent Decree, Section XIV, ¶35, at page 19

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Section 2 - Activities of the Monitor

The Monitor was appointed by the Court on July 19, 2011 and started monitoring activities on August 3, 2011. During the past year, the Monitor has engaged in numerous activities designed to initiate and encourage necessary compliancerelated actions, assist the Defendants in the implementation of the Consent Decree requirements, facilitate communication between the parties, engage in activities to inform the public about the requirements of the Decree and evaluate overall compliance.
At the outset, it is important to state clearly that the Monitor has received full cooperation and support from the Defendants, including the Departments of Human Services and Home and Family Services, the Governor’s office, the Attorney General’s office and, in particular, the management team and staff at the Division of Developmental Disabilities (DDD). DDD has provided the Monitor with unfettered access to program staff, class members, class member records and requested information and documents. Plaintiffs’ counsel and representatives as well as counsel for the Intervenors have also been readily available and responsive to the Monitor whenever called upon. In all of the parties’ meetings, discussions have been productive and on point toward the goal of compliance with the Decree.
The Monitor has also experienced full cooperation and support from the community service providers, ICF/DD facility staff, advocacy organizations and family associations throughout the state of Illinois through the provision of information, facilitation of meetings and direct input on issues relating to compliance activities.
Class members, as well as their guardians and families have also been forthcoming and responsive to the Monitor and continuously expressed a willingness to

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participate in activities and share their experiences in order to assist the Monitor in
evaluating compliance.
Activities of the Monitor over the past year include the following:
 The Monitor held initial separate meetings with all counsel to discuss expectations and obtain various perspectives on challenges pertaining to compliance activities.
 The Monitor has facilitated each of the parties’ meetings. These meetings were held on 8/22/11, 9/19/11, 10/24/11, 12/5/11, 1/23/12, 3/29/12 and 6/21/12. These parties meetings are now being scheduled routinely each quarter in order to maintain regular line of communication among the parties and to document progress and concerns on a timely basis. To increase efficiency and productivity, these meetings have now been bifurcated to include full participation of the parties and Intervenors for discussion and input relating to paragraphs 4-10, 25 and 45 of the Decree and only class counsel and defendants’ participation with regard to the remaining provisions of the Decree.
 Initial and continuous meetings have been conducted with key staff at DDD and DHS who have specific responsibilities relating to implementation of compliance related activities. The Associate Director of DDD has been the key liaison with the Monitor in facilitating meetings, document production and development and coordination of compliance activities.
 The Monitor has devoted a significant amount of time and effort to provide information sessions across the state to class members, potential class members, families, guardians, community service providers, advocacy organizations, ICF/DD providers, PAS agencies and other stakeholders. These information sessions provided an overview of the Decree and Implementation Plan as well as an update of compliance activities and ways stakeholders can play a vital role in providing information and feedback on Ligas related issues. Audiences of more than twenty of these information sessions have included more than 1,800 individuals.
 Monthly meetings are held with the DDD Director to review progress and challenges related to implementation activities designed to develop strategies to address current issues. The Monitor has also had several meetings with the DHS Secretary to provide an update of activities and any concerns about overall compliance.

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 The Monitor has also met on several occasions with the Governor’s office to provide an overview of activities and discuss any overall compliance concerns.
 The Monitor has reviewed hundreds of documents provided by the defendants, class counsel, service providers, PAS agencies, advocacy organizations and families that have provided significant information, insight and perspective to compliance activities and challenges.
 The Monitor has reviewed all information on the defendants’ various websites relevant to compliance activities and policies that relate to the Decree. The Monitor has worked directly with DDD staff to review and modify information on the Ligas page or the DDD website.
 The Monitor has provided his telephone and email contact information widely across the state in order to hear directly from class members, families, guardians, service providers and PAS agencies about questions and concerns relative to implementation of compliance related activities. As a result, there have been numerous inquiries and concerns received which require specific follow-up and clarification with the defendants. This process has helped clarify many policy questions that have emanated as result of new compliance activities.
 In accordance with the Decree, the Monitor developed, with input from the parties and intervenors, Compliance Evaluation Standards.4 These Standards were completed on July 17, 2012. These Standards include agreed-upon standards as well as the specific methodology the Monitor will utilize in measuring compliance.

4 ¶32 of June 15, 2011 Consent Decree at page 17

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Section 3 - Overall Activities of the Defendants and Parties

Implementation of activities to foster compliance with the Decree has required the infusion of significant resources and personnel efforts by the defendants. It is important to state at the outset that the developmental disabilities system in Illinois has, through the past years, been fraught with inadequate funding, slow growth of capacity, shortages of staff and a weak infrastructure. Within two months after the approval of the Decree, a new Director of DDD was hired. During the same period, the defendants entered into two other major consent decrees and announced the closures of two state-operated developmental centers.

Including those individuals in crisis, individuals on the waiting list and those in ICFs/DD who have requested home community based services, there are currently approximately 12,000 Ligas class members. This overall scenario presented the defendants with a seemingly Sisyphean task of entering into a new way of responding to the needs of people with intellectual and developmental disabilities.

The defendants, however, through planning and coordination, have undertaken a systematic approach toward compliance with the Decree. A team within DDD was assigned to specific tasks related to various requirements of the Decree. A Ligas budget was developed. New resources were created or identified to support development of community-based supports. A Ligas website was established. The Ligas Implementation Plan was drafted and negotiated with the parties and intervenors. Policies were developed and/or modified to address Ligas requirements. Communications about Ligas-related activities were sent to families, class members, community services providers and PAS agencies. This report, in the section immediately below, provides specific information about these activities. In many instances, these activities have resulted or will result in compliance within the timeframes established in the Decree. In some instances, as specified below, compliance with the timeframes of the Decree has been slow or

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will be difficult to achieve within the timeframes prescribed unless additional steps are taken. These strong efforts of the defendants, however, have established a foundation upon which substantial compliance can be obtained and sustained over time. It is important for the parties to appreciate that this is the end of the first year of at least a nine year period of implementation of compliance activities.
During this first year of implementation, the parties and intervenors have also collectively contributed toward resolution of issues as they arise. Through the parties’ meetings as well as informal communication methods, the parties and intervenors have effectively negotiated timeframes, compliance documents (to include the Implementation Plan and Outreach RFP) and have worked well together to clarify compliance issues.
The Monitor has served as a facilitator with the parties toward productive resolution of issues. With regard to the defendants, the Monitor has assumed a more hands-on role as compliance activities have evolved. This means at times advising the defendants through the offering of suggestions, and, when necessary, the Monitor will goad the defendants toward the direction needed to achieve sustained compliance. This method of mentoring and consultation will continue as long as there is continued priority on compliance with the Decree and measurable progress.

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Section 4 – Compliance Requirements and Activities
This section provides a specific review of the compliance requirements in each of the nine major areas of compliance, which include the following:
1. Resources and Capacity 2. Class Member List(s) 3. Transition Service Plans 4. Transition for Class Members in ICFs/DD 5. Crisis Services 6. Transition for Class Members on Waiting List 7. Outreach 8. Implementation Plan 9. Data Reports
Each area of compliance is listed below in a separate section that includes: a description of the requirements in the Consent Decree; timeframes or deadlines for compliance; related activities described in the Implementation Plan and; the status of implementation of compliance activities by the defendants. In accordance with this provision, this section is considered by the Monitor as the primary measure of compliance with the Decree. For some of the requirements, the timeframes for implementation of the specific timeframes have not yet transpired. In these instances, the Monitor will report on activities that have occurred so far and, where appropriate, the likelihood that these actions will lead to timely compliance.
There are also findings in two other distinct areas of the Decree including services to named plaintiffs and dispute resolution.

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Resources and Capacity The Decree requires that resources for community services to be provided consistent with the choice of a class member and the requirements of paragraphs 17 through 19 and 21 through 23 of the Decree. Resources necessary to meet the needs of individuals with developmental disabilities who choose to receive services in ICFs/DD shall be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree. Funding for services for individuals with developmental disabilities will be based on the individual’s needs using federally approved objective criteria regardless of whether the individual chooses to receive services in an ICF/DD or in a community-based setting. Amendments to the state Medicaid plan will continue to include ICF/DD services as an alternative choice for long term services.5 Annual budgets will be sufficient to fund the services necessary to comply with the Decree consistent with the choices of individuals with developmental disabilities, including class members.6
The Implementation Plan calls for a continuation of activities to develop new community services providers and the voluntary conversion of ICFs/DD to community-based services.7 The Implementation Plan also calls for the development of annual budget proposals to incorporate the necessary resources to carry out the provisions of the Decree. The Plan also includes resources for a listing of specific contractual agreements necessary to address the anticipated increase in demand for services, additional DDD staff to be hired in order to manage compliance and prepare compliance-related reports and funding for direct services for class members as they are identified to receive community services.8

5 ¶ 4 of June 15, 2011 Consent Decree at page 7 6 ¶ 5 of June 15, 2011 Consent Decree at pages 7and 8. 7 Ligas Implementation Plan, 12/15/11, Section IV, Page 13. 8 Ligas Implementation Plan, 12/15/11, Section X, Page 20-22.

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In order to comply with the provisions of the Decree regarding resources, the
defendants engaged in numerous activities. These activities include the following:
 A Ligas budget was developed for Fiscal Year 2013 and beyond. The DDD Director presented a six-year budget to the parties and intervenors at the December 5, 2011 parties’ meeting. The projected budget information presented reflected the needed growth in community capacity called for in the Decree. The budget planning assumptions were also included in the presentation. There were no changes projected in the budget levels for people living in ICF/DD settings. The Ligas budget totals $38.9 million in FY13. The anticipated Ligas expenditures for the six-year period from FY12-FY17 is $456.4 million. Six months later, it was announced that the legislature reduced the overall budget by 4%. The DHS Secretary assured the parties that there will be no specific cuts to services. It is expected that these reductions will be absorbed through delayed start-up and reduced annualization of new services.
 Since then, Department of Human Services (DHS) has recently announced instituted changes in the reimbursements as well methods and standards for establishing payments for home and community-based services, particularly targeting small (1-4 person) Community Integrated Living Arrangements (CILA). Many of these changes are designed to realign the prior disincentives in the reimbursement rate structure for smaller community homes. These changes include the following:
o An increase in the staff fringe benefit percentage for all CILAs from 20% to 25%.
o Modification of direct care staffing funding formulas for 1, 2, 3 and 4 person homes;
o Increase minimum direct care staff coverage by two hours per day;
o Update housing allowances for CILA sites with a capacity of four persons or fewer;
o Adjust funding for vehicle purchases and vehicle operation for CILA sites with a capacity of four persons or fewer; and
o Implement funding formula changes in nursing services reimbursement for medication administration and nurse monitoring.
These changes will be effective October 1, 2012. It is estimated that these combined changes will result in an increase of $19.30 million in new annualized state expenditures.

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 A new Ligas Implementation Team was funded and is being assembled. Positions for this team includes the following:
o Compliance Coordinator – This position is currently vacant and the work is being shared by the DDD Associate Director and a senior staff within BTS.
o Program and Data Support Staff – This position has not yet been established.
o Bureau of Quality Management Staff (7) - Three positions were filled in FY12. One position was posted and qualifications have been approved. Two positions are being filled through the state attrition process.
o Bureau of Transition Services Staff (4) – Two positions were filled in FY12. Two positions have not yet been posted.
o Appeals Unit Staff – Position was filled in FY12
o Rates Section Staff – Position was filled in FY12
o Medicaid Waiver Staff (3) - Two positions were posted and candidates were identified and are pending final approval.
 Budget allocations were identified for contract services and service enhancements for PAS agencies.
 Grants for PAS agencies were enhanced to facilitate Ligas-related activities.
o Effective July 1, 2012 grants to PAS agencies for intake and screening have been increased across the board by 10%. This increase is to allow for the expected increase in work demand.
o Reimbursement funds for PAS agencies work in PUNS-related activities will be structured to allow for expedited payments.
 Proposed amendments were submitted to the Center for Medicare and Medicaid (CMS) for the expansion of the Medicaid Home and Community Based Services (HCBS) Waiver. On June 13, 2012 the defendants submitted application to increase the adult waiver capacity from 15,920 individuals to 18,200 individuals. This increase was designed to allow for sufficient increase in capacity to serve the number of new class members called for to comply with the Decree. These requested amendments were approved by CMS on September 20, 2012. The defendants and the Monitor will track capacity growth closely and, if necessary, the defendants will submit additional amendments in the future.

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 The DDD Director has pledged to re-assemble a workgroup of stakeholders to evaluate the rates and rate structure for funding of home and communitybased services.
The Monitor commends the defendants for the many steps taken as described
above in order to identify resources to support expanded community-based
capacity to comply with the Decree. While each one of these efforts are of
consequence and will play a significant role in moving implementation forward,
still more needs to be done. The Monitor has the following specific concerns with
regard to resources:
 It is important that the full Ligas Implementation Team needs to be hired and functioning in order to meet the many challenging demands of the Decree and Implementation Plan. As listed above, only 8 of the 18 new staff positions have been filled. It is absolutely necessary for the defendants to expeditiously move forward and hire and train these new staff. Overall, DDD is already seriously understaffed to implement all of its responsibilities along with the added responsibilities that the implementation of the Decree presents.
 Although reassembling a community rates workgroup is an important step toward rebalancing the funding and rate structure of home and communitybased services, this issue must be given top priority and move forward with vivacity. Even with the recent rates enhancements listed above, the overall rates for home and community-based services in Illinois remain to be among the lowest in the country. With the demand for new services statewide as called for in Ligas implementation, it will be quite difficult to expect providers to continue expansion or to attract new community providers with such low rates.
 The Ligas budget also includes $446 thousand in FY12 and $1.9 million in FY13 for contractual agreements called for in the Implementation Plan. To date, other than agreements with PAS agencies, there have not been any specific contracts executed or implemented for Ligas implementation. Contracts are called for in the areas of Outreach, Transition Planning and a Family Support liaison. Over the next six months, the Monitor will work closely with DDD to make sure these contracts are in place and fully operational.
 An extraordinarily long reimbursement cycle for reimbursement only compounds the challenge of operating with low rates and, at the same time,

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asking the provider community to step forward and borrow even more in order to serve more people. The Monitor has received reports from many providers that reimbursement payments typically can take from seven to nine months. Even those who qualify for the “expedited payment” often report as much as 60 days or more for reimbursement payment. Over the next year, the Monitor will review this issue carefully to determine its degree of impact with compliance with the Decree.

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Class Member List(s)

The Decree requires the defendants to maintain a statewide database in which all Class Members are enrolled. 9 Defendants are also required to promptly revise the class member database and waiting list data.10
The Implementation Plan describes the process for the development and maintenance of a class member list that will be accessible to the Monitor and Class Counsel. Intervenors’ counsel will have access to the class list as provided in the Implementation Plan. DDD will use its PUNS database to maintain a list of Waiting List class members. The Plan also calls for DDD to review the adequacy of the PUNS database.
Upon recommendation by the Monitor and agreement of the parties and intervenors, the defendants have developed and maintained two class member lists.
First, there is now a list of class members pursuant to ¶2 (a) of the Decree, who: qualify for Medicaid Waiver services; live in an ICF/DD with nine or more residents and; have affirmatively requested community-based services or placement in a community-based setting. As of September 12, 2012 there were 697 class members in this category. The defendants maintain a list that contains, at a minimum: the names of individuals; the documentation to verify their written affirmative request; date of birth; social security number and; the name of the facility in which they live. Development of this list has been challenging and has required numerous modifications. Due to many various factors, including data entry errors, difficult transcription, interpretations of hand-written forms, undated or unsigned applications as well as numerous name discrepancies, initial lists contained many inaccuracies. The most recent list has been reviewed and re-

9 ¶8 June 15, 2011 Consent Decree at Page 8. 10 ¶9 June 15, 2011 Consent Decree at Page 9.

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reviewed and appears to be consistent with the requirements. Of particular concern has been ensuring that none of those listed as Objectors are not included on the list, unless there is a more current affirmative written statement that the individual and/or guardian has changed their mind and has since requested services in a community-based setting. A senior staff member within the DDD has been assigned to maintain this list and inform the Monitor of any particular updates and concerns. As a result of the events above, the quality and veracity of this list has continued to improve.
Second, there is a list of class members pursuant to ¶2 (b) of the Decree who: qualify for Medicaid Waiver services; live in a family home and; are in need of and have affirmatively requested home and community-based services or services in a community-based setting. These individuals are known as Waiting List Class Members. As of September 12, 2012, there were 10,894 class members in this category. This list is also maintained as a subset of the overall waiting list (Commonly known as the PUNS list) for services.
Development and refinement of this list has also proven to be quite challenging. Utilization of this initial list revealed that much of the class member information was outdated and/or inaccurate. A large number of addresses were incorrect and some individuals had moved out of state. Contact information was often inaccurate or outdated. Out of the initial 1330 individuals selected from this list to be funded for services, more than 350 individuals could not even be located. Some individuals on the initial list are now deceased. In more than 100 other instances, after individuals were contacted, it was determined that they no longer needed or wanted home and community-based services or services in a community-based setting.
As soon as these inaccuracies were discovered, DDD took immediate action to address these problems. The PAS agencies have the primary responsibility to update the information on the waiting list. Communications were sent to each

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PAS agency with clear instructions on updating data on the waiting list and reminding them of their responsibility regarding individual updates. DDD assigned a key staff member as well as an additional professional staff member to work on this list as a high priority. These two staff are now in constant communications with PAS agency representatives to correct inaccurate data and update waiting list information. Budget allocation adjustments have also been made to ensure that payments to PAS agencies are reimbursed for PUNS entry and update activities on an expedited basis. These efforts thus far have been quite effective.
The Monitor is concerned about the often outdated and inaccurate data on the PUNS waiting list. This problem has already had a negative impact on compliance with another primary requirement of serving Waiting List class members. (See section on Transition for Class Members on Waiting List).
Over the next six months, the Monitor will continue to work closely with the DDD staff responsible for maintenance of the class member lists. As called for in the Compliance Evaluation Standards, the Monitor will then conduct a review of class member records using a random selection method of class members on both class member lists. Results of this review will be provided to the parties and intervenors.
As an overall note, the problems identified in the class member lists issue are also symptomatic of a more endemic issue within DDD – the lack of a comprehensive integrated data system. It will be important for DHS over the next several years to address this issue and develop a plan to address the overall need for a data system that is responsive and consistent with the ever-growing challenges within DDD and DHS. The Monitor recognizes that development of a comprehensive data system will require a significant initial investment of resources. The outcome of such an endeavor, however, would help ensure effectively coordinated services for class members and others.

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Transition Service Plans The Decree requires the defendants to develop transition plans for all class members who are selected to be served pursuant to the Decree. Transition plans shall describe all services required, how they will be developed and obtained and a timetable for transition.11 Transition plans will be developed by a Qualified Professional in conjunction with the class member and guardian and others, as appropriate.12
The process for transition planning will include the class member’s personal vision, preferences, strengths, and needs in home, community and work and shall reflect the value of supporting relationships, productive work, participation in community life and personal decision making.13 Services and supports will be integrated into the community and consistent with choices of class members and guardians. Transition plans shall not be limited by the current availability of services but be within the confines of the waiver and State Plan.14 Transition plans for class members who are determined to be in crisis will be developed.15
The Implementation Plan calls for a phase-in process for the completion of a transition service plan for each class member seeking services in a communitybased setting. The Plan outlines an 18-month long process that includes a pilot trial period, re-evaluation and state-wide implementation by July 1, 2013. This process ensures coordination required between PAS/ISC agencies and class members.16

11 ¶11 June 15, 2011 Consent Decree at Page 9. 12 ¶12 June 15, 2011 Consent Decree at Page 9. 13 ¶13 June 15, 2011 Consent Decree at Page 9 & 10. 14 ¶14 June 15, 2011 Consent Decree at Page 10. 15 ¶21.(b) June 15, 2011 Consent Decree at Page 12. 16 Ligas Implementation Plan, 12/15/11, Section VI, Page 15

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The defendants have begun to implement the transition planning process
consistent with what is described in the Implementation Plan. These activities
include the following:
 DDD developed Transition Service Plan documents through a process of receiving broad input from the parties, class members and families, PAS agencies and other key stakeholders. These documents include a Transition Plan format and accompanying instructions for class members moving from their homes or ICFs/DD to CILA and a more abbreviated form for class members seeking community-based services in crisis situations. On June 26, 2012, DDD facilitated a conference call of all PAS agencies, who will be responsible for completion of the Transition Service Plans, to discuss the proposed plan and receive final input. Once input was received, documented and modifications were made, the forms and instructional guidelines were finalized in July 2012.
 The finalized guidelines for the Transition Service Plans were also posted on the DDD Website. (Ligas website page)
 Two of the PAS of agencies who had volunteered to participate in the pilot evaluation process were selected. These PAS agencies selected to participate in the pilot are Developmental Disability Services of Metro East and Suburban Access, Inc.
 Following an initial conference call, both of the selected pilot PAS agencies and their program staff participated in a half–day training on August 23, 2012. The Monitor participated in this training activity.
 Each of the pilot agencies then selected a sampling of class members living at home and living in ICFs/DD who would participate in the sample. The total sampling size is 141 individuals. The period for completing the pilot and evaluating its results will continue through December 2012. Monthly conference calls with the two pilot PAS agencies will be conducted by DDD with the Monitor’s participation to review progress and implementation challenges throughout the pilot period.
 After reviewing the results of the pilot activities, DDD will make necessary changes to the forms and processes in the beginning of 2013.
 By May 31, 2013, DDD will provide training to all 18 PAS agencies and begin statewide implementation of the new Transition Service Plan by July 1, 2013.

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With regard to the transition planning process for class members in crisis, the defendants took a slightly different approach. DDD drafted modifications to the existing Crisis Funding Request and developed the Crisis Transition Plan and Funding Request. (Final Draft 7/25/12) This form and format, along with detailed instructions, were posted on the DDD website and disseminated to all PAS agencies for input. These documents were finalized and were required to be utilized by all PAS agencies statewide beginning September 14, 2012. Since this crisis transition planning form is a relatively minor adaptation to an existing form, a pilot process was not considered necessary.

The Monitor is generally pleased with the progress the defendants have made toward the development of a Transition Service Plan. Converting a system from virtually no transition service planning to a person-centered approach as required in the Decree necessitates a carefully planned and deliberate process that takes time to evolve. As these Transition Service Plans are evaluated, needed modifications will be completed and training and retraining will be implemented.
Another component of this process will be the training of PAS agencies and others on effective person-centered planning. The Ligas Implementation Plan calls for a consultant to be identified to work with the DDD Bureau of Transition Services during the first two years of the Decree to review transition plans and train PAS agencies and providers on their development.17 To date, this consultant has not been identified or hired. This consultant should be hired as soon as possible to begin work in coordination with the transition planning development schedule.
Over the next year, the Monitor will carefully review the further transition planning process and report to the parties on the progress and challenges identified.

17 Ligas Implementation Plan, Section X, at page 21

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Transition for Class Members in ICFs/DD
The Decree requires all class members in ICFs/DD to transition to community services or community-based settings consistent with their transition plans if, at the time of transition, the class members request placement in a Community-Based Setting as confirmed and documented in accordance with the Decree.18
 One third of class members in this category will transition by 12/15/2013. The number of class members to transition during this period will be determined by June 15, 2013.
 Two thirds of class members in this category will transition by 12/15/2015. The number of class members to transition during this period will be determined by June 15, 2015.
 All class members in this category will transition by 6/15/2017. The total number of class members to transition from ICFs/DD will be determined by June 15, 2017.
The Implementation Plan calls for the identification and referral of these class members to PAS/ISC agencies for assistance in transition to community-based settings. The number of people identified for transition from ICFs/DD is expected to change, pursuant to the results of the outreach process described below. PAS/ISC agencies will monitor the adjustment and resolve issues as they are identified. 19

It is unknown exactly how many class members in this category will be identified on June 15, 2013. Of the number of class members identified on that date, onethird are required to be served by December 15, 2013. As reported in the Class Member List section, there were 697 class members in ICFs/DD as of September 12, 2012. As of that same date, 153 class members in this category have received
18 ¶17 June 15, 2011 Consent Decree at Page 10. 19 Ligas Implementation Plan, 12/15/11, Section V, Page 14 -15

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funding for community-based services or services in a community-based setting. Of the 153 who have received funding, at least 113 of these class members have actually started community-based services and billing for these services has been verified. On September 7, 2012, DDD sent requests to PAS agencies for monthly updates for 528 class members to determine the status of choice and selection of community services providers and projected transition dates. The overwhelming majority (97%) of class members who have transitioned have requested and received funding for Community Integrating Living Arrangements, (CILA) and the remainder of the class members (3%) have requested and received funding for home-based services (HBS) and have returned to their family home.
It should be noted that, to date, 19 individuals living in ICFs/DD who were contacted to receive transition supports to community services have since changed their minds and chosen to stay living in the ICF/DD. In each of these instances the individual’s choices were respected and they were removed from the class member list.
A large number of class members who were living in ICFs/DD (61) who have moved services in a community-based setting did so as a result of a voluntary downsizing or closure agreement. There are expected to be at least 200 additional individuals who will be identified over the next year who are living in ICFs/DD now and will need to move due to voluntary downsizing or closure agreements. It will be imperative for the defendants to ensure that these individuals are provided with the opportunity to review an array of options so they can make an informed decision about where and how they want to receive services and supports. The Monitor has discussed this with the parties and DDD staff and will be working closely with the defendants in tracking how choices are being facilitated for individuals who are affected by implementation of voluntary downsizing and closure plans.

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Crisis Services
The Decree requires the defendants to serve Class members who meet the crisis criteria described in ¶21 (a) of the Decree and who request community services or placement in a community-based setting expeditiously.20 Services and/or placement will be provided in a manner consistent with the transition plan.
The Implementation Plan calls for the PAS/ISC agencies to continue to submit requests for services from individuals in crisis situations. DDD will ensure that class members are served expeditiously.21 The Monitor established the standard, with the agreement of the parties, that the timeframe to receive services for class members in crisis will be 24-72 hours, although this timeframe may vary, depending on individual circumstances, or if temporary services are in place to address the immediate crisis.22
As mentioned in the introductory section, on May 1, 2012, the Monitor notified the defendants and class counsel of non-compliance in that crisis services were not being provided expeditiously as called for in paragraph 21(c) of the Decree. After a sampling review of the crisis services for class members from June 2011 to April 2012, the Monitor found a large percentage of class members who were not served for weeks and, in some instances, months, who needed services immediately. The Monitor recommended that the defendants develop a plan to address these issues. The defendants acknowledged the problem and immediately developed a draft corrective action plan and reviewed the plan with the Monitor. This draft plan was then presented to the parties and discussed at the June 21, 2012 parties’ meeting. Following the meeting, class counsel provided written comments to the defendants on June 28, 2012 on the corrective action for crisis services. The defendants, in conjunction with the Monitor have since modified this plan and have moved forward with many of the action steps. The DDD Deputy Director for Community
20 ¶21.(C) June 15, 2011 Consent Decree at Page 12. 21 Ligas Implementation Plan, 12/15/11, Section VIII, at Page 19 22 Compliance Evaluation Standards, July 17, 2012 at Page 14

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Services has been assigned the lead responsibility for overseeing implementation of the crisis corrective action plan.
Some of the key action steps in the Crisis Service Request Action Plan include the following:
 DDD has developed an internal quality assurance process and checklist for management staff and Network Coordinators to individually evaluate each crisis request packet to ensure timeliness and completion.
 The internal database has been modified to ensure accuracy of entities.  Network staff have been provided additional training in the areas of crisis
data entry and processing crisis requests.  Network Coordinators have now been assigned authorization to issue Pre-
Award Letters in order to expedite processing of these letters.  Training will be conducted in October 2012 for DDD Network staff and
PAS agencies about submitting complete and accurate crisis funding requests, and being fully prepared when presenting requests to the Review Committee.  The frequency for internal DDD informal review committee meetings has been increased to reduce the lag time in approval.  Rate setting unit staff have been instructed to give high priority to crisis requests which will be specifically labeled as high priority. Distribution of award letters will also be streamlined and conveyed electronically.  A management report will be designed for improved overall internal monitoring of crisis requests. The first management report will be produced in the first week of January 2013.
Since the Crisis Corrective Action Plan has been implemented, the Monitor has reviewed the crisis requests from June 15, 2012 through September 7, 2012. There have been 70 crisis service requests during that period. The defendants provided a status report to the Monitor showing the activities and outcomes of each one of these requests. The results of this review show significant progress, even for those requests processed prior to implementation of the corrective action plan. In most instances, protective and/or emergency services were in place in a

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matter of days and not weeks, although some of the requests have taken longer than the 24-72 hour established standard. The defendants should be commended for acknowledging the extent and seriousness of the problem and responding with the requisite level of urgency which, to date, has demonstrated early positive outcomes. As mentioned in the Transition Service Plan section above, the defendants have developed and are now implementing the Crisis Transition Plan and Funding Request form. Utilization of this form as prescribed should result in a more effective and uniform manner in processing crisis request. Historically, the defendants process approximately 300 to 350 crisis requests per year. Hopefully, as more individuals on the waiting list are served, this large demand for crisis requests will decrease. In the meantime, the Monitor will continue to closely evaluate the implementation of the corrective action plan and communicate the results to the parties. As called for in the Compliance Evaluation Standards, the Monitor will conduct a 100% document review of all class members served in crisis and 5% random sampling of direct communication with class members or their families to evaluate the response of the defendants and outcomes.

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Transition for Class Members on Waiting List

The Decree requires Class members described in ¶2.b of the Decree will transition to community-based services. These class members are referred to in the Decree as "Waiting List Class Members.23 Class members described in ¶2.b and ¶22 (a) and ¶22 (b) will transition in accordance with the following schedule:
 Community-based services or placement in a community-based setting for 1,000 Waiting List class members will begin by June 15, 2013.
 Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2014.
 Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2015.
 Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2016.
 Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2017.
 Following June 15, 2017, Waiting List class members will receive community-based services or placement in a community-based setting at a reasonable pace.24
The Implementation Plan incorporates the criteria for prioritization for selection of class members who are on the waiting list to receive funding for community-based services or services in a community-based setting. Within each category, selections will be made based on the length of time on the waiting list database.25

As reported in the Class Member List section above, the PUNS list shows 10,894 individuals who qualify as Waiting List class members. In order to implement a

23 ¶22.(c) June 15, 2011 Consent Decree at Page 13. 24 ¶23.(c) June 15, 2011 Consent Decree at Page 13. 25 Ligas Implementation Plan, 12/15/11, Section VII, Page 17-19

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systematic process for selections of class members to effectuate services for the initial 1,000 individuals by June 15, 2013, the defendants engaged in several selection events. (Commonly referred to as “PUNS pulls”) The first selection event identified 800 individuals believed to be class members occurred in February 2012. After an initial screening process, 65 individuals were removed from this list and 735 letters were sent to the class member and/or guardian and their respective PAS agencies indicating that funding for community-based services or services in a community-based setting would be available upon application. The second selection event occurred in June 2012, which identified an additional 626 individuals and, after initial screening 22 individuals were removed from the list, resulting in 604 application letters being sent to the class members and respective PAS agencies. A third selection event is occurring presently and 1,500 individuals believed to be class members are being selected. Each of the selection events have chosen people in accordance within the criteria for prioritization as listed in the Ligas Implementation Plan.
As reported in the Class Member List section above, this selection process exposed significant shortfalls in the reliability of the PUNS list data. For example, from the initial selection of 800 individuals, 120 individuals were determined as unable to locate, 109 individuals have since refused services, 24 individuals have moved out of state, 17 individuals were found to be ineligible for HCBS services, 17 individuals were located in settings rendering them ineligible to be class members and 10 individuals are now deceased. These calculations alone result in nearly 300 individuals out of 800 (or 37%) who, if PUNS data were accurate would not have been considered class members. It should be noted that the initial selection of class members, generally, include many of those who have been waiting for services the longest. Thus some of the data for these individuals is more than six years old, contributing, in part, to the high level of inaccuracy.

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DDD recognized the degree of inaccuracies and took immediate action to address the problem. Additional staff have been assigned to assist PAS agencies in updating PUNS data and, in a number of instances, have helped the PAS agencies directly in locating individuals or information about individuals through research and various database inquiries. This process has been successful but is arduous and produces results slowly.
Despite the gross inaccuracies of the PUNS list for the initial selections, there has been significant movement over the past six months in an effort to comply with the requirements. Movement toward the provision of services for those found eligible is as follows:
 As of September 1, 2012, services have been initiated for 135 class members.
 An additional 30 class members have received finding awards and services are about to begin soon.
 Packets for another 73 individuals have been completed to DHS for funding approval.
 348 individuals are in the process of receiving Level II and Level III screening by PAS agencies and requests are being processed.
 Initial contact has been made with an additional 114 individuals who have confirmed that they have requested services.

In summary, if all of the above individuals who are being processed for services actually begin services by June 15, 2013, (An extraordinarily optimistic scenario) this comes to a total of only 700 class members, well short of the 1,000 class members as required in the Decree.
Meeting this requirement can only be possible if at least 300 more class members are served who are being selected for the current selection event involving 1,500 names from the PUNS list. Even if the letters to the class members from this selection event are sent as early as mid October 2012, it would be unrealistic to expect actual services to begin for many of these individuals by June 15, 2013.

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The Monitor is gravely concerned about the likelihood of full compliance with this
requirement in the Decree. To address this area of possible non-compliance, the
Monitor suggests that the defendants take some additional steps toward further
progress.
 First, some additional staffing assistance should be assigned to provide the necessary support to manage and conduct follow-up activities for the next large selection event. Reviewing PUNS data, working with the PAS agencies and identifying barriers during this process is an individuallydriven and labor intensive process that requires an “all hands on deck” approach.
 Secondly, DDD should develop its own technical assistance arm for PAS agencies to teach, train and monitor the updating and entry of PUNS list information and processing of applications for services. The responsiveness of the PAS agencies throughout this process has varied greatly. Effort will be needed to ensure consistency and uniformity statewide.
 Third, DDD should identify areas where processing of service applications has moved slowly and develop administrative remedies where necessary. For example, it has been reported that processing the applications for Medicaid eligibility for some class members has taken several months, even where individuals already qualify for Supplemental Security Income (SSI) which indicates a strong likelihood for Medicaid eligibility. DDD or DHS could assist in the process of expediting the application process, thus moving applications forward more quickly.
 Finally, DDD could poll community service providers in every region to determine existing service options and opportunities that could be shared with PAS agencies to make individual choices more effective.
To assist in compliance with this requirement of the Decree, the Monitor suggests
a special dedicated meeting in early January 2013 with the defendants and class
counsel to provide a comprehensive update on progress at that point and identify
and address any barriers to compliance.

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Outreach The Decree requires the defendants to maintain a fair and accessible process by which individuals or their guardians can affirmatively request services and maintain records of those requests.26
The Implementation Plan outlines numerous activities designed to identify individuals throughout the state who are or will be in need of home and community based services and services in a community based setting. These activities include training and information sessions as well as the development and distribution of written materials to broad based audiences.
For potential class members living in ICFs/DD, the Plan provides a detailed description and requirements for the development of a Request for Proposals (RFP) to secure the services of an outside contractor(s) to contact all potential class members and determine and document an informed decision on whether they are requesting services in a community-based setting.

The defendants engaged in numerous activities to comply with the Outreach requirements of the Decree and activities described in the Ligas Implementation Plan. At the initial parties’ meeting, it was agreed by the parties and memorialized by the Monitor that for those individuals who live in ICF/DD settings, they are considered a class member if they have completed a PASS Form 1238 or its predecessor, DHMDD Form1243, or DD PAS 10 form, or the Request form disseminated through plaintiffs' counsel, and checked the box that they choose Home and Community Based Services.
The Defendants, and in many instances, in conjunction with the Monitor, engaged in activities to inform stakeholders as well as the community at large about the
26 ¶25 June 15, 2011 Consent Decree at Page 14

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requirements of the Decree and how services can be sought and received by
qualified class members. Some of these activities include the following:
 DDD and the Monitor has have been conducting training activities for each of the 18 PAS agencies on the requirements of the Decree and Implementation Plan and, in particular, their role in facilitating choice for class members.
 DDD has developed a Ligas website27 that includes a full and downloadable description of the requirements of the Decree, updates on documents and activities related to the Decree and contact information for parties interested in more information. This website is updated on a regular basis.
 DDD maintains a consumer-friendly PAS agency locator function on the DDD website whereby families can locate their PAS agency by simply entering their county or zip code.
 DDD has also structured the 1-888-DDPLANS toll free number so that families can be directed to the Ligas inquiry staff support.

With regard to outreach to persons living in ICFs/DD, the defendants, with input from representatives from class counsel, intervenors counsel and the Monitor, developed a Ligas Outreach Request for Proposals (RFP) (Reference #22028606). The RFP was released to the public for solicitation on September 13, 2012 and proposals are due to DHS no later than October 9, 2012. This RFP is designed to secure the services of an independent contractor to maintain a fair and accessible process by which individuals with developmental disabilities or their legal guardians can affirmatively request in writing to receive community-based services or services in a community-based setting or continue to receive services in an ICF/DD.
The Monitor is pleased that the outreach RFP has been released and looks forward to the selection of a contractor so work on this important endeavor can begin. At this juncture, the timetable for work by the contractor is six months behind schedule.

27 http://www.dhs.state.il.us/page.aspx?item=40989

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Implementation Plan The Decree requires that the defendants finalize the Implementation Plan, with input from the parties and intervenors.28 The Implementation Plan must be filed with the Court by December 15, 2011. The Implementation Plan shall be updated and amended at least annually.29
The Ligas Implementation Plan was negotiated by the parties and intervenors and filed with the Court by the defendants on December 15, 2011. There was joint agreement by all parties, the Intervenors and the Monitor on the initial Implementation Plan. The Plan was ordered as a supplement to the Decree on February 15, 2012.
The defendants have utilized the Ligas Implementation Plan as their blueprint for activities designed to comply with the decree. At each scheduled parties’ meeting, the defendants provide a verbal update of Plan activities and respond to questions from class counsel and counsel for the intervenors. There have also been significant inquiries from key stakeholders and members of the public at large about implementation activities.
December 15, 2012 marks the one year point since the Ligas Implementation Plan was filed with the Court. The Monitor recommends that the defendants resubmit a proposed amended Ligas Implementation Plan with necessary revisions at the next scheduled parties meeting for review and input. Following the input from the parties, intervenors and the Monitor, the defendants should file the updated plan to the Court, as required in the Decree.

28 ¶27 June 15, 2011 Consent Decree at Page 15. 29 ¶28 June 15, 2011 Consent Decree at Page 15

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Data Reports
The Decree requires the defendants to provide the Monitor, Plaintiffs, Class counsel, Intervenors and Intervenors' Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants' compliance with the Decree and Defendants' progress towards achieving compliance.30 Not less than every six months, defendants shall provide data reports to the Monitor, class counsel and intervenors.
Implementation Plan Activities – The Implementation Plan calls for the submission of data reports.
The defendants provided a draft data report format to the parties, intervenors and Monitor and have received their input. Since then, the data reports have been resubmitted to the parties and intervenors with additional input and feedback. Most recently, on August 20, 2012 the defendants submitted the Data Reports to the parties, intervenors and Monitor with data included from the first six months and second six months.
The Data Reports include class member data regarding the class member list(s), services to class members in ICFs/DD, services to class members from the Waiting List, ICF/DD resident outreach, transition service plans, crisis services, voluntary ICF/DD closure and downsizing agreements, eligibility appeals and the Ligas budget. The Monitor finds the form and format for class member data to be acceptable. It will be increasingly important, however, to ensure that data with regarding budget expenditures and shortfalls, if any, are updated on a regular basis.

30 ¶ 33 of June 15, 2011 Consent Decree at page 18.

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Services for Named Plaintiffs
The Decree requires the defendants within sixty days to offer each of the Named Plaintiffs the opportunity to receive appropriate community-based services or services in a community-based setting.31 The defendants have complied with this requirement of the Decree. All five named plaintiffs were offered services in community based settings and have successfully transitioned to their new homes or received home-based services funded through the Illinois home and community-based waiver.

Dispute Resolution
The Decree clarifies the rights of class members to appeal or seek administrative or judicial review pursuant to governing law through the existing fair hearing process. Class members may also avail themselves of any informal appeal process that currently exists.32
The Monitor reviewed the appeal data with the defendants in April 2012 and identified a number of problems with the appeal process. Scheduling of appeals hearings and obtaining written hearing determinations were taking an inordinately long time, in some instances as much as six months to a year. The appeals application process was often confusing to individuals and families and some families reported that they were not aware of their appeal rights.

31 ¶37 June 15, 2011 Consent Decree at Page 21 32 ¶24 June 15, 2011 Consent Decree at Page 14

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As a result of these problems, the defendants, with input from class counsel, developed and are implementing an appeals corrective action plan that includes the following activities and tasks:
 HFS has hired an additional three new Administrative Law Judges as hearing officers and one additional attorney to support the hearing process.
 The newly hired ALJ’s, at the request of HFS, conducted site visits to several CILA settings to better understand community-based services for people with developmental disabilities.
 The application process was streamlined so that appeals come directly to DDD rather than the additional pass through with HFS.
 A draft to include modifications of the appeals rights form is being finalized.
 Appeals unit staff have been instructed in writing to give top priority to crisis appeals.
 Appeals unit staff are being trained to expedite informal appeals.
 An internal checklist has been drafted to provide effective and ongoing tracking of appeals.
 PAS agencies are being re-trained on preparing complete appeal requests.
 Weekly internal management reports will be generated to ensure internal reviews are scheduled on a timely basis.
 Management reports will be incorporated into the Ligas data reports.
The Monitor is confident that the above action steps will greatly alleviate many of the procedural problems with the appeals process. Over the next year, the Monitor will review appeals data with the defendants and provide the parties with findings and recommendations for improvement.

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Section 5 – Overall Comments
As shown throughout this report, compliance with the Decree requires a systematic and comprehensive approach by the defendants, coupled with an infusion of significant resources now and over the next nine years. The report also illustrates the complexity of the various requirements and how each requirement is inextricably intertwined with many of the other requirements. In drafting this report and in conducting monitoring activities, the Monitor found it somewhat challenging to maintain focus not only on the details of compliance, but also on the fundamental principles of the Decree – That class members will be afforded the opportunity for real choices about where and how services will be provided and - Resources will be made available to respect these choices. Keeping those principles in mind, the parties and intervenors can be pleased that at least 323 class members have received funding approval for community-based services who, in the opinion of the Monitor, would not have received this funding without the impetus of the Decree.33 This “bottom line” should not be overlooked.
In addition to this measure of success, there are numerous structural, procedural and cultural changes that have taken place over the past 15 months. In many ways, implementation of compliance related activities has exposed significant flaws in the service delivery system for people with intellectual and developmental disabilities. Some of these flaws have been addressed and many, if not most, still linger. Some of the compliance concerns articulated in this report are not because of lack of effort of the defendants but rather due to longstanding systemic and resources problems, that have yet to be resolved.

33 This number includes 153 class members transitioning from ICFs/DD, 165 Waiting List class members and five named plaintiffs.

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The Monitor will continue to work diligently with the parties and intervenors to address these problems until substantial compliance with all of the requirements becomes a reality.

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36

 
 Case: 1:05-cv-04331 Document #: 571 Filed: 10/01/13 Page 1 of 43 PageID #:11292

UNITED STATES DISTRICT COURT
 NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION


STANLEY LIGAS, et al.,

)

)

Plaintiffs,

)

vs.

)

) No. 05 C 4331

JULIE HAMOS, in her official capacity as )

Director of the Illinois Department of

) Judge Holderman

Healthcare and Family Services, et al.,


)

)

Defendants.


)

)


SECOND ANNUAL REPORT OF THE MONITOR


Case: 1:05-cv-04331 Document #: 571 Filed: 10/01/13 Page 2 of 43 PageID #:11293

STANLEY LIGAS, etal. v. JULIE HAMOS, etal.

Second Annual Report of the Monitor

September 30,2013

Submitted by:

Tony Records, Monitor
 7109 Exeter Road
 Bethesda, MD 20814
 301-529-9510
 traconsult@mindspring.com


Section 1 ~ Introduction This report is respectfully submitted to the Court, the Parties and the Intervenors in accordance with the Consent Decree (Decree) approved and filed by the Court on June 15,2011. Specifically, the Decree requires that:

The Monitor shall file annual reports to the Court, which shall be served on all Parties and Intervenors and be made publicly available. Such reports shall include the information necessary; in the Monitor's professional judgment, for the Court, Plaintiffs and Intervenors to evaluate Defendants' compliance or non-compliance with the terms of the Decree.'
The Monitor's First Annual Report was submitted to the Court and the parties on
. September 27, 2012. This second report addresses those activities that took place . since that date. The Monitor has engaged in numerous activities consistent with Section XIV (Monitoring and Compliance) of the Decree. There have been twelve parties' meetings since the approval of the Decree. During each of these meetings, the Monitor has given a verbal report of progress and concerns regarding . compliance as well as a review of activities. The Monitor has also met with and talked to counsel and representatives of the parties and intervenors separately on
I Consent Decree, Section XIV, ~34, at Page 19.

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an ongoing basis. No prior drafts of this report or any part of this report have been submitted to the parties, intervenors or anyone else. This report was delivered by email to the parties and intervenors on September 30, 2013.

This report is organized in five sections. Following the introduction is a section describing the activities of the Monitor during the past year and anticipated activities for the next year. This is followed by a brief and general description of actions taken by the Defendants during this period. The next section is the primary section, which includes a sequential description of activities and findings listed in order of requirements of the Decree and as listed in the established Compliance Standards developed by the Monitor in accordance with the Decree? Finally, the Monitor has included some brief overall comments designed to communicate a broad description of progress and successes thus far, as well as anticipated possible roadblocks to compliance in the future.

This report includes one finding of noncompliance, with regard to transition planning. More than 150 class members transitioned to community-based settings in western Illinois without the benefit of a Ligas Service Transition Plan as called for in the Decree and the Ligas Implementation Plan. Details of this finding and corresponding recommendations are in Section 6, Transition Service Plans (page 22-23) of this report. A discussion of necessary action steps to resolve this matter will be discussed at the next parties meeting on October 9,2013. The Monitor is not requesting the Court to take any action on this matter at this time.

There is another instance during this reporting period when it was necessary the Monitor work with the parties to resolve an issue of compliance. This issue is regarding the promulgation of changes by the Illinois legislature regarding the ICF/DD bed hold policy. In this instance, the intervenors invoked a claim of non­
2 Consent Decree, Section XlV, '132, at pages 17 and 18.

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compliance pursuant to Paragraph 35 of the Decree. On May 23,2013, the Monitor issued a special report to include a determination of non-compliance with the Decree. Although the defendants did not agree with this determination, subsequent legislation was passed which partially corrected the stated problem. This issue has yet to be fully resolved. (See Section 4, Resources and Capacity for further details.)
There are no other findings of noncompliance in this report.

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Section 2 - Activities of the Monitor
The Monitor was appointed by the Court on July 19,2011 and started monitoring activities on August 3, 2011. Activities of the Monitor during the first year of implementation are fully described in the First Annual Report filed with the Court on September 27,2012. During the past year, the Monitor has continued to engage in numerous activities designed to initiate and encourage necessary compliance-related actions, assist the Defendants in the implementation of the Consent Decree requirements, facilitate communication between the parties, inform the class members, families and members of the general public about the requirements of the Decree as well as evaluate overall compliance.
It is important to state once again that the Monitor has continued to receive full cooperation and support from the Defendants, including the Department of Human Services, Department of Healthcare and Family Services, the Governor's office, the Attorney General's office and, in particular, the management team and staff at the Division of Developmental Disabilities (DDD). DDD has provided the Monitor with continuous and unfettered access to program staff, class members, class member records and requested information and documents. Plaintiffs' counsel and representatives as well as counsel for the Intervenors have also been readily available and responsive to the Monitor whenever called upon. In all of the parties' meetings, discussions have been productive and on point toward the goal of compliance with the Decree.
The Monitor has also experienced full cooperation and support from the community service providers, ICFIDD facility staff, advocacy organizations and family associations throughout the state of Illinois through the provision of information, facilitation of meetings and direct input on issues relating to compliance activities.

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Class members, as well as their guardians and families have also been forthcoming
and responsive to the Monitor and continuously expressed a willingness to
participate in activities and share their experiences in order to assist the Monitor in
evaluating compliance.
Activities of the Monitor over the past year include the following:
./ The Monitor continued to hold separate meetings and phone calls with all counsel to discuss expectations and obtain various perspectives on challenges pertaining to compliance activities .
./ The Monitor has facilitated each of the parties' meetings as well as special single issue meetings. Meetings during this reporting period were held on 9/27/12, 12/13/12, 1/11/13,3/5/13,4/5/13 and 7/12/13. The next parties' meeting is scheduled for October 9, 2013. These parties' meetings are scheduled routinely, at least each quarter, in order to maintain a regular line of communication among the parties and to document progress and concerns on a timely basis. To increase efficiency and productivity, these meetings have been bifurcated to include full participation of the parties and intervenors for discussion and input relating to paragraphs 4-10, 25 and 45 of the Decree and class counsel and defendants' participation with regard to the remaining provisions of the Decree .
./ Initial and continuous meetings have been conducted with key staff at DDD and DHS who have specific responsibilities relating to implementation of compliance related activities. The Associate Director of DDD has been the key liaison with the Monitor in facilitating meetings, document production and development and coordination of compliance activities.
./ The Monitor has continued to devote a significant amount of time and effort to continue to provide information sessions, listening sessions and "town hall" meetings across the state to class members, potential class members, families, guardians, community service providers, advocacy organizations, ICFIDD providers, PAS agencies and other stakeholders. These sessions provided an overview of the Decree and Implementation Plan as well as an update of compliance activities and ways stakeholders can playa vital role in providing information and feedback on Ligas related issues. Audiences of more than thirty-five of these information and listening sessions over the past two years have included more than 3,500 participants.

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./ Regularly scheduled meetings are held with the DDD Director to review progress and challenges related to implementation activities designed to develop strategies to address current issues. The Monitor has also had several meetings with the DRS Secretary to provide an update of activities and any concerns about overall compliance.
./ The Monitor has also met on a quarterly basis with the Governor's office to provide an overview of activities and discuss any overall compliance concerns .
./ The Monitor has reviewed hundreds of documents provided by the defendants, class counsel, service providers, PAS agencies, advocacy organizations and families that have provided significant information, insight and perspective to compliance activities and challenges.
./ The Monitor has reviewed all information on the defendants' various websites relevant to compliance activities and policies that relate to the Decree. The Monitor has worked directly with DDD staff to review and modify information on the Ligas page or the DDD website .
./ The Monitor has provided his telephone. and email contact information widely across the state in order to hear directly from class members, families, guardians, service providers and PAS agencies about questions and concerns relative to implementation of compliance related activities. As a result, there have been scores of inquiries and concerns received which require specific follow-up and clarification with the defendants. This process has helped clarify many policy questions that have emanated as result of new compliance activities .
./ The Monitor now participates in monthly scheduled conference calls with class counsel and the defendants to discuss individual class member issues and concerns. These calls, scheduled for the first Tuesday of each month, have been quite helpful in resolving individual issues and have also been informative in identifying systemic issues and policies that may affect compliance with the Decree .
./ The Monitor also participates in meetings of the Ligas Class Member/Family Advisory Group that has been recently formed for the parties to hear directly from class members and their families regarding their experiences as members of the Ligas class.

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Section 3 - Overall Activities of the Defendants and Parties

.Year two of implementation of the Decree, compared to the previous year, can be described as a year of productivity. Despite the numerous obstacles articulated by the Monitor in the First Annual Report, the defendants took a "can do" approach toward implementation and worked fastidiously to achieve compliance. Financially, the state, while facing straitened circumstances, came up with the resources necessary to initiate services and supports for more than more than 2,000 class members thus far. This is truly significant.

The Monitor is in no way suggesting that all is perfect or even near perfect. The Illinois system of services for people with developmental disabilities remains to be deeply flawed. This report will pinpoint numerous areas where much improvement and restructuring is needed, including one area of non-compliance. Development of processes and internal mechanisms to achieve and maintain compliance, however, has moved forward with purpose and direction. Some of these activities over the past year by the defendants include the following:

./ The defendants have exceeded their requirements to initiate services for

class members who are on the waiting list and class members in ICFs/DD.

As of September 1,2013,1,356 class members who live at home have

initiated services and 519 additional class members living in ICFs/DD have

moved. Additionally, 269 class members were served over the past year

who were found to be in crisis. These accomplishments should not be

understated.

.

./ The pilot for Ligas Service Transition Plan (LSTP)has been completed. and, as of July 1,2013, is now fully operational statewide. DDD has also established a system to track LSTP production and, in the future, will be able to provide information on Data Reports regarding LSTP development.

./ An Outreach contractor has been retained and has begun work toward contacting potential class members to provide information on possible service options as called for in the Decree. Outreach staff have been hired and initial training and orientation has been completed.

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.,/ Significant resources were added to the FY13 appropriations to address the provider payment cycle problems that were cited in the Monitor's First Annual Report. These added resources will be a significant factor in addressing the cash-flow problems and, in some instances, allow providers to consider expansion in order to serve more class members .
.,/ These has been significant "clean-up" activity with regard to the Prioritization of Urgency of Need for Services (PUNS) waiting list of class members in order to provide increased accuracy and credibility in the selection process for class members on the list.
.,/ The speed of responsiveness in which the provision of crisis services for Ligas class members has vastly improved through the implementation of the defendants' corrective action plan.
.,/ The defendants have conducted monthly reviews with each of the eighteen Pre-Admission Screening (PAS) agencies to evaluate movement of class member activities from the PUNS list as well as transition of class members from ICFslDD to community-based settings.
There are also a number of encumbrances that have continued to interfere with
implementation activities and threaten substantial compliance. Some of these
encumbrances include the following:
.,/ Opportunities for employment and a path to employment for class members are extremely limited. Although the Governor and Legislator have elevated employment to a high priority, much needs to be done in order to make employment a reality for class members .
.,/ Despite efforts by the defendants, as identified in the Monitor's First Annual Report, reimbursement rates of funding for community-based settings remain to be among the lowest in the country
.,/ Many class members who were selected for funding for Community Integrated Living Arrangement (CILA) chose home based services and some cited the lack of flexibility in the CILA program as the reason for this selection.
The issues listed above and more will be discussed in detail in the body of this report.

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Section 4 - Compliance Requirements and Activities
This section provides a specific review of the compliance requirements in each of the nine major areas of compliance, which include the following:
1. Resources and Capacity 2. Class Member List(s) 3. Transition Service Plans 4. Transition for Class Members in ICFslDD 5. Crisis Services 6. Transition for Class Members on Waiting List 7. Outreach 8. Implementation Plan 9. Data Reports 10. Dispute Resolution
Each area of compliance is listed below in a separate section that includes: a description of the requirements in the Consent Decree; timeframes or deadlines for compliance; related activities described in the Implementation Plan and; the status of implementation of compliance activities by the defendants. In accordance with this provision, this section is considered by the Monitor as the primary measure of compliance with the Decree. For some of the requirements, the timeframes for implementation of the specific timeframes have not yet transpired. In these instances, the Monitor will report on activities that "have occurred so far and, where appropriate, the likelihood that these actions will lead to timely compliance.
This section also includes comments about the establishment of the Ligas Class Member and Family Advisory Group which is called for in the revised Implementation Plan.

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Resources and Capacity The Decree requires resources for community services to be provided consistent with the choice of a class member and the requirements of paragraphs 17 through 19 and 21 through 23 of the Decree. Resources necessary to meet the needs of individuals with developmental disabilities who choose to receive services in ICFs/DD shall be made available and such resources will not be affected by Defendants' fulfillment of their obligations under the Decree. Funding for services for individuals with developmental disabilities will be based on the individual's needs using federally approved objective criteria regardless of whether the individual chooses to receive services in an ICF/DD or in a community-based setting. Amendments to the state Medicaid plan will continue to Include ICF/DD services as an alternative choice for long term services.:' Annual budgets will be sufficient to fund the services necessary to comply with the Decree consistent with the choices of individuals with developmental disabilities, including class members."
The Implementation Plan calls for a continuation of activities to develop new community services providers and the voluntary conversion of ICFs/DD to community-based services. 5 The Implementation Plan also calls for the development of annual budget proposals to incorporate the necessary resources to carry out the provisions of the Decree. The Plan also includes resources for a listing of specific contractual agreements necessary to address the anticipated increase in demand for services, additional DDD staff to be hired in order to manage compliance and prepare compliance-related reports and funding for direct services for class members as they are identified to receive community services. 6

3 ~ 4 of June 15,2011 Consent Decree at page 7
 4 ~ 5 of June 15,2011 Consent Decree at pages 7and 8.
 5 Ligas Implementation Plan, 12/15/11, Section IV, Page 13.

6 Ligas Implementation Plan, 12/15/11, Section X, Page 20-22.


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In order to comply with the provisions of the Decree regarding resources, the
defendants engaged in numerous activities. These activities include the following:
• A Ligas budget was developed by the Governor and approved by the legislature for Fiscal Year 2014. This budget calls for the increase of $32.5 million in new funds for implementation of Ligas activities. This increase is above and beyond the increases necessary to annualize funding for services and supports that began in FY20 13.
• The defendants' data reports also indicate that spending for ICF/DD services has remained constant, with an FY 2014 budget projection of $370.1 million. Although this amount is slightly lower than FY 2013, there are clear trends and projections for fewer individuals to be served in ICF/DD facilities. The chart below illustrates the ICF/DD budget activity over the past four years.

Fiscal Year
FY2011 FY2012 FY2013 FY2014*
*ProJected

ICFIDD Census
6,427 6,414 6,074 5,800*

Budget (In Millions)
$392.8 $381.1 $372.4 $370.1

Per Person Annual Budget
$60,993 $59,417 $61,311 $63,810

• As reported in the Monitor's First Annual Report, DHS instituted changes in the reimbursements as well methods and standards for establishing , payments for home and community-based services, particularly targeting small (1-4 person) Community IntegratedLiving Arrangements (CILA). Many of these changes are designed to realign the prior disincentives in the reimbursement rate structure for smaller community homes. These changes have taken full effect.
• The Ligas Implementation Team has been fully funded ($1.68 million) and is mostly in place. Positions for .this team includes the following:
o Compliance Coordinator(1 position) - This position is currently vacant; however, a staff person has been assigned to serveas the lead coordinator for Ligas activities. These are his full-time duties. In addition, a person from the Medicaid Waiver unit has been assigned responsibilities for coordination activities, especially those surrounding the waiting list. These are her full-time duties.

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o Program and Data Support Staff (1 position) - Funding for this position is being used to contract with a retired employee who has a great deal of knowledge and experience with the DD service system, the Department's budgeting practices, and data systems.
o Bureau of Quality Management Staff (7 positions) - All seven positions have been filled.
o Bureau of Transition Services Staff (4 positions) - All four positions have been filled.
o Appeals Unit Staff (1 position) - This position was filled in FY 12 o Rates Section Staff (1 position)- This position was filled in FY12 o Medicaid Waiver Staff (3 positions) - All three positions have been
filled.
In the Monitor's First Annual Report, only eight of these 18 positions had been filled. At this juncture, 17 of the 18 positions have now been filled and responsibilities for the remaining position are being fulfilled.
The Ligas budget also includes $2.69 million in FY2014 for contractual agreements called for in the Implementation Plan. Specific allocations for contractual services include the following:
./ Outreach activities. Funds for the independent outreach contractor and related costs .
./ Increased funding for PAS agencies to include: o Increased eligibility determinations o Development of Ligas Service Transition Plans o Increased PUNS enrollment activity o New ISSA Services
./ An independent contractor has been hired to provide training and technical assistance to PAS agencies in the development of Ligas Service Transition Plans. This contractor has started and has begun work with three PAS agencies.

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./ Negotiations are nearly complete with an independent contractor to provide family support and advocacy to waiting list class members on a statewide basis.
A year ago, amendments were approved by the Center for Medicare and Medicaid (CMS) for the expansion of the Medicaid Home and Community Based Services (HCBS) Waiver from 15,920 individuals to 18,200 individuals. It is projected that as many as 21;300 individuals will be served in the Medicaid Waiver program by the end ofFY 2014. DHS will need to secure approval for this expected increase. This projected increase is designed to allow for sufficient increase in capacity to serve the number of new class members called for to comply with the Decree. The defendants and the Monitor will continue to track capacity growth closely and, if necessary, the defendants will submit additional amendments in the future.

Concerns Regarding Resources
The steps above illustrate a clear commitment by the defendants to allocate significant resources to implement the necessary activities to comply with the Decree. There are still some key areas, however, which will require direct attention and, in some instances, additional resources, including the following.
Despite the enhancements to the reimbursement rates for community services cited in the Monitor's First Annual Report, the overall rates for community services remain to be among the lowest in the country. A number of providers have informally reported to the Monitor that they would be willing to expand community services, especially small CILA settings, if the rates were realistic and commensurate with actual costs for providing services in smaller, often more desirable settings. As a result, the large majority of community-based settings developed have been large 7-8 person settings, very often not the choice of the class members. It will important for Illinois to move forward and establish a rate

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structure that promotes community flexibility, individual choice and fully integrated activities. Over the next six months, the Monitor will work with DRS and the parties to identify recommendations for rate adjustments

As reported in the introductory section of this report, there was an instance when it was necessary the Monitor work with the parties to resolve an issue of compliance. This issue is regarding the promulgation of changes by the Illinois legislature regarding the ICF/DD bed-hold policy. These changes resulted in a negative impact on financial impact on ICFs/DD that was a estimated loss of as much as $8 million annually.

In this instance, the intervenors invoked a claim of non-compliance pursuant to

Paragraph 35 of the Decree claiming that enactment of this legislation was a

violation of the Decree. After meeting and conferring with the parties reviewing

relevant information, on May 23,2013, the Monitor issued a special report to

include a determination of non-compliance with Paragraph 4 of the Decree. Since

then,,

the

parties

discussed

the

matter

again .

at

the

July

12,2013

parties

meeting.

The legislature rescinded part of the legislation, thus reducing the amount of

financial hardship on ICF/DD providers by approximately 75%. This matter has

not yet been fully resolved. The Monitor will continue to work with the parties in

the attempt to come to a final resolution of this matter.

A final issue with regard to resources that warrants immediate attention is the need for additional support within DRS, and, in particular, DDD to implement key activities related to the Decree. The absence of an effective data system, for example, continues to make it difficult for staff to track day-to-day activities of class member services and support. The lack of an employment coordinator

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significantly reduces the likelihood of successful implementation of employment services initiatives. The lack of an assigned Medicaid waiver manager makes it nearly impossible for DDD to continuously evaluate the effectiveness and flexibility of the waiver and fashion policy recommendations for change. Due to the success of Ligas activities, the number of people supported by DDD is increasing rapidly. Since the approval of the Decree, it is estimated that the number of people served by the home and community-based waiver will increase by more than 20% over the next few years. A management team and infrastructure must be in place to support this rapid growth. Over the next six months, the Monitor will work with the DHS Secretary and DDD Director to identify recommendations to strengthen the support provided by the Department for Ligas class members.

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Class Member List(s)

The Decree requires the defendants to maintain a statewide database in which all Class Members are enrolled. 7 Defendants are also required to promptly revise the class member database and waiting list data. g

The Implementation Plan describes the process for the development and maintenance of a class member list that will be accessible to the Monitor and Class Counsel. Intervenors' counsel will have access to the class list as provided in the Implementation Plan. DDDwill use its PUNS database to maintain a list of Waiting List class members. The Plan also calls for DDD to review the adequacy of the PUNS database.

Upon recommendation by the Monitor and agreement of the parties and


intervenors, the defendants have developed and maintained two class member


lists.


J

There is now a list of class members pursuant to ~2 (a) of the Decree, who: qualify for Medicaid Waiver services; live in an ICFIDD with nine or more residents and; have affirmatively requested community-based services or placement in a community-based setting. As of September 1, 2013 there were 892 class members in this category. The defendants maintain a list that contains, at a minimum: the names of individuals; the documentation to verify their written affirmative request; . date of birth; social security number and; the name of the facility in which they live. Since the Monitor's First Annual Report, the accuracy and veracity of this list has improved significantly. The most.recent list has been reviewed and re­ reviewed and appears to be consistent with the requirements. Of particular concern in the Monitor's First Annual report was ensuring that none of those listed as Objectors are not included on the list, unless there is a more current affirmative

7 ~8 June 15,2011 Consent Decree at Page 8.
 8'19 June 15,2011 Consent Decree at Page 9.


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written statement that the individual and/or guardian has changed their mind and has since requested services in a community-based setting. During the past year, the Monitor facilitated a meeting with the defendants, class counsel and counsel for the intervenors to conduct a detailed review of the list of objectors. This list was then reconciled and disseminated to the parties and intervenors. A senior staff member within DDD has been assigned to maintain this list and inform the Monitor of any particular updates and concerns. A monthly review and update of ICF/DD class member list is conducted with PAS agencies.
There is also a list of class 'members pursuant to,-r2 (b) of the Decree who: qualify for Medicaid Waiver services; live in a family home and; are in need of and have affirmatively requested home and community-based services or services in a community-based setting. These individuals are known as Waiting List Class Members. As of September 15,2013, there were 14,110 class members in this category. This list is also maintained as a subset of the overall waiting list (Commonly known as the PUNS list) for services.
As reported in the Monitor's First Annual Report, development and refinement of this list has also proven to be quite challenging. Initial utilization of this initial list revealed that much of the class member information was outdated and/or inaccurate. A large number of addresses were incorrect and some individuals had moved out of state. Contact information was often inaccurate or outdated. Some individuals on the initial list are now deceased. In more than 400 other instances, after individuals were contacted, it was determined that they no longer needed or wanted home and community-based services or services in a community-based setting.

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DDD took immediate and deliberate actions to address these problems. The PAS agencies have the primary responsibility to update the information on the waiting list. Communications were sent to each PAS agency with clear instructions on updating data on the waiting list and reminding them of their responsibility regarding individual updates. DDD assigned a key staff member as well as an additional professional staff member to maintain and update this list as a high priority. These two staff are and have been in constant communications with PAS agency representatives to correct inaccurate data and update waiting list information. Budget allocation enhancements have also been made to ensure that payments to PAS agencies are adequately reimbursed for PUNS entry and update. activities on an expedited basis. These efforts thus have been quite effective. The Monitor has worked closely with DDD to ensure that the waiting list of class members is updated. This list has grown by more than 3,000 class members over the past year. This is due, in part, to a number of individuals "aging in" to the Class by virtue of turning 18 years old. In other instances, families have requested that their loved one be added to the waiting list because of the renewed hope that implementation of Ligas Decree has engendered. As an overall note, and as reported in the Monitor's first report, the problems identified in the class member lists issue are also symptomatic of a more endemic issue within DDD - the lack of a comprehensive integrated data system. It will be important for DRS over the next several years to address this issue and develop a plan to address the overall need for a data system that is responsive and consistent with the ever-growing challenges within DDD and DRS. The Monitor recognizes that development of a comprehensive data system will require a significant initial investment of resources. The outcome of such an endeavor, however, would help ensure effectively coordinated services for Ligas class members and others.

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Transition Service Plans The Decree requires the defendants to develop transition plans for all class members who are selected to be served pursuant to the Decree. Transition plans shall describe all services required, how they will be developed and obtained ~nd a timetable for transition.' Transition plans will be developed by a Qualified Professional in conjunction with the class member and guardian and others, as appropri•ate. 10
The process for transition planning will include the class member's personal vision, preferences, strengths, and needs in home, community and work and shall reflect the value of supporting relationships, productive work, participation in community life and personal decision making. II Services and supports will be integrated into the community and consistent with choices of class members and guardians. Transition plans shall not be limited by the current availability of services but be within the confines of the waiver and State Plan. 12 Transition plans for class members who are determined to be in crisis will be developed. 13
The Implementation Plan calls for a phase-in process for the completion of a transition service plan for each class member seeking services in a community­ based setting. The Plan outlines an I8-month long process that includes a pilot trial period, re-evaluation and state-wide implementation by July 1,2013. This process ensures coordination required between PASIISC agencies and class members."

9 ~II June 15,2011 Consent Decree at Page 9.


10 '112 June IS, 20 II Consent Decree at Page 9.


II ~13 June 15, 20 II Consent Decree at Page 9 & 10.


12~14June 15,2011 Consent Decree at Page 10.


13 ~2I.(b) June 15,2011 Consent Decree at Page 12.

.


14 Ligas Implementation Plan, 2013 Revisions, 2/25/13 Section VI, Page 18


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The defendants have begun to implement the transition planning process
consistent with what is described in the Implementation Plan. These activities
include the following:
• DDD has completed the development of the Ligas Service Transition Plan (LSTP) documents through a process of receiving broad input from the parties, class members and families, PAS agencies and other key stakeholders. These documents include the LSTP format and accompanying instructions for class members moving from their homes or ICFs/DD to CILA. The final version of the LSTP as well as corresponding instructions can also be found on the DDD Website. (http://www.dhs.state.il.us/page.aspx?item=40989) An abbreviated transition plan format was developed for class members seeking community-based services in crisis situations.
• Two PAS agencies, Developmental Disability Services of Metro East and Suburban Access, Inc. piloted the utilization of the LSTP for a six month period in FY13 through January 2013. Each of the pilot agencies selected a sampling of class members living at home and living in ICFs/DD who participated in the sample. The total sampling size was more than 150 individuals. Monthly conference calls with the two pilot PAS agencies were conducted by DDD with the Monitor's participation to review progress and implementation challenges throughout the pilot period.
• After reviewing the results of the pilot activities, DDD, with input from the Monitor and class counsel, made necessary changes to the forms and processes in the beginning of calendar year 2013.
• On April 16,2013, DDD, with assistance from the Monitor, conducted the initial training for all PAS agency management staff on the LSTP requirements, planning document and transition planning process. During the remainder of April and through May 2013, DDDand the Monitor provided training to all 18 PAS agencies and service coordinators. This training reached over 300 individuals. Once the LSTP training sessions were completed for each PAS agency, they began implementation of the new Transition Service Plan on a statewide basis by July 1,2013.
• For those class members who moved into a community-based setting prior to July 1,2013 and did not have the benefit ofa LSTP, a Modified Version of the LSTP was developed. PAS agencies are required to complete this Modified Version for each applicable class member no later than the second quarter ofFY2014.

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With regard to the transition planning process for class members in crisis, DDD designed modifications to the existing Crisis Funding Request and developed the Crisis Transition Plan and Funding Request. This form and format, along with detailed instructions, were posted on the DDD website and disseminated to all PAS agencies for input. These documents were finalized and were required to be utilized by all PAS agencies statewide beginning September 14,2012. Since this crisis transition planning form is a relatively minor adaptation to an existing form, a pilot process was not considered necessary..

The Monitor is generally pleased with the progress the defendants have made toward the development of a Transition Service Plan. Converting a system from virtually no transition service planning to a person-centered approach as required in the Decree necessitates a carefully planned and deliberate process that takes time to evolve. As these Ligas Transition Service Plans are evaluated by DDD and the Monitor, needed modifications will be completed and training and technical assistance, as necessary, will be implemented.

Another component of this process will be the training ~f PAS agencies and others on effective person-centered planning. The Ligas Implementation Plan calls for a consultant to be identified to work with the DDD Bureau of Transition Services to review transition plans and train PAS agencies and providers on their development.P This consultant, Dr. Mark Friedman, was hired in August 2013 and has now begun his work.
Over the next year, the Monitor will conduct a random sampling review of LSTPs as called for in the Compliance Evaluation Standards and report to the parties on the results.

IS Ligas Implementation Plan,20l3 Revisions, Section X, at page 24

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Specific Compliance Finding with Regard to Transition Planning
In September 2012, the Department of Healthcare and Family Services (DHFS)
 and the Department of Public Health entered into an Agreement with St. Mary's
 Square, an ICFIDD facility in Galesburg, IL to develop a "replacement plan" to
 close the facility within 36 months. Subsequently, a replacement proposal was
 also developed and revised on March 14,2013. At that time the facility served
 205 individuals. The Replacement Proposal specifically states that

Individuals transferring from the Facility who are deemed to be Ligas class members will be afforded the services and supports as described in section VII, paragraphs 10-16 of the Ligas v. Hamos Consent Decree, in accordance with the Ligas v. Hamos Implementation Plan. 16 This Replacement Proposal was signed by the authorized representative of St. Mary's Square and the Director ofDDD. Less than six months later, on August 29,2013, the facility closed. Approximately 200 Ligas members had moved to home and community-based settings. Approximately 192 of these class members moved to homes operated by the same provider, into the same model of 8-person group home in two neighboring towns in western Illinois.
On August 20, 2013, the Monitor met with DDD, St. Mary's Square leadership and staff, the PAS Agency - Westen). Illinois Services Center, (WISC), DDD staff, the Office of the State Guardian (OSG) and selected community services staff. It . was discovered at that meeting that nearly all of the class members had moved without the benefit of a Ligas Service Transition Plan. Most of these individuals moved after July 1, 2013. It should also be stated that WISC, the PAS agency involved had completed the training for LSTPs on April 16,2013. The lack of LSTPs for all of these class members constitutes a serious violation of Paragraph 10 of the Decree.

16 St. Mary's Square Living Center Replacement Proposal, Revised March 14,2013, Page 3

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There appears to be a number of systemic malfunctions that led to this noncompliance, including the hasty manner in which the facility moved to close the facility without regard to the required processes, the lack of responsibility of thePAS agency to facilitate the development of LSTPs and the lack of oversight ofDHS to ensure that LSTPs were in place prior to these class members' move.
It is the Monitor's view and finding that these class members and/or their guardians were not given the opportunity to make informed decisions or provided with an objective menu of viable options prior to their move. This is wholly unacceptable.
As a consequence, the Monitor recommends that DHS, in conjunction with the Monitor, conduct a full investigation of this matter and develop a report with findings and recommendations, to include:
• A written report to include a sequence of actions that took place that led to this noncompliance;
• A listing of class members who were moved without LSTPs; • A remedial plan to ensure that choice and options be given to each
class member adversely affected; and • A list of recommendations that will ensure that such noncompliance
does not recur. This investigation should be completed no later than January 10,2014. This recommendation will be further discussed at the October 9,2013 parties' meeting. ,

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Additional Concerns Regarding Transition Planning
Paragraph 13 and 14 of the Decree state: The process for transition planning will include the class member's personal vision, preferences, strengths, and needs in home, community and work and shall reflect the value of supporting relationships, productive work, participation in community life and personal decision making. 17 and: Services and supports will be integrated into the community and consistent with choices of class members and guardians. Transition plans shall not be limited by the current availability of services but be within the confines of the waiver and State Plan. 18
In order for implementation of this requirement occur, the transition planning. process must include a broad menu of real choices for each class member. This includes the size of community residential setting and employment.
Data provided by the defendants show that, among all class members who transitioned to Community Integrated Living Arrangement (CILA) settings in the first two years of implementation, 69% transitioned to settings of seven or eight residents. For those who transitioned from ICFIDD facilities 75% moved to settings of seven or eight individuals. Only 8% of those class member who transitioned from an ICFIDD facilities to CILA settings, moved to settings of four persons or fewer. These data strongly suggest to the Monitor that the option of movement to smaller settings is, for many class members, not one that is sufficiently presented or sufficiently explored. Anecdotally, many families have reported to the Monitor that their clear preference was a smaller setting, but were told that this is not an option because of "availability" or "cost effectiveness."

17 ~13 June 15,2011 Consent Decree at Page 9 & 10. 18 ~14 June 15,2011 Consent Decree at Page 10.

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Services in smaller settings certainly falls within the realm of current best practices. In fact, the Federal Center for Medicare and Medicaid Services (CMS) has enacted financial incentives for states that transition individuals from ICFIDD facilities to settings of four persons or fewer' though t,he Money Follows the Person (MFP) program. Class members and their families should be given that choice. If they choose a smaller setting, efforts should be made to ideritify options consistent with the requirements in the Decree.
Another area in which, in the Monitor's view, adequate real choice is not afforded, is that of employment. While the specific data are not available, it is quite clear that an overwhelming number of class members are transitioning into daytime activities that do not include real employment or even provide for a path to employment. Again, many families, class members and guardians, anecdotally, have reported to the Monitor that the option of competitive employment was not even considered during the transition planning process or was dismissed as "unrealistic" or simply not presently available. This must change. For adults with .developmental disabilities, employment should be the default daytime activity and should be the first option presented.
This year, the Governor signed into law the Illinois Employment First Act which establishes a definition of competitive employment and incorporates specific 'requirements for state agencies to implement activities to promote employment and establish measurable goals and objectives toward employment activities." Enactment of this legislation provides the timely impetus for the parties to work together to take steps to implement strategies to ensure that the employment option is a viable one for Ligas class members.
Over the next year, the Monitor will be working with the parties to ensure that all options, including the option of smaller home settings and real employment, are provided to class members throughout the transition planning process.

19 HB2591 Enrolled, Illinois Employment First Act

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Transition for Class Members in ICFslDD
The Decree requires all class members in ICFs/DD to transition to community services or community-based settings consistent with their transition plans if, at the time of transition, the class members request placement in a Community-Based Setting as confirmed and documented in accordance with the Decree. 2o
• One third of class members in this category will transition by 12115/2013. The number of class members to transition during this period will be determined by June 15,2013.
• Two thirds of class members in this category will transition by 12/15/2015. The number of class members to transition during this period will be determined by June 15,2015.
• All class members in this category will transition by 6/15/2017. The total number of class members to transition from ICFs/DD will be determined by June 15,2017.
The Implementation Plan calls for the identification and referral of these class members to PAS/ISC agencies for assistance in transition to community-based settings. The number of people identified for transition from ICFs!DD is expected to change, pursuant to the results of the outreach process described below. PASIISC agencies will monitor the adjustment and resolve issues as they are identified. 21

889 class members in this category were identified on June 15,2013. Of the number of class members identified on that date, one-third are required to be served by December 15,2013. As reported in the Class Member List section, there were 892 class members in ICFs/DD as of September 1,2013. Asof that same date, 560 class members in this category have received funding for
20'17 June 15, 2011 Consent Decree at Page 10.
 21 Ligas Implementation Plan, 12115111, Section Y, Page 14 -15


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community-based services or services in a community-based setting. Of the 560 who have received funding, at least 519 of these class members have actually started community-based services and billing for these services has been verified. This far exceeds the requirement that one-third oflCFIDD class members move prior to December 15,2013. DDD sends requests to PAS agencies for monthly updates for all ICFIDD class members to determine the status of choice and selection of community services providers and projected transition dates.
The overwhelming majority (99%) of class members who have transitioned have requested and received funding for Community Integrating Living Arrangements, (CILA) and the remainder of the class members (1%) have requested and received funding for home-based services (HBS) and have returned to their family home.
It should be noted that, to date, at least 90 individuals living in ICFslDD who were contacted to receive transition supports to community services have since changed their minds and chosen to stay living in the ICFIDD. In each of these instances the individual's choices were respected and they were removed from the class member list.
A large number of class members who were living in ICFslDD who have moved services in a community-based setting did so as a result of a voluntary downsizing or closure agreement. There are expected to be even more individuals who will be identified over the next year who are living in ICFslDD now and will need to move due to voluntary downsizing or closure agreements. It will be imperative for the defendants to ensure that these individuals are provided with the opportunity to review an array of options so they can make an informed decision about where and how they want to receive services and supports. The Monitor has discussed this with the parties and DDD staff and will be working closely with the defendants in tracking how choices are being facilitated for individuals who are affected by implementation of voluntary downsizing and closure plans.

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Crisis Services
The Decree requires the defendants to serve Class members who meet the crisis criteria described in ~21 (a) of the Decree and who request community services or placement in a community-based setting expeditiously.f Services and/or placement will be provided in a manner consistent with the transition plan.
The Implementation Plan calls for the PAS/ISC agencies to continue to submit requests for services from individuals in crisis situations. DDD will ensure that class members are served expeditiously.r' The Monitor established the standard, with the agreement of the parties, that the timeframe to receive services for class members in crisis will be 24-72 hours, although this timeframe may vary, depending on individual circumstances, or if temporary services are in place to address the immediate crisis."
As reported in the Monitor's First Annual Report, on May I, 2012, the Monitor notified the defendants and class counsel of non-compliance in that crisis services were not being provided expeditiously as called for in paragraph 21(c) of the Decree. After a sampling review of the crisis services for class members from June 2011 to April 2012, the Monitor found a large percentage of class members who were not served for weeks and, in some instances, months, who needed services immediately. The Monitor recommended that the defendants develop a plan to address these issues. The defendants acknowledged the problem and immediately developed a draft corrective action plan and reviewed the plan with the Monitor. This draft plan was then presented to the parties and discussed at the June 21,2012 parties' meeting. Following the meeting, class counsel provided written comments to the defendants on June 28, 2012 on the corrective action for crisis services. The defendants, in conjunction with the Monitor have since modified this plan and have moved forward with many of the action steps. The
22 ~21.(C) June 15, 2011 Consent Decree at Page 12. 23 Ligas Jmplementation Plan, 12/15/11, Section VIII, at Page 19 24 Compliance Evaluation Standards, July 17,2012 at Page 14

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DDD Deputy Director for Community Services has been assigned the lead responsibility for overseeing implementation of the crisis corrective action plan.
Some of the key action steps in the Crisis Service Request Action Plan include the following:
• DDD has developed an internal quality assurance process and checklist for management staff and Network Coordinators to individually evaluate each' crisis request packet to ensure timeliness and completion.
• The internal database has been modified to ensure accuracy of entities. • Network staff have been provided additional training in the areas of crisis
data entry and processing crisis requests. • Network Coordinators have now been assigned authorization to issue Pre­
Award Letters in order to expedite processing of these letters. • Training was in October 2012 for DDD Network staff and PAS agencies
about submitting complete and accurate crisis funding requests, and being fully prepared when presenting requests to the Review Committee. • The frequency for internal DDD informal review committee meetings has been increased to reduce the lag time in approval. .• Rate setting unit staff have been instructed to give high priority to crisis requests which will be specifically labeled as high priority. Distribution of award letters will also be streamlined and conveyed electronically. • A management report was designed for improved overall internal
 monitoring of crisis requests.

After nearly a full year, implementation of this corrective action plan has shown significant, if not remarkable, improvement in the results. The Monitor reviewed crisis class member information and data from 145 crisis requests during FY 2Q13. In addition, in accordance with the Compliance Standards, the Monitor randomly selected 5% of class members among those crisis requests, and for those class . members, conducted an in-depth review. The results showed that 95% (139) of the class members who were found to be in crisis, received services with a 24-72 hour period after their crisis status was confirmed. This finding demonstrates that

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the defendants' efforts were wholly successful. The Monitor will continue to work with the defendants, including a joint review of the crisis management reports, to continue to improve crisis responsiveness. It should be noted that there were a number of instances that were identified by the Monitor, where the processing of the crisis applications and request information packets development moved slowly prior to the crisis review process by DDD. The Monitor will work with the DDD management staff to establish a mechanism to track and improve that part of the process,
The defendants' data reports indicate that, in FY 2012,288 class members who. requested service pursuant to the crisis criteria were served and, in FY 2013, 269 class members in crisis were served. This represents a slightly downward trend of crisis requests over the past several years. Historically, the defendants process approximately 300 to 350 crisis requests per year. It is likely that this downward trend is, in part, due to a large number of class members in the emergency and critical categories being selected from the waiting list for funding. As mentioned in the Transition Service Plan section above, the defendants have developed and are now implementing the Crisis Transition Plan and Funding Request form. Utilization of this form as prescribed appears to' have resulted in a more effective and uniform manner in processing crisis requests.

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Transition for Class Members on Waiting List
The Decree requires Class members described in ~2.b of the Decree will transition to community-based services. These class members are referred to in the Decree as "Waiting List Class Members.f Class members described in ~2.b and ~22 (a) and ~22 (b) will transition in accordance with the following schedule:
• Community-based services or placement in a community-based setting for 1,000 Waiting List class members will begin by June 15,2013.
• Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15,2014.
• Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15,2015.
• Community-based services or placement in a community-based setting for an additional -SOO Waiting List class members will begin by June 15, 2016.
• Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2017.
• Following June 15, 2017, Waiting List class members will receive community-based services or placement in a community-based setting at a reasonable pace.26
The Implementation Plan incorporates the criteria for prioritization for selection of class members who are on the waiting list to receive funding for community-based services or services in a community-based setting. Within each category, selections will be made based on the length of time on the waiting list database."

25 '22.(c) June 15, 2011 Consent Decree at Page 13. 26 '123.(c) June 15,2011 Consent Decree at Page 13. 27 Ligas Implementation Plan, 12/15/12, Section VII, Page 21

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As reported in the Class Member List section ·above, the PUNS list shows 14,110 individuals who qualify as Waiting List class members. In order to implement a systematic process for selections of class members to effectuate services for the initial 1,000 individuals by June 15,2013, the defendants engaged in several selection events. (Commonly referred to as "PUNS pulls") The first selection event identified 800 individuals believed to be class members and occurred in February 2012. After an initial screening process, 65 individuals were removed from this lis~ and 735 letters were sent to the class members and/or guardians and their respective PAS agencies indicating that funding for community-based services or services in a community-based setting would be available upon application. The second selection event occurred in June 2012, which identified an additional 626 individuals and, after initial screening 22 individuals were removed from the list, resulting in 604 application letters being sent to the class members and respective PAS agencies. A third selection event occurred in October 2012 and 1,500 individuals believed to be class members were selected. A fourth selection event occurred in September 2013 with 500 individuals selected and 27 names were removed for various reasons, resulting in 473 letters being sent . to class members and respective PAS agencies. In summary, 3579 letters have been sent to Ligas waiting list class members over the past 20 months. Each of the selection events have chosen people in accordance within the criteria for prioritization as listed in the Ligas Implementation Plan. The breakdown of the recent selection event is available on the DDD website: (http://www.dhs.state.il.us/page.aspx?item=67339)

The Monitors' First Annual Report identified numerous problems' with the integrity of the class member lists and the defendants' efforts to address these problems. Despite the serious concerns cited a year ago, the Monitor is pleased to report that the defendants have, to date, complied with this requirement of the Decree.

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As of September 1, 2013, the status of provision of services for those individual
 found eligible as waiting list class members is as follows:

• As of September 1,2012, services have been initiated for 1,356 class members.
• An additional 121 class members have received finding awards and services are about to begin soon.
• Packets for another 25 individuals have been completed to DHS for funding approval.
• 363 individuals are in the process of receiving Level II screening by PAS agencies and requests are being processed.
• Initial contact has been made with an additional 83 individuals whohave confirmed that they have requested services.
In summary, the defendants' hard work in this area, has resulted in outcomes that have far exceed the requirements of the Decree. The defendants are also well on the way to meeting or exceeding the requirements for the provision of services to waiting list class members of an additional 500 individuals by July 30, 2014 .
. The Monitors' First Annual Report expressed grave concerned about the likelihood that the defendants would achieve full compliance with this provision of the Decree. These concerns were followed by numerous recommended steps designed to better manage the PUNS data and infuse new resources into the process. These concerns and recommendations were heeded and resulted in deliberate actions that resulted in a changed climate of movement and productivity. The defendants are to be congratulated for their hard work in this area and for applying the necessary resources and assistance where they were needed.

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There are, however, some concerns with regard to the outcomes of these activities. The Ligas Implementation Plan calls for selection for funding to identify 50% of those selected to be served through the CILA out-of-home supports and 50% to be selected to receive home-based support services." Data provided by DDD for the first two years of service provision show that less than 20% of those selected are now being served through CILA supports and more than 80% are being served through the home-based supports program. This outcome is statistically significant enough to warrant Close and careful examination. It is not clear what has led to this irregularity with regard to expectations and results. Absent a detailed review, any reasons given for this would be mostly speculative. The Monitor recommends, therefore, that a review be conducted by the defendants, with support from the Monitor and input from class counsel, to determine the reasons for the number of class members who were selected for CILA who ,did not accept CILA supports and services.

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Outreach The Decree requires the defendants to maintain a fair and accessible process by which individuals or their guardians can affirmatively request services and maintain records of those requests.i"
The Implementation Plan outlines numerous activities designed to identify individuals throughout the state who are or will be in need of home and . community-based services and services in a community based setting. These activities include training and information sessions as well as the development and distribution of written materials to broad based audiences.
For potential class members living in ICFsIDD, the Plan provides a detailed description and requirements for the development of a contact to secure the services of an outside contractor(s) to contact all potential class members and determine and document an informed decision on whether they are requesting services in a community-based setting. 29
The defendants engaged in numerous activities to comply with the Outreach requirements of the Decree and activities described in the Ligas Implementation Plan. At the initial parties' meeting, it was agreed by the parties and memorialized by the Monitor that for those individuals who live in ICFIDD settings, they are considered a class member if they have completed a PASS Form 1238 or its predecessor, DHMDD Form1243, or DD PAS 10 form, or the Request form disseminated through plaintiffs' counsel, and checked the box that they choose Home and Community Based Services.

28 ~25 June IS, 20 II Consent Decree at Page 14 29 Ligas Implementation Plan, 2013 Revisions, December 15,20] 2

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The Defendants, and in many instances, in conjunction with the Monitor, engaged
in activities to inform stakeholders as well as the community at large about the
requirements of the Decree and how services can be sought and received by
qualified class members. Some of these activities include the following:
• DDD and the Monitor have continued conducting training activities for each of the 18 PAS agencies on the requirements of the Decree and Implementation Plan and, in particular, their role in facilitating choice for class members.
• DDD has developed and maintained a Ligas website that includes a full and downloadable description of the requirements of the Decree, updates on documents and activities related to the Decree and contact information for parties interested in more information. This website is updated on a regular basis. See: http://www.dhs.state.il.us/page.aspx?item=40989
• DDD maintains a consumer-friendly PAS agency locator function on the DDD website whereby families can locate their PAS agency by simply entering their county or zip code.
• DDD has also structured the 1-888-DDPLANS toll free number so that families can be directed to the Ligas inquiry staff support.
• DDD has established, widely publicized and maintained, a Ligas complaint contact within the Division who responsible to receive and memorialize inquiries, complaints and requests for information from class members, families other interested parties. This staff person also maintains a log of complaints and related follow-up activities.

With regard to outreach to persons living in ICFs/DD, the defendants, with input from representatives from class counsel, intervenors counsel and the Monitor, developed a Ligas Outreach Request for Proposals (RFP). This RFP was released to the public for solicitation on September 13,2012 and proposals were due to DHS no later than October 9,2012. This RFP was designed to secure the services of an independent contractor to maintain a fair and accessible process by which individuals with developmental disabilities or their legal guardians can affirmatively request in writing to receive community-based services or services in a community-based setting or continue to receive services in an ICF/DD.

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There were no responsive bids to this RFP. As a result, DHS identified a qualified contractor, the Council on Quality and Leadership, (CQL) to serve as the Outreach Contactor. Over the past six month, CQL eng~ged in numerous initial steps and activities to prepare for implementation of their outreach responsibilities. These steps include:
• CQL has identified and hired a project director to be the full-time manager of outreach operations;
• With input from the parties and intervenors, CL drafted a protocol and flowchart of outreach activities;
• With input from the parties and intervenors, CQL drafted telephone contact script to be used for outreach activities;
• Conducted a training and orientation to review outreach responsibilities and activities for ICF/DD providers. DDD, the Monitor, class counsel participated in the session. The intervenors participated by phone. This training and orientation was held in Springfield on June 26, 2013.
• CQL has hired all staff who will be responsible for scheduling interviews and interview class members and families. Resumes for these staff were provided to DDD and the Monitor.
• All staff attended a three-day training session from September 10, 2013 through September 13,2013 in Pontiac. DDD and the Monitor provided key elements ofthis training.
Contacts with potential class members will begin in October 2013. The contactor will begin by contacting potential class members and families from ICFIDD facilities from two distinct geographical areas within Illinois to includeone area in the suburban Chicago area and one in southern Illinois.
It is expected that outreach activities for potential class members living in ICFs/DD will transpire over the next three years. It will be important for CQL and
I
DDD to provide ongoing communications with the Monitor, parties and intervenors, regarding progress, outcomes and barriers to implementation.

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Implementation Plan
The Decree requires that the defendants finalize the Implementation Plan, with input from the parties and intervenors" The Implementation Plan must be filed with the Court by December 15,2011. The Implementation Plan shall be updated . and amended at least annually."

The original Ligas Implementation Plan was negotiated by the parties and intervenors and filed with the Court by the defendants on December 15, 2011. There was joint agreement by all parties, the Intervenors and the Monitor on the initial Implementation Plan. This Plan was approved by the Court and ordered as a supplement to the Decree on February 15,2012. Subsequently, DDD provided .updates and proposed revisions to the Implementation Plan and provided a draft to the parties and intervenors. These revisions were negotiated and submitted to the Court without objection on February 22,2013. At a brief hearing on March 5, 2013, the Court approved the revised Implementation Plan.
The defendants have utilized the Ligas Implementation Plan as their blueprint for activities designed to comply with the Decree. At each scheduled parties' meeting, the defendants provide a verbal update of Plan activities and respond to questions from class counsel and counsel for the intervenors. There have also been significant inquiries from key stakeholders and members of the public at large about implementation activities.

The Monitor recommends that the defendants resubmit a proposed amended Ligas Implementation Plan with necessary revisions prior to the scheduled parties meeting in January 2014 for review and input. Following the input from the parties, intervenors and the Monitor, the defendants should file the updated plan to the Court, as required in the Decree.
30 ~27 June 15, 2011 Consent Decree at Page 15.
 31 '128 June 15, 2011 Consent Decree at Page 15


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Data Reports
The Decree requires the defendants to provide the Monitor, Plaintiffs, Class counsel', Intervenors and Intervenors' Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants' compliance with the Decree and Defendants' progress towards achieving compliance.f Not less than every six months, .defendants shall provide data reports to the Monitor, class counsel and intervenors.
Implementation Plan Activities - The Implementation Plan calls for the submission of data reports. The defendants have provided Data Reports to the parties, intervenors and Monitor on August 20, 2012, February 15,2013 and August 15,2013. The Data Reports include class member data regarding the class member list(s), services to class members in ICFs/DD, services to class members from the Waiting List, ICF/DD resident outreach, transition service plans, crisis services, voluntary ICF/DD closure and downsizing agreements, eligibility appeals and the Ligas budget. The Monitor finds the form and format for class member data to be useful and acceptable. It will be increasingly important, however, to ensure that data with
,
regarding budget expenditures and shortfalls, if any, are updated on a regular basis.

32, 33 of June 15,2011 Consent Decree at page 18.

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Services for Named Plaintiffs The Decree requires the defendants within sixty days to offer each of the Named Plaintiffs the opportunity to receive appropriate community-based services or services in a community-based setting."
The defendants have complied with this requirement of the Decree. All five named plaintiffs were offered services in community based settings and have successfully transitioned to their new homes or received home-based services funded through the Illinois home and community-based waiver.

Ligas Class Member/Family Advisory Committee
The Implementation Plan calls for the establishment of the Ligas Class Member/Family Advisory Committee." This Committee has now been established and conducted its first organizational meeting on June 27, 2013. Minutes of the meeting have been completed and the committee is scheduled to meet again in Chicago on October 8, 2013

Dispute Resolution
The Decree clarifies the rights of class members to appeal or seek administrative or judicial review pursuant to governing law through the existing fair hearing process. Class members may also avail themselves of any informal appeal process that currently exists."
The Monitor reviewed the appeal data with the defendants in April 2012 and identified a number of problems with the appeal process. Scheduling of appeals hearings and obtaining written hearing determinations were taking an inordinately

33 ~3 7 June 15, 2011 Consent Decree at Page 21 34 Ligas Implementation Plas, Revised 2013, at Page 12
35 '124 June 15, 2011 Consent Decree at Page 14

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long time, in some instances, as much as six months to a year. The appeals application process was often confusing to individuals and families and some families reported that they were not aware of their appeal rights.
As a result of these problems, the defendants, with input from class counsel, developed and have implementing an appeals corrective action plan that includes . the following activities and tasks:

• HFS has hired an additional three' new Administrative Law Judges as hearing officers and one additional attorney to support the hearingprocess,
• The newly hired ALl's, at the request of HFS, conducted site visits to several Cll.A settings to better understand community-based services for people with developmental disabilities.
• The application process was streamlined so that appeals come directly to DDD rather than the additional pass through with HFS.
• A draft to include modifications of the appeals rights form is being
 finalized.

• Appeals unit staff have been instructed in writing to give top priority to crisis appeals.
• Appeals unit staff are being trained to expedite informal appeals.
• An internal checklist has been drafted to provide effective and ongoing tracking of appeals.
• PA~ agencies are being re-trained on preparing complete appeal requests.
• Weekly internal management reports will be generated to ensure internal reviewsare scheduled on a timely basis.
• Management reports will be incorporated into the Ligas data reports.
. From a general review of the appeals data, it appears that the appeal process has '
improved somewhat, particularly in conducting hearings within a reasonable

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timeframe. The Monitor, however, has not yet conducted a comprehensive review of the appeals data and process with the defendants. This will occur over the next six months. The Monitor will then provide the parties with findings and recommendations for improvement.
Section 5 - Overall Comments
Over the first two years of implementation of the Ligas Decree, the Monitor has watched gradual, yet constant growth in the defendants' capacity to achieve compliance and support class members and their families to the best of their ability. The defendants' effort is unquestionably-strong and evident. The results of these efforts are now coming to fruition. Since June 15,2011, services have been provided for more than 2,200 class members, including ICF/DD class members, waiting list class members and those in crisis. A year ago, the Monitor expressed much vexation and doubt noting the many difficulties and challenges facing compliance. Through the diligent work of the defendants, with full cooperation from class counsel and the intervenors, much has been accomplished.
r
The Monitor will continue to work diligently with the parties and intervenors until substantial compliance with all of the requirements becomes a reality.

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 Case: 1:05-cv-04331 Document #: 583 Filed: 10/01/14 Page 1 of 49 PageID #:11387

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al.,

)

)

Plaintiffs,

)

vs.

)

) No. 05 C 4331

JULIE HAMOS , in her official capacity as )

Director of the Illinois Department of

)

Judge Holderman

Healthcare and Family Services, et al. ,

)

)

Defendants.

)

)

THIRD ANNUAL REPORT OF THE MONITOR

Case: 1:05-cv-04331 Document #: 583 Filed: 10/01/14 Page 2 of 49 PageID #:11388

STANLEY LIGAS, et al. v. JULIE HAMOS, et al.

Third Annual Report of the Monitor

September 30, 20 14

Submitted by:

Tony Records, Monitor 51 Taormina Lane Ojai, CA 93023 301-529-9510 traconsult@mindspring.com

Section 1 -Introduction This report is respectfully submitted to the Court, the Parties and the Intervenors in accordance with the Ligas Consent Decree (Decree) approved and filed by the Court on June 15, 2011. Specifically, the Decree requires that:
The Monitor shall file annual reports to the Court, which shall be served on all Parties and Intervenors and be made publicly available. Such reports shall include the information necessary, in the Monitor's professional judgment, for the Court, Plaintiffs and Intervenors to evaluate Defendants' compliance or non-compliance with the terms of the Decree. 1
The Monitor's First Annual Report was submitted to the Court and the parties on September 27, 2012, and the Monitor's Second Annual Report was submitted on September 30, 2013. This third report addresses those activities that took place in the past year. The Monitor has engaged in numerous activities consistent with Section XIV (Monitoring and Compliance) of the Decree. There have been sixteen parties' meetings since the approval of the Decree. During each of these meetings, the Monitor has given a verbal report of progress and concerns
1 Co nsent Decree, Section XIV, ,134 , at Page 19.

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regarding compliance as well as a review of activities. The Monitor has also met with and talked to counsel and representatives of the parties and intervenors separately on an ongoing basis. No prior drafts of this report or any part of this report have been submitted to the parties, intervenors or anyone else. This report was delivered by email to the parties and intervenors on October I, 2014.

This report is organized in five sections. Following the introduction is a section describing the activities of the Monitor during the past year and anticipated activities for the next year. This is followed by a brief and general description of actions taken by the Defendants during this period . The next section is the primary section, which includes a sequential description of activities and findings listed in order of requirements of the Decree and as listed in the established Compliance Standards developed by the Monitor in accordance with the Decree. 2 Finally, the Monitor has included some brief overall comments designed to communicate a broad description of progress and successes thus far, as well as anticipated possible roadblocks to compliance in the future.

This report includes no finding of noncompliance. There are, however, severa l concerns identified, which, if not effectively addressed, could result in noncompliance. There are also four specific recommendations incorporated in this report which will be discussed by the pa11ies at the next scheduled parties' meeting on November 21, 2014. The Monitor is not requesting the Court to take any action on these matters at this time.

There is another instance during this reporting period when it was necessary for the Monitor work with the parties to resolve an issue of compliance . This issue is regarding the reimbursement rates for ICFs/DD. In this instance, the intervenors invoked a claim of non-compliance pursuant to Paragraph 35 of the Decree . On
2 Consent Decree , Section XIV , p2. at pages 17 and 18.

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August I, 2014, the Monitor issued a special report that did not find noncompliance with the Decree. This issue has yet to be fully resolved. (See Section 4, Resources and Capacity, for further details.) There are no findings of noncompliance in this report.

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Section 2 - Activities of the Monitor
The Monitor was appointed by the Court on July 19, 20 II and began monitoring activities on August 3, 20 II. Activities of the Monitor during the first and second year of implementation are fully described in the First and Second Annual Reports filed with the Court. During the past year, the Monitor has continued to engage in numerous activities designed to initiate and encourage necessary compliancerelated actions, assist the Defendants in the implementation of the Consent Decree requirements, facilitate communication between the parties, inform the class members , families and members of the general public about the requirements of the Decree as well as evaluate overall compliance.
It is important to state once again that the Monitor has continued to receive full cooperation and support from the Defendants, including the Department of Human Services, Department of Healthcare and Family Services, the Governor's Office, the Attorney General ' s office and, in particular, the management team and staff at the Division of' Developmental Disabilities (ODD). DOD has provided the Monitor with continuous and unfettered access to program staff, class members, class member records and other requested information and documents. Plaintiffs' counsel and representatives as well as counsel for the Intervenors have also been readily avai !able and responsive to the Monitor whenever called upon. In all of the parties' meetings, discussions have been productive and on point toward the goal of compliance with the Decree.
The Monitor has also experienced full cooperation and support from the community service providers, ICF/DD facility staff, advocacy organizations and family associations throughout the state of Illinois through the provision of information , facilitation of meetings and direct input on issues relating to compliance activities.

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Class members, as well as their guardians and families have also been forthcoming
and responsive to the Monitor and continuously expressed a willingness to
participate in activities and share their experiences in order to assist the Monitor in
evaluating compliance.
Activities of the Monitor over the past year include the foJlowing:
../ The Monitor continued to hold separate meetings and phone calls with all counsel to discuss expectations and obtain various perspectives on challenges pertaining to compliance activities .
../ The Monitor has facilitated each of the parties' meetings as well as special single issue meetings and conference calls. Quarterly meetings during this reporting period were held on October 9, 2013, January 9, 2014, May I, 2014 and August 26, 2014. The next parties' meeting is scheduled for November 21,2014. These parties' meetings are scheduled routinely, at least each quarter, in order to maintain a regular line of communication among the parties and to document progress and concerns on a timely basis. To increase efficiency and productivity, these meetings have been bifurcated to include full participation of the parties and intervenors for discussion and input relating to paragraphs 4-10, 25 and 45 of the Decree and class counsel and defendants' participation with regard to the discussion of the remaining provisions of the Decree.
../ Continuous meetings, emails and phone calls have been conducted with key staff at DOD and DHS who have specific responsibilities relating to implementation of compliance related activities. The Associate Director of DOD has been the key liaison with the Monitor in facilitating meetings, document production and development and coordination of compliance activities .
../ The Monitor has continued to devote a significant amount of time and effort to continue to provide information sessions, listening sessions and "town hall" meetings across the state to class members, potential class members, families, guardians, community service providers, advocacy organizations, ICF/DD providers, PAS agencies and other stakeholders. These sessions provided an overview of the Decree and Implementation Plan as well as an update of compliance activities and ways stakeholders can play a vital role in providing information and feedback on Ligas related issues. Audiences of more than 40 of these information and listening

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sessions over the past three years have included more than 4,600 participants .
../ Regularly scheduled meetings are held with the DDD Director to review progress and challenges related to implementation activities designed to develop strategies to address current issues . The Monitor has also had several meetings with the DHS Secretary to provide an update of activities and any concerns about overall compliance.
../ The Monitor has also met on a quarterly basis with the Governor's office to provide an overvie\V of activities and discuss any overall compliance concerns .
../ The Monitor has reviewed hundreds of documents provided by the defendants , class counsel, service providers, PAS agencies, advocacy organizations and families that have provided significant information, insight and perspective to compliance activities and challenges .
../ The Monitor has reviewed all information on the defendants' various websites relevant to compliance activities and policies that relate to the Decree. The Monitor has worked directly with DOD staff to review and modify information on the Ligas page or the DDD website.
../ The Monitor has provided his telephone and email contact information widely across the state in order to hear directly from class members, families, guardians, service providers and PAS agencies about questions and concerns relative to implementation of compliance related activities. As a result, there have been scores of inquiries and concerns received which require specific follow-up and clarification with the defendants. This process has helped clarify many policy questions that have emanated as result of new compliance activities .
../ The Monitor participates in monthly scheduled conference calls with class counsel and the defendants to discuss individual class member issues and concerns. These calls have been quite helpful in resolving individual issues and have also been informative in identifying systemic issues and policies that may affect compliance with the Decree.
../ The Monitor also patticipates in meetings of the Ligas Class Member/Family Advisory Group that has been formed for the parties to hear directly from class members and their families regarding their experiences as members of the Ligas class.

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Section 3 - Overall Activities of the Defendants
During year three of implementation of the Decree, the defendants have continued to work steadfastly on the specific actions described in the Ligas Implementation Plan as well as issues articulated in the Monitor's Second Annual Report . A number of new activities are also now underway which are designed to ensure compliance with the Decree. Resources for implementation, however, are significantly strained, as the Governor's budget, calling for expanded funding to address the continued growth in community services and supports was rejected by the legislature.
Some of these activities over the past year by the defendants include the following:
./ The defendants have once again exceeded their requirements to initiate services for class members who are on the waiting list and class members in ICFs!OD. As of September I, 2014, 1,969 class members who live at home have initiated services and 741 additional class members living in ICFs!OD have moved. Additionally, 397 class members were served over the past year who were found to be in crisis. These accomplishments should not be understated .
./ Implementation of the Ligas Service Transition Plans (LSTP) for class members who move is now fully underway. The defendants have retained a consultant to assist in the development of quality assurance mechanisms to review transition plans in the future .
./ The Outreach contractor made ongoing progress toward contacting potential class members to provide information on possible service options as called for in the Decree and the Implementation Plan .
./ There has been continuous "clean-up" activity with regard to the Prioritization of Urgency of Need for Services (PUNS) waiting list of class members in order to provide increased accuracy and credibility in the selection processes for class members on the Iist.

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../ The speed of responsiveness in which the provision of crisis services for Ligas class members has continued to improve through the implementation of the defendants' corrective action plan .
../ The defendants have continued ongoing reviews with each of the eighteen Pre-Admission Screening (PAS) agencies to evaluate movement of class member activities from the PUNS list as well as transition of class members from ICFs/DD to community-based settings .
../ The defendants have instituted policy changes to eliminate some prescreening procedures for class members leaving ICFs/DD, thereby streamlining the overall process by weeks.
There are also a number of encumbrances that have continued to interfere with implementation activities and, thereby, threaten substantial compliance . Some of
these encumbrances include the following:

../ As mentioned above, the Governor's budget request for increased funding to meet the growing demand due to implementation of Ligas compliance activities was rejected by the legislature. If these budget shortfalls are not soon addressed, there is little likelihood that compliance with all of the requirements can be assured .
../ Opportunities for employment and a path to employment for class members continue to be extremely limited. Initial analyses of Transition Plans for class members revealed that real employment is not even discussed as an option for the majority of class members.
../ Despite efforts by the defendants , as identified in the Monitor's First and Second Annual Reports, reimbursement rates of funding for communitybased settings remain among the lowest in the country. These low rates continue to contribute to limited options for class members entering serv1ces .
../ Many class members who were selected for funding for a Community Integrated Living Arrangement (CILA) chose home based services and some cited the lack of flexibility in the CILA program as the reason for this selection.
The issues listed above and more will be discussed in detail in the body of this report.

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Section 4- Compliance Requirements and Activities
This section provides a specific review of the compliance requirements in each of the nine major areas of compliance, which include the following:
1. Resources and Capacity 2. Class Member List(s) 3. Transition Service Plans 4. Transition for Class Members in ICFs/DD 5. Crisis Services 6. Transition for Class Members on Waiting List 7. Outreach 8. Implementation Plan 9. Data Reports 10. Dispute Resolution
Each area of compliance is listed below in a separate section that includes: a description of the requirements in the Consent Decree; timeframes or deadlines for compliance; related activities described in the Implementation Plan and; the status of implementation of compliance activities by the defendants. In accordance with this provision, this section is considered by the Monitor as the primary measure of compliance with the Decree. For some of the requirements, the deadlines for implementation of the specific timeframes may not have yet transpired. In these instances, the Monitor will report on activities that have occurred so far and, where appropriate, the likelihood that these actions will lead to timely compliance.
This section also includes comments about the activities of the Ligas Class Member and Family Advisory Committee, which was established during the second year of implementation.

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Resources and Capacity The Decree requires resources for community services to be provided consistent with the choice of a class member and the requirements of paragraphs 17 through 19, and 21 through 23 of the Decree. Resources necessary to meet the needs of individuals with developmental disabilities who choose to receive services in ICFs!DD shall be made available and such resources will not be affected by Defendants' fulfillment of their obligations under the Decree. Funding for services for individuals with developmental disabilities will be based on the individual's needs using federally approved objective criteria regardless of whether the individual chooses to receive services in an ICF!DD or in a community-based setting. Amendments to the state Medicaid plan will continue to include ICF!DD services as an alternative choice for long term services. 3 Annual budgets will be sufficient to fund the services necessary to comply with the Decree consistent with the choices of individuals with developmental disabilities, including class members.4
The Implementation Plan calls for a continuation of activities to develop new community services providers and the voluntary conversion of ICFs/ 00 to community-based services. 5 The Implementation Plan also calls for the development of annual budget proposals to incorporate the necessary resources to carry out the provisions of the Decree. The Plan also includes resources for a listing of specific contractual agreements necessary to address the anticipated increase in demand for services, additional DOD staff to be hired in order to manage compliance and prepare compliance-related reports and funding for direct services for class members as they are identified to receive community services. 6

J ~14 of June 15, 20 I I Consent Decree at page 7
• ~1 5 of June 15. 20 II Consent Decree at pages 7and 8.
5 Ligas Implementation Plan, 3/25 / 14, Section IV , Page 13. 6 Ligas Implementation Plan, 3/25114, Section X. Page 26-27.

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In order to comply with the provisions of the Decree regarding resources, the
defendants engaged in numerous activities. These activities include the following :
• A Ligas proposed budget was developed by the Governor for Fiscal Year 2015. This budget calls for the increase of $26.6 million in new funds for full implementation of Ligas activities. The Governor ' s proposed FY 15 budget overall for ODD was $1 ,641 ,662 ,300. This included the increases necessary to annualize funding for services and supports that began in FY2014 as well as $30 million in new funds for long-needed increases in salaries for direct-support staff in community-based services and ICF/DD services.
The Governors' proposed FY 15 budget was rejected by the legislature who, instead, approved a budget for DOD for $1,556,421,600. This amount represents a " flat-line" budget of no increase whatsoever and an enormous shortfall of $82.4 million less than requested. This amount is clearly inadequate and, if not addressed through the supplemental budget process later this fiscal year, could seriously jeopardize the gains in resources made over the past two years.

• The defendants ' data reports also indicate that spending for ICF/00 services has remained relatively constant, with an FY 2015 budget projection of $252 million. Although this amount is slightly lower than FY 2014, there are clear trends and projections for fewer individuals to be served in ICF/DD facilities . The chart below illustrates the ICF/00 budget activity over the past four years.

Fiscal Vear
FY2011 FY2012 FY2013 FY2014 FY2015*
*ProJected

ICF/DD Census
6,427 6,414 6,074 5,608 5,550

Budget (In Millions) $392.8 $3 81.1 $372.4 $356.3 $352.0

Per Person Annual Budget
$60,993 $59 ,417 $61 ,311 $63,810 $63 ,423

Regarding the expenditures of ICF/00 services, the intervenors invoked a notice of non-compliance relating to funding for ICF/DD services on January 7, 2014. After unsuccessful attempts by the parties and the

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Monitor to resolve this issue informally, the Monitor issued a Special Report on August I, 2014. While the Monitor did not find the defendants out of compliance with the Decree in this Report, there have been and remain to be serious concerns about the rates and rate structure for ICFIDD services as well as home and community-based services.
• The Ligas Implementation Team has been fully funded and is in place. Positions for this team includes the following: o Compliance Coordinator (I position) o Program and Data Support Staff (I position) o Bureau of Quality Management Staff (7 positions) o Bureau of Transition Services Staff (4 positions) o Appeals Unit Staff (I position) o Rates Section Staff (I position) o Medicaid Waiver Staff (3 positions)
In the Monitor's Second Annual Report, 17 of these 18 positions had been filled . At this juncture, all 18 positions have now been secured and their responsibilities are being fulfilled.
The Ligas budget also calls for contractual agreements as specified in the Implementation Plan. Specific allocations for contractual services include the following:
../ Outreach activities . Funds for the independent outreach contractor and related costs .
../ Increased funding for PAS agencies to include: o Increased eligibility determinations o Development of Ligas Service Transition Plans o Increased PUNS enrollment activity o New ISSA Services

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./ An independent contractor has been hired to provide training and technical assistance to PAS agencies in the development of Ligas Service Transition Plans. This contractor has already made a significant contribution to transition plan compliance requirements. (see section on Transition Planning)
./ An independent Illinois entity has been contracted to provide family support and advocacy to waiting list class members and their families on a statewide basis. The Ligas Family Advocacy program (LFA) is now fully operational and staffed. Families of class members have already started to indicate their pleasure and satisfaction with the services that the LFA program provides.
./ For class members in ICF/DD setting and for those class members in Community Integrated Living Arrangement (CILA) settings, there has been an increase in the monthly Personal Needs Allowance (PNA). Effective September I, 2014 the monthly allocation for PNA will be increased to $60. This represents a I 00% increase for those living in ICF/DD settings, and 20% increase for those living in CILA settings.
In January 2014, the Federal Rules (1915[c]) regarding home and communitybased waiver settings were modified. Timeframes were established the US Commission on Medicare and Medicaid (CMS) whereby states could develop a transition plan to comply with the new rules. These rules contain new definitions of settings as well as provisions for assurances of services being provided in the most integrated setting. The rules also include new requirements for personcentered planning for individuals in home and community-based settings. Illinois chose to submit its transition plan, after seeking broad stakeholder input, by March of 2015. The Monitor, in conjunction with the parties, should follow this transition plan process closely as implementation of these new rules will have significant impact on Ligas class members.

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Concerns Regarding Resources The actions above illustrate a clear commitment by the defendants to allocate significant resources to implement the necessary activities to comply with the Decree. There are still some key areas, however, which will require direct attention and, in some instances, additional resources, as defined below. Despite the modest enhancements to the reimbursement rates for community services cited in the Monitor's First Annual Report, the overall rates for community services remain among the lowest in the country. There have been no cost-of-Jiving increases in community-based services' rates for more than 7 years.
Community services' providers have continued to report to the Monitor that they would be willing to expand community services, especially small CILA settings, if the rates were realistic and commensurate with actual costs for providing services in smaller, often more desirable settings. As a result, the significant majority of community-based settings developed have been large 7-8 person settings, very often not the choice of the class members, and certainly not consistent with best practices. Rates for supported employment services are also comparatively low, resulting in no available employment services in many parts of the state. It will be important for Illinois to move forward and establish a rate structure that promotes community flexibility, individual choice and fully integrated activities. Efforts to move forward to adjust rates for community services have not been productive. As reported above, there are also serious concerns about the rates and rate structure for ICF/DD services. In their written submissions on this issue, the intervenors made a solid and credible argument that these rates are problematic. There has been no cost-of-living increases for ICF/DD services since 2008.

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The degree of anxiety over the rates and rate structure has continued to escalate during the three years of implementation. The time has come to obtain clarity and direction on the issue of rates for services in Illinois.

Recommendation #1 -By March 31, 2015, the defendants, with input from the parties, intervenors and Monitor, should develop contractual parameters and identify an independent contractor to analyze and evaluate the rates and rate structure for home and community-based services and supports as well as rates for ICF!DD services. Once this contractor is identified, a report should be submitted with a full analysis and recommendations by September 30, 2015.

Another issue with regard to resources that warrants immediate attention is the need for additional support within DHS, and, in particular, DOD to implement key activities related to the Decree. The lack of an employment coordinator significantly reduces the likelihood of successful implementation of employment services' initiatives. The lack of an assigned Medicaid waiver manager makes it nearly impossible for DDD to continuously evaluate the effectiveness and flexibility of the waiver, and fashion policy recommendations for change. There is a lso the absence of a management position to oversee and communicate with the 18 independent PAS/ISSA agencies responsible for screening, eva luation, transition planning and service coordination for Ligas class members. Due to the success of Ligas activities, the number of people supported by ODD is increasing rapidly. Since the approval of the Decree, it is estimated that the number of people served by the home and community-based waiver will increase by more than 20% over the next few years. The many tasks needed to keep up with this expansion have been placed on the shoulders of the current ODD staff structure. The time is now overdue to develop a management structure to respond to the rapid growth due to implementation of Ligas activities .

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Recommendation #2- The defendants should establish the following new positions within DDD:
I. DDD Director of Employment. It has been stated repeatedly by the Monitor and other entities that the opportunity for employment for class members is not being considered during the transition planning process, or not being offered, or simply not available in certain regions of the state. This situation will not change without direct staff management responsibilities assigned to oversee an outcome-based plan to increase employment opportunities for class members.
2. DDD Director of Waiver Services. As stated in this report and previous reports, the number of class members served through the home and community-based waivers has expanded exponentially. As the new waiver rules are more numerous and complex, CMS oversight has become more vigorous and the waiver operational modifications are in the state of continuous change, specific management support is sorely needed.
3. DDD Director of Service Coordination- As stated above, the 18 service coordination agencies require management oversight, technical assistance, guidance and policy direction in order to maintain services, waiting list responsibilities and facilitation of class member choice. The agencies are the lynchpin of implementation of Ligas activities.

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Class Member List(s)

The Decree requires the defendants to maintain a statewide database in which all Class Members are enrolled. 7 Defendants are also required to promptly revise the class member database and waiting list data. 8
The Implementation Plan describes the process for the development and maintenance of a class member list that will be accessible to the Monitor and Class Counsel. Intervenors' counsel will have access to the class list as provided in the Implementation Plan. DOD will use its PUNS database to maintain a list of Waiting List class members. The Plan also calls for DOD to review the adequacy of the PUNS database.
Upon recommendation by the Monitor and agreement of the parties and intervenors, the defendants have developed and maintained two class member lists.
There is now a list of class members pursuant to ~2 (a) of the Decree, who: qualify for Medicaid Waiver services; live in an ICF/DD with nine or more residents and; have affirmatively requested community-based services or placement in a community-based setting. As of September 23, 2014 there were 1,217 class members in this category. The defendants maintain a list that contains, at a minimum: the names of individuals; the documentation to verify their written affirmative request; date of birth; social security number and; the name of the facility in which they live.
Since the Monitor's First Annual Report, the accuracy and veracity of this list has improved significantly. The most recent list has been reviewed andre-reviewed and appears to be consistent with the requirements. A senior staff member within

7 ,18 June 15, 20 II Consent Decree at Page 8. 8 ~9 June 15, 20 II Consent Decree at Page 9.

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DDD has been assigned to maintain this list and inform the Monitor of particular updates and concerns. A monthly review and update of ICF/DD class member list is conducted with PAS agencies. This monthly review entails checking for sufficient documentation, inquiring about the status of community transition of class members, verifying that transition plans are being developed, where appropriate and identifying any problems that may interfere with community transition.

There is also a list of class members pursuant to ~2 (b) of the Decree who: qualify for Medicaid Waiver services; live in a family home and; are in need of and have affirmatively requested home and community-based services or services in a community-based setting. These individuals are known as Waiting List Class Members. As of September 23, 2013, there were 15,190 class members in this category. This list is also maintained as a subset of the overall waiting list (Commonly known as the PUNS list) for services.

As reported in the Monitor's First Annual Report, development and refinement of this list has also proven to be quite challenging. Utilization of this initial list revealed that much of the class member information was outdated and/or inaccurate. A large number of addresses were incorrect and some individuals had moved out of state. Contact information was often inaccurate or outdated. Some individuals on the initial list are now deceased. In more than 400 other instances, after individuals were contacted, it was determined that they no longer needed or wanted home and community-based services or services in a community-based setting.
DDD took immediate and deliberate actions to address these problems. The PAS agencies have the primary responsibility to update the information on the waiting

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list. Communications were sent to each PAS agency with clear instructions on updating data on the waiting list and reminding them of their responsibility regarding individual updates. DOD assigned a key staff member as well as an additional professional staff member to maintain and update this list as a high priority. These two staff are and have been in constant communications with PAS agency representatives to correct inaccurate data and update waiting list information. The Monitor has worked closely with DOD to ensure that the waiting list of class members is updated . This list has grown by more than 2,000 class members over the past two years . This is due, in part, to a number of individuals "aging in" to the class by virtue of turning 18 years old. In other instances, families have requested that their loved one be added to the waiting list because of the renewed hope that implementation of the Ligas Decree has engendered.
This past year, a number of additional steps were taken to improve the veracity of the PUNS list. DOD established an automated process to add new class members from PUNS who become eligible due to age or other new adults on the list. There is also an ongoing process to remove individuals from the class list if they are no longer eligible for a valid reason such as moving out of state, ineligible for M edicaid, etc. There is also a PUNS workgroup that has recommended a proposal to facilitate annual updates to the PUNS record system. DHS has requested resources through the Balancing Incentive Program (BIP) funds to disperse to PAS agencies as one-time awards for additional resources to assist with the backlog of overdue PUNS updates. DOD is waiting for confirmation of utilization of these funds from CMS.

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As an overall note, and as reported in the Monitor's first two reports, the problems identified in the class member lists' issue are also symptomatic of a more endemic issue within DDD- the lack of a comprehensive integrated data system. It has become increasingly important for DHS to address this issue and develop a plan to address the overall need for a data system that is responsive and consistent with the ever-growing challenges within DDD and DHS. The Monitor recognizes that development of a comprehensive data system will require a significant initial investment of resources. The outcome of such an endeavor, however, would help ensure effectively coordinated services for Ligas class members and others.

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Transition Service Plans
The Decree requires the defendants to develop transition plans for all class members who are selected to be served pursuant to the Decree. Transition plans shall describe all services required, how they will be developed and obtained, and a timetable for transition.9 Transition plans will be developed by a Qualified Professional in conjunction with the class member, guardian and others, as appropn0ate. 10
The process for transition planning will include the class member's personal vision, preferences, strengths, and needs in home, community and work and shall reflect the value of supporting relationships, productive work, participation in community life and personal decision making. 11 Services and supports will be integrated into the community and consistent with choices of class members and guardians. Transition plans shall not be limited by the cunent availability of services but be within the confines of the waiver and State Plan . 12 Transition plans for class members who are determined to be in crisis will be developed. 13
The Implementation Plan called for a phase-in process for the completion of a transition service plan for each class member seeking services in a communitybased setting. The Plan outlines an 18-month long process that included a pilot trial period, re-evaluation and state-wide implementation by July 1, 2013. This process ensured coordination required between PAS/ISC agencies and class members. 14

9 ~ II June 15 , 20 I I Consent Decree at Page 9. 10 ~1 12 June 15, 20 II Consent Decree at Page 9. 11 13 June 15.20 11 Consent Decree at Page 9 & 10.
I·' ~ 14 June 15 . 20 I I Consent Decree at Page I 0.
13 ~; 21.(b) June 15, 2011 Consent Decree at Page 12. 14 Ligas Implementation Plan , 2014 Revision s, 3/25114 Section VI, Page 18-20

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With regard to the transition planning process for class members in crisis, DOD designed modifications to the existing Crisis Funding Request and developed the Crisis Transition Plan and Funding Request. This form and format, along with detailed instructions, were posted on the DOD website and disseminated to all PAS agencies for input. These documents were finalized and were required to be utilized by all PAS agencies statewide beginning September 14, 2012 . Since this crisis transition planning form is a relatively minor adaptation to an existing form, a pilot process was not considered necessary.

The Monitor is generally pleased with the progress the defendants have made toward the development and operationalizing of a Transition Service Plan. Finally, it can now be assured that every class member that moves has a transition plan in place. Converting a system from virtually no transition service planning to a person-centered approach as required in the Decree necessitates a carefully planned and deliberate process that will continue to take time to evolve. As these Ligas Transition Service Plans are evaluated by DDD, the Consultant and the Monitor, needed modifications will be completed and training and technical assistance, as necessary, will be implemented.

A key component of this process has been the training of PAS agencies and others on effective person-centered planning. The 2014 Ligas Implementation Plan called for a consultant to be identified to work with the DOD Bureau of Transition Services to review transition plans and train PAS agencies and providers on their development. 15 This consultant, Dr. Mark Friedman, was hired in August 2013 and has now completed a year of work .

15 Ligas lmplemenlalion Plan.201 3 Revisions. Section X, at page 24

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For the past year, Dr. Friedman has worked closely with DDD staff, the Monitor and all 18 PAS agencies to improve the quality and effectiveness of Ligas Transition Service Plans (TSP). Dr. Friedman recently (9/25114) submitted a report to DDD on the status of the quality of the transition plans. Highlights of Dr. Friedman's report include the following:
• Two rounds of training were conducted that included all PAS agencies that had developed TSPs during 2013. This training included hands-on consultation using real examples of TSPs to identify strengths and deficiencies.
• A comprehensive review of 114 TSPs was conducted utilizing a method of evaluation and checklist that was reviewed by the Monitor and DDD management staff. As a result, a proficiency profile was developed for each PAS agency, including a score for each element of measurement.
• Overall findings by Dr. Friedman revealed the following:
o The most serious deficiency was the low scoring in the level of participation of the class member in transition planning. In only 47% of the plans reviewed, was there evidence that the class member was present in the transition planning.
o Employment opportunities were not being offered or considered in most TSPs.
o Class members with a high level of behavior or medical needs were often unable to obtain CILA service due to lack of available providers willing or able to provide these services.
o TSPs were not being effectively utilized as the foundation for the development of the ISP following placement.
o Choices of activities and services were often limited due to unresolved barriers in certain regions of the state.
o Review of TSPs showed marked improvement over the period of a year.
o Revisions to the TSP were necessary to address some of the noted deficiencies.

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To address the deficiencies in his report, Dr. Friedman also offered a number of recommendations, some of which include the following:
• Finalize and disseminate revisions to the TSP Form and Instructions. • Develop tracking method of class members with a TSP who have not
obtained services due to unsolved barriers. • Provide training to class members on how to effectively participate in the
TSP process, • Continue technical assistance and training to PAS/ISC agencies, focusing
on those agencies with the lowest proficiency scores. • Finalize the process for the DDD Bureau of Transition Services to review
TSPs. • Hire a DDD Director of Employment. Create an employment workgroup
within DDD. Provide training for day services and residential providers on employment. • Provide more opportunities for less than 24-hour CILA services.
As part of Dr. Friedman's contract, he also coordinated several training seminars and webinars on employment opportunities for class members. A nationally acclaimed employment expert was identified and retained to conduct these training seminars. These training opportunities were specifically targeted to PAS/ICS agencies and community service providers. Four more employment training opportunities are also scheduled over the next several months in various regions of the state, as well as webinar opportunities for those who choose to participate on-line.
The Monitor will review Dr. Friedman's report with the parties at the next scheduled parties' meeting to discuss his findings and recommendations and next steps to be take.

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Follow-up on Specific Compliance Finding with Regard to Transition Planning The Monitor's Second Annual Report issued a finding of non-compliance with regard to the lack of transition planning for those class members previously living at St. Mary's Square ICF/DO. As a consequence, the Monitor recommended that DHS, in conjunction with the Monitor, conduct a full investigation of this matter and develop a report with findings and recommendations. The defendants accepted this finding and ODD conducted a full review of each class member who moved from St. Mary's Square, with the primary focus on the assurance of the development of a retroactive Modified Ligas Transition Service Plan. A schedule of the development of these plans was coordinated with the responsible PAS/ISSA agency and class members. Guardians were also invited to participate in the process. Within six months, all Modified TSPs were completed for all class members who had moved. As a result of this experience DOD will, in the future, involve the PAS/ISSA agency earlier in the process of a ICF/DO voluntary downsizing or closure plan to ensure that true options of services are presented. Once the options are presented, the class member and/or guardian will have the full opportunity to examine these options in order to make an informed decision. In the past year, the Monitor, in conjunction with DDD staff have also met with several PASIISSA agencies who are in the process of facilitating transition plans for class members who are involved in an ICF/DD voluntary downsizing or closure initiative. The Monitor will continue to carefully review downsizing activities to ensure that service options are presented and individual choices are made in an orderly and appropriate sequence.

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Additional Concerns Regarding Transition Planning
Paragraphs 13 and 14 of the Decree state: The process for transition planning will include the class member's personal vision, preferences, strengths, and needs in home, community and work and shall reflect the value of supporting relationships, productive work, participation in community life and personal decision making. 16 and : Services and supports will be integrated into the community and consistent with choices of class members and guardians. Transition plans shall not be limited by the current availability of services but be within the confines of the waiver and State Plan. 17
This is an update of, as well as a repeated concern, expressed in the Monitor's Second Annual Report.
In order for implementation of this requirement to occur, the transition planning process must include a broad menu of real choices for each class member. This includes the size of community residential setting and employment.
Updated FY20 14 Data provided by the defendants reveal that, among all class members who transitioned to Community Integrated Living AITangement (CILA) settings in the first three years of implementation, 63% transitioned to settings of seven or eight residents. For those who transitioned from ICF/DD facilities, 71% moved to settings of seven or eight individuals. Only 13% of those class member who transitioned from an ICF/DD facilities to CILA settings, moved to settings of four persons or fewer. These data strongly suggest to the Monitor that the option of movement to smaller settings is, for many class members, not one that is sufficiently presented or sufficiently explored . Anecdotally, many families have

16 ~ 13 June 15, 20 I I Consent Decree at Page 9 & I 0. 17 ,: 14 June 15, 20 I I Consent Decree at Page I 0.

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reported to the Monitor that their clear preference was a smaller setting, but were told that this is not an option because of"availability" or "cost effectiveness."
Services in smaller settings is consistent with current best practices. In fact, the Federal Center for Medicare and Medicaid Services (CMS) has enacted financial incentives for states that transition individuals from ICF/DD facilities to settings of four persons or fewer through the Money-Follows-the-Person (MFP) program. Class members and their families should be given that choice. If they choose a smaller setting, efforts should be made to identify options consistent with the requirements in the Decree.
Another area in which adequate real choice is not afforded is that of employment. While the specific data are not available, it is quite clear that an overwhelming number of class members are transitioning into daytime activities that do not include real employment, or even provide for a path to employment. Again, many families, class members and guardians, anecdotally, have reported to the Monitor that the option of competitive employment was not even considered during the transition planning process or was dismissed as "unrealistic" or simply not presently available. This must change. For adults with developmental disabilities, employment should be the default daytime activity and should be the first option presented.
Last year, the Governor signed into law the Jllinois Employment First Act which establishes a definition of competitive employment, and incorporates specific requirements for state agencies to implement activities to promote employment and establish measurable goals and objectives toward employment activities . 18 Enactment of this legislation provided the impetus for the parties to work together to implement strategies that ensure viable employment options for Ligas class members.

18 HB2591 Enrolled, Illinois Employment First Act

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In July of 2014, the President signed new legislation passed by Congress known as the Workforce Innovation and Opportunity Act. This legislation significantly limits placements at sheltered workshops and other environment where people with disabilities make less than minimum wage. Under this statute, individuals with disabilities 24 years old and under will no longer be able to work for less than the minimum wage unless they first receive pre-employment transition services and try vocational services.
The provision of employment services is now a standing agenda item for all parties ' meetings. Over the next year, the Monitor will continue to work with the
parties to ensure that illl. options, including the option of smaller home settings and
real employment, are provided to class members throughout the transition planning process.
Recommendation #3- The defendants, with input from the Monitor and the parties, will develop an evaluation of class members who were selected for funding pursuant to the Ligas process, and did not choose or obtain the services for which they were selected. This evaluation should include inquiring into why services were not selected, and determining which options were presented to the class member, based on those services identified in the TSP.

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Transition for Class Members in ICFs!DD
The Decree requires all class members in ICFs/DD to transition to community services or community-based settings consistent with their transition plans if, at the time of transition, the class members request placement in a Community-Based Setting as confirmed and documented in accordance with the Decree. 19
• One third of class members in this category will transition by 12/15/2013. The number of class members to transition during this period will be determined by June 15, 2013.
• Two thirds of class members in this category will transition by 12/15/2015. The number of class members to transition during this period will be determined by June 15, 2015.
• All class members in this category will transition by 6/J 5/2017. The total number of class members to transition from ICFs/DD will be determined by June 15,2017.
The Implementation Plan calls for the identification and referral of these class members to PASIISC agencies for assistance in transition to community-based settings. The number of people identified for transition from ICFs/DD is expected to change, pursuant to the results of the outreach process described below. PAS/ISC agencies will monitor the adjustment and resolve issues as they are identified. 20

1138 class members in this category were identified on September 1, 2014. Ofthe number of class members to be identified on June 15, 2015, two-thirds are required to be served by December 15, 2015. As September 1, 2014, 792 class members in this category have received funding for community-based services or services in a community-based setting. Of the 792 who have received funding, at
19 ~ 17 June 15, 2011 Consent Decree at Page I0. 20 Ligas Implementation Plan, 12115111, Section V, Page 14-15

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least 741 of these class members have actually started community-based services and billing for these services has been verified. These data indicate that the defendants are well on the way to meet the compliance requirement that two-thirds of ICF/DD class members move prior to December 15, 2015 . DDD sends requests to PAS agencies for monthly updates for all ICF/DD class members to determine the status of choice and selection of community services providers and projected transition dates. Recently, DDD enacted a policy change to help streamline the process for transitioning class members to the community-based settings. This new (August 26, 2014) policy reduces the requirement for a full Level II screening and expands the time requirements for valid psychological evaluations and physical examinations. 21 This practice is commonly known as " presumptive eligibility" as people who live in ICF/DD settings have already been determined to require an ICF/DD level of need. The overwhelming majority (99%) of class members who have transitioned have requested and received funding for Community Integrating Living Arrangements , (CILA) and the remainder of the class members (I%) have requested and received funding for home-based services (HBS) and have returned to their family home. It should be noted that, to date, at least 120 individuals living in ICFs/DD who were contacted to receive transition supports to community services have since changed their minds and chosen to stay living in the ICF/DD. In each of these instances the individual ' s choices were respected, and they were removed from the class member list.

21 Information Bulletin , DD . I4 .03 9, Pre-Admission Screening Manual Revisions- Required Assessments

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A large number of class members who were living in ICFs/DD who have moved services in a community-based setting did so as a result of a voluntary downsizing or closure agreement. There are expected to be even more individuals who will be identified over the next year who are living in ICFs/DD now and will need to move due to voluntary downsizing or closure agreements . It will be imperative for the defendants to ensure that these individuals are provided with the opportunity to review an array of options so they can make an informed decision about where and how they want to receive services and supports. The Monitor has discussed this with the parties and DOD staff, and will be working closely with the defendants in tracking how choices are being facilitated for individuals who are affected by implementation of voluntary downsizing and closure plans.

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Crisis Services
The Decree requires the defendants to serve Class members who meet the crisis criteria described in ~21 (a) of the Decree and who request community services or placement in a community-based setting expeditiously. 22 Services and /or placement will be provided in a manner consistent with the transition plan .
The Implementation Plan calls for the PAS/ISC agencies to continue to submit requests for services from individuals in crisis situations . DDD will ensure that class members are served expeditious1y.23 The Monitor established the standard, with the agreement of the parties, that the timeframe to receive services for class members in crisis will be 24-72 hours, although this timeframe may vary, depending on individual circumstances, or if temporary services are in place to address the immediate crisis?4
On May 1, 2012, the Monitor notified the defendants and class counsel of noncompliance. Crisis services were not being provided expeditiously as called for in paragraph 21 (c) of the Decree. After a sampling review of the crisis services for class members from June 2011 to April 2012, the Monitor found a large percentage of class members who were not served for weeks, and in some instances months, but who needed services immediately. The Monitor recommended that the defendants develop a plan to address these issues. The defendants acknowledged the problem and immediately developed a draft corrective action plan, and reviewed the plan with the Monitor. This draft plan was then presented to the parties and discussed at the June 21, 2012 parties' meeting. Following the meeting, class counsel provided written comments to the defendants on June 28, 2012 on the corrective action for crisis services. The defendants, in conjunction with the Monitor have since modified this plan, and have moved forward with many of the action steps. The DOD Deputy Director for
22 ,21 .(C) June 15 . 20 II Consent Decree at Page 12. 21 Ligas Impl ementation Plan, 3/25/14. Section VIII. at Page 24-25 24 Compliance [valu ation Standards, July 17, 2012 at Page 14

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Community Services has been assigned the lead responsibility for overseeing
implementation of the crisis corrective action plan.
Some of the key action steps in the Crisis Service Request Action Plan include the
following:
• DOD has developed an internal quality assurance process and checklist for management staff and Network Coordinators to individually evaluate each crisis request packet to ensure timeliness and completion.
• The internal database has been modified to ensure accuracy of entries.
• Network staff have been provided additional training in the areas of crisis data entry and processing crisis requests.
• Network Coordinators have now been assigned authorization to issue PreA ward Letters in order to expedite processing of these letters.
• Training was held in October 2012 for DOD Network staff and PAS agencies about submitting complete and accurate crisis funding requests, and being fully prepared when presenting requests to the Review Committee.
• The frequency for internal DDD informal review committee meetings has been increased to reduce the lag time in approval.
• Rate setting unit staff have been instructed to give high priority to crisis requests which will be specifically labeled as high priority. Distribution of award letters will also be streamlined and conveyed electronically.
• A management report was designed for improved overall internal monitoring of crisis requests.

During the past year, the Monitor hired a Program Analyst, Ms. Melanie Reeves Miller, to assist with the review of Crisis services. DDD provided a class member-specific Crisis Management Report of all Crisis activities in FY 14, from July I, 2013 to June 30, 2014. There were a total of 397 confirmed crisis requests during FY2014.
According to data provided by the defendants, 71 crisis requests were classified as abuse, 233 were classified as neglect, and 93 were due to the individual being homeless. (See Chart #1)

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ass1f1cat1on o

93

71

233

equests
Abuse Neglect Homeless

Chart#!
Services provided to class members in crisis included four types of CILA (Community Integrated Living Arrangement) options: 24-Hour CILA, Host Family CILA, Intermittent CILA, and Family CILA, in addition to Home-Based Support Services (HBS). Of the 397 crisis requests, 177 were approved to receive 24-Hour CILA, 7 were approved to receive Host Family CILA, 20 were approved to receive Intermittent CILA, and 13 were approved to receive Family CILA. Home-Based Support Services were approved for 180 class members.

180

177

20

13

7

24-Hour CILA Host Family CILA Intermittent Cl LA Family CILA HBS

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After nearly two years of implementation, this corrective action plan has continued to show significant improvement in the results. The Monitor reviewed crisis class member information and data from all 397 crisis requests during FY 2014 . The results showed that 95% (3 77) of the class members who were found to be in crisis, received some services within a 24-72 hour period after their crisis status was confirmed. These findings demonstrate that the defendants ' efforts have continued to be successful. The Monitor will continue to work with the defendants, including joint reviews of the crisis management reports , to improve crisis responsiveness.
It should be noted that there were a number of instances that were identified by the Monitor where the processing of the crisis applications and request information packets development moved slowly prior to the crisis review process by ODD. The Monitor will work with the ODD management staff to establish a mechanism to track and improve that part of the process,
The defendants' data reports indicate that, in FY 2012 , 288 class members who requested service pursuant to the crisis criteria were served. FY 2013 , 269 class members in crisis were served , a slight upturn from the previous year. In FY 2014 the number of class members who required crisis services, surprisingly, jumped to 397 , a 4 7% increase over the previous year. It is not clear why this sharp increase in crisis requests occurred.
As mentioned in the Transition Service Plan section above, the defendants have developed and are now implementing the Crisis Transition Plan and Funding Request form . Utilization of this form as prescribed appears to have resulted in a more effective and uniform manner in processing crisis requests.
Recommendation #4- The defendants, in conjunction with the Monitor and input from class counsel, should conduct an analysis of Crisis data to determine the relationship between Crisis applicants and the PUNS list, too so that the necessity for community outreach activities can be determined.

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Transition for Class Members on Waiting List
The Decree requires that Class members described in ,j2.b of the Decree will transition to community-based services . These class members are referred to in the Decree as "Waiting List Class Members. 25 Class members described in ~2.b and ,122 (a) and ~22 (b) will transition in accordance with the following schedule :
• Community-based services or placement in a community-based setting for I ,000 Waiting List class members will begin by June 15, 2013.
• Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2014 .
• Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15 , 2015 .
• Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2016.
• Community-based services or placement in a community-based setting for an additional 500 Waiting List class members will begin by June 15, 2017 .
• Following June 15, 2017 , Waiting List class members will receive community-based services or placement in a community-based setting at a reasonable pace. 26
The Implementation Plan incorporates the criteria for prioritization for selection of class members who are on the waiting list to receive funding for community-based services or services in a community-based setting. Within each category, selections will be made based on the length of time on the waiting list database .27

25 ,J22.(c) .lune 15, 20 II Consent Decree at Page 13.
26 ~2 3 .(c) June 15, 20 II Consent Decree at Page 13. 27 Ligas Implementation Plan, 3/25114, Section VII , Page 23-24

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Case: 1:05-cv-04331 Document #: 583 Filed: 10/01/14 Page 38 of 49 PageID #:11424
As reported in the Class Member List section above, the PUNS list shows 15,190 individuals who qualify as Waiting List class members. In order to implement a systematic process for selections of class members to effectuate services for the initial 1,000 individuals by June 15, 2013, the defendants engaged in several selection events. (Commonly referred to as "PUNS pulls") The first selection event identified 800 individuals believed to be class members and occurred in February 2012 . After an initial screening process, 65 individuals were removed from this list and 735 letters were sent to the class members and/or guardians, and their respective PAS agencies, indicating that funding for community-based services or services in a community-based setting would be available upon application . The second selection event occurred in June 2012, which identified an additional 626 individuals, and after initial screening 22 individuals were removed from the list, resulting in 604 application letters being sent to the class members and respective PAS agencies. A third selection event occurred in October 2012 and I ,500 individuals believed to be class members were selected. A fourth selection event occurred in September 2013 with 500 individuals selected and 27 names were removed for various reasons, resulting in 4 73 letters being sent to class members and respective PAS agencies. The last and most recent selection event was for 700 class members in March of 2014 . In summary, 4 ,306 letters have been sent to Ligas waiting list class members over the past three years. Each of the selection events have chosen people in accordance with the criteria for prioritization as listed in the Ligas Implementation Plan. The breakdown of the recent selection event is available on the DDD website: (http://www.d hs .state .il. us/page. aspx?item=67339)

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As of September 1, 2014, the status of provision of services for those individual found eligible as waiting list class members is as follows:
• As of September 1, 2014, services have been initiated for 1,969 class members.
• An additional 89 class members have received funding awards, and services are about to begin soon.
• Packets for another 24 individuals have been completed, and sent to DHS for funding approval.
• 499 individuals are in the process of receiving or have completed Level II screening by PAS agencies, and requests are being processed.
• Initial contact has been made with an additional 146 individuals who have confirmed that they have requested services.
In summary, the defendants' hard work in this area has continued to result in outcomes that have far exceeded the requirements of the Decree. The defendants are also well on the way to meeting or exceeding the requirements for the provision of services to waiting list class members of an additional 500 individuals by July 30, 2015.
The Monitors' First Annual Report expressed grave concern about the likelihood that the defendants would achieve full compliance with this provision of the Decree. These concerns were followed by numerous recommended steps designed to better manage the PUNS data, and infuse new resources into the process. These concerns and recommendations were heeded and resulted in deliberate actions that resulted in a changed climate of movement and productivity. The defendants are to be congratulated once again for their hard work in this area and for applying the necessary resources and assistance where they were needed.

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There remain, however, some concerns with regard to the outcomes of these activities. The Ligas Implementation Plan called for selection for funding to identify 50% of those selected to be served through the CILA out-of-home supports, and 50% to be selected to receive home-based support services. Data provided by DDD for the first two years of service provision show that less than 15% of those selected are now being served through CILA supports, and more than 85% are being served through the home-based supports program. This outcome is statistically significant enough to warrant close and careful examination. It is not clear what has led to this irregularity with regard to expectations and results. Absent a detailed review, any reasons given for this would be speculative. Implementation of Recommendation #3 (See page 28) should provide the parties with a meaningful analysis of why so many class members are not accepting the CILA services that are offered to them.

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Outreach The Decree requires the defendants to maintain a fair and accessible process by which individuals or their guardians can affirmatively request services and maintain records of those requests. 28
The Implementation Plan outlines numerous activities designed to identify individuals throughout the state who are or will be in need of home and community-based services, and services in a community based setting. These activities include training and information sessions, as well as the development and distribution of written materials to broad based audiences.
For potential class members living in ICFs/DD, the Plan provides a detailed description and requirements for the development of a contract to secure the services of an outside contractor(s) who will contact all potential class members and determine and document an informed decision on whether they are requesting services in a community-based setting. 29
The defendants engaged in numerous activities to comply with the Outreach requirements of the Decree, and activities described in the Ligas Implementation Plan. At the initial parties' meeting, it was agreed by the parties and memorialized by the Monitor that for those individuals who live in ICF/DD settings, they are considered a class member if they have completed a PASS Form 1238 or its predecessor, DHMDD Form1243, or DO PAS 10 form, or the Request form disseminated through plaintiffs' counsel, and checked the box that they choose Home and Community Based Services.

28 ~25 June 15. 20 II Consent Decree at Page 14 29 Ligas Implementation Plan. 2014 Revisions, March 25.2014, at page II

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The Defendants, and in many instances in conjunction with the Monitor, engaged
in activities to inform stakeholders as well as the community at large about the
requirements of the Decree and how services can be sought and received by
qualified class members. Some of these activities include the following:
• DOD and the Monitor have continued conducting training activities for each of the 18 PAS agencies on the requirements of the Decree and Implementation Plan and, in particular, their role in facilitating choice for class members.
• DOD has developed and maintained a Ligas website that includes a full and downloadable description of the requirements of the Decree, updates on documents and activities related to the Decree, and contact information for parties interested in more information. This website is updated on a regular basis . See: http://www.dhs.state.il.us/page.aspx?i tem =40989
• DOD maintains a consumer-friendly PAS agency locator function on the DOD website whereby families can locate their PAS agency by simply entering their county or zip code.
• DOD has also structured the 1-888-DDPLANS toll free number so that families can be directed to the Ligas inquiry staff support.
• DOD has established, widely publicized and maintained a Ligas complaint contact within the Division who is responsible to receive and memorialize inquiries, complaints and requests for information from class members, families , and other interested parties. This staff person also maintains a log of complaints and related follow-up activities .

With regard to outreach to persons living in ICFs/00, the defendants, with input from representatives of class counsel, intervenors counsel and the Monitor, developed a Ligas Outreach Request for Proposals (RFP). This RFP was released to the public for solicitation on September 13, 2012 and proposals were due to DHS no later than October 9, 2012.
There were no responsive bids to this RFP . As a result, DHS identified a qualified contractor, the Council on Quality and Leadership, (CQL) to serve as the Outreach Contractor. The Monitor's Second Annual Report outlined the initial and preparatory steps for outreach implementation. At this juncture, outreach

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activities are at the full stages of implementation. CQL provides DDD with monthly updates of progress on activities.
As of September 1, 2014, CQL continues to conduct outreach activities in the following PASIJSSA areas: Developmental Disabilities Services Metro East (DDSME); Suburban Access, Inc.; Service, Inc.; Central Illinois Service Access; Champaign Co Regional Planning Commission; Great Rivers Service Coordination; and Prairieland Service Coordination; Access Services of Northern Illinois (Access NI); CSO of Rock Island and Mercer (CSO!RJM); and Day One Network. DDD provided a list for another group of Potential Class Members identified as being in the West Central part of Illinois with outreach starting in late September.
As of September 1, 2014, CQL has attempted initial outreach with 1,018 potential class members, and has completed or closed initial outreach to 767 potential class members. Of these 767 potential class members, 487 have chosen to remain in their current ICF/DD, 143 have arranged a meeting with CQL and 137 did not want any outreach activity conducted . CQL has completed 102 outreach meetings with class members and/or guardians. Of these I02 meetings, 62 individuals chose to remain at their current ICF/DD, 37 are exploring a move to a community-based setting, 2 individuals chose to move to a different ICF/DD and 1 has not decided. Outreach efforts have not been successful for 116 individuals, mostly due to the inability to make contact.
It is expected that outreach activities for potential class members living in ICFs/DD will take place over the next two years. It will be important for CQL and DDD to provide ongoing communications with the Monitor, parties and intervenors regarding progress, outcomes and barriers to implementation.

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Implementation Plan
The Decree requires that the defendants finalize the Implementation Plan, with input from the parties and intervenors. 30 The Implementation Plan must be filed with the Court by December 15, 2011. The Implementation Plan shall be updated and amended at least annually. 31 The original Ligas Implementation Plan was negotiated by the parties and intervenors and filed with the Court by the defendants on December 15, 2011. There was joint agreement by all parties, the Intervenors and the Monitor on the initial Implementation Plan. This Plan was approved by the Court and ordered as a supplement to the Decree on February 15,2012. Subsequently, ODD provided updates and proposed revisions to the Implementation Plan and provided a draft to the parties and intervenors. These revisions were negotiated and submitted to the Court without objection on February 22,2013. The second revision of the Implementation Plan was negotiated by the parties and filed with the Court on March 25, 2014.
The defendants have utilized the Ligas Implementation Plan as their blueprint for activities designed to comply with the Decree. At each scheduled parties' meeting, the defendants provide a verbal update of Plan activities, and respond to questions from class counsel and counsel for the intervenors. There have also been significant inquiries from key stakeholders and members of the public at large about implementation activities.

The Monitor recommends that the defendants resubmit a proposed amended Ligas Implementation Plan with necessary revisions prior to the scheduled parties' meeting in January 2015 for review and input. Following the input from the parties, intervenors and the Monitor, the defendants should file the updated plan with the Court, as required in the Decree.
30 ~27 June 15. 20 I I Consent Decree at Page 15. 31 ~28 June 15,2011 Consent Decree at Page 15

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Data Reports
The Decree requires the defendants to provide the Monitor, Plaintiffs, Class counsel, Intervenors and Intervenors' Counsel, and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants' compliance with the Decree and Defendants' progress towards achieving compliance. 32 Not less than every six months, defendants shall provide data reports to the Monitor, class counsel and intervenors.
Implementation Plan Activities- The Implementation Plan calls for the semiannual submission of data reports. The defendants have provided Data Reports to the parties, intervenors and Monitor on August 20,2012, February 15,2013, August 15, 2013, February 15, 2014 and August 15, 2015. The Data Reports include class member data regarding the class member Jist(s), services to class members in ICFs/DD, services to class members from the Waiting List, ICF/DD resident outreach, transition service plans, crisis services, voluntary ICF/DD closure and downsizing agreements, eligibility appeals and the Ligas budget. The Monitor finds the form and format for class member data to be useful and acceptable. It will be increasingly important, however, to ensure that data regarding budget expenditures and shortfalls, if any, are updated on a regular basis.

",133M June 15,2011 Consent Decree at page 18.

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Services for Named Plaintiffs The Decree requires the defendants within sixty days to offer each of the Named Plaintiffs the opportunity to receive appropriate community-based services or services in a community-based setting. 33
The defendants have complied with this requirement of the Decree. All five named plaintiffs were offered services in community based settings and have successfully transitioned to their new homes or received home-based services funded through the Illinois home and community-based waiver. The Monitor maintains occasional contact with the named plaintiffs and their families.
Ligas Class Member/Family Advisory Committee
The Implementation Plan calls for the establishment of the Ligas Class Member/Family Advisory Committee .34 This Committee is now fully operational and meets at two locations that are connected by video conferencing. These meetings are also attended by DOD staff, class counsel, the Monitor and family advocates. A chairperson and vice-chairperson have been elected. During the past six months, this committee developed a report to the defendants and the Monitor to offer observations and suggestion on implementation issues identified from their personal experiences, as well as information received from other class members and families.
The Monitor will review the reports and suggestions by this Committee with the defendants and respond accordingly.

33 ,137 June I5, 2011 Consent Decree at Page 21
34 Ligas Implementati on Pl as, Revised 2013 , at Page 12

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Dispute Resolution

The Decree clarifies the rights of class members to appeal or seek administrative or judicial review pursuant to governing law through the existing fair hearing process. Class members may also avail themselves of any informal appeal process that currently exists. 35

The Monitor reviewed the appeal data with the defendants in Apri I 20 12 and identified a number of problems with the appeal process. Scheduling of appeals hearings and obtaining written hearing determinations were taking an inordinately long time, in some instances as much as six months to a year. The appeals application process was often confusing to individuals and families, and some families reported that they were not aware of their appeal rights.

As a result of these problems, the defendants, with input from class counsel, developed and have implemented an appeals corrective action plan that includes the following activities and tasks:

• HFS has hired an additional three new Administrative Law Judges as hearing officers and one additional attorney to support the hearing process.
• The newly hired ALJ's, at the request of HFS, conducted site visits to several CILA settings to better understand community-based services for people with developmental disabilities.
• The application process was streamlined so that appeals come directly to DDD rather than the additional pass through with HFS.
• A draft to include modifications of the appeals rights' form is being finalized.
• Appeals unit staff have been instructed in writing to give top priority to crisis appeals.

35 ~24 June 15,2011 Consent Decree at Page 14

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• Appeals unit staff are being trained to expedite informal appeals. • An internal checklist has been drafted to provide effective and ongoing
tracking of appeals. • PAS agencies are being re-trained on preparing complete appeal requests. • Weekly internal management reports will be generated to ensure internal
reviews are scheduled on a timely basis. • Management reports will be incorporated into the Ligas data reports. From a review of the 2014 appeals data, it is clear that the appeal process has improved substantially, particularly in conducting hearings within a reasonable time frame.
Based on conversations with stakeholders, families and class members, there appears to be a lack of awareness about the availability of the appeals process and individual rights in the Medicaid program. Although there is written information about rights and the appeal process, the information does not seem to reach the intended users. This lack of awareness was also identified by the Ligas TSP consultant, and mentioned by members of the Ligas Class Member and Family Advisory Committee.
Over the next six months, the Monitor will work with the defendants to develop an enhanced information sharing strategy to ensure that information about hearing rights and appeals is effectively conveyed to class members and families.

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Section 5- Overall Comments
After three years of implementation, the defendants' strong efforts have continued to result in positive real-life outcomes for class members. Sometimes there is too much emphasis on what is going wrong, with little attention on what is going right. The Monitor hopes that this report conveys an appropriate balance of success and challenges. Since June 15, 20 II, services have been provided for more than 3,100 class members, including ICF/DD class members, waiting list class members and those in crisis. Through the diligent work of the defendants, with full cooperation from class counsel and the intervenors, much has been accomplished.
This fourth year of implementation presents some seemingly formidable challenges ahead- serious budget shortfalls, statistically unacceptable lack of employment options and limited options for small community settings. The Monitor will continue to work with the parties to address these challenges and communicate with class members and their families.

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 Case: 1:05-cv-04331 Document #: 590 Filed: 06/17/15 Page 1 of 1 PageID #:11455
Honorable Sharon Johnson Coleman
UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS ORDER OF THE EXECUTIVE COMMITTEE
It appearing that further judicial action is required in 05 C 4331, Ligas et al., v. Hamos et al., before the Hon. James F. Holderman, who is no longer sitting; and
It further appearing that the Executive Committee has determined that the abovereferenced case should be reassigned by lot; therefore
It is hereby ordered that the Clerk of Court is to reassign 05 C 4331, Ligas et al., v. Hamos et al., by lot to another district judge of this Court.
ENTER: FOR THE EXECUTIVE COMMITTEE
Hon. Rubén Castillo, Chief Judge
Dated at Chicago, Illinois this 17th day of June, 2015

 
 Case: 1:05-cv-04331 Document #: 597 Filed: 06/30/15 Page 1 of 2 PageID #:11474

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

Stanley Ligas, et al., Plaintiffs,
v. Felicia Norwood, et al.,
Defendant.

)

)

)

)

Case No. 05 C 4331

)

)

Judge Sharon Johnson Coleman

)

)

)

AGREED ORDER TO MAINTAIN COMPLIANCE WITH CONSENT DECREE

This case is before the Court on the parties’ Joint Emergency Motion to Approve Agreed

Order. The parties have advised the Court that the State of Illinois has not yet passed a budget

appropriation for the State Fiscal Year beginning on July 1, 2015 (the “FY 2016 budget”). In the

absence of a FY 2016 budget appropriation, Defendants will continue to provide all programs,

services and personnel required by the Consent Decree (Dkt. #549), including without limitation

any Implementation Plans issued pursuant to Section XIII of the Consent Decree approved by

this Court on June 15, 2011 (Dkt. #549). It is the position of the Illinois State Comptroller that,

without an appropriation, the Comptroller does not have the authority to continue to make

payments for current services, programs and personnel that are necessary to maintain compliance

with the Consent Decree unless specifically ordered to do so by the Court.

In order to maintain compliance with the Consent Decree, IT IS HEREBY ORDERED

THAT:

1. Until the FY 2016 budget takes effect, the Comptroller shall continue to make all

payments for all services, programs and personnel, at a level no less than the levels paid in Fiscal

1

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Year 2015, that are necessary to comply with the Consent Decree and Implementation Plans. This order shall remain in effect until the effective date of the FY 2016 budget.
2. On or before July 1, 2015, Defendants shall publish this Order by (i) posting it on the DHS website, and (ii) transmitting a copy of the Order to all personnel and to all contractors and providers of services under the Consent Decree, including without limitation any contractors or providers of services that received prior notice of a possible reduction in payments or the reduction in or termination of a contract as the result of the delays in completing a FY 2016 budget appropriation, via email where available and by such other additional means as the Defendants employ for communications to the foregoing persons and entities in their usual course of business.

Dated: June 30, 2015

SO ORDERED

BY: ____________________________ United States District Judge

2

 
 Case: 1:05-cv-04331 Document #: 610 Filed: 08/18/15 Page 1 of 5 PageID #:11630

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, ET AL., Plaintiffs,
v. FELICIA NORWOOD, ET AL.,
Defendants.

)

)

)

)

Case No. 05 cv 4331

)

)

Judge Sharon Johnson Coleman

)

)

)

ORDER

This case is before the Court on Plaintiffs' and Intervenors' Joint Motion to Enforce Consent

Decree and Agreed Order (Docket #602) (the "Motion"). The Court taking into consideration the

Consent Decree Order previously entered in this case, the urgency of the plaintiffs and intervenors

needs, the unquestioned budget crisis for the State of Illinois. Weighing all these facts the Court

makes the following ruling.

A. The Consent Decree entered in this matter on June 15, 2011 (Docket #549) requires the

State of Illinois to fund services for more than 10,000 Illinois residents with

developmental disabilities, including those living in Community Integrated Living

Arrangement ("CILAs"), those living in Intermediate Care Facilities for the

Developmentally Disabled ("ICF-DDs"), those living in Community-Based Settings, and those

living at home but in need of Community-Based Services (as these terms are defined in

the Consent Decree). The Consent Decree was intended to redress violations of Title II of

the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act,

29 U.S.C. § 794(a); and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v.

B. When it became clear that the State of Illinois would not pass a budget appropriation for

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the State Fiscal Year beginning on July 1, 2015 ("FY 2016"), the Illinois State Comptroller took the position that she would not continue to make payments necessary to maintain the State's compliance with the Consent Decree unless specifically ordered to do so by the Court. C. On June 30, 2015, the Court entered the Agreed Order to Maintain Compliance with Consent Decree (Docket #597) ("Agreed Order"). The Agreed order states: "Until the FY 2016 budget takes effect, the Comptroller shall continue to make all payments for all services, programs and personnel, at a level no less than the levels paid in Fiscal Year 2015, that are necessary to comply with the Consent Decree and Implementation Plan." D. Despite the Consent Decree and the Agreed Order, on July 23, 2015, the State of Illinois sent letters to developmental disability service providers informing them that the State will fund services only for Class Members under the Consent Decree and not for any other Individual with Development Disabilities for whom funding is required under the Consent Decree, including Individuals with Developmental Disabilities living in ICF­ DDs or CILAs who are not Class Members. E. The State's refusal to provide funding for services provided to Individuals with Developmental Disabilities living in ICF-DDs and CILAs, as well as those living at home and receiving Community-Based Services, who are not Class Members, is a violation of the Consent Decree and the Agreed Order. F. Providers of services to Individuals with Developmental Disabilities are reliant on the State for funding needed to provide essential services to Individuals with Developmental Disabilities. As a result of the State's failure to provide funding as required by the Consent Decree and Agreed Order, many providers of services to Individuals with

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Developmental Disabilities, including Class Members, are in imminent danger of closing. Individuals with Developmental Disabilities are reliant on service providers to meet their daily needs, such as feeding, the administration of essential medications, dressing, toileting, and supervision. If service providers close due to the lack of funding from the State, Individuals with Developmental Disabilities, Class Members and non-Class Members, will have to be moved to unfamiliar and inappropriate settings, assuming such alternative settings even exist. The very individuals the Consent Decree was designed to protect will be unable to obtain services necessary for their health and welfare and will be grievously and irreparably harmed. G. Immediate relief is necessary to prevent violations of the Consent Decree, Agreed Order, and Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132, Section 504 of the Rehabilitation Act, 29 U.S.C. § 794(a), and Title XIX of the Social Security Act, 42 U.S.C. §§ 1396-1396v.
THEREFORE, IT IS HEREBY ORDERED THAT:
1. Plaintiffs' and Intervenors' Joint Motion to Enforce Consent Decree and Agreed Order is granted.
2. The Illinois State Comptroller shall timely make all payments for all services, programs, and personnel during the State Fiscal Year beginning on July 1, 2015 ("FY 2016"), at a level no less than the levels paid in Fiscal Year 2015, for all Beneficiaries of the Consent Decree (Docket #549) (as "Beneficiaries" are defined in Paragraph 3 of this Order). For payments due for services provided in July 2015 for any and all Beneficiaries of the Consent Decree for which claims have been submitted as of the date of this Order, the State of Illinois shall process and pay all such claims by August 21, 2015. For payments due for services provided in August 2015 for any and all Beneficiaries of the Consent Decree for which claims

Case: 1:05-cv-04331 Document #: 610 Filed: 08/18/15 Page 4 of 5 PageID #:11633
are submitted by August 18, the State of Illinois shall process and pay all such claims by September 4, 2015. By September 18, 2015, the State of Illinois should be in total compliance with the Consent Decree. 3. The Defendants will immediately begin processing all Medicaid claims for fiscal year 2016 for services provided to the range of individuals that are the subject of Plaintiffs' and Intervenors' Joint Motion to Enforce Consent Decree, including but not limited to Class Members (as defined in the Consent Decree), Individuals with Developmental Disabilities (as defined in the Consent Decree) who have chosen to reside in Intermediate Care Facilities for the Developmentally Disabled ("ICF-DDs"), Individuals with Developmental Disabilities receiving Community-Based Services (as defined in the Consent Decree), and Individuals with Developmental Disabilities receiving services in Community-Based Settings (as defined in the Consent Decree) throughout the State of Illinois ("Beneficiaries"). 4. For all claims submitted on or after September 1, 2015, the Illinois Department of Healthcare and Family Services and the Department of Human Services shall process and the Comptroller shall pay all claims covered by this Order at a level and within the time period that such claims were paid in Fiscal Year 2015. Providers that were paid on an expedited basis during FY 2015 shall be paid on the same expedited basis for services rendered during FY 2016. All other providers shall be paid within sixty days after the end of the month in which services are rendered. 5. On or before August 21, 2015, the Secretary of the Department of Human Services shall issue a letter supplementing his July 23, 2015 letter (Exhibit 3 to the Joint Motion). The letter shall detail the State of Illinois' plan to process and pay all claims for services rendered during FY 2016 to Beneficiaries of the Consent Decree in a manner and at a time consistent with the State of Illinois's obligations under this Order , the Agreed Order (Docket

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#602), and the Consent Decree. Attached to this supplemental letter will be a copy of this Order. Defendants shall publish the supplemental letter and Order by (i) posting it on the DHS website, and (ii) transmitting a copy of the letter with this Order to all personnel and to all contractors and providers of services under the Consent Decree, including without limitation any contractors or providers of services that received the July 23 letter or other notice of a possible reduction in payments or the reduction in or termination of a contract as the result of the delays in completing a FY 2016 budget appropriation, via email where available and by such other additional means as the Defendants employ for communications to the foregoing persons and entities in their usual course of business. 6. This Order shall remain in effect until the State enacts a budget for FY 2016 or until further order of this Court. 7. This matter is set for a status hearing on September 9, 2015 at 9:00 a.m. At that time the parties shall report to the Court on the State's compliance with this Order. Date: August 18, 2015
Entered: _____________________________ SHARON JOHNSON COLEMAN United States District Judge

 
 Case: 1:05-cv-04331 Document #: 624 Filed: 09/01/15 Page 1 of 2 PageID #:11966

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

Stanley Ligas, et al., Plaintiffs,
v. Felicia Norwood, et al.,
Defendants.

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)

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Case No. 05 C 4331

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Judge Sharon Johnson Coleman

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ORDER
This case is before the Court on Plaintiffs’ and Intervenors’ Emergency Joint Motion For Entry a Rule to Show Cause (Docket #614) (the “Motion”), all parties being present for the hearing and the Court having considered the parties’ filings, the Court makes the following ruling:
1. The Court, at this time, does not reach the issue of whether the State or its officials are in contempt of this Court.
2. The Court denies the State’s request to modify this Court’s Order dated August 18, 2015 (Docket #610)
3. If at any time the State believes that it may not be able to comply with any provision of the Consent Decree or this Court’s August 18, 2015 Order, the State must immediately bring the State’s potential non-compliance to the attention of the Court, the Monitor, the Plaintiffs, and the Intervenors before such non-compliance occurs.
4. The State shall promptly reinstate for FY 2016 the Expedited Payment Program for Community Integrated Living Arrangements on the same terms and conditions as existed
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during FY 2015. The State shall advise all providers who were notified of the program’s suspension that the program has been reinstated. 5. The Illinois Department of Healthcare and Family Services, the Department of Human Services, and the Illinois State Comptroller shall provide such information to the Court Monitor and at such intervals as she may from time to time request to enable her to evaluate and to advise the Court and the Parties regarding the State’s compliance with the Consent Decree and the Orders entered by this Court. 6. This matter is set for a status hearing on October 16, 2015 at 9:30 a.m. At that time the parties shall report to the Court on the State’s compliance with this Order and the August 18, 2015 Order.

Dated: September 1, 2015 nunc pro tunc

SO ORDERED
BY: ____________________________
Sharon Johnson Coleman United States District Judge

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 Case: 1:05-cv-04331 Document #: 627 Filed: 01/08/16 Page 1 of 44 PageID #:11970

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al.,
Plaintiffs, vs.
FELICIA NORWOOD, in her official capacity as Director of the Illinois Department of Healthcare and Family Services, et al.,
Defendants.

)
)
) ) ) ) No. 05 C 4331 ) ) ) Judge Sharon Johnson Coleman ) )

FOURTH ANNUAL REPORT OF THE MONITOR

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Stanley Ligas, et al. v. Felicia Norwood, et al.
Fourth Annual Report of the Monitor January 7, 2016
INTRODUCTION
This report is respectfully submitted to the Court, the Parties and the Intervenors in accordance with the Ligas Consent Decree (Decree), which was approved and filed by the Court on June 15, 2011. The Decree requires that:
The Monitor shall file annual reports to the Court, which shall be served on all Parties and Intervenors and be made publicly available. Such reports shall include the information necessary, in the Monitor’s professional judgment, for the Court, Plaintiffs and Intervenors to evaluate Defendants’ compliance or non-compliance with the terms of the Decree. 1
The first Ligas Monitor, Tony Records, was appointed by the Court on July 19, 2011. Upon his retirement, the current Monitor’s appointment was effective on July 1, 2015. Mr. Records’ generous sharing of his time and expertise during this transition has been invaluable to the current Monitor.
The first three Annual Reports of the Monitor were submitted by Mr. Records on September 27, 2012, September 30, 2013 and September 30, 2014. Based upon the timing of the current Monitor’s appointment in July, 2015, the reporting
1 Consent Decree, ¶ 34 at page 19 2

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schedule has been revised for this year to allow the Monitor six months for an initial evaluation of compliance with the terms of the Decree. The process of completing this Fourth Annual Report would have been significantly more difficult without the unfailing cooperation of the Defendants, Plaintiffs’ counsel and representatives, counsel for the Intervenors, service providers, advocacy organizations, family associations and others too numerous to mention. Input from those protected by the Decree and their families was not only critical to the Monitor’s initial education about this case but is also a barometer of the Decree’s effectiveness at this stage of its implementation.
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CHALLENGES
The current Monitor’s appointment coincided with the beginning of FY 2016 and
the absence of a State budget for Illinois. Initial activities of the Monitor were
thus necessarily related to participating in efforts to maintain funding for services
provided to all of those protected by the Decree as well as for others who share
services with them, as partial funding for any given service would have caused
many providers to either close their doors or significantly decrease operations.
On June 30, 2015, United States District Judge Sharon Johnson Coleman signed an
“Agreed Order to Maintain Compliance with Consent Decree” which summarized
the issue at that time as follows:
This case is before the Court on the parties’ Joint Emergency Motion to Approve Agreed Order. The parties have advised the Court that the State of Illinois has not yet passed a budget appropriation for the State Fiscal Year beginning on July 1, 2015 (the “FY 2016 budget”). In the absence of a FY 2016 budget appropriation, Defendants will continue to provide all programs, services and personnel required by the Consent Decree (Dkt. #549), including without limitation any Implementation Plans issued pursuant to Section XIII of the Consent Decree approved by this Court on June 15, 2011 (Dkt. #549). It is the position of the Illinois State Comptroller that, without an appropriation, the Comptroller does not have the authority to continue to make payments for services, programs and personnel that are necessary to maintain compliance with the Consent Decree unless specifically ordered to do so by the Court.
In order to maintain compliance with the Consent Decree, IT IS HEREBY ORDERED THAT: 1. Until the FY 2016 budget takes effect, the Comptroller shall continue to make all payments for all services, programs and personnel, at a level no less than the levels paid in Fiscal Year 2015, that are necessary to comply with the Consent Decree and Implementation Plans. This order shall remain in effect until the effective date of the FY 2016 budget. 2. On or before July 1, 2015, Defendants shall publish this Order by (i) posting it on the DHS website, and (ii) transmitting a copy of the Order to all personnel and to all contractors and providers of services under the Consent Decree, including without limitation any contractors or providers of services that received prior notice of a possible reduction in payments or the reduction in or termination of a contract as the result of delays in completing a FY 2016 budget appropriation, via
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email where available and by such other additional means as the Defendants employ for communications to the foregoing persons and entities in their usual course of business.
Following negotiations and conversations among the Parties, Intervenors and Monitor, as well as input to the Monitor from countless individuals and their family members in addition to providers of day, residential and advocacy services, a Joint Motion by the Plaintiffs’ and Intervenors’ to Enforce Consent Decree and Agreed Order was granted and another order was signed by Judge Coleman, this time on August 18, 2015, which states, in part:
Despite the Consent Decree and the Agreed Order, on July 23, 2015, the State of Illinois sent letters to developmental disability providers informing them that the State will fund services only for Class Members under the Decree and not for any other Individual with Developmental Disabilities for whom funding is required under the Consent Decree, including Individuals with Developmental Disabilities living in ICF-DDs or CILAs who are not Class Members.
Citing violation of both the Consent Decree and the Agreed Order, Judge Coleman enumerated the deleterious effects, on both providers of services and Individuals with Developmental Disabilities, of the State’s “failure to provide funding as required by the Consent Decree and Agreed Order” and concluded that “immediate relief is necessary”. The 8/18/2015 Order sets forth detailed requirements for the Comptroller’s timely payments “for all services, programs, and personnel during the State Fiscal Year beginning on July 1, 2015 (“FY 2016”), at a level no less than the levels paid in Fiscal Year 2015, for all Beneficiaries of the Consent Decree.” The Order ends with: “This Order shall remain in effect until the State enacts a budget for FY 2016 or until further order of this Court” and a status hearing was scheduled for September 9, 2015.
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Prior to the scheduled status hearing, on August 25, 2015, Plaintiffs and Intervenors filed an Emergency Joint Motion for Entry of a Rule to Show Cause when the State did not comply with the Court’s Order of August 18, 2015 to make court ordered payments to service providers by August 21, 2015. A hearing was held on August 26th, immediately prior to these payments were initiated. Following that hearing, on August 31st, Plaintiffs and Intervenors requested that the Court order Defendants to provide to the Monitor information regarding which payments were being made, why others weren’t being made and when payments could be expected. Judge Coleman’s Order, dated September 1, 2015 requires, among other provisions:
If at any time the State believes that it may not be able to comply with any provision of Consent Decree or this Court’s August 18, 2015 Order, the State must immediately bring the State’s potential non-compliance to the attention of the Court, the Monitor, the Plaintiffs and the Intervenors before such non-compliance occurs.
The Order also requires:
The Illinois Department of Healthcare and Family Services, the Department of Human Services and the Illinois State Comptroller shall provide such information to the Court Monitor and at such intervals as she may from time to time request to enable her to evaluate and to advise the Court and the Parties regarding the State’s compliance with the Consent Decree and the Orders entered by this Court.
At the Parties Meeting on September 17, 2015, it was reported by Defendants that all payments to providers of services to those protected by the Ligas Consent Decree were up to date; that the State will notify the Monitor, Plaintiffs and Intervenors if any delays in payments are anticipated; and that the State has every intention of complying with the Ligas Consent Decree. However, it was also noted that the fiscal situation in Illinois is getting worse on a daily basis as the State’s expenditures exceed revenue. The Monitor requested monthly reports of
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the status of such payments and the Defendants have been providing positive information monthly as well as at the Court’s scheduled status hearings. The Monitor has provided to the Defendants an “Information Request Regarding Ligas Payments” to be used in the event that noncompliance is anticipated by the State in this matter.
The remainder of the Monitor’s first six months have been focused upon several major and interrelated issues which directly impact the Consent Decree’s implementation, including:
§ Lack of a budget for the State of Illinois resulting in uncertainties for beneficiaries of the Consent Decree and their families, agencies, staff, providers of all types of services, and advocates;
§ Low wages creating a staffing crisis for providers of all types of services in their efforts to recruit and maintain adequate staffing and appropriate training for staff with existing inadequate funding for wages and high staff turnover levels;
§ Initiation of waiver services still pending for more than one year, and for as much as three or more years, for 153 class members who have been selected between March, 2012 and March, 2014 via the PUNS process as well as for 101 Ligas ICFDD class members seeking DD Waiver services;
§ Limited availability of small CILAs in certain geographic areas and for individuals with more intense medical, behavioral or physical needs;
§ Inadequate availability of flexible, person-centered, integrated day activities or employment for individuals seeking such opportunities; and
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§ Reported potential for inadequate availability of resources for implementation of the Consent Decree during the second half of Fiscal Year 2016.
Despite the Defendants’ ongoing commitment to compliance with the Decree, Mr. Records noted in his Third Annual Report that “resources for implementation, however, are significantly strained”2 and that there were “several concerns identified, which, if not effectively addressed, could result in non-compliance”.3 The current Monitor’s experience in Fiscal Year 2016 thus far is that the status of such resources has significantly worsened. In the current report, there is a finding of noncompliance in this area. (See section I herein.)
2 Third Annual Report of the Monitor, page 7 3 Third Annual Report of the Monitor, page 2
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OVERALL IMPLEMENTATION ACTIVITIES
The Monitor has, over the past six months, engaged in innumerable activities consistent with the requirements of the Decree and as deemed necessary by the Monitor in order to become familiar with all aspects of the Ligas case. These include:
Ø Communicating regularly with the Parties and Intervenors; Ø Reviewing data and other information provided by the Defendants at
agreed upon intervals as well as on a more frequent basis whenever requested by the Monitor; Ø Reviewing hundreds of documents provided by Class Counsel, Counsel for the Intervenors, service providers, Independent Service Coordination (ISC) agencies and advocacy organizations; Ø Meetings with the management team and staff at the Division of Developmental Disabilities (DDD) and with the Department of Human Services (DHS) in Chicago and Springfield, including with the DDD Director and DHS Secretary; Ø Participating in monthly conference calls with Plaintiffs’ Counsel and Defendants regarding individual class member issues; Ø Responding to scores of individual requests from Class members and their family members or advocates; Ø Participating in meetings, conference calls and forums with ISC and provider agencies, provider organizations, family and advocacy groups, the Ligas Class Member/Family Advisory Council; Ø Visiting Class members and those represented by Counsel for the Intervenors where they live, work and attend programs; and Ø Addressing the impact of the State’s fiscal crisis upon those protected by the Decree, including constant communication with the Counsel for Plaintiffs, Defendants and Intervenors as well as with service providers ranging in size and type from the largest agencies operating ICFs/DD and
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CILAs to families receiving Home Based Services and individuals caring for one family member.
The Defendants continue to engage in actions required by the Consent Decree and Ligas Implementation Plan through such activities as:
Ø Continually exceeding, in number, the requirements to initiate services for class members both on the waiting list and living in ICFs/DD;
Ø Revising the process for developing Ligas Service Transitions Plans (LSTPs) as well as the format and required content of LSTPs;
Ø Continuing the PUNS Integrity Project to increase accuracy and validity of the PUNS selection process and updates;
Ø Reviewing the eighteen ISC agencies to monitor transitions from both the PUNS list and ICFs/DD to community-based services, although the survey protocol has recently been significantly reduced;
Ø Increasing the speed of responses to crisis situations; and Ø Maintaining data required to assess compliance with the Consent Decree. Ø Engaging in community outreach activities Ø Participating in meetings of the Ligas Class Member/Family Advisory
Committee Ø Improving the processing of appeals
The 2013 Revision of the Implementation Plan required the establishment of the Ligas Class Member/ Family Advisory Committee.4 This Committee meets quarterly at two locations that are connected by videoconferencing. DDD staff, Class counsel, the Monitor, family advocates and self-advocates attend these meetings. The Monitor has found these meetings to be informative and they have facilitated the Monitor’s initial efforts to meet Class Members and family
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advocates. The Monitor will review reports and suggestions provided by this Committee with the Defendants and will respond to the Committee. Individual concerns and questions brought to the Monitor by Committee members will also be addressed promptly.
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COMPLIANCE REQUIREMENTS AND ACTIVITIES
Pursuant to ¶32 of the Consent Decree, Compliance Evaluation Standards were finalized in July 2012 to provide “objective standards to guide the Monitor in evaluating the Defendants’ compliance with the Decree.” The Ligas Implementation Plan, required by ¶29 of the Decree, is “supplemental to the Decree” and the Monitor therefore also reports on activities specified in the Implementation Plan as they relate to each of the Compliance Standards indicated below:
I. Resources and Capacity II. Class Member List(s) III. Transition Service Plans IV. Transition for Class Members in ICFs/DD V. Crisis Services VI. Transition for Class Members on Waiting List VII. Outreach VIII. Implementation Plan IX. Data Reports While each of these areas of compliance is addressed separately in the following sections of the current report, more information is provided related to the areas which currently have the greatest impact upon those protected by the Consent Decree.
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I. Resources and Capacity Paragraph 4 of the Consent Decree requires, in part:
Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs using federally approved objective criteria regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based Setting…
And Paragraph 5 of the Decree requires:
Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings.
As there is no approved State budget for FY 2016, and it is not clear whether any proposals previously submitted on behalf of agencies early in the budget process are still under consideration, it cannot be assumed that the sufficient funds described in ¶5 will be available.
Section IV of the Ligas Implementation Plan (FY15 Revisions-6-5-15) addresses the development of community capacity, cites ¶4 and ¶5 of the Decree, and notes therein:
Within the first six years of the Consent Decree, the DDD will provide services to 3,000 individuals currently living at home with their families or in another community arrangement. These will include both Home-Based Support Services (HBS) and Community Integrated Living Arrangement (CILA) services, inclusive of all support services provided under the Waiver. In addition, an unidentified number of individuals will be moving from ICFs/DD to HBS or CILA services. This will require at least an estimated 20% expansion of Waiver capacity. (The exact amount cannot be known until the individuals in ICFs/DD are identified.) Individuals selected to receive services under this Consent Decree may choose from any qualified and willing providers as defined in
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the Waiver. … In order to meet the required expansion, current providers will be called upon to increase the size of their operations and new providers may be needed.5
Of significance is the fact that prior benchmarks for initiating services to these 3000 individuals have been met or exceeded. As of 12/1/2015, services have been initiated for 2,399 individuals, (96%) of the 2,500 individuals on the PUNS list required to be receiving services by 6/30/2016. This is reflective of the consistent, focused efforts being made by DDD, in cooperation with family members, service providers, ISCs and many others, to comply with the Consent Decree. However, the current Implementation Plan, also in Section IV, includes a subsection entitled “Facilitating Services for Selected Class Members.” This subsection references Class members who were selected for Waiver services through the first four selections from the PUNS list but who had not begun receiving services as of September 1, 2014. The Monitor has worked closely for the past several months with DDD and the Plaintiffs to identify barriers confronting this group of class members and to strategize how best to meet their needs and expectations without further prolonging their time on the “pending services” list. This will likely be true, going forward, for ICF/DD Class Members who are awaiting moves into community-based settings if the “qualified and willing providers” noted above in the reference to Section IV of the Implementation Plan remain unable to expand their community development or even maintain current levels of services.
Based on the most recent data provided to the Monitor, as of December 14, 2015 a total of 101 Ligas ICFDD class members were noted to be awaiting requested
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services. Cases “pending” refers to Ligas ICFDD Class Members who have been seeking DD Waiver services for over one year. Major reasons for the pending status include:

Reason

Total

Waiting for downsizing or CILA development

36

Geographical preference

11

Individual/ guardian/ family want specific provider

10

Guardian not actively pursuing/waiting for appropriate CILA

8

Expanding search

5

Now moving forward in process

5

Undecided about receiving services

4

Behavioral needs

3

Geographic preference plus mobility needs

3

Individual deceased

3

Needs health stabilization

3

Communication between ISC and individual/guardian/family

2

Issue not identified

2

Age and Mobility needs

1

Behavioral needs plus communication between ISC and individual/guardian/family 1

Geographic preference plus mobility, behavioral and mental health needs

11

Geo preference plus medical and behavioral needs

1

Geo preference plus medical needs

1

Medical and physical needs

1

Stay in ICFDD

2

Visiting

1

Waiting for information from ICFDD

1

Data provided to the Monitor as of December 14, 2015 regarding Ligas Class Members selected from the Prioritization of Urgency of Need for Services (PUNS)
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list indicates 153 cases are pending. Of these, 51 were selected in the 3 selection events or “PUNS pulls” in 2012 (February=7, June=8, October=36), 10 were selected in the September 2013 pull, and 92 in the March 2014 selection event. Major reasons for the pending status include:

Reason

Explanation

Total

Geographical preference

Individual/guardian/family has a location preference; may be waiting for additional 22 development or opening to occur.

Waiting on assessment

ISC is waiting for needed assessments to complete PAS Level II.

13

Undecided about receiving ISC is waiting for Individual/guardian/family to decide if they want to pursue

10

services

offered DD Waiver services.

Expanding search

Individual/guardian/family has decided to expand their geographical preference.

9

Services refused- pending

Individual/guardian/family chose to not participate in offered DD Waiver services

9

closure on PUNS

and ISC needs to update PUNS.

Waiting for home to be ready A provider has been identified and selected and development is underway. There is 8 an agreement between individual/guardian/family and provider that they will be working together.

Issue not identified

More information is needed.

7

Communication between ISC Individual/guardian/family is not always responsive, but ISC continues to make

6

and family

attempts at communication.

Family is now ready to move Individual/guardian/family is now ready to actively pursue DD Medicaid Waiver

6

forward

services

Medicaid- family needs to

Individual does not have active Medicaid. Individual/guardian/family needs to

6

follow through

follow through on Medicaid application process.

Unable to locate

ISC has not been able to locate the individual and closed their PUNS case.

6

Undecided between CILA/AHBS

Individual wants DD Waiver services, but has not chosen between residential

6

services or home supports.

Choosing Provider

Individual/guardian/family is in process of choosing CILA provider or interviewing

5

Service Facilitators.

Individual/family want specific provider

Individual/guardian/family have a provider agency preference, may be waiting for

5

additional development or opening to occur.

Behavior needs

ISC is having difficulty finding a provider that can meet the individual's behavioral

4

support needs.

Geographic preference plus Individual/guardian/family has a location preference, and individual requires an

4

mobility needs

accessible home.

Medicaid- financial eligibility Individual had too many assets to be financially eligible for Medicaid.

4

issue

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Waiting for individual/family ISC has presented referral/screening/service opportunities to the

4

to respond to opportunities individual/guardian/family and is waiting for a response.

Ineligible Setting

Individual is not a Ligas Class member due to his/her residential setting.

3

Recent Medicaid approval

Individual has recently been approved for Medicaid.

3

Behavior and medical needs ISC is having difficulty finding a provider that can meet the individual's behavioral

2

and medical support needs.

Geographic preference plus ISC is having difficulty finding a provider within the preferred geographical location

2

behavior needs

that can meet the individual's behavioral support needs.

Medicaid- denial

Medicaid application has been denied.

2

PAS Level II now complete

ISC has needed assessments and has now completed the PAS Level II.

2

Preferred home features

Individual/guardian/family is looking for a home that has their preferred design or

2

setting.

Visiting

A provider has been identified and individual is participating in trial visits.

2

Geographic preference plus Individual/guardian/family has a location preference and multiple service needs

1

"multiple needs"

Geographic preference plus ISC is having difficulty finding a provider that can meet the individual's medical

1

medical need

support needs within their desired location.

Guardianship issue

Guardianship is currently being established.

1

Medicaid- financial eligibility Individual has too many assets to be financially eligible for Medicaid and

1

issue plus poor

individual/guardian/family is not responsive to ISC.

communication

Medicaid- spend down issue Individual lost Medicaid eligibility due to unmet spend down.

1

Mental health needs plus

ISC is having difficulty finding a provider that can meet the individual's mental

1

behavior

health and behavioral support needs.

Needs medical stabilization Individual is currently experiencing health issues that requires stabilization before

1

continuing in this process.

Out of state

Individual has moved out of Illinois.

1

Recent decision to pursue

Individual/guardian/family who previously had refused services have recently

1

services

decided they want to pursue offered DD Waiver services.

Waiting on assessment plus Individual's behavioral needs are making it difficult to successfully participate in

1

behavior

evaluations that are required for PAS Level II assessment.

Want housemates with same Guardian wants individual to live in a home housemates of the same religions and

1

religion/same gender

gender.

On 12/15/2015, the Monitor participated in a conference call of sixty-eight providers from across the state who provide ICFDD, CILA, ISC and Developmental
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Training services (DT). Of that group, there was not one provider stating a willingness to consider expanding services while experiencing an unprecedented “staffing crisis” due to inadequate funding of wages, primarily for direct support personnel (DSPs) but also for supervisory and nursing personnel. Several agencies noted that despite the State’s and families’ interest in smaller settings, they are actually or at least considering increasing the size of residential settings in response to budget deficits caused by insufficient funding for program operations and lack of adequate staffing. ICFs/DD are also experiencing this workforce crisis, which is not surprising as neither CILAs nor ICF rates have increased since 2008 while operating costs have increased annually.
Without disclosing any names of individuals or agencies, following are a sampling of comments from service providers addressing their top concerns:
“In my 40+ years working in the disabilities field in Illinois, I have never encountered such a staff recruitment problem. I would characterize is as a desperate situation.”
“The most obvious risk is when you truly need two people present and on duty, but you may have only one staff member.”
“Providers are reporting double-digit vacancy and turnover rates; staffing programs at bare-minimum levels and focusing staff
resources solely on the safety of individuals.”
“Without doubt, the number one issue affecting quality of life and the basic issues of safety and freedom from harm is the inability to recruit direct support staff because of the noncompetitive entry wage level.”
“All providers have stalled opening new CILAs and are also reducing existing CILA capacity to stay financially stable. Inability to attract and retain staff and uncertainty of future funding levels are the main factors that limit providers’ ability to open new CILAs. Across the board,
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providers would be able to increase their capacity and open new homes, but they have no way of staffing them.”
“A four-person CILA which would serve three Ligas Class Members has been ready to open for four months but remains vacant because the agency
cannot adequately staff existing operations.”
“20% of an agency’s population are Ligas Class Members. The agency has a 20% vacancy rate in direct support positions and is taking steps to move people into larger residential settings due to the inability to staff smaller settings. The agency has closed residential intake despite a long waiting list.”
“An agency is closing a CILA and moving residents to vacancies in other homes it operates due to staffing shortages.”
In addition, prior to, during and following that conference call, some problematic trends were identified which also point to inadequate funding:
§ Three agencies reported having from 39 to 65 DSP positions vacant and are therefore not considering any referrals for residential expansion, including for Ligas Class Members living in an ICFDD who wish to move out.
§ An agency with a turnover rate of over 30% among DSP positions faces significant challenges in staffing programs that serve people with significant medical and behavioral support needs because there is no differential within the CILA and DT rates to account for the necessary intensity of support.
§ Chicago-based agencies are struggling to remain competitive with other employers in the area due to the city-wide minimum wage increase to $10.00 per hour effective July 1, 2015, with no commensurate increase in reimbursement rates.
§ The average (not starting) DSP’s wage is $9.35 per hour which is insufficient to maintain staff. Even the providers who are able to pay $1.00 to $2.00 more per hour are experiencing significant vacancy and turnover levels.
§ The State pays direct support workers in other programs significantly higher than the reimbursement wage for DSP personnel in community agencies, resulting in staff leaving community agencies to work for other State programs.
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§ One agency reported a $500,000.00 annual loss in developmental training services due to the staffing ratio required for people including Ligas Class Members with intense behavioral and medical support needs.
§ One agency is losing $20,000.00 annually for each person living in an ICFDD setting due to significant medical needs, the need to pay a higher wage to attract staff and insufficient reimbursement rates. The provider cannot consider developing smaller CILAs for these individuals because the losses would increase.
§ ISC agencies reported there is a growing list of families who have been selected for CILA services but cannot find a provider agency who will serve their family member due to their inability to expand services, the more intensive support needs of the person or the agency will only fill vacancies in existing settings which do not meet the families’ expectations.
§ Reliance on the 53R/D programs to address the needs of people with more significant medical and behavioral support needs is ineffective. This program assigns additional DSP hours to a specific person in response to a provider request based on the more challenging needs of the person. Often, the skill level that individuals require is beyond that of a DSP position and providers cannot fill existing DSP positions so having additional hours is not a solution.
§ The FY 2016 reduction back to pre-September 1, 2014 levels in the Personal Needs Allowance overall and the significantly lower payment for people living in ICFs/DD severely limits individuals’ ability to pay for needed items and to access community resources.
§ ICFs/DD have had to cut existing services, including nursing and a variety of therapy services, to those currently being served due to inadequate rates.
§ The Illinois Association of ICF/DD Providers, Inc. (IAIP) issued a report in April, 2015, reflecting a cost study of FY2013 which showed that 40% of the 204 ICF/DD facilities in Illinois at that time had a Negative Net Income in that year. Subsequently, it was reported that since that time losses have only increased as costs have risen and no reimbursement increases have been provided.
§ In a special report regarding ICF/DD resources in August, 2014, Tony Records stated that, while not identifying Defendants’ failure to increase rates as a violation of the Decree, “the overall level of rates for ICFs/DD and community based options have become increasingly problematic and pose an intermediate as well as long term insidious threat to continued compliance with the Decree. This issue must stay high on the agenda for the parties’ attention, and will not go away on its own.”
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The Monitor fully appreciates the opportunity to bring individual concerns to key staff at DDD and has become accustomed to their immediate follow-ups in all cases. However, when the concern is inadequate staffing at a CILA or lack of community development due to the types of concerns noted above, even the best efforts of truly committed professionals cannot resolve the problems. The Monitor applauds the Defendants’ success in meeting and exceeding previous benchmarks for both class members on the PUNS list and those living in ICFs/DD who want to move. However, the bleak picture painted by those previously most likely to implement the needed capacity building does not bode well for those already selected during PUNS pulls, but not yet receiving services or those still living in ICFs with hopes of moving to small CILAs in the community. Addressing the inadequacy of rates to provide acceptable wages for DSPs in both ICFs/DD and CILAs appears to be a good place to start.
While writing this report, the Monitor learned of ongoing efforts by a coalition of provider and advocacy organizations, among others, to get the attention of Defendants and legislators focused on the consequences of allowing this issue to remain unaddressed. The Monitor fully supports an increase in reimbursement rates to increase wages for DSPs in order to facilitate the provision of adequate, appropriate supports in both community living arrangements and ICFs/DD while encouraging the required expansion of community capacity, as noted in the Implementation Plan. Failure to remedy this crisis is already having a negative impact upon individuals, as noted above, and spreads to other areas of the Consent Decree as well. When committed providers are admitting that their staff
21

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have to focus primarily on safety, it cannot be assumed that the entitlements of those protected by the Consent Decree are being guaranteed or that the expectations of the beneficiaries of the Decree and their families are being met. This, coupled with the absence of a State budget which prevents the Defendants from demonstrating compliance with ¶5 of the Consent Decree, creates unprecedented difficulties for all involved. Until such time as concrete steps are taken to enact a State budget and address the staffing crisis and resulting decrease in service quality as well as lack of development in the community, the Monitor finds noncompliance with this compliance standard.

The Defendants’ activities related to the budget have typically been described in this section of Annual Reports of the Monitor. However, in the absence of a State budget, no meaningful information is available at the current time related to budget proposals, appropriations, spending plans or anticipated individual allocations.

It is worthy of note, however, that the Ligas Implementation Team remains intact with all eighteen positions filled despite turnover of specific staff in some of the positions:

Compliance Coordinator Program and Data Support Staff Bureau of Quality Management Staff Bureau of Transition Services Staff Appeals Unit Staff Rates Section Staff Medicaid Waiver Staff

1 position 1 position 7 positions 4 positions 1 position 1 position 3 positions

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The Third Annual Report recommended that three leadership positions be added within DDD to provide additional support in the areas of employment, waiver services and service coordination. Although such specific positions were not created, there are now key staff whose responsibilities clearly include the Employment First initiative, the expanded home and community-based services waiver and oversight of the eighteen service coordination agencies. The Monitor agrees that a Director’s position in each of these areas is preferable, but applauds DDD’s staff reassignments, particularly during the current fiscal climate, which do not diminish the Ligas Management Team numbers while addressing these significant areas related to the Decree’s implementation.
Unfortunately, the Ligas Family Advocacy Program, which had been reported in the Third Annual Report be “fully operational and staffed” and about which the previous Monitor had been receiving very positive feedback from families of Class Members, is now only partially staffed. It is unclear whether additional funding will be provided once there is a state budget in place. It is recommended that funding be reinstated to support this valuable resource for Waiting List Class members and their families statewide. Similarly, the temporary increase, as referenced above, in the monthly Personal Needs allowance for Class Members living in ICFs/DD and CILAs during FY2015 should be reinstated.
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II. Class Member List(s) Paragraphs 8 and 9 of the Consent Decree require that the defendants maintain a statewide database in which all Class Members are enrolled and which, along with waiting list data, is promptly revised. The Implementation Plan requires that DDD review the adequacy of the PUNS database.
Paragraph 2 of the Consent Decree requires that there is a list of Class Members who qualify for Medicaid Waiver services, live in an ICF/DD with nine or more residents and have affirmatively requested community-based services or placement in a community-based setting. Another list is required of Class Members who qualify for Medicaid Waiver services, live in a family home and are in need of and have affirmatively requested home and community-based services or services in a community-based setting. The individuals on this list are known as Waiting List Class Members and this list is considered a subset of the PUNS list.
According to the Third Annual Report, and despite previous inconsistencies as well as outdated information in the Class Member lists, DDD has begun addressing the problems, including establishing an automated process to add new Class Members to the PUNS list as well as remove those who are no longer eligible. Data regarding overdue PUNS updates are reported to the parties and the Monitor quarterly, most recently on 9/1/2015, and show progress in decreasing the number of overdue updates.
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The first three annual reports have identified the need for a comprehensive integrated data system within DDD and DHS. Over the next few months, the Monitor will review with DDD and DHS the status of this issue.
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III. Transition Service Plans The Third Annual Report of the Monitor as well as the 2015 Revisions of the Implementation Plan provide comprehensive reviews of the progress that has taken place over the past two years in addressing significant problems within the transition planning process. That level of detail will not be repeated herein. Rather, a summary of improvements and of next steps is being provided.
The Consent Decree is quite specific with regard to who participates in the development of Transition Service Plans (TSPs), what is included therein, under what circumstances they are required, and that they are not to be “limited by the current availability of services but be within the confines of the waiver and the State Plan”.6 The Third Annual Report notes progress toward “the development and operationalizing of a Transition Service Plan” and acknowledges that “Converting a system from virtually no transition service planning to a personcentered approach as required in the Decree necessitates a carefully planned and deliberate process that will continue to take time to evolve.”7 This evolution has included a consultant’s work to make needed modifications and provide training as well as technical assistance; a comprehensive review of 114 TSPs, which found inadequate participation of class members in their own transition planning, employment opportunities not being considered or offered; difficulty experienced by class members with significant behavioral or medical needs in finding providers willing or able to provide these services; inadequate use of TSPs as the foundation for the development of the Individual Support Plan (ISP) following placement;
6 ¶14, Ligas Consent Decree, page 10 7 Third Annual Report of the Monitor, 9/30/2014, page 22
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limited choices of activities and services in certain regions of the state. One year later, review of new TSPs reportedly showed marked improvement. The TSP form and instructions were then modified; class members were trained in effective participation in the transition planning process; and training continued for ISC agencies, focusing on those whose transition plans indicated least progress.
Over the next six months, the Monitor will select a sample of the transition plans completed since January 2015, at which time the most recent version of the plans was consistently in use. The Monitor’s Data and Program Analyst, Melanie Reeves Miller, will assist in reviewing and evaluating these plans to determine whether further revisions or training are needed and whether the plans are facilitating provision of appropriate services and supports chosen by the class members, families or guardians with whom the plans were developed. In addition, concerns raised by the Monitor in the Third Annual Report will be considered, including whether preferred size of CILAs, real employment and day services are being provided as described in the TSPs.
Related to this standard, in October, 2015, DDD developed and sent out questionnaires to 201 of the 700 individuals selected in March of 2014 for CILA services or Adult Home Based Services (AHBS), but chose AHBS. Questions included whether or not families were satisfied with the selection process, why a particular service was selected, whether they had visited CILAs, how satisfied they were (are) with their ISC agency. A remarkable number of responses, 89 or over 40%, was received within approximately one month and a staff person at DDD has
27

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been designated to review the responses and follow up with those who included questions or concerns. The Monitor has requested and received copies of the 89 responses and will confer with DDD on the outcome of this process, including perhaps contacting some of the respondents independently.
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IV. Transition for Class Members in ICFs/DD The Consent Decree requires in ¶17 that within six years after the approval of the Decree, all class members residing in ICFs/DD as of the date of the approval of the Decree will transition to community services or community-based settings consistent with their transition plans if, at the time of the transition, the class member requests placement in a Community-Based Setting as confirmed and documented in accordance with the Decree.
It is required that one-third of the class members in this category transition to the community by 12/15/2013, two-thirds by 12/15/2015, and all by 6/15/2017. The actual target numbers are fluid, based upon ongoing additions and removals from the list defining this category, but for the 2013 and 2015 target dates the Defendants exceeded the target numbers. As of 12/31/2015, the target number of class members residing in ICFs/DD to be transferred to the community was 932 of the 1399 class members known in this category as of 6/15/15. The actual number of such transitions as of 12/1/15 was 1255 of 1446 then active Ligas ICF/DD class members, more than 300 beyond the target.
Defendants are to be congratulated on their efforts to streamline the process for these transitions and on the fact that the overwhelming majority (1235, 98%) of these class members who have transitioned have received funding for CILAs, as they requested. The remaining individuals requested and received Home Based Funding (17) and funding for Community Living Facilities (CLFs) (3).
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An issue that will be pursued with DDD by the Monitor, however, is the fact that 63% of these transitions into CILAs as of 12/1/2015 were into CILAs serving 8 individuals, 19% into CILAs serving 4 people, 9% into CILAs serving 6 people, 5% into CILAs serving 5 people, 2% into CILAs serving 7 people, 1% into CILAs serving 3 people, 1% into CILAs serving 1 person and none into CILAs serving 2 people.
In addition, and as was suggested in the Third Annual Report, while ICFs/DD downsizing or closures continue, class members must be offered a variety of options and opportunities to make informed decisions about where, how and with whom they choose to receive services and supports. The Monitor will continue to work closely with the defendants in tracking how such choices are facilitated, particularly in light of the obstacles related to community development that are noted in Section I herein.
Finally, the Monitor will continue to work with DDD and the Plaintiffs to facilitate transitions of Ligas ICF/DD Class Members from the “pending services” list.
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V. Crisis Services As indicated in ¶21(a)-(b) of the Ligas Consent Decree, “an individual is in a situation of “Crisis” if he or she is at imminent risk of abuse, neglect, or homelessness. The provision of interim emergency services (including interim placement in an ICF-DD where no placement in a Community-Based Setting was immediately available) will not necessarily exclude the Individual from being deemed to be in a situation of Crisis. If, following a screening, the Individual who is determined to be in Crisis requests appropriate Community-Based Services to be provided in the Family Home or requests placement in a Community-Based Setting, Defendants will promptly develop, in conjunction with the Class Member, a Transition Service Plan.”
State Defendants are required to serve expeditiously class members who meet the above-described criteria and who request community services or placement in a community-based setting. A review of crisis requests from July 1, 2014 through June 30, 2015 indicated that 485 crisis service requests were received and reviewed by DDD with 461 requests approved.8
According to the crisis data, between 7/1/14 and 6/30/15, one hundred (100) crisis requests received were classified as abuse, 245 were classified as neglect, and 116 were due to the individual being homeless.
8 Ligas Data Report June 30, 2015 31

Case: 1:05-cv-04331 Document #: 627 Filed: 01/08/16 Page 32 of 44 PageID #:12001

ClassiﬁcaNon of Crisis Requests

116

100

245

Abuse Neglect Homeless

The above data indicates a slight increase from data ending 6/30/14 (as referenced in the chart below).
ClassiﬁcaNon of Crisis Requests

93

71

233

Abuse Neglect Homeless

Services provided to class members in crisis included four types of CILA (Community Integrated Living Arrangement) options: 24-Hour CILA, Host Family CILA, Intermittent CILA, and Family CILA, in addition to Home-Based Support Services (HBS). Of the 461 crisis requests approved, 244 were approved to receive
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24-Hour CILA, 3 were approved to receive Host Family CILA, 19 were approved to receive Intermittent CILA, and 17 were approved to receive Family CILA. HomeBased Support Services were approved for 178 class members:
Services Authorized July 1, 2014 - June 30, 2015

178
244
19 17
3

24-Hour CILA Host Family CILA Intermirent CILA Family CILA Home-Based Services

Compared to data ending 6/30/14:

Services Authorized July 1, 2013 - June 30, 2014

180

177

13 20 7

24-Hour CILA Host Family CILA Intermirent CILA Family CILA Home-Based Services
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Combining the two reporting years (7/1/13-6/30/15), a total of 858 crisis requests have been approved by DDD.
ClassiﬁcaNon of Crisis Requests July 1, 2013 - June 30, 2015

209

171

478

Abuse Neglect Homeless

Services were provided to class members in crisis within four types of CILA (Community Integrated Living Arrangement) options:
Services Authorized July 1, 2013 - June 30, 2015

358 421
39 30
10

24-Hour CILA Host Family CILA Intermirent CILA Family CILA Home-Based Services
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Case: 1:05-cv-04331 Document #: 627 Filed: 01/08/16 Page 35 of 44 PageID #:12004
During the 2013/2014 reporting period, the Monitor established, with the agreement of the parties, that the timeframe to receive services for class members in crisis will be 24-72 hours, although this timeframe may vary, depending on individual circumstances, or if temporary services are in place to address the immediate crisis. The Monitor noted, during the 2014/2015 reporting period, a marked improvement in timely review of the crisis packet upon receipt by defendants. Additionally, review of the data associated with the 461 crisis requests received between July 1, 2014 and June 30, 2015 revealed that, in nearly all cases, a “safety plan” had been determined to be in place for the class member in order to ensure safety and reduction of risk while awaiting approval of services. However, the Monitor has concerns as to the determination of adequacy of a safety plan wherein the class member in crisis is not in a permanent or stable situation (e.g., jail, psychiatric hospital, nursing home). It is recommended that the Defendants and Monitor confer to clarify criteria for determining adequacy of a safety plan.
For the most part, State Defendants had ensured prompt authorization of services following review of a crisis packet. However, the Monitor noted many cases where, although a safety plan was indicated as being in place, the initiation of services was delayed for more than a week and sometimes for up to a month or more. Based on the current data reviewed, for 93 individuals (20% of the 461 individuals), services did not begin for at least ten days with some delays in excess of a month.
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Finally, review of crisis data for the two-year reporting period indicated that eight (8) class members had requested crisis services on two occasions. In all of these cases, the safety plan/service put into place following the initial crisis situation proved unsuccessful after a period of between one and nine months, at which point the class member was again found to be in crisis and in need of services. Without further data and information, it appears that the most recent authorizations of services in response to the second crisis situations have been adequate.

As recommended in the Monitor’s third report, “The DDD, in conjunction with the Monitor and input from the Parties, will conduct an analysis of crisis data to determine the relationship between crisis applicants and the PUNS list. This analysis will be completed by September 30, 2015.” The DDD conducted the above referenced analysis and provided to the Monitor on January 5, 2016. According to the analysis, DDD utilized FY13 and FY14 data for a two-year comparison.

FY13 and FY14 Approved Crisis Placements

PUNS Category prior to Crisis Date CRITICAL EMERGENCY FULLY SERVED MOVED OTH CLOSED PLANNING WITHDRAWN NOT ON PUNS PRIOR TO CRISIS Total

Total 206 352 28 1 21 19 4 14 645

FY13 and FY14 Approved Crisis Placements and Length of time on PUNS Waiting List

Time Period

Number of Placements

% of Total

One Month or Less

43 7%

Over 1 Month to 1 Year

147 23%

1 to 2 Years

85 13%

2 to 3 Years

52 8%

3 Years or More

318 49%

Total

645 100%

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The above charts show the PUNS enrollment categories for the crisis requests, as well as the length of time of PUNS enrollment prior to receipt of the crisis request. It should be noted that each individual seeking community-based services, including those in crisis situations, must enroll in PUNS. Therefore, some enrollments were completed as the crisis requests were being processed.
The previous Monitor’s basis for recommending this analysis was to determine whether local PUNS outreach activities were identifying individuals in need or whether individuals were coming forward for crisis services who were largely unknown to the system. According to DDD, its analysis showed that the majority of individuals were previously identified and enrolled on the waiting list, thus not reflecting outreach to be a major concern.
The DDD did, however, identify that some individuals in crisis situations were not selected for services because their enrollments were out of date and did not reflect their current circumstances. The PUNS Integrity Project has been implemented to bring and maintain PUNS enrollments current with the intent to address this concern.
While the Defendants noted the above as reasons for individuals in crisis situations not being selected for services, the Monitor is concerned that nearly half (49%) of the individuals with approved crisis placements were on the PUNS waiting list for 3 years or more.
The Monitor greatly appreciates the assistance of Melanie Reeves Miller, the Monitor’s Data and Program Analyst, in conducting this review of Crisis Services.
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VI. Transition for Class Members on Waiting List The Consent Decree requires that Class Members described in ¶2 of the Decree will transition to the community and be referred to as Waiting List Class Members.9 A specific schedule for such transitions to community-based services or community-based settings is delineated in ¶23 which requires the following:
Ø 1000 by June 15, 2013 Ø Additional 500 by June 15, 2014 Ø Additional 500 by June 15, 2015 Ø Additional 500 by June 15, 2016 Ø Additional 500 by June 15, 2017
Following June 15, 2017, Waiting List Class Members will receive communitybased services or placement in a community-based setting at a reasonable pace.10
The Implementation Plan11 incorporates criteria for the prioritization of selections of Waiting List Class Members, including:
• Recorded on the PUNS (Prioritization of Urgency of Need for Services) database as being in an emergency situation and needing out-of-home supports or in a critical situation and needing in-home or day supports;
• Residing at home with a primary caregiver age 75 or over; • Leaving the Public School System in the past 5 years; or • Residing at home with a primary caregiver age 60 or over.
Within each category, selections will be made by the length of time on the database.
9 ¶22(c) 10 ¶23 11 Implementation Plan, 2015 Revisions, 6/5/2015, section VII, page 26-27
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As stated previously herein, benchmarks for 2013, 2014 and 2015 have been reached or exceeded and defendants have already reached approximately 96% of the June, 2016 target of 2500 such placements. This is a tremendous achievement and demonstrates the State’s commitment of necessary resources as were needed. However, as noted in Section I herein, the service delivery system is currently facing exceptional barriers to ongoing success and the Monitor will continue working with the Parties, providers, advocates and families to resolve systemic problems endangering the ongoing placements of Ligas Waiting List Class Members.
In addition, the Monitor will confer with the DDD to clarify the situation of those on the “pending services” list who have been selected via the PUNS process but for whom services have not yet been initiated, in light of the stated priority for PUNS selections to be made within each category on the basis of length of time on the database. It appears that this criterion could perhaps be applied to those waiting on the “pending services” list as well.
Finally, the requirement to place remaining Waiting List Class Members “at a reasonable pace” following June 15, 2017 requires that the Parties, with all due speed and with input from the Monitor, direct their attention to defining “reasonable pace” and planning its implementation.
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VII. Outreach
The Consent Decree at ¶25 states:
Defendants shall maintain a fair and accessible process by which Individuals with Developmental Disabilities or their legal guardians can affirmatively request in writing to receive Community-Based Services and/or placement in a Community-Based Setting or to receive ICF-MR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests.
Defendants’ outreach efforts are well documented in both the Third Annual
Report of the Monitor and the 2015 Revisions of the Implementation Plan. These details will not be repeated herein. However, a summary of some of the recent
and ongoing efforts follows:
Community Outreach Ø ISC agencies are trained on the requirements of the Consent Decree and the provisions of the Implementation Plan. Ø DDD, the Plaintiffs and the Monitor participate in information sessions about the Consent Decree for self-advocates, families, providers and others. Ø DDD maintains a user friendly ISC locator on its website. Ø The DDD website includes an overview of the Consent Decree as well as the Decree itself, Annual Reports of the Monitor, information about Class Members’ rights and eligibility. Ø DDD has established, publicized and maintains a Ligas complaint contact within the Division who maintains a log of complaints and related follow-up activities.
Outreach to Persons in ICFs/DD Ø Most recently, DDD secured the services of an independent contractor, The Council on Quality and Leadership (CQL) to identify potential Class Members living in ICFs/DD. These potential Class Members do not include those who specifically excluded themselves from the Class by having objected to the Decree prior to its approval
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or by submitting a written request to be excluded prior to the compilation of the initial class list. CQL’s work will continue through January 31, 2016 and a final report will then be issued. The chart below details CQL’s process during FY 14 and FY 15.

Outreach Activity

FY15 FY16

1 Total Potential Class Members Pending Contact

2620 590

2 # With Initial Phone Contact

546 1272

3 # Choosing Not to Meet w/Outreach Contractor

393 941

4 # Choosing Not to Meet at This Time, but Want Future Contact

29 32

5 # Choosing to Meet w/Outreach Contractor

124 299

5a # Completed Written Request for Community Services Through Outreach 32 83

5b # Undecided

18 36

5c # Pending

13 46

5d # Choosing ICF/DD

61 134

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VIII. Implementation Plan Paragraph 28 of the Consent Decree requires that the Implementation Plan be updated and amended at least annually. The Defendants have complied with this requirement and the most recent revisions were completed in June, 2015.
The Implementation Plan updates and proposed revisions are provided by the Defendants to the Plaintiffs, Intervenors and Monitor for consideration. Each year, negotiations have taken place and resulted in jointly developed revisions being agreed upon before being submitted to the Court. At each scheduled Parties’ meeting, the Defendants provide a verbal update of the Plan’s activities and respond to inquiries from Class counsel, counsel for the Intervenors and the Monitor.
It is recommended that the next proposed revisions be presented at the Parties’ meeting which follows the one already scheduled for January 21, 2016.
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IX. Data Reports Paragraph 33 of the Consent Decree requires the Defendants to provide to the Monitor, Class counsel, Intervenors and Intervenors’ Counsel and publicly make available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress toward achieving compliance. Defendants are required to provide these data reports not less than every six months. The Monitor acknowledges that the Ligas Data Reports are submitted timely and that interim data requested by the Monitor is also provided promptly. DDD staff are consistently available to answer the Monitor’s questions and address concerns related to data reports.
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Closing Comments
Having been appointed by the Court only six months prior to completing this report, the Monitor is grateful to Mr. Records for doing all of the critical foundational work at the initiation of this case and for all that he accomplished over the following four years. Appreciation is also extended to the Parties, Intervenors, families, advocates, providers and Class Members who have shared their expertise and insight into all aspects of this case as well as demonstrating what can be achieved through strong, cooperative efforts. The Monitor looks forward to continuing to work toward shared goals for the benefit of those protected by the Ligas Consent Decree.

Respectfully Submitted:

Ronnie Cohn Court Monitor ligas.monitor@gmail.com (914) 649-1856

44

 
 Case: 1:05-cv-04331 Document #: 637 Filed: 06/28/16 Page 1 of 3 PageID #:12164

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

Stanley Ligas, et al., Plaintiffs,
v. Felicia Norwood, et al.,
Defendants.

)

)

)

)

Case No. 05 C 4331

)

)

Judge Sharon Johnson Coleman

)

)

)

AGREED ORDER TO MAINTAIN COMPLIANCE WITH CONSENT DECREE

This case is before the Court on the parties’ Joint Motion to Approve Agreed Order. The

parties have advised the Court that the State of Illinois has not yet passed a budget appropriation

for the State Fiscal Year beginning on July 1, 2016 (the “FY 2017 budget”). In the absence of a

FY 2017 budget appropriation, Defendants will continue to provide all resources, programs,

services and personnel required by the Consent Decree (Dkt. #549), including without limitation

any Implementation Plans issued pursuant to Section XIII of the Consent Decree approved by

this Court on June 15, 2011 (Dkt. #549). It is the position of the Illinois State Comptroller that,

without an appropriation, the Comptroller does not have the authority to continue to approve

payments for services, programs and personnel that are necessary to maintain compliance with

the Consent Decree unless specifically ordered to do so by the Court.

In order to maintain compliance with the Consent Decree, IT IS HEREBY ORDERED

THAT:

1. “Beneficiaries” of the Consent Decree and covered by this Order include Class

Members (as defined in the Consent Decree), Individuals with Developmental Disabilities (as

defined in the Consent Decree) who have chosen to reside in Intermediate Care Facilities for the

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Developmentally Disabled (“ICF-DDs”), Individuals with Developmental Disabilities receiving Community-Based Services (as defined in the Consent Decree), and Individuals with Developmental Disabilities receiving services in Community-Based Settings (as defined in the Consent Decree) throughout the State of Illinois.
2. The Comptroller shall continue to timely approve and make payments for all services, programs and personnel, at a level and within the time period that such payments were made in Fiscal Year 2016, that are necessary to comply with the Consent Decree and Implementation Plans. The Court’s previous Orders of June 30, 2015 (Dkt. #597), August 18, 2015 (Dkt. #610) and September 1, 2015 (Dkt. #624) are incorporated herein and shall continue in effect. This Order shall remain in effect until the earlier of the effective date of the Fiscal Year 2017 budget or July 1, 2017, or until further order of this Court.
3. On or before July 1, 2016, Defendants shall publish this Order by (i) posting it on the DHS website, and (ii) transmitting a copy of the Order to all personnel and to all contractors and providers of services under the Consent Decree via email where available and by such other additional means as the Defendants employ for communications to the foregoing persons and entities in their usual course of business.
4. The Illinois Department of Healthcare and Family Services, the Department of Human Services, and the Illinois State Comptroller shall provide such information to the Court Monitor on a monthly basis to enable her to evaluate and to advise the Court and the Parties regarding the State’s compliance with the Consent Decree and the Orders entered by this Court.
5. If at any time the State believes that it may not be able to comply with any provision of the Consent Decree or this Order, the State must immediately bring the State’s potential noncompliance to the attention of the Court, the Monitor, the Plaintiffs, and the Intervenors before such non-compliance occurs.
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6. The State shall maintain its expedited payments consistent with the terms and conditions that existed during FY 2015.

Dated: June 28, 2016

SO ORDERED

BY: ____________________________ Sharon Johnson Coleman

3

 
 Case: 1:05-cv-04331 Document #: 642 Filed: 11/17/16 Page 1 of 40 PageID #:12188
Ligas Implementation Plan
2016 Revisions
State of Illinois
Department of Human Services, Division of Developmental Disabilities 11/16/16
This Implementation Plan has been developed by the Division of Developmental Disabilities, with input from the Plaintiffs, Intervenors, and Monitor to accomplish the obligations and objectives set forth in the Ligas v. Hamos Consent Decree. (Case: 1:05-cv-04331 Document #: 549)

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LIGAS IMPLEMENTATION PLAN 2016 Revisions
November 16, 2016
Section I. Executive Summary
Background of Litigation and Overview of Consent Decree On June 15, 2011, the State entered into a Consent Decree settling the Ligas v. Hamos lawsuit, filed on July 28, 2005 on behalf of individuals with developmental disabilities who were residing in private, State-funded facilities (Intermediate Care Facilities for Persons with Developmental Disabilities or ICFs/DD) of nine or more persons or who were at risk of being placed in such facilities. Plaintiffs sought placement in CommunityBased Settingsi and receipt of Community-Based Services. The Consent Decree, which is available on the Division of Developmental Disabilities’ (DDD) website,ii identifies two groups of Class Members:
 Adult individuals in Illinois with developmental disabilities who qualify for Medicaid Waiver services, who reside in ICFs/DD with nine or more residents, and who affirmatively request to receive Community-Based Services or placement in a Community-Based Setting.
 Adult individuals in Illinois with developmental disabilities who qualify for Medicaid Waiver services, who reside in a Family Home, who are in need of Community-Based Services or placement in a Community-Based Setting, and who affirmatively request Community-Based Services or placement in a Community-Based Setting.
The Decree does not force individuals who do not want Community-Based Services or placement to move. Nor does it force providers to close beds or enter into downsizing agreements with the State against their will. The tenets of the Decree will assist the DDD in expanding its community-based system to meet the growing demand for those services, while continuing to honor an individual's choice in deciding on the types of services and settings he or she prefers in order to live a personally fulfilling and productive life. The Decree includes the following provisions:
 Services for Individuals Currently Residing in ICFs/DD Within six years of approval of the Decree, all individuals living in ICFs/DD as of the effective date of the Decree who have affirmatively requested Community-Based Settings will move to Community-Based Settings. Placements must be implemented for one-third of all such individuals every two years of this six-year period. For those individuals who
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wish to continue living in an ICF/DD, the Decree requires the State to honor that choice and to continue to provide adequate funding to meet the needs of such individuals.
 Services for Individuals Currently Residing in the Family Home The DDD will continue to expeditiously serve all people who meet the established crisis criteria. There will be no limit to the number of people served who meet the crisis criteria. The DDD will serve 3000 individuals on the Waiting List for Community-Based Services or placement in a Community-Based Setting, as defined in the Decree, over the next six years (1,000 within the first two years and 500 each year the next four years) with homebased support services or in community-based residential settings. After the end of the six year period, all Class members on the Waiting List shall move off the Waiting List at a reasonable pace.
 Other General Provisions  Evaluations and Transition Service Plans will focus on individual desires and goals and will not be limited by existing services. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent appropriate and consistent with the choices of the class member and his or her legal guardian. The State, however, will not be required to develop or offer services that are not part of the approved Waiver or Medicaid State Plan.
 The Department of Human Services (DHS) will seek sufficient funds in annual budget requests to develop and maintain the services described in the Decree. Implementation of the Decree is not, however, dependent on legislative appropriation of new funds.
 A monitor has been appointed by the Court to oversee compliance with the Decree and report on progress to the Court on an annual basis. After nine years of the approval of the Decree, the State may petition the Court to terminate the monitoring process.
The Implementation Plan
This document sets forth the State’s plans to implement the provisions of the Consent Decree. It is being developed consistent with Paragraph 26 of the Consent Decree and has incorporated input received from the Plaintiffs, Intervenors, and other advocates throughout the system.
References to paragraph numbers in each of the sections below refer to paragraphs within the Consent Decree from which language is excerpted. For full context, readers should refer to the Consent Decree. Should any language in the Implementation Plan unintentionally conflict with that of the Consent Decree, the Consent Decree governs.
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Section II, Development and Maintenance of the Class Member List, describes the compilation of an initial list of class members and the DDD’s further development and maintenance of that list. These efforts will be on-going as additional individuals request to be added to or removed from Class Membership as a result of outreach activity.
Section III, Outreach, provides information regarding the DDD’s efforts to identify individuals in need of residential or in-home supports, as well as those Potential Class Members who wish to move from ICFs/DD. It is the intention of the DDD to partner with the Plaintiffs and other advocates to ensure individuals and their guardians are given accurate and complete information about their options.
Section IV, Development of Community Capacity, discusses the need to expand and develop new service capacity to meet the requirements of the Decree for Class Members seeking services. The DDD intends to work with both existing providers and recruit new providers to fill the growth in service delivery.
Section V, Community-Based Services/Placement for Individuals Residing in ICFs/DD, addresses the opportunity for Class Members residing in ICFs/DD to move to community-based services. At 2 ½, 4 ½, and 6 years from the approval of the Consent Decree (June 15, 2011), the DDD will have implemented services to one-third of these Class Members. Monitoring activities will be underway to achieve the goal of successful transitions.
Section VI, Transition Planning, outlines a plan and time frame for implementing the use of Transition Service Plans for Class Members. This new process will present a system change for the entire service delivery system. The Transition Service Plans will be developed prior to the selection of service providers to describe the services a Class Member needs. The goal of this process is to ensure service delivery focused on and tailored to the individual.
Section VII, Waiting List for Community Services and Placement, details the process for Class Members living at home to be selected for the 3,000 new community capacities. Individuals will be selected each year from the DDD’s waiting list.
Section VIII, Community Crises, confirms the DDD will continue its current practices in serving individuals in crisis situations. These services will be above the 3,000 capacities being developed for Class Members residing at home.
Section IX, Appeal Process, refers to the right to appeal any denial, suspension, termination, or reduction of services, as well as the process for informing Class Members of this right.
Section X, Resources Necessary for Implementation, outlines additional resources required by the DDD to implement the provisions of the Consent Decree. These resources include contractual services for administrative functions, additional staff, and direct services for Class Members. Also discussed in this section is the budget
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development to both maintain existing services and implement the new provisions of the Decree.
Section XI, Interagency Agreements, lists the two agreements currently in place among State governmental entities to secure matching Medicaid funds for developmental disabilities services. It is believed these agreements are sufficient to implement the provisions of the Decree.
Section XII, Process for Plan Reporting and Modification, provides for the annual review and update of this Implementation Plan. Reports will be produced every six months by the DDD containing data and information regarding compliance activities.
Section XIII, Acronyms, lists the acronyms used in this document.
Section II. Development and Maintenance of the Class Member List
Paragraph 6. Within thirty (30) days after Approval of the Decree, Defendants shall compile an initial list of Class Members by taking the list of Individuals to whom notice of Preliminary Approval of this Decree was sent, adding those Individuals from whom any of the Parties received a written, affirmative request to receive Community-Based Services or placement in a Community-Based Setting after notice of Preliminary Approval of this Decree was sent, but excluding (i) those individuals who filed objections to the Proposed Consent Decree that was the subject of the July 1, 2009 Fairness Hearing as described in Paragraph 3(i) above, and (ii) those Individuals from whom Defendants receive written requests that the Individuals do not wish to receive Community-Based Services or placement in a Community-Based Setting.
Paragraph 8. Defendants shall maintain a statewide database in which all Class Members are enrolled.
Consistent with Paragraph 6 of the Consent Decree, the Attorney General’s Office provided to the Monitor and Plaintiffs on July 15, 2011, an initial list of Class Members. Intervenors were also given a copy of the initial list. The list includes:
 Adults (age 18 and above) enrolled in the State’s Prioritization of Urgency of Need for Services (PUNS) database as of June 15, 2011, who were not already living in a 24-hour Community-Based Setting or State-Operated Developmental Center (SODC); and
 Individuals who had submitted written requests to be included in the Class to the Attorney General’s Office;
 But not those excluded from the class, as set out immediately below and in Paragraph 6 of the Decree.
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The Parties have agreed that, for those individuals who live in ICF/DD settings, they are a Class Member if they have completed an Illinois Form 1238iii or its predecessor, DMHDD Form 1243; or the DDPAS-10 Formiv; or the Request Form disseminated through Plaintiffs’ counsel; and checked the box indicating he or she chooses Home and Community-Based Services. An individual will not be a Class Member if he or she completed one of the above forms and checked the box choosing services in an ICF/DD or if he or she otherwise objected to the terms of the Consent Decree at the Court’s fairness hearing or objected otherwise in writing per Paragraph 6 of the Decree, unless a subsequent communication to DDD requests Community-Based Services or placement in a Community-Based Setting.
DDD, with the assistance of the Monitor, has completed a review of the initial list to ensure it includes only individuals for whom the State has a current record affirmatively requesting Community-Based Services or Settings. This review included a comparison of the initial list to the list of objectors to the Consent Decree.
This initial list of Class Members was also compared with the State’s PUNS database of individuals waiting for services and the following action has been taken:
 The records for Class Members are marked as a Ligas Class Member, along with the date the person was added to the Class Member listing. Records for those in the initial list show this date as June 15, 2011. The record also reflects whether the Class Member was living in the Family Home, an ICF/DD on June 15, 2011, or an ICF/DD after June 15, 2011.
 PAS/ISC agencies have completed PUNS enrollment for all individuals included in the initial listing who were not previously enrolled. The State continues to add individuals to the class list as they request Community-Based Services or placement through the normal PUNS process, per the existing PUNS manual.v It will also add those individuals who inform the State they choose to move from ICFs/DD through the completion of Form 1238, Choice of Supports and Services, or the DDPAS-10 Form. Efforts to identify additional Class Members are discussed in the Outreach section of this plan.
 If a person requests to be removed from the class at any point during the time of the Consent Decree, their record will be so marked, along with the date and reason. Reasons for leaving the class include: o Individual chose to stay in ICF/DD o Individual chose to move to ICF/DD o Individual is deceased o Individual moved out of State o Individual was determined by DDD to be ineligible for the Medicaid Waiver o Individual withdrew from the class without giving a reason o Other
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Thus, the individual’s record will be marked as “removed” but the record itself will not be deleted. Prior to marking an individual’s record as “removed”, the DDD will ensure the individual was informed of his or her rights as a Class Member by a PAS/ISC agency or an independent contractor. For people found to be ineligible, the DDD will refer these individuals to the appropriate state agency in which they may be eligible (e.g. the Division of Mental Health or the Division of Rehabilitation Services). For people found to be ineligible, if such individuals are later found eligible (as a result of an appeal or otherwise), those individuals will be added back to the class as described in the above process.
The State will continue to use its PUNS database to maintain the list of Class Members. Each Class Member will have a PUNS enrollment and his or her record will be marked with the data elements described above.
The DDD will maintain the class list. The Monitor and Class Counsel will have access to the class list, including contact information, on an on-going basis. The DDD also will provide to Intervenors’ Counsel the class list that DDD will use to compare with the listing of all ICF/DD residents to determine which ICF/DD residents will be contacted by the Outreach contractors as provided in Section III of this Implementation Plan, subject to Intervenors’ Counsel’s agreement to: (1) maintain the list as “attorneys’ eyes only”; (2) not disseminate any name on the list beyond Intervenors’ Counsel; and (3) not contact any individual on the list, the individuals’ guardians or the ICFs/DD in which those individuals reside. The DDD will produce for the Monitor, Class Counsel, and Intervenors’ Counsel semi-annual summary reports of additions to and removals from the list.
As part of the annual reviews of the Implementation Plan (see Section XII), the DDD will review the adequacy of the PUNS database in capturing the information needed for implementation of the Decree.
A fall 2014 analysis of the 22,693 then-active PUNS records indicated that 11,070, or 48.78%, are more than one-year old. 4,703, or 20.72% are three or more years out of date; 2,480, or 10.93%, are five or more years out of date. It is the State’s goal that all PUNS records be current within one year.
The DDD has conducted a special initiative, the PUNS Integrity Project, to ensure information and data on individuals enrolled is accurate, complete, and current. This project will cover a period of fourteen months from May 1, 2015, through June 30, 2016. Funds are being disbursed to provide the 18 independent service coordination agencies that process enrollments and updates with additional resources to work with individuals and families to bring records up to date.
Allocations for each of the 18 agencies have been determined according to each agency’s estimated percent of the population of Illinois. For the total project, the funding is:
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11,070 overdue records x $120.03 (3 hours at the hourly ISC rate of $40.01) = $1,328,732.10.
The funds were disbursed as grant payments in four portions:  1/7th, or two of the 14 months-worth of the funds were released in May of 2015,  During the first quarter of FY16, each agency received additional funds to bring them to 50% of their total allocation for the project so the agencies could secure the needed ISC time to begin the updates,  Another 25% was disbursed in the third quarter of FY16 when an agency reaches and maintains 75% compliance with the annual update requirements, and  The remaining 25% was disbursed in the fourth quarter of FY16 when an agency reached and maintains 95% compliance with the annual update requirements.
As of September 1, 2016, the number of outstanding records is 575. 96.8% of the PUNS records statewide are now current within one year. All 18 ISC agencies met or exceeded the 95% benchmark by the end of the initiative.
Section III. Outreach
Paragraph 25. Defendants shall maintain a fair and accessible process by which Individuals with Developmental Disabilities or their legal guardians can affirmatively request in writing to receive Community-Based Services and/or placement in a Community-Based Setting or to receive ICF-MR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests.
The DDD’s outreach efforts will be directed to:
 identifying individuals with developmental disabilities throughout the State who are or will be in need of residential or in-home supports funded through DDD Medicaid services; and
 Identifying individuals residing in ICFs/DD on or before June 15, 2011, who may choose to transition to Community-Based Settings and services. Objectors to the Consent Decree will not be contacted. The DDD will work in conjunction with Class Counsel to coordinate efforts on outreach.
Community Outreach
DDD will use the existing PUNS database, enrollment form, and manual as tools to identify, record, and track information regarding individuals newly identified as in need of services. The DDD will continue to complete PUNS enrollments through contracted entities. There are currently 17 local PAS/ISC agencies with contracts through the DDD for PUNS enrollments.
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Outreach efforts include:
 Training of PAS/ISC agencies on the requirements of the Consent Decree and the provisions of the Implementation Plan;
 Development and maintenance of special brochures, flyers, and posters, which can be downloaded from the DDD website;vi
 Coordination with trade associations, local schools, special recreation associations, and other advocacy organizations to publicize the Ligas Consent Decree and PUNS;
 Distribution of information regarding PUNS and Ligas to Medicaid-enrolled health care providers via the State Medicaid agency’s list serve;
 Distribution of materials at special events such as conferences, seminars, etc.;
 Inclusion of culturally appropriate materials, alternative means of communication, and easily understandable language in efforts to publicize the Ligas Consent Decree and PUNS, including targeting communities identified as under-reported;
 Maintenance of the PAS/ISC office locator function on the DDD website; and
 Maintenance of the 1-888-DDPLANS toll free number to connect families with their local PAS/ISC office.
DDD, with the assistance of the Monitor, provided initial training to the PAS/ISC agencies on the Ligas Consent Decree and their role in its implementation. Since that time, DDD and the Monitor have provided informational and training sessions through phone conferences (as was the case with information about the Outreach vendor) or through face-to-face meetings (as was the case with the implementation of the Ligas Transition Service Plan).
DDD and the Monitor have continuously provided information sessions about the Ligas Consent Decree around the State during conferences and other meetings of the major trade and advocacy organizations within the developmental disabilities system. These sessions have included self-advocates, family members, providers, special education teachers, ombudsmen, and Office of State Guardian employees.
Materials on the current DDD website include an overview of the Consent Decree, the six month data reports, the Monitor’s annual reports, information about Class Members’ rights, information about Class Member eligibility, and other materials, including the Consent Decree itself. With the assistance of the Monitor and in coordination with the PAS/ISC agencies, DDD developed information on the DDD website which can be used by the PAS/ISC agencies and other organizations that specifically address class membership and the rights of class members.
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DDD continues to maintain the PAS/ISC office locator function and the toll free number.
Outreach to Persons in ICFs/DD
In addition to the efforts to inform and identify individuals throughout the population as a whole, the DDD focused on outreach efforts to identify Potential Class Members residing in ICFs/DD. (Potential Class Members residing in ICFs/DD are those ICF/DD residents who (1) are not Class Members and (2) did not exclude themselves from the class by having objected to the Decree prior to its approval or by submitting a written request to be excluded prior to compilation of the initial class list per Paragraph 6 of the Decree.) The DDD secured the services of a contractor, the Council on Quality Leadership (CQL), to contact all Potential Class Members residing in ICFs/DD.
CQL initially conducted outreach efforts in two geographic areas: St. Clair and Madison Counties, and the South and Southwest Suburbs of Cook County. These areas were chosen because they were the areas in which the Ligas Transition Service Plan was piloted, and the PAS/ISC agencies in the area were further along in experience with that process. Outreach efforts were then conducted in the remaining geographic areas of the State. CQL conducted their outreach under specified guidelines approved by the prior Monitor and based on DDD provided training, to ensure individuals and their guardians chose the service alternative they feel best met their needs.
CQL completed its outreach activities in all areas of the State, including initial contacts and meetings with individuals, guardians, and family members, and the contractual arrangement ended on January 31, 2016. , In order to provide individuals’ guardians, and family members sufficient time to explore options and make decisions, any Potential Class Members or their guardians needing additional time for decisions were referred to the local ISCs and Division staff as necessary. CQL’s report on the ICF/DD outreach was provided to the Parties and Monitor on April 8, 2016. Per its final report, CQL identified 123 individuals who chose to become Class Members and were added to the Class Member list. Of these, 107 resided in the ICFs/DD on June 15, 2011, and have been referred to the ISC agencies for assessment and linkage to community-based services; 16 were admitted to the ICFs/DD after June 15, 2011, and have been referred to the ISC agencies for continued PUNS enrollment and future selection. In addition, 55 individuals requesting additional time to consider their options as Potential Class Members have been given contact information for the appropriate ISC agencies for future contact if desired. Division staff will contact the 55 individuals or their guardians by mail prior to the end of calendar year 2016. DDD also provided a summary report on the 123 individuals.
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General Information Sharing
In order to better inform individuals and family members, the DDD expanded and maintains the Ligas page on its website. The page is located at http://www.dhs.state.il.us/page.aspx?item=66987. It developed materials for this page with input from the Monitor, Plaintiffs, and family representatives. It also continues to give presentations about the Consent Decree around the State at conferences, annual meetings, and other events hosted by other organizations and agencies. If there are an insufficient number of such events to enable DDD to educate the public about the Consent Decree, DDD will create and host its own events. The DDD will post a schedule on its website of all events in which it will present information about the Consent Decree.
Ligas Class Member/Family Advisory Committee (CMAC)
The Defendants, in conjunction with the Monitor and with input from the Parties, established and continue to support a Ligas Class Member/Family Advisory Committee (CMAC). This committee provides ongoing consultation and advice to the Defendants, Monitor and Parties regarding implementation of Ligas activities from the perspective of Class Members and their families. Members of the CMAC were selected by the Defendants with input from the Parties. The Defendants provide administrative support to the CMAC and, when necessary, reimburse approved costs associated with Class Member/family travel. Summaries of CMAC meetings and any written recommendations are provided to the Parties for review and comment. Meetings of the CMAC are open to the public. Meeting dates and summaries are posted on the DDD’s website athttp://www.dhs.state.il.us/page.aspx?item=69772.
Section IV. Development of Community Capacity
Paragraph 4. The choices of Individuals with Developmental Disabilities, including Class Members, to receive Community-Based Services or placement in a Community-Based Setting or to receive ICF/MR services in an ICF-DD will be honored; provided, however, that this commitment to honoring choice does not alter Defendants’ current obligations under existing law regarding licensed ICFDD capacity system-wide or at any specific ICF-DD, and provided that, under current applicable law, this commitment does not entitle an Individual with Developmental Disabilities to receive ICF/MR services in a specific ICF-DD. Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such individuals under the Decree and the Implementation Plan consistent with such choices. While the Decree remains in effect, any amendment to the State Plan submitted by the State pursuant to 42 U.S.C.§ 1396, et seq. will continue to include ICF-DD services as an alternative choice for long-term care services for eligible Individuals with Developmental Disabilities. Nothing in this Decree shall impair Defendants’ ability to make changes in their provision of supports and services to Individuals with
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Developmental Disabilities, including Class Members, regardless of setting, provided that Defendants continue to honor Individuals’ choices and fulfill Defendants’ obligations under the Decree and Implementation Plan. Resources necessary to meet the needs of Individuals with Developmental Disabilities who choose to receive services in ICFs-DD shall be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree, including the obligations under Paragraphs 17 through 19 and 21 through 23. Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs using federally approved objective criteria regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based Setting; provided, however, nothing in this Decree shall require Defendants to change their current method for establishing funding or from adopting new methods based upon federally approved objective criteria.
Paragraph 5. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings.
Within the first six years of the Consent Decree, the DDD will provide services to 3,000 individuals currently living at home with their families or in another community arrangement. These services will include both Home-Based Support Services (HBS) and Community Integrated Living Arrangement (CILA) services, inclusive of all support services provided under the Waiver. In addition, an unidentified number of individuals will be moving from ICFs/DD to HBS or CILA services. This will require at least an estimated 20% expansion of Waiver capacity. (The exact amount cannot be known until the individuals in ICFs/DD are identified.) Individuals selected to receive services under this Consent Decree may choose from any qualified and willing providers as defined in the Waiver.
Illinois has a substantial base of qualified HBS, CILA, and day program providers. There are approximately 213 licensed CILA providers, 134 HBS service facilitation agencies, 154 developmental training providers, and 73 supported employment providers, as well as providers of therapies, assistive technology, and other support services as provided under the Waiver. DDD continues to communicate with both new and existing providers to increase capacity to serve this expanded population of individuals.
As part of the annual review of the Implementation Plan (see Section XII), the DDD is reviewing progress toward this needed expansion and will modify the Implementation Plan as necessary to implement the provisions of the Decree. Incorporating suggestions from the Plaintiffs and the Monitor, the DDD is focusing on three identified issues: (1) broadening awareness of services, (2) facilitating services for selected Class Members,
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and (3) analyzing potential barriers to CILA services. These three issues are discussed below.
Information Bulletins to Broaden Awareness of Services
In the 2015 Implementation Plan, DDD committed to issuing and/or posting to its website two Information Bulletins to clarify (1) the number of Direct Support Person hours available to Intermittent and Family CILAs, and (2) the availability of home and vehicle modifications, adaptive equipment and assistive technology under the Waiver. These Bulletins were posted and/or released in August, 2015, and are available at http://www.dhs.state.il.us/page.aspx?item=78890 and http://www.dhs.state.il.us/page.aspx?item=78893.
Facilitating Services for Selected Class Members
Through the first four selections from the waiting list, 8.9%, or 307 Class Members, who had been selected for Waiver services, had not begun receiving services as of September 1, 2014. As more than a year had passed since these individuals were selected for services, the DDD conducted a focused review of these Class Members to analyze the reason for the delay in service implementation. Although the DDD has consistently exceeded benchmarks for implementing services to Class Members from the waiting list, the DDD directed special attention to these 307 situations to ensure those selected are able to access needed services.
Since the 307 Class Members were identified with barriers to services, the DDD continued efforts to facilitate services for these individuals and others who have since been identified as waiting for services for more than one year following selection from the PUNS waiting list.
Data Reporting, Focused Selection and the PUNS Selection List
To avoid any confusion on the status of individuals who have been selected from the PUNS list but have not yet initiated services, DDD proposes that the parties focus on the whole Ligas Services List, as opposed to a sample. As previously agreed upon, a selection of individuals were previously identified based on point-in-time criteria for further examination of the obstacles to community transition and to identify potential patterns and/or trends that may be able to be remedied. This group has been referred to as the “Pending Services List” and has been the subject of continued monitoring and discussion between the parties and monitor. However, as many of the individuals remaining on the Ligas Services List are also in the process of obtaining services, and may at one point or another, meet those same previously used criteria, it would be a disservice to the remaining class members to continuously focus on only the smaller sample.
DDD will instead report on all active class members seeking and/or in need of services on the Ligas Services List, and will no longer report separately on the “Focus” or
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“Pending Services” list of individuals. To facilitate this tracking and reporting, during the spring of 2016, DDD created a database from the data contained in the Ligas Services List of all Class Members for whom funding has been authorized for services. The proposed data fields for this database have been shared with the Monitor and Plaintiffs for their input. Once finalized, this will enable the parties and Monitor to conduct inquiries and searches of particularly situated Class Members based on these data fields.

With respect to the monthly calls between Defendants and Parties to discuss specific individuals, DDD remains willing to continue these calls to discuss Ligas class members with funding sources who continue to seek community–based services, but prefers to discuss other Waiver matters, including matters involving Ligas class members who have not yet been selected for services, non-Ligas individuals and situations involving crisis determinations separately as they do not require input of Plaintiffs’ and State counsel or the Monitor.

DDD will include in the monthly reports a summary of all class members who have either been removed from the Ligas selection list or placed on “hold.” In addition, in a separate submission that will be provided only to the Plaintiffs and Monitor, DDD will identify the factual basis for the determination.

Analysis of HBS Selections

In addition, the DDD conducted an inquiry with ISC agencies and guardians in situations where an individual was selected from the waiting list for CILA services but chose HBS. The purpose of this review was to determine if there were barriers to accessing CILA services and, if so, to identify strategies for addressing any identified barriers. The review has been completed and produced the following results:

Surveys were sent to 201 individuals who were among the 700 individuals selected during March, 2014, for CILA services but who chose to receive HBS services. Of the 201 surveys sent, 95 individuals responded (47.3%). The responses are summarized below:

Did the Independent Service Coordination (ISC) agency discuss both the Community Integrated Living Arrangement (CILA) services and the Adult HomeBased Services (AHBS) program after you received the invitation letter?

YES NO No Answer Total

91 95.79% 3 3.16% 1 1.05% 95 100.00%

Did the ISC agency talk with you about specific CILA

providers located within your local region?

YES

NO

74 77.89% 17 17.89%

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No Answer Total

4 4.21% 95 100.00%

How would you rate your interactions with the ISC agency?

Excellent Acceptable Needs Improvement Unacceptable No Answer Total

64 67.37% 27 28.42% 2 2.11% 1 1.05% 1 1.05% 95 100.00%

Have you ever visited a CILA?

YES NO No Answer Total

39 41.05% 55 57.89% 1 1.05% 95 100.00%

If yes, how many CILA’s have you visited?

1 2 3 4 5 More than 5 No Answer Total

15 15.79% 11 11.58% 6 6.32% 5 5.26% 1 1.05% 1 1.05% 56 58.95% 95 100.00%

Did you consider choosing CILA services prior to selecting AHBS?

YES NO No Answer Total

35 36.84% 57 60.00% 3 3.16% 95 100.00%

Please indicate your reasons or considerations for choosing AHBS over CILA services? Check all that apply.

Wanted to stay in family home: Family not ready for CILA option:

YES NO No Answer Total
YES NO
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76 80.00% 1 1.05% 18 18.95% 95 100.00%
54 56.84% 0 0.00%

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No Answer Total

41 43.16% 95 100.00%

Concerns with Developmental Training Program:

YES NO No Answer Total

9 9.47% 0 0.00% 86 90.53% 95 100.00%

Lack of Local Options:

YES NO No Answer Total

16 16.84% 0 0.00% 79 83.16% 95 100.00%

Desired CILA provider is not developing capacity locally:

YES NO No Answer Total

5 5.26% 0 0.00% 90 94.74% 95 100.00%

Concerns with Behavioral Issues:

YES NO No Answer Total

10 10.53% 0 0.00% 85 89.47% 95 100.00%

Concerns with Medical Issues:

YES NO No Answer Total

16 16.84% 0 0.00% 79 83.16% 95 100.00%

Other - (Please provide specific information):
On a scale of 1 – 10, are you satisfied with the AHBS selection? 1 being unsatisfied, 10 being fully satisfied

Provided Comment No Comment Total
1 2 3 4 5 6 7 8 9

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24 25.26% 71 74.74% 95 100.00%
3 3.16% 0 0.00% 0 0.00% 1 1.05% 2 2.11% 1 1.05% 5 5.26% 10 10.53% 14 14.74%

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10 No Answer Total

54 56.84% 5 5.26% 95 100.00%

Please provide any suggestions that you believe would improve the process of initiating services once an individual has been selected

Provided Comment No Answer Total

30 31.58% 65 68.42% 95 100.00%

Based on these survey results, the DDD is pleased with the overall level of satisfaction with the AHBS Program and ISC experience. The DDD has reviewed the comments made by the respondents and addressed any outstanding individual issues. The Plaintiffs and DDD note that 41% of respondents indicated they had visited a CILA setting prior to the choice of the AHBS Program. DDD has reviewed ISC procedures and will propose modifications by November 1, 2016, to ensure individuals and guardians are provided information on the availability of services which address the individual’s identified needs and are offered the opportunity to visit one or more CILA settings prior to making a decision about the type of Waiver setting they wish to pursue.

New Providers and Programs

Any existing providers interested in implementing new programs or any entities interested in becoming providers through the DDD are directed to visit the DDD’s web page about becoming a new providervii. This web page informs potential providers about the qualification process, regulations, compliance issues, staff training requirements, DDD contact persons, etc. In addition, for potential new providers that require a license or certification such as CILA or developmental training providers, prior to the acceptance of a license or certification application, the DDD mandates attendance at one of the orientation sessions provided by the DDD approximately twice per year. Information about these sessions is posted on the DDD website. At these sessions, community services, quality assurance, and rates staff give joint presentations about provider regulations and processes and are available to answer questions from potential providers.

The DDD continues to encourage providers of day services to develop options that reflect the value of supporting the Class Member with relationships, productive work, participation in community life, and personal decision-making. At the end of Section VI below, a description of a new employment initiative is provided. It is hoped this initiative will result in greater access to employment services for Class Members and that new providers and existing providers will work with the DDD to increase support for Class Members in employment activities.

In addition, although the DDD is not required to modify its Waiver under the Consent Decree, the DDD is exploring the possibility of including additional day program options during the renewal of its adult Waiver. These additions would include options that focus on community access and paths to employment. At the time of the 2016 revisions to this
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Plan, discussions are underway with stakeholders. Individuals associated with the Parties and Intervenors are included among the stakeholders. DDD will update the Parties, Intervenors, and Monitor as this work progresses.
Conversion of ICF/DD Capacity
The DDD may enter into voluntary closure agreements with providers of ICFs/DD. In situations involving voluntary closures, the DDD shall ensure that ICF/DD residents transitioning to a new residential setting are provided with a Transition Service Plan as called for in Paragraph 13 of the Consent Decree, are informed of their right to explore options among any qualified provider, and are given a choice of qualified residential providers if they choose to explore those options. For ICFs/DD of 16 or more capacities, closure agreements provide for rates during the closure period that recognize the need for coverage of fixed costs while individuals are transitioning to new residential settings of their choice, whether operated by the same or a different provider.
In order to provide more detail about the downsizing/closure process, a sample agreement is available for reference on the DDD’s website.viii
In response to prior concerns involving lack of choice provided to individuals residing in ICF/DDs that were closing or downsizing, the DDD continues to ensure that Class Members impacted by downsizing or closure of an ICF/DD have a Transition Service Plan or Modified Transition Service Plan prior to moving to community-based services
Provider Qualifications and Training
The qualifications for each type of Waiver provider are specified in Appendix C of the Waiver.ix Training requirements are listed and described in the DDD’s training catalogue available on the DDD’s website.x
The quality improvement system for the Waiver is described in Appendix H of the Waiver. Performance measures are outlined throughout the Waiver itself.
PUNS Class Members-Ligas Services List “Hold” and Removal
To date, PUNS selections under the Ligas decree have offered services to individuals who have identified their needs as either in the emergency or critical categories. Therefore, it is assumed that these individuals are in need of services within one year. It is with these self-reported needs in mind that the following criteria are proposed. When individuals on the PUNS list are selected for services (the “Ligas Services List”), both the individual/guardian and ISC Agency are notified of the PUNS selection and advised to contact the other to begin the process of securing Community-Based Services. The Class Member or his or her guardian is required to complete an application within 6 months of the mailing of the PUNS selection letter. Extensions of time are provided upon request and upon good cause shown and a demonstration that efforts to obtain services have been made as noted below.
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For individuals who do not complete the process for placement and receipt of services once selected from the PUNS list, their cases may either be placed on “hold” or removed from the Ligas Services List. The following guidelines shall be used in making these determinations:
Removal from Ligas Services List
Under the following circumstances, an individual may have their name removed from the Ligas Services List. Removal from this list does not necessarily result in removal from the PUNS list, nor does it have any bearing on the individual’s ability to seek waiver services outside of the Ligas Decree.
 Individuals who are ineligible for services will be removed from the services list and will also be removed from the PUNS list, subject to their right to appeal. Reasons for ineligibility include but are not limited to death, relocation out of state, clinical ineligibility, and inability to financially qualify for Medicaid1.
 Individuals who do not meet Ligas class member requirements will be removed from the Ligas Services List but will remain on the PUNS waiting list. 2
 Individuals/guardians that decline services and affirmatively request to be placed in the “Planning” category of need on PUNS will be removed from the Ligas Selection List and will remain on the PUNS database under “Planning.” Families/guardians who decline services will be able to re-initiate their Ligas services for a period of 3 months after the date services were declined. After the 3 month period expires, the Ligas PUNS selection will no longer be valid and the person will remain on the PUNS database in the “Planning” category.
 Individuals/guardians who decline services and request to be removed from PUNS will be removed from the Ligas Selection List and will be removed from the PUNS database. Individuals/guardians will be able to re-initiate the Ligas services for a period of 3 months after the date services were declined. After the 3 month period expires, the Ligas PUNS selection will no longer be valid. If the family/guardian wishes to re-enroll in PUNS, they will have to do so according to the existing PUNS procedure.
 Refusal to complete or failure to cooperate in the assessment process. This includes but is not limited to any of the following: o Failure to either make contact with or respond to inquiries (telephonic, written or other) from the assigned ISC Agency within the initial 6 month period following the mailing of the selection letter [Note that as it
1 Individuals and their guardians will be afforded a full 9 month time period (with extensions as needed for good cause) to become eligible for Medicaid. 2 Class Members must be 18 years of age or older and residing in either a family home or an ICF/DD of 9 or more individuals. State Operated Developmental Centers, SNF-Peds, Skilled Nursing Facilities, residential schools or correctional facilities are among the settings that are not eligible settings.
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implements this process, the DDD will issue instructions to ISC Agencies requiring standardized contact attempts that will include two phone calls or texts and two letters or e-mails at a minimum]; o Failure to engage in and begin the assessment process within the initial 6 month period; o After obtaining an extension on the initial 6 month application deadline, failure to complete the assessment and obtain an eligibility determination within 9 months from the date of mailing of the PUNS selection letter. Extensions will be granted upon a showing of continued engagement with the ISC Agency and for extraordinary circumstances.
Ligas Services “Hold” Category
Individuals who complete the assessment process and are determined to be eligible for waiver services may be placed into the “hold” category. Individuals placed in the “hold” category will not receive continued placement services but will not forfeit their Ligas Services selection or PUNS status. Rather, individuals and/or guardians in the “hold” category will be contacted by their ISC Agency once every 6 months for a period of two years. During that two year period, the individual/guardian may at any time elect to proceed with obtaining waiver services based on their Ligas PUNS selection by contacting either DDD or the ISC Agency. After 18 months of being placed into the “hold” category, the DDD will issue written notice to the individual or guardian that the individual’s Ligas selection letter will be forfeited if no action is taken within six months.
If the two-year period expires with no further activity in furtherance of placement, the individual’s Ligas selection letter will be forfeited. However, in the event that the individual/guardian elects to continue the placement process within the two-year period, the individual/guardian must continue to engage with the ISC Agency in furtherance of community placement in order to remain on the active Ligas Services List.
Individuals may be placed in the “hold” category for the following reasons:  Seeking services from particular provider(s);  Awaiting opportunity to move with particular peers;  Inability to decide on a provider;  Deciding between home-based and CILA services;  Determining whether to proceed with waiver services;  To allow time to address medical or personal matters (including but not limited to rehabilitation, medical procedures, family emergencies or other matters that may delay decisions as to services);  Other reasons with approval from DDD.
Monitor’s Concerns Regarding Capacity Development
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In the Fourth Annual Monitor’s Report (see Pages 6 and 7; full report can be found at http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of %20DD/LIGAS4thAnnualReportofMonitor01072016.pdf), the Monitor identified the following issues she believes are interrelated issues which directly impact the Consent Decree’s implementation, including:
 Lack of a budget for the State of Illinois resulting in uncertainties for beneficiaries of the Consent Decree and their families, agencies, staff, providers of all types of services, and advocates;
 Low wages creating a staffing crisis for providers of all types of services in their efforts to recruit and maintain adequate staffing and appropriate training for staff with existing inadequate funding for wages and high staff turnover levels;
 Initiation of waiver services still pending for more than one year, and for as much as three or more years, for 153 class members who have been selected between March, 2012 and March, 2014 via the PUNS process as well as for 101 Ligas ICFDD class members seeking DD Waiver services;
 Limited availability of small CILAs in certain geographic areas and for individuals with more intense medical, behavioral or physical needs;
 Inadequate availability of flexible, person-centered, integrated day activities or employment for individuals seeking such opportunities; and
 Reported potential for inadequate availability of resources for implementation of the Consent Decree during the second half of Fiscal Year 2016.
The State has issued a response to the Monitor’s Report in which it disagreed with certain of the findings. The State response can be found at http://www.dhs.state.il.us/page.aspx?item=64489. The Parties, Intervenors, and Monitor continue to discuss these matters, and while the disagreements as to certain of the Monitor’s findings have not yet been resolved, it was agreed that the State should proceed with filing of this Implementation Plan.
Per the request of the Monitor and Parties, the following represents additional activities currently underway within the Division of Developmental Disabilities. These activities, while related to certain of the Monitor’s concerns, are not specific to Ligas. As such, the State does not consider them to be a part of, nor governed by either the Ligas Consent Decree or the Implementation Plan. The State makes no representations as to the end result from these activities, but will continue to update the Parties and Monitor on progress and developments in these two areas as they occur.
 Enhanced Staffing in CILA and Developmental Training Settings. The State recognizes that some individuals with extraordinary behavior and/or medical needs may require additional staffing supports in CILA and Developmental Training settings. In recent years, such supports have been awarded separately
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from the base rates, and providers have been required to separately track and bill for these additional supports. (This process has been referred to informally via Computer System Program Codes 53R and 53D.) At the time of the writing of the 2016 updates, the Division is in the midst of changing this process so that the additional supports will be incorporated into the base rates and services. It is believed the new process will give providers more flexibility in directing available resources to best meet their needs and the needs of the individuals served. A draft Information Bulletin on this topic was prepared and issued for stakeholder comment. A workgroup of selected stakeholders convened in July, 2016 and continues to work with the Division to finalize the changes.
 The Division has added a new service under its adult Medicaid Waiver called Short-term Stabilization Homes (SSH). Under this new service, four homes are being developed that may serve up to four persons at a time who are in need of temporary stabilization services due to extraordinary behavior issues. The State received approval on June 28, 2016, from the federal Centers for Medicare and Medicaid Services of its amendment to add this new service to the Waiver. The initial year of operation is being funded through Balancing Incentive Program funds. They are equipped with high staffing and oversight ratios, as well as the necessary staff or consultants to address the behavior and medication needs.
 The Division is increasing the number of Behavior Therapy hours an individual may receive under the adult Waiver. On June 28, 2016, the federal Centers for Medicare and Medicaid Services issued approval for the State to increase the number of hours from 66 annually to 104 annually, with a provision that more hours could be awarded with prior approval. This change is effective as of July 1, 2016. The Division is developing an Information Bulletin to inform stakeholders of the increase and the process for requesting prior approval for additional hours in extraordinary situations. The target date for releasing the draft bulletin for review and comment is November 30, 2016.
 Public Act 98-0901 gave the Division authorization to allow Direct Support Persons in settings of 16 or fewer capacities the ability to administer insulin injections when appropriately trained by and under the direction of a registered nurse. This authority should open more opportunities for individuals with diabetes. 59 Ill. Adm. Code 116, Administration of Medication in Community Settings, governs medication administration by staff. On June 24, 2016, the necessary amendatory language for Rule 116 was published in the Illinois Register for public review and comment. While the rule promulgation is underway, the Division is planning voluntary training sessions for nurse trainers during the fall of 2016 so that they can be prepared to implement the new rule language with the Direct Support Persons as soon as it is finalized.
 Waiver Employment and Day Program Services. The Division is working with a subject matter expert made available through a State Mentoring grant with the Federal Department of Labor to explore opportunities to enhance access to
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employment services. This work is closely aligned with the Supported Employment efforts, as well as reviews of current day service options. The consultant is helping to facilitate a group of stakeholders that are currently discussing the possibility of additional day services being incorporated into the renewal of the Adult Waiver in 2017.
 The Division is developing a web-based reporting and search mechanism for identifying and tracking vacancies within residential and day programs, as well as new development plans. Under this new application, providers will be able to record vacant residential and day program capacity, indicating whether the vacancies are specific to gender, whether the vacancies are accessible with regard to mobility issues, and in which counties (or community areas in the case of Cook County) the vacancies are located. Providers will also be able to record their willingness to develop new service capacity by county, including employment services and non site-based day options. Class Members and guardians seeking services, as well as Independent Service Coordination Agency staff, may then search the web application to identify potential providers. An interagency agreement and funding authorization was approved on July 8, 2016, for the programming resources to develop this application. Planning meetings are underway. The application is targeted for development by March 1, 2017.
Section V. Community-Based Services/Placement for Individuals Residing in ICFs/DD
Paragraph 17. …within six (6) years after Approval of the Decree, all Class Members residing in ICFs-DD as of the date of Approval of the Decree (regardless of when in this timeframe the Class Member affirmatively requested placement in a Community-Based Setting) will transition to Community-Based Settings consistent with their Transition Service Plan, if, at the time of transition, the Class Member requests placement in a Community-Based Setting…
Per the Consent Decree, at 2 ½, 4 ½, and 6 years respectively, the DDD will have implemented services to one-third of the individuals who were residing in ICFs/DD as of June 15, 2011 who inform the DDD they choose to move to Community-Based Placements. The number of individuals who have either requested to move, or who are moving due to voluntary downsizing and closure agreements of the ICFs/DD in which they are residents, calculated at 24 months following approval of the Consent Decree, i.e., June 15, 2013, was 889. As of December 31, 2013, 565 residents of ICFs/DD have moved to CILAs, 337 (59.6%) of whom had been residents of ICFs/DD that are the subject of voluntary downsizing and closure agreements. Any of the individuals who were residing in ICFs/DD as of June 15, 2011, who are newly identified as choosing to move to community-based services after June 15, 2013, will be offered services over the course of Years three through six.
As August 31, 2016, there are 1,478 confirmed Class Members who are or were residing in ICFs/DD on or prior to June 15, 2011. The DDD is instructing the PAS/ISC agencies
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to work with these individuals as they become Class Members to submit applications for Waiver services. Applications will be processed as they are received by the DDD.
As individuals are identified as choosing to move via the process described in the Outreach section above, pre-admission screening entities will be instructed to complete Medicaid Waiver eligibility assessments for them per the DD Pre-Admission Screening Manualxi and to report the results to the DDD via the ROCS software.xii Service options will be presented, per the same manual, to those individuals determined eligible. These options will be recorded on the DDPAS-10 Form. Transition Service Plans, as described below in the Transition Planning section, will be developed for those who choose to move.
The DDD monitors the transitions of individuals from ICFs/DD to Community-Based Settings or Services. Staff within the DDD’s Bureau of Transition Services is assigned to each individual, maintaining monthly contact with the applicable PAS/ISC agencies during the transition process. Monitoring activities are tracked through an internal database.
In addition to the activities by State staff, the PAS/ISSA monitor the individual’s successful adjustment to the new services by completing four weekly visits with the Class Member during the first month and quarterly visits thereafter. In the event the ISSA identifies problems, it shall take steps to resolve issues locally and refer matters as needed to the DDD per the Problem Resolution Protocol within the ISSA Guidelines.xiii It may also request more hours for additional visits per the Guidelines.
In March of 2015, the DDD began conducting a focused review of 161 Class Members residing in ICFs/DD who had become a Class Member over a year ago but had not yet begun receiving services. As more than a year had passed since these individuals were identified for services, the DDD is analyzing the reason for the delay in service implementation. Although the DDD has consistently exceeded benchmarks for implementing services to Class Members from ICFs/DD, the DDD is directing special attention to facilitate services for these individuals and others who have since been identified as waiting for services for more than one year.
ICF/DD Class Members-“Hold” and Removal from Active Class Member Status
Class Members residing in ICF/DDs begin the transition process by submitting a written request for community-based services. Once that request is received, the individual is considered to be an “Active” or “Confirmed” Class Member and transition planning begins. Unlike Class Members selected from the PUNS list, there is no target time frame for completion of an application, assessment or eligibility determination. However, as there are numerous Class Members seeking transition services, and in light of the timeframes dictated by the Decree, it is for the benefit of those actively seeking transition that focus should be shifted to those individuals. Individuals not actively engaged in
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seeking transition services may therefore be placed on the “hold” list or removed from the Active/Confirmed list under the following circumstances:
Removal of Class Members from Active/Confirmed List
Class Members who have previously expressed an interest in seeking community-based services may be removed under the following circumstances:
 Individuals who are ineligible for services will be removed from the Active/Confirmed list. Reasons for ineligibility include death, relocation out of state, clinical ineligibility, and inability to financially qualify for Medicaid3.
 Individuals who do not meet Ligas class member requirements will be removed from the Ligas Services List but will remain on the PUNS waiting list. 4
 Declined Community –Based services, demonstrated by completion of a written document stating their or their guardian’s preference to remain in the ICF/DD.
ICF/DD “Hold” Category
As with individuals selected from the PUNS list, Ligas Class Members may be placed into the “hold” category under the following circumstances:
 Seeking services from particular provider(s), including waiting for a particular provider to downsize their ICF/DD operations;
 Awaiting opportunity to move with particular peers;  Inability to decide on a provider;  Determining whether to proceed with waiver services;  To allow time to address medical or personal matters (including but not limited to
rehabilitation, medical procedures, family emergencies or other matters that may delay decisions as to services);  Other reasons with approval from DDD.
As with those selected from PUNS, Ligas Class Members in an ICF/DD who have been placed into the “hold” category will be contacted by their ISC Agency every 6 months for a period of two years. After 18 months of being placed into the “hold” category, the DDD will issue written notice to the individual or guardian that the individual will be removed from the class list if no action is taken within six months. If the Class Member is willing to actively engage in seeking community-based services at the two-year mark, the ISC Agency will continue placement activities, including expanding geographic
3 Individuals and their guardians will be afforded a full 9 month time period (which includes extensions as needed for good cause) to become eligible for Medicaid. 4 This includes situations where a Class Member has moved from an eligible setting to a non-eligible setting and is no longer seeking community-based services. In those circumstances, while the individual may no longer be a Ligas Class Member, they will still be able to request and apply for Waiver services. A Class Member’s eligibility is not lost by a move from an ICF/DD to a nursing facility or State-Operated Developmental Center for short-term stabilization stays of 120 days or less.
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locations, expanding provider searches, and exploring other options for community services. Class Members’ preferences will be identified and will remain an integral part of the planning process. The Class Member cannot, however, continue to remain on hold indefinitely. If the Class Member is unwilling to proceed with transition services at the end of the two year “hold” period, the Class Member will be removed from the class list and the ISC Agency will no longer be responsible for continued contact. If the individual wishes to explore community-based services at a later date, the individual will be able to seek community-based services through the PUNS procedures. Individuals placed on hold will not be included in determining compliance with the ICF/DD benchmarks.
Individuals who Decline Community-Based Services to Remain in ICF/DD
Individuals or guardians of individuals selected for Ligas services (either as a PUNS selection or as a result of a request to transition from an ICF/DD) who elect to remain in an ICF/DD will be sent by the ISC agency one follow up letter 6 months after declining Ligas services to confirm their selection. If, at the 6 month follow up, the individual or guardian confirms their selection of ICF/DD services (either by affirmatively confirming or failing to respond to the letter) the individual will be removed from the Ligas Services List. The individual will further be removed from the Ligas Class Member list, but may re-join the class upon written request for waiver services. Any individual who joins or re-joins the class after December 30, 2016, will not be guaranteed services by June 15, 2017, but will instead be provided community services within six months after the person joins or re-joins the class, unless reasonable efforts have not resulted in a community placement. ICF/DD residents, who were in ICF/DDs on June 15, 2011, have until June 15, 2017 to join or re-join the class. . In the event the individual or guardian responds to the ISC Agency’s letter by stating in writing that they wish to again explore Ligas transition services, the transition process will continue where it was left.
The DDD developed a database to enhance its capacity to track and analyze issues involving efforts to facilitate services to these Class members, which is operational as of the date of this Plan.
Section VI. Transition Planning
Paragraph 11. The Transition Service Plan shall describe the services the Class Member requires in a Community-Based Setting or through Community-Based Services; where and how such services can be developed and obtained; the supports and services the Class Member will need during his or her transition to a Community-Based Setting; and a timetable for completing that transition.
Paragraph 12. The Transition Service Plan shall be developed by a Qualified Professional in conjunction with the Class Member and, where one has been appointed, the Class Member’s legal guardian, and, where appropriate, the Class Member’s family members, friends and support staff who are familiar with the Class Member.
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Paragraph 13. The process for developing a Transition Service Plan shall focus on the Class member’s personal vision, preferences, strengths and needs in home, community and work environments and shall reflect the value of supporting the Class Member with relationships, productive work, participation in community life, and personal decision-making.
Paragraph 14. All services and supports in the Transition Service Plan must be integrated into the community to the maximum extent possible, consistent with the choices of the Class Member and the Class Member’s legal guardian.
Paragraph 15. The Transition Service Plan shall not be limited by the current availability of services, provided, however, that nothing in this paragraph obligates Defendants to provide the types of services beyond those included in the Waiver and/or the State Plan.
Implementation of the use of Transition Service Plans is a system change for the entire service delivery system. Time is needed in order to affect this change.
DDD has completed a variety of initiatives and tasks in order to further the implementation of the Transition Service Plans. These include, but are not limited to modification of the Transition Service Plan forms, trainings to PAS/ISC agencies, procurement of a contractor to provide technical assistance to PAS/ISC agencies, and continued monitoring and review of Transition Service Plans to ensure standards are met.
The process addresses the coordination required between PAS/ISC agencies when a Class Member is moving from one geographic location to another. The training for the PAS/ISC agencies will emphasize their respective responsibilities in such situations.
Transition Service Plans are being completed for each individual leaving an ICF/DD or the Family Home. In no more than 12 months prior to the development of the Transition Service Plan, the Class Member must be presented with all of his or her service alternatives. Transition Plans are not required for those individuals who will be receiving Home-Based Support Services (HBS) in their own or family’s home. An individual service plan is still required for each individual in the HBS Program as described in the Waiver.
No individuals were required to wait for the development and implementation of this process in order to move to a Community-Based Setting. PAS/ISC agencies followed the processes described in the DD PAS Manual to assist individuals in obtaining needed services. Now that the Transition Service Plan process is implemented, the Plans shall be completed within sufficient time to provide appropriate and sufficient transitions of Class Members in accordance with the deadlines set forth in the Decree. For those Class Members who moved to a Community-Based Setting without a Transition Service Plan, the ISSA will work with the Class Member and guardian to ensure needed modifications are made to the Individual Service Plan to address the Class Member’s personal vision,
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preferences, strengths and needs in home, community and work environments. The DDD, with input from the Plaintiffs and Monitor developed a Modified Transition Service Plan for this purpose. The DDD instructed PAS/ISC agencies to complete Modified Transition Service Plans for all individuals who moved prior to July 1, 2013 without a Transition Service Plan in place. 466 Modified Transition Service Plans were required and completed.
This Transition Service Plan is separate from the Individual Service Plans completed for all individuals enrolling in the Waiver. The Individual Service Plans are completed prior to the individual transitioning to community-based services and are inclusive of risk assessments to ensure the health and general well-being of the individuals.
The DDD will focus efforts to enhance access to supported and competitive employment opportunities as part of the Transition Service Plan process. These efforts will be funded in part through an Employment First project supported by the federal Balancing Incentive Program. As described in the Balancing Incentive Program funding proposals:
The first phase of this project will include working with a consultant (or consulting group) and stakeholders to:
 Define the types of opportunities we wish to promote;
 Determine provider qualifications;
 Review and, as needed, modify current rate structure;
 Discuss maximum utilization issues; and
 Establish data collection and benchmark expectations.
The second phase will include obtaining services through an RFI process to:
 Assist 200 individuals in the Adult DD Waiver in accessing supported and competitive employment; and
 Develop a procedural guide and other materials for use by providers throughout the Illinois system in assisting and supporting individuals to find and maintain employment.
At the time of this Implementation Plan update, the Division has held several all-day meetings with a stakeholder group and national consultant to draft new service definitions, determine associated provider and staff qualifications, and explore rate methodology and funding issues. The most recent meeting occurred on September 14, 2016. The draft product is now being finalized with the national consultant. At the same time, the Division issued two Notices of Funding Opportunities (NOFOs) for the second phase of the project: one for direct service providers to assist individuals in accessing supported and competitive employment, and one for a vendor to conduct an evaluation
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and technical assistance for the project. The applications were due on September 19, 2016. 26 potential vendors applied for the direct service NOFO, and 4 potential vendors applied for the evaluation and technical assistance NOFO. Division staff are now reviewing the applications. The target date for issuing the new contracts is November, 2016.
To better inform the upcoming initiative described above, the DDD reviewed LTSPs submitted between January 1, 2015 (the date plans were first required in the revised format) and May 21, 2015 (the date of the review) to identify plans that included a preference for employment. There were 145 plans submitted during this time period. Of those plans, 58 (40%) indicated employment; 87 (60%) did not. The DDD obtained from the ISCs a status report of the implementation of the employment provisions of these plans, identified potential barriers, determined next steps for individual situations, and compiled summary data for use in Phase I of the above initiative. The initial status report was compiled, summarized, and discussed at the September 15, 2015, Parties meeting.
For continuing monitoring of the overall Plans, during the third quarter of FY2016, the DDD provided a sample list of 223 Ligas Transition Service Plans to the Ligas Court Monitor per her parameters. This list identified each Ligas Class Member by an assigned sample number with the corresponding Independent Service Coordination Agency. The court monitor completed a review of the list and submitted a request to DDD for copies of 57 Ligas Transition Service Plans to be included in the sample review. The LTSPs were provided to the Ligas Court Monitor. The court monitor has made a subsequent request for the Individual Service Plans (ISP) of each individual in the sample. DDD has provided the requested information. The Court Monitor shared her review tool/protocol with the Ligas Parties on April 7, 2016.
As the work to increase employment opportunities for Class Members continues through the BIP Project and Waiver renewal, during Fiscal Year 2017 the Division will work to develop collaborative procedures with the Division of Rehabilitation Services regarding access to Vocational Rehabilitation services. It will also continue to emphasize the importance of addressing employment issues and opportunities during the Transition Service Plan process with Independent Service Coordination Agencies through Information Bulletins.
Section VII. Waiting List for Community Services and Placement
Paragraph 22(d). Within two (2) years after Approval of the Decree, Defendants shall provide, in accordance with the Class Members’ Transition Service Plans, appropriate Community-Based Services and/or placement in Community-Based Settings for at least 1,000 Waiting List Class Members who are selected from the Waiting List…with these Class Members served in order of priority. In each of the third, fourth, fifth and sixth years following Approval of the Decree, Defendants shall serve at least 500 additional Waiting List Class Members who are selected from the Waiting List, again in order of priority.
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Paragraph 23. All Class Members who are on the Waiting List after the end of the sixth year following Approval of the Decree shall receive appropriate Community-Based Services and/or placement in a Community-Based Setting, such that they move off the Waiting List at a reasonable pace…
Over the first six years of the Decree, the DDD is to serve under the Medicaid Waiver an additional 3,000 individuals from the waiting list. The addition of these 3,000 capacities will be accomplished by adding people to both the CILA and HBS programs.
The provision of community-based services and/or placement in a community-based setting for waiting list Class Members pursuant to Paragraph 22(d) of the Consent Decree will be based on an annual compliance date of 1000 class members by June 30, 2013 and 500 Class Members per year by June 30 for the next four years thereafter. This annual compliance date is consistent with the State of Illinois fiscal year as well as the semiannual date for information provided in the required data reports.
The DDD will use the following process for selecting individuals to be served from the Class Member waiting list:
Exclude anyone whose record is not labeled as a Ligas Class Member. As secondary edits to double check for accuracy of the list and selection, exclude the following records in all cases:
 Persons previously selected in PUNS selections [These individuals have already been chosen and offered services.],
 Persons in the Planning category [These individuals are not seeking services within the year, but are anticipating the need for services within five years.],
 Persons who are under the age of 18 [These individuals are not Class Members.],  Persons residing in Child Care Institutions (Program Code 19D) and Community
Living Facilities (Program Code 67D) [These individuals are already receiving residential services.],  Persons already enrolled in the Children’s Support and Residential Waivers (Waiver Codes D1 or D2) [These individuals already have a funding path for entrance into the adult Waiver.],  Persons who are client type [These individuals are not Class Members.]:
o B, Bogard Class Members, o C, CILA participants, o F, Family Assistance Program developmental disabilities participants, o K, Family Assistance Program mental health participants, o S, State-Operated Developmental Center residents, and o W, Mental Health Home-Based Support Services participants, and  Persons who are client type [These individuals already have a funding path for entrance into the adult Waiver.]: o G, Children’s Support Waiver participants, and o R, Children’s Residential Waiver participants.
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When selecting adults for HBS, exclude anyone already in the HBS program.
Selections will include individuals enrolled in the adult Waiver who indicate a need for more services. For example, persons receiving day program services who may request in-home supports, or persons receiving HBS services who may request CILA services, will be included in the selection process for the 3,000 capacities. Individuals admitted to ICFs/DD after June 15, 2011 who choose to move will also be included in the selections.
Per the original Implementation Plan, the selections were to include the following:
For every 100 individuals selected, include for residential services criteria:
25 individuals who are recorded on the PUNS database as being in an emergency situation (i.e., needing services immediately)xiv and needing out-of-home supports;
25 individuals residing at home with a primary caregiver age 75 or over.
For every 100 individuals selected, include for Home-Based Support Services:
20 individuals who are recorded on the PUNS database as being in an emergency (i.e., needing services immediately) or critical (i.e., needing services within the year) situation and needing in-home or day supports; ` 15 individuals leaving the Public School System in the last 5 years (use age 22 as selection criteria);
15 individuals residing at home with a primary caregiver age 60 or over.
Within each category, selections will be made by length of time on the database.
The DDD selected sufficient numbers to enroll in the Waiver 1,000 individuals in the first two years of the Decree and 500 in year three and will select sufficient numbers to enroll in the Waiver 500 in each of Years four through six. As of September 1, 2016, 2,644 individuals have been served from the PUNS list.
With the expansion envisioned under the Decree, it is believed the waiting list will move at a faster pace after Year Six. The DDD will continue to work with its MIS division to create a system by which DDD can summarize data on the average length of time individuals wait on the PUNS database. Summary information regarding the PUNS enrollments can be found on the DDD’s website.xv
Although PUNS selection categories have been modified previously, beginning in 2015, selections will be returned to the process outlined in the original Implementation Plan.
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That is, one-half of the selections will focus on those individuals requesting 24-Hour CILA services and one-half will focus on those individuals requesting HBS services.
Section VIII. Community Crises
Paragraph 21(c). Defendants shall ensure that all Class Members who are determined to be in a situation of Crisis, and who request to receive CommunityBased Services and/or placement in a Community-Based Setting, receive such services and/or placement in such setting expeditiously.
The PAS/ISC agencies will continue to submit requests for services from individuals in crisis situations, and the DDD will continue to process these requests, using existing criteria available on the DDD website.xvi These requests are not part of the 3,000 capacities to be provided under Section VII, Waiting List for Community Services and Placement. The DDD will ensure individuals are served expeditiously. Through agreement between the DDD and the Monitor, “served expeditiously” is reviewed as receiving some supports or services within a 24 to 72 hour period after an individual’s crisis status is confirmed to ensure the individual’s safety.
The DDD initially provided the Monitor with baseline information regarding crisis requests and subsequently shared information regarding the crisis requests approved and denied between FY12 and FY16 (year to date). As part of its compliance reports, the DDD continues to provide to the Monitor data regarding the crisis requests approved and denied. The Monitor reviews a sample of these requests and is given additional information upon request.
As stated in his third annual report:
The Monitor reviewed crisis Class Member information and data from all 397 crisis requests during FY 2014. The results showed that 95% (377) of the Class Members who were found to be in crisis, received some services within a 24-72 hour period after their crisis status was confirmed. These findings demonstrate that the Defendants' efforts have continued to be successful. The Monitor will continue to work with the Defendants, including joint reviews of the crisis management reports, to improve crisis responsiveness.
The Monitor further notes in his third annual report:
The Defendants' data reports indicate that, in FY 2012, 288 Class Members who requested service pursuant to the crisis criteria were served. FY 2013, 269 Class Members in crisis were served, a slight upturn from the previous year. In FY 2014 the number of Class Members who required crisis services, surprisingly, jumped to 397, a 47% increase over the previous year. It is not clear why this sharp increase in crisis requests occurred.
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Per the Monitor’s recommendation in connection with the increase in crisis requests described above, the DDD, in conjunction with the previous Monitor and input from the Parties, conducted an analysis of crisis data to determine the relationship between crisis applicants and the PUNS list. This analysis shows the following:

PUNS Category prior to

Crisis Date

CRITICAL

206

EMERGENCY

352

FULLY SERV

28

MOVED

1

OTHER CLOSED

21

PLANNING

19

WITHDRAWN

4

Not on PUNS prior to

crisis

14

Total

645

Time on PUNS until Crisis Placement

This table describes FY13 and FY14 Approved Crisis Placements and the length of time these individuals were on the PUNS waiting list.

Time Period One Month or Less Over 1 Month to 1 Year 1 to 2 Years 2 to 3 Years 3 Years or More

Number of Placements
43 147
85 52 318

% of Total 7%
23% 13%
8% 49%

Total

645

100%

DDD continues to fund crisis requests for services. It was anticipated that the number of crisis requests would decrease as the Ligas PUNS selections occurred; however, the requests are instead increasing. In order to ensure fair and equal access for all individuals seeking services, the Division proposes reviewing and modifying the current crisis guidelines. The Division will propose draft language to the Parties by November 30, 2016, for review. As Crisis is defined in the Consent Decree, modifying current guidelines may require the Parties to agree on modifying the Consent Decree and securing approval by the Court. As modifications are considered, the Division will also post them on its website for public comment prior to finalizing and implementing them.

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On Pages 34 through 36 of the Fourth Annual Monitor’s report, which is available on the DDD’s website at http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of %20DD/LIGAS4thAnnualReportofMonitor01072016.pdf, the Monitor raised concerns regarding the adequacy of crisis safety plans, as well as concerns that nearly half (49%) of the individuals with approved crisis placements were on the PUNS waiting list for 3 years or more. Per her recommendation, the Defendants and Monitor will confer during 2016 to clarify criteria for determining adequacy of a safety plan. The efforts described above regarding the review of the current crisis guidelines, as well as the PUNS Integrity project, will consider the PUNS waiting time.
Section IX. Appeal Process
Paragraph 24. Any Class Member who disputes a decision by Defendants or a Community Service Provider regarding eligibility for, or delivery of, CommunityBased Services or placement in a Community-Based Setting shall, pursuant to governing law, have the right to appeal or seek administrative or judicial review of such decisions through Defendants’ existing Fair Hearings process (as set forth in 89 Ill.Adm.Code Part 120) or as otherwise provided by law. Class Members also may avail themselves of any informal appeal process that currently exists.
Individuals may appeal any denial, suspension, termination, or reduction of Home and Community-Based Waiver Services. The appeal process, including time frames, is described in Title 59, Chapter 1, Part 120.xvii Individuals are informed of this right to appeal through the use of Form IL462-1202, Notice of Individual’s Right to Appeal, available on the DDD website.xviii Individuals are also informed of their right to appeal a determination of ineligibility via the DDPAS-10 Form, available on the DDD website.xix
DDD remains in compliance with the appeal requirements of the Decree.
Section X. Resources Necessary for Implementation
Paragraph 5. Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members.
Each year of the Consent Decree, the DDD and the DHS Budget Office will prepare annual proposals for inclusion in the Governor’s Introduced Budget for the funds necessary to carry out the provisions of the Decree. These proposals will include items that are currently funded and must be maintained as well as items that require new funding. Further information can be found in the Ligas 6 Month Data Report dated 12/31/15 (http://www.dhs.state.il.us/page.aspx?item=83066).
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The DDD will make every effort to maximize federal Medicaid match for the direct services and administrative activities. The DDD reviews rejected claims and works with providers to correct or complete data for claims submissions. The DDD needs to increase those efforts and account for the anticipated growth in volume as Waiver capacity expands. An additional staff person has been hired to assist with these efforts. Where applicable, the Money Follows the Person grant will be used to secure enhanced match during the first year of community-based services for those individuals who leave ICFs/DD for eligible settings under the grant. In addition, funds from the federal Balancing Incentive Program will be used to support Waiver capacity expansion and improve access to supported and competitive employment services. Existing interagency agreements describe the coordination between DDD and HFS regarding Medicaid match. See the following Section XI.
Appropriations
The DDD’s budgets since Fiscal Year 12 combined the major appropriation line for community-based services and ICF/DD services into one line. This enables the DDD to redirect resources, if appropriate, as individuals and providers make future choices regarding service provision. The DDD will request that this practice continue in each subsequent year of the Consent Decree. However, the DDD will maintain sufficient records to enable the Monitor to determine whether the State is fulfilling its obligations under Paragraph 4 of the Decree, including its obligation to provide funding sufficient to meet the needs of those who choose to live in ICFs/DD and to ensure that such resources are not affected by the State’s fulfillment of its obligation to provide Community-Based Services or Settings to those who choose those service options.
Annually, per the deadline established by the Governor’s Office of Management and Budget, the DDD will calculate and submit details of needed resources for consideration for inclusion in the Governor’s Introduced Budget for the following fiscal year. Each year the needed resources for implementation of the Consent Decree, separate and apart from the maintenance items specified above, will include, at a minimum, funding for:
 Community-Based Services and Community-Based Settings, both new funds for those beginning services and annualized funds for those who began services in the prior year;
 Assessments and outreach;  Special rates for ICFs/DD voluntary closure agreements; and  Contractual consultants and staff.
The proposed budget for Ligas implementation will be annually presented to the Parties and Intervenors. Budget information is included in the data reports.
A final budget was not approved by the State prior to FY 2016. Accordingly, the Court entered an order that until the FY 2016 budget takes effect, the Comptroller shall continue to make all payments for all services, programs and personnel for all beneficiaries of the Consent Decree, at a level no less than the levels paid in Fiscal Year 2015, that are necessary
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to comply with the Consent Decree and Implementation Plans. The order shall remain in effect until the effective date of the FY 2016 budget or until further order of the Court. The Court also ordered that the State shall provide information to the Court Monitor to enable her to evaluate and to advise the Court and the Partiers regarding the State’s compliance. A similar order was entered by the Court for FY17. The State has demonstrated continued compliance with the Order.
Federal Approval of Waiver Capacity
Each year, as new enrollment opportunities are made available for individuals, the DDD will work with HFS to submit an amendment increasing the capacity of the adult Waiverxx, as needed.
The adult Waiver was renewed by the federal government effective July 1, 2012. As part of that renewal, the total capacity of the Waiver was increased to 19,000 in anticipation of the expected growth during FYs 13 and 14. An amendment was submitted to and approved by the federal Centers for Medicare and Medicaid Services to increase the capacity of the adult Waiver to 20,840.
Section XI. Interagency Agreements
Interagency agreements, necessary to carry out the provisions of the Decree, are in place among the Departments. Specifically, there is an interagency agreement among the Departments of Children and Family Services, Healthcare and Family Services, Human Services, and Public Health that addresses the interactions involving developmental disabilities Medicaid programs. In addition, there is an interagency agreement specific to the implementation of the Money Follows the Person grant. These agreements are available upon request from the DDD. At this point, the DDD does not anticipate the need for any new interagency agreements to implement the Decree.
Section XII. Process for Plan Reporting and Modification
Paragraph 28. The Implementation Plan shall be updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate…
Paragraph 33. …Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress toward achieving compliance. Prior to the first report, the Parties and the Monitor will agree on the data and information that must be included in such reports…
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Pursuant to Paragraph 28 of the Decree, the DDD will review the Implementation Plan on an annual basis. Changes will be made, as needed, with the assistance of the Monitor. The proposed modifications will be submitted to the Monitor. The Plaintiffs and, if applicable, the Intervenors, will be given the opportunity for input. Per Paragraph 33 of the Decree, the DDD will report data and information regarding its progress toward compliance with the provisions of the Decree. The Parties, Intervenors, and Monitor agreed to a standard format for these data reports, which are now being produced twice per year by February 15th and August 15th. [By mutual agreement, the deadline for the first report was extended so the DDD could incorporate information regarding the Governor’s proposed budget for FY13.] These reports are being posted on the DDD’s website as they are available.
Section XIII. Acronyms
The following, for reference, is a list of acronyms used throughout this document: CILA – Community Integrated Living Arrangement DDD – Division of Developmental Disabilities DHS – Illinois Department of Human Services HBS – Home-Based Support Services HFS – Illinois Department of Healthcare and Family Services ICF/DD – Intermediate Care Facility for Persons with Developmental Disabilities ICF/MR – Intermediate Care Facility for Persons with Mental Retardation ISC – Independent Service Coordination ISSA – Individual Service and Support Advocacy JCAR – Joint Committee on Administrative Rules PAS – Pre-Admission Screening PUNS – Prioritization of Urgency of Need for Services RFP – Request for Proposals ROCS – Reporting of Community Services
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i Capitalized terms in the Implementation Plan are defined in the Implementation Plan are defined in the
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Consent Decree.
ii The link for the Ligas Consent Decree is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/LigasCo nsentDecree061511.pdf.
iii The link to Form IL1238, Choice of Supports and Services, is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Forms/IL462-1238.pdf.
iv The link to the DDPAS-10 Form is http://www.dhs.state.il.us/OneNetLibrary/4/documents/PAS/DDPAS100111.pdf.
v The link to the PUNS Manual is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Manuals/DD%20Manuals/Illinois%20PUNS% 20Manual.pdf.
vi The link to the PUNS brochures, flyers, and posters is http://www.dhs.state.il.us/page.aspx?item=31104.
vii The link to the new provider page is http://www.dhs.state.il.us/page.aspx?item=47336.
viii The link to the sample downsizing agreement is http://www.dhs.state.il.us/page.aspx?item=50038.
ix The link to the adult DD Waiver is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/Adult%2 0DD%20Waiver.pdf.
x The link to the DDD’s training information is http://www.dhs.state.il.us/page.aspx?item=45209.
xi The link to the DD Pre-Admission Screening Manual is http://www.dhs.state.il.us/page.aspx?item=53018.
xii The link to the ROCS Software is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/MentalHealth/DHSCRSManual.p df.
xiii The link to the ISSA Problem Resolution Protocol is http://www.dhs.state.il.us/page.aspx?item=56642.
xiv The PUNS database categorizes individuals into emergency, critical, and planning needs. See the PUNS Manual for definitions of these categories. The link to the PUNS Manual is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Manuals/DD%20Manuals/Illinois%20PUNS% 20Manual.pdf.
xv The link to the PUNS summary reports is http://www.dhs.state.il.us/page.aspx?item=51905.
xvi The link to the crisis criteria is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/DD%20Reports/Community%20Emergency% 20Criteria%20-%20Adults.pdf.
xvii The link to Rule 120 is http://www.ilga.gov/commission/jcar/admincode/059/05900120sections.html.
xviii The link to Form IL462-1202, Notice of Individual’s Right to Appeal is http://www.dhs.state.il.us/OneNetLibrary/27897/documents/Forms/IL462-1202.pdf.
xix The link to the DDPAS-10 Form is http://www.dhs.state.il.us/OneNetLibrary/4/documents/PAS/DDPAS100111.pdf.
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xx The link to the adult DD Waiver is http://www.dhs.state.il.us/OneNetLibrary/27896/documents/By_Division/Division%20of%20DD/Adult%2 0DD%20Waiver.pdf.
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 Case: 1:05-cv-04331 Document #: 646 Filed: 01/20/17 Page 1 of 57 PageID #:12232
Stanley Ligas, et al. v. Felicia Norwood, et al.
Fifth Annual Report of the Monitor
January 20, 2017
INTRODUCTION
This report is respectfully submitted to the Court, the Parties and the Intervenors in accordance with ¶34 the Ligas Consent Decree (Decree), which was approved and filed by the Court on June 15, 2011. The Decree requires that:
“The Monitor shall file annual reports to the Court, which shall be served on all Parties and Intervenors and shall be made publicly available. Such reports shall include the information necessary, in the Monitor’s professional judgement, for the Court, Plaintiffs and Intervenors to evaluate Defendants’ compliance or non-compliance with the terms of the Decree.”
The first Ligas Monitor, Tony Records, was appointed by the Court on July 19, 2011. Upon his retirement, the current Monitor’s appointment was effective on July 1, 2015. The first three Annual Reports of the Monitor were submitted by Mr. Records on September 27, 2012; September 30, 2013 and September 30, 2014. Based upon the timing of the current Monitor’s appointment in July, 2015, the reporting schedule was changed to January, 2016 to allow the Monitor six months for an initial evaluation of the Defendants’ compliance with the terms of the Decree. The Fourth Annual Report was filed with the Court and distributed to the Parties and Intervenors on January 7, 2016. It was subsequently made available on the DHS website and distributed widely.
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The ongoing cooperation of the Defendants, Plaintiffs’ counsel and representatives, counsel for the Intervenors, service providers, advocacy organizations, family associations and others too numerous to mention has been invaluable in completing the current report. Input from those protected by the Decree and their families remains critical to the Monitor’s efforts on an almost daily basis as well as during annual evaluations of the Decree’s effectiveness at each stage of its implementation.
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CHALLENGES
The Monitor’s Fourth Annual Report cites the lack of a State budget for Fiscal Year (FY) 2016 in Illinois and describes in detail how funding was guaranteed for providers serving all of those protected by the Consent Decree. It is stated therein that the lack of a budget for the State of Illinois resulted in uncertainties for beneficiaries of the Consent Decree and their families, agencies, advocates, staff and providers of all types of services. Federal Court orders to address these issues are quoted therein and the Monitor’s requirement of monthly updates from DHS regarding timeliness of such payments is referenced. This “Information Request Regarding Ligas Payments” remains in effect. In light of the lack of a State budget for FY17, which continues to date, the Plaintiffs, Defendants and Intervenors prepared an “Agreed Order to Maintain Compliance with Consent Decree” and filed with the Court on 6/26/16 a Joint Motion to Approve Agreed Order. This Order, which was approved by United States District Judge Sharon Johnson Coleman on 6/27/16 and entered on 6/28/16 requires, in part, that:
“The Comptroller shall continue to timely approve and make payments for all services, programs and personnel, at a level and within the time period that such payments were made in Fiscal Year 2016, that are necessary to comply with the Consent Decree and Implementation Plans. The Courts previous orders of June 30, 2015 (Dkt. #597), August 18, 2015 (Dkt.#610) and September 1, 2015 (Dkt. #624) are incorporated herein and shall continue in effect. This Order shall remain in effect until the earlier of the effective date of the Fiscal Year 2017 budget or July 1, 2017, or until further order of this Court.”
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“The Illinois Department of Healthcare and Family Services, the Department of Human Services, and the Illinois State Comptroller shall provide such information to the Court Monitor on a monthly basis to enable her to evaluate and to advise the Court and the Parties regarding the State’s compliance with the Consent Decree and Orders entered by this Court.”
“If at any time the State believes that it may not be able to comply with any provision of the Consent Decree or this Order, the State must immediately bring the State’s potential non-compliance to the attention of the Court, the Monitor, the Plaintiffs and the Intervenors before such non-compliance occurs.”
“The State shall maintain its expedited payments consistent with the terms and conditions that existed during FY 2015.”
To date, Defendants have maintained funding at the same level paid in FY 2016 which, though noted to be inadequate in the Fourth Annual Report, remains in compliance with the 6/28/16 Court Order.
The Monitor’s Fourth Annual Report addresses the fact that low wages, particularly those paid to Direct Support Professionals (DSPs), resulted in a staffing crisis for providers of services in their efforts to recruit, train and maintain adequate staffing with the existing wages. There has been a great deal of discussion at all levels during the past year without improvement in this situation. The staffing crisis continues as another year has passed with no relief in terms of salary increases, DSP vacancy rates either staying the same or increasing and the
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heightening impact of no increases in rates to providers since 2008 combined with ongoing higher costs of operating.
The Monitor’s Fourth Annual Report describes delays in initiation of waiver services for class members once they have been selected from the PUNS list. Herein it is noted that a new tracking system has been developed to actively monitor those class members seeking services.
The Monitor’s Fourth Annual Report notes limited availability of small CILAs in some geographic areas as well as for individuals with more intense medical, behavioral or physical needs. The Monitor has been informed during Fiscal Year 17 that this situation is worsening as new CILA development is being delayed due to lack of availability of DSPs willing to accept current wages and that some existing small CILAs are at risk of either closing or being consolidated into larger homes due to staff turnover rates of up to 70%. Some providers are actually stating that they are no longer able to accept into their CILAs individuals with more significant needs due to the provider agencies’ inability to recruit, repeatedly retrain (at significant cost) and consistently maintain sufficiently skilled staff to serve these individuals.
The Monitor’s Fourth Annual Report discusses inadequate availability of flexible, person-centered, integrated day activities or employment for individuals seeking such opportunities, all of which remains problematic. Efforts have begun through the Employment First initiative that appear to be promising but it is too soon to
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evaluate the outcomes. In addition the day training requirement for those living in CILAs is a deterrent to those individuals looking for homes in the community but preferring other daytime activities that are more customized and/or integrated into the community.
The Monitor’s Fourth Annual Report notes that despite the Defendants’ ongoing commitment to compliance with the Consent Decree, the previous Monitor had expressed concern that resources for implementation are “significantly strained” and that “if not effectively addressed could result in non-compliance”. The current Monitor’s finding, in January, 2016, of non-compliance with regard to Resources and Capacity is repeated herein. (See section I below.)
The Monitor has initiated conversations with the Division of Developmental Disabilities (DDD) within the Department of Human Services (DHS) regarding the processes utilized to monitor the quality of services provided to beneficiaries of the Consent Decree. Information requests were submitted to DDD and all documents were promptly provided. Discussions are ongoing among the Monitor and the Parties. (See section I. Resources and Capacity)
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OVERALL IMPLEMENTATION ACTIVITIES
The Monitor has, over the past year, sought and also received unsolicited input regarding many aspects of the implementation of the Ligas Consent Decree. Such activities are consistent with the Decree’s Compliance Evaluation Standards which state, in part:
“On an ongoing basis, the Monitor will seek and encourage class members, families and guardians of class members, the private provider community and members of the general public to provide written and verbal feedback on issues related to compliance with the Decree. Informal meetings and conference calls will also be conducted with defendants’ counsel and staff, class counsel and intervenors’ counsel regarding their respective experiences as well as information they may have with regard to compliance activities.”
The Monitor’s implementation activities over the past year included: • Communicating regularly with the Defendants, Plaintiffs and Intervenors; • Convening more frequent Parties’ meetings than had previously been the practice in order to address the most critical issues impacting those protected by the Consent Decree as well as to attempt to reach consensus on the development of the Ligas Implementation Plan 2016 Revisions; • Convening meetings to address the “Reasonable Pace” provision of the Consent Decree which is scheduled to become effective on June 15, 2017; • Reviewing data and other information provided by the Defendants at agreed upon intervals as well as on a more frequent basis as requested by the Monitor;
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• Reviewing hundreds of documents provided by Class Counsel, Counsel for the Intervenors, service providers, Independent Support Coordination (ISC) agencies, advocacy organizations and individuals;
• Participating in Status Conferences, which are currently being held approximately every 60 days, with Judge Coleman, Defendants, Class Counsel and Counsel for the Intervenors;
• Meeting with members of the management team and staff at the Division of Development Disabilities (DDD) within the Department of Human Services (DHS);
• Participating in monthly conference calls with Plaintiffs’ Counsel and Defendants regarding individual class member issues;
• Responding promptly to frequent inquiries from class members and their families, guardians and advocates;
• Presenting information regarding Ligas matters to large and small groups of parents, ISCs, service providers, provider organizations, advocates, the Ligas Class Member/ Family Advisory Council, and the Ligas Family Advocacy Program;
• Participating in a panel convened by the Senate Committee on Human Services to address the status and future of the implementation of the Ligas Consent Decree;
• Visiting individuals where they live, work and attend programs; • Initiating numerous conference calls with Defendants, Plaintiffs and
Intervenors to address significant issues on a timely basis; • Initiating a discussion with the Developmental Disabilities Division (DDD)
of the Department of Human Services (DHS) regarding the overall quality monitoring of Independent Support Coordination (ISC) agencies and Community Integrated Living Arrangements (CILAs); and • Addressing, in a variety of ways, the impact upon those protected by the Consent Decree of the State’s overall fiscal crisis and the specific issue of inadequate wages for Direct Support Professionals.
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The Defendants continue to engage in actions required by the Consent Decree and Ligas Implementation Plan through such activities as:
• Meeting or numerically exceeding the Consent Decree’s benchmarks for initiating services for class members on the waiting list as well as those living in ICFs/DD;
• Responding promptly and comprehensively to information requests from the Monitor;
• Participating in issue specific conference calls and videoconferences initiated by the Monitor beyond those which are scheduled on a routine basis;
• Participating in monthly conference calls with the Monitor and Equip for Equality (EFE) regarding individual Class member issues as well as promptly following up on individual Class member issues brought directly to DDD by the Monitor in response to contacts from family members and guardians;
• Conducting reviews of all of the ISC agencies and a sample of the CILAs on an annual basis as well as responding to the Monitor’s requests for additional information regarding the processes and protocols involved in this system;
• Maintaining agreed upon data required to assess compliance with the Consent Decree;
• Participating in a cooperative, though eventually unsuccessful, effort with the Plaintiffs, Intervenors and Monitor to reach consensus on the content of the 2016 Revisions of the Ligas Implementation in order to continue the practice of filing jointly with the Court the 2016 Revisions of the Ligas Implementation Plan;
• Recently developing, with input from the Plaintiffs and Monitor, a more comprehensive list of those who have been selected to receive services from the Prioritization of Urgency of Need for Services (PUNS) database and are still seeking services; and
• Organizing and participating in quarterly meetings of the Ligas Class Member/Family Advisory Committee.
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The Ligas Class Member/ Family Advisory Committee was established in compliance with the 2013 Revision of the Ligas Implementation Plan and meets quarterly at two locations which are connected by videoconferencing and telephone. DDD staff, Class counsel, the Monitor, family advocates and selfadvocates regularly attend these meetings and guest speakers are invited to meetings upon request of the members or as suggested by DDD or the Monitor. The Monitor finds these meetings to be informative and brings questions, concerns as well as suggestions from these meetings to others as necessary.
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COMPLIANCE REQUIREMENTS AND ACTIVITIES
Pursuant to ¶32 of the Consent Decree, Compliance Evaluation Standards were finalized in July 2012 to provide “objective standards to guide the Monitor in evaluating the Defendants’ compliance with the Decree.” The Ligas Implementation Plan, as required by ¶29 of the Decree, “is supplemental to the Consent Decree and the Monitor therefore also reports on activities specified in the Implementation Plan as they relate to each of the following Compliance Evaluation Standards:
I. Resources and Capacity II. Class Member List(s) III. Transition Service Plans IV. Transition for Class Members in ICFs/DD V. Crisis Services VI. Transition for Class Members on Waiting List VII. Outreach VIII. Implementation Plan IX. Data Reports As noted in the Fourth Annual Report of the Monitor, while each of these areas of compliance is addressed separately in the following sections of the current report, more attention is given to the areas which currently have the greatest impact upon those protected by the Consent Decree.
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I. Resources and Capacity
Paragraph 4 of the Consent Decree requires, in part: “Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such Individuals under the Decree and the Implementation Plan…” “Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs using federally approved objective criteria regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based setting…”
Paragraph 5 of the Decree requires, in part: “Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings.”
In addition, the Compliance Evaluation Standards indicate that: “The defendants will provide the proposed annual budget and cost assumptions to the parties, intervenor and Monitor that specify spending plans for all activities related to compliance with the Decree in sufficient detail to permit an evaluation of Defendants’ compliance with the Decree.”
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For Fiscal Year 2017, the second consecutive year, there is no approved State Budget and no assurance that this impasse will be resolved within the second half of Fiscal Year 2017. The Implementation Plan 2016 Revisions document recognizes that Federal Court orders continue to require that all payments be made for “all services, programs and personnel for all beneficiaries of the Consent Decree, at a level no less than the levels paid in Fiscal Year 2015, that are necessary to comply with the Consent Decree and Implementation Plans”. While the Defendants continue to comply with the Orders, including providing to the Monitor monthly reports of payments made, DHS has not provided to the Monitor, Plaintiffs or Intervenors, or within the 2016 Implementation Plan Revisions, any indication of how the agency will be addressing the shortage of DSPs due to inadequate wages.
The DHS website includes the 2/17/2016 Illinois Budget Briefing Presentation which states that “The proposed budget for FY 17 continues to provide critical services to the most vulnerable in Illinois. The Agency continues its commitment to rebalancing—moving individuals with developmental disabilities, mental illness or physical disabilities out of institutional care and into community settings.” There is no indication by DHS in the 2016 Implementation Plan Revision that addresses how this “rebalancing” may be funded or how the staffing crisis in general will be addressed. This is part of the reason that this Implementation Plan was filed with the court by the Defendants alone, without a joint motion including the Plaintiffs and Intervenors.
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Therefore, as it was during the preparation of the Monitor’s Fourth Annual Report, it is impossible for the Monitor to make a finding that the sufficient funds referenced in ¶5 will be available.
The Fourth Annual Report includes dozens of statements from service providers, families and others detailing not only the fiscal problem causing the unprecedented staffing shortage in CILAs and ICFs/DD but also its impact upon the people who live in these homes. These statements remain relevant but will not be repeated herein as the Monitor has received additional, more recent input from countless family members and providers of services and supports to beneficiaries of the Consent Decree. For example:
“We have consistently run 15% (staff) vacancy rates in Residential DSP openings since 2008. This past year it has increased to 25-30%. We do not have enough staff to meet the needs of the clients. This includes consistent difficulty in assisting with: ADLs (activities of daily living), particularly with hygiene and cleaning; community access; managing finances. Because these needs are not consistently being met, the clients have increased incidents of maladaptive behaviors and both clients and families are dissatisfied with services.”
“Residents have to get used to different staff in their home each day. Staff have to learn all the outcomes, behavior and counseling plans each time they are in a new house. This affects the residents because they aren’t able to build trust with staff as they are not consistently in the home. Multiple family members and guardians have called with complaints about the inconsistent staffing and how that impacts the quality of services.”
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“There have been multiple staff who have left to work at home health agencies due to pay.”
“We are not in a position to expand our CILA capacity. We are unable to fill the current shifts we have within our current homes. Taking on more homes would mean more vacancies.”
“We have closed three CILA homes and sold buildings to reduce costs. Occupancy in 2008 was nine homes with no home having more than 5 people. In 2015, we operated 6 CILA locations. Occupancy ranges from four to eight people per house.”
“For CILAs and ICFs, we have: downsized staffing due to large yearly deficit; cut back on community outings; trimmed health insurance coverage. Through the admission process, we have declined more difficult individuals with medical or behavioral issues.”
“A huge shortage in staffing directly impacts the program and the quality of time spent with an individual. This situation has created the need to redirect focus to maintaining personal care with ADLs rather than to skill acquisition and skill retention. This directly impacts the agency’s ability to achieve our mission, goals and overall objective. This truly becomes a disservice to the individuals we serve.”
“The work of a Direct Support Professional is both physically and mentally exhausting. While the work can be very rewarding, the impact of staffing shortages and mandatory overtime does not equate to equal pay for equal work. It is far too easy to find a less stressful and demanding job paying an equal or higher rate of pay. Over the past year, the long term effects of the state’s failure to increase the rate of pay has created a reduction in our applicant pool and an increase in our turnover.”
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“Our group homes run with minimal staffing, which does not provide opportunities to promote community integration. Scheduled outings are reduced or foregone. This also creates an increased risk to both our staff and individuals. Since the high staffing shortages, the agency has had to implement a system for voluntary, and then ultimately mandatory, overtime to cover all shifts in our group homes. The extra hours staff are working have the potential to increase mental and physical exhaustion, which ultimately increase the risk of injury or errors with respect to personal care and quality of care.”
“Given the current residential and nursing rates, we are unable to support individuals with more advanced nursing or behavioral needs. We neither have the community resources nor support staff to adequately address and manage these individuals.”
“Staff work overtime and extra shifts to meet basic needs and residents are not in the community as they should be. Less consistent caregivers reduce the quality of care and increase the opportunity for error, particularly medication administration errors. Lack of consistent staff and individual attention results in less individual goal progress and increased behavioral issues.”
“This organization would be closed in three months if it operated only on what the State currently pays our organization. “
“To train a DSP requires not only completing the DSP curriculum, but also agency and program orientation. Costs average $2846.00 per person per training alone. This does not include advertising and time spent reviewing and interviewing candidates. With a turnover of 32%, the CILA program had 1/3 of its staff missing during the last year.”
“Recently the staff who left were good, longer term employees who told us
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that they left due to wages. There have been several over the past eight years who were working two jobs and left to find one job that paid a living wage. The reality is that many DSP positions remain open so only basic needs are being addressed. It is impossible to provide the staff time and individualized supports necessary for building community relationships and employment opportunities.”
“We have experienced several times when staffing has dropped so low that we were unable to staff all of our CILA homes for the weekends and have had to close some of them to keep proper staffing ratios. Consumers then have to be relocated to another home for the weekend.”
“The Fiscal Year 2016 reduction in the monthly personal allowance for CILA residents has forced most consumers to spend all their monthly funds on medical items, clothing and hygiene products leaving no money for leisure activities or hobbies which are important to the resident.”
“My daughter has experienced five trips to the Emergency Room over the past eighteen months, is not being provided with the opportunities included in her ISP, has only one staff member on most shifts to meet the needs of all four women who live together and have significantly differing levels of need, and isn’t always provided with healthy food.” (The Monitor regularly addresses such concerns with families, service providers and DDD staff.)
“DSP turnover rate in our CILA homes is 70.32% over the past twelve months. Due to the large amounts of overtime, we have staff that are tired and not at the top of their performance abilities.”
“Consumer behavior and skill development is directly impacted by the revolving door of staff. Staff barely have a chance to review Individual Support Plans or Behavior Plans before they have to move to another
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house to fill a vacant shift or they leave. We are in a constant staff training mode. Consumers become confused from having to adapt to various staff personalities and it is almost impossible to gain trust in the person who is responsible for assisting in bathing, toileting, etc. Decisions are focused on who do we have at each house and which staffing option produces the least amount of risk to the consumer and the organization. It is very difficult to go beyond meeting just the consumers’ basic needs of food, clothing and shelter. Person centered planning requires one on one interaction with the resident. We try to let residents make individual choices, but often they have to go on group outings. It is even more difficult to deal with unscheduled requests for community access and to visit friends and family. We have reduced the assistance in providing transportation for family visits, especially those out of town. We often struggle to find enough staff to take consumers to medical appointments.”
“Our DSPs are essential to the well being of residents. DSPs provide companionship; assist with daily activities such as shopping, eating, grooming, minor healthcare; facilitate extracurricular activities. As a result of low wages and insufficient benefits, the agency has seen a turnover rate of over 25%. The constant turnover of DSPs is very disruptive to residents as they lose DSPs to whom they have become attached and then must adjust to new staff. This leads to a lower quality of life for individuals as well as more behavioral and mood issues.”
“When Chicago raised the minimum wage to ten dollars, our agency saw its labor pool evaporate. Many applicants are unqualified for the DSP position and DSP positions have taken over ninety days to fill with some remaining vacant for 120 days or more. The decrease in DSPs puts our ability to meet the needs of residents at risk. We have to devote more time and money to staff recruitment, using money that should be going to programs for residents. “
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“Person-centered planning has been hardest hit by inadequate State funding. Day program rates cannot even cover basic transportation, let alone what is needed for more individualized activities. Residential rates only provide for a bare minimum level of staffing, which does not allow for individualized activities. We are not reimbursed for the more experienced and skilled level of staff person needed to carry out person-centered plans. Ligas Class Members are seeing their integration into the community curtailed because of the lack of State funding and are not being provided with the services set forth in their Transition Service Plans. Our agency is now faced with the choice of discharging residents, closing programs, or providing less than adequate care, all at the expense of individuals with disabilities.”
“My daughter lives in an ICF/DD (Intermediate Care Facility/ Developmental Disabilities) and has an intellectual disability, seizure disorder as well as limited communication skills. With more direct care staff leaving in recent years, there is a constant flow of new staff who do not know my daughter. Due to my daughter’s limited communication skills and complex medical needs, it takes several months for a new staff member to get to know and understand her. More important, it takes several months for my daughter to feel comfortable with the new staff person who must help her with her most personal needs. My daughter has a calcium deficiency due to seizure disorder medications, which makes it critical that her teeth be properly cared for. New staff do not know how to properly care for my daughter’s teeth and the poor dentition has caused her to lose teeth and has caused the condition of her remaining teeth to worsen. The constant turnover of staff and use of temporary staff has also caused her to suffer increased anxiety as she does not feel comfortable having a new person take care of her until she builds a bond with that person.”
“My son lives in a CILA and has autism, an anxiety disorder and limited verbal skills. Routine and predictability are extremely important for my son
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and the lack of these results in his becoming very anxious, fearful and frustrated. Until last year, my son lived in a four-person CILA, but then the operating agency had to consolidate and increase the capacity of its CILAs in order to cut costs. My son moved to a different house for six people and it is anticipated that this house will be increased to eight residents in order to further cut costs. Moving to a new home with more residents is very confusing to him and I am concerned for his safety and the safety of the other residents because it is much more difficult for a single staff person to adequately supervise six or eight individuals with significant developmental disabilities rather than four. Staff work a lot of overtime, resulting in their fatigue, stress and inability to do more than complete basic tasks. They don’t have the time, energy or experience to provide the personalized care that my son and other residents need. My son loves activities in the community and used to get out into the community at least once each week, but now only gets once or twice each month. He is often alone in his room and bored, anxious and frustrated. He is being severely limited.”
Even more far reaching than individual or large group contacts with the Monitor, and demonstrating widespread concern with the wages paid to Direct Support Professionals (DSPs) who provide what is aptly described as “front line services” to those living in CILAs and ICFs in the community, is the fact that both chambers of the Illinois Legislature passed bills in the fall of 2016 to provide “livable wages” to such employees. This legislation was vetoed by the Governor and an attempted override of the veto was unsuccessful.
As noted above, this crisis goes beyond the money involved in raising wages to the impact of the situation on the beneficiaries of the Consent Decree. On October 17, 2016, the Illinois Senate Human Services Committee held a hearing
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on the “Current Status and Future of Compliance with the Ligas Consent Decree and Related Subject Matter.” The Monitor, Plaintiffs’ Counsel, Intervenors’ Counsel and DHS Chief of Staff were invited to speak, as were a parent, two service providers and a direct support professional.
DHS’ Chief of Staff, Fred Flather, reported on the State’s accomplishments in meeting or exceeding the benchmarks required by the Consent Decree for moving Class Members into the community. He also described the ongoing process of defining the “reasonable pace,” as required by the Consent Decree, at which those who choose to live in community-based settings will be able to move to such environments following the six years during which these benchmarks will have been measured. In addition, at this hearing as well as during Parties’ meetings over the past several months, DHS indicated that the agency is not opposed to raising wages for DSPs but that this needs to be addressed within the context of the budget process.
Scott Mendel, Counsel for the Intervenors, spoke about his daughter’s positive experience living in an ICF/DD and described the Intervenors’ participation as a party in the Ligas case. He cited paragraph 4 of the Consent Decree with regard to the State’s responsibility to both honor the residential choices, including ICFs/DD, of all individuals with developmental disabilities and provide the resources necessary to meet the needs of those who choose to live in ICFs/DD. He noted that “Like CILAs, the reimbursement rates provided to ICFs/DD have not increased since March 2008” and that “in those almost nine years costs have increased
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dramatically. As a result, the resources provided by the State are no longer sufficient to meet the needs of ICF/DD residents. The insufficient rates are having a severe adverse effect on ICF/DD residents. Residents are not receiving the care they require as a result of low reimbursement rates leading to increased DSP turnover; reduced physical, occupational and speech therapy; reduced community outings; reduced recreational opportunities. This is a violation of the Decree.”
Barry Taylor, Vice President for Civil Rights and Systemic Litigation at Equip for Equality and lead counsel in Ligas v. Norwood, represented the Plaintiffs and, following a brief overview of the case and Consent Decree implementation, stated: “While the State has so far met its quantitative requirements under the Consent Decree, we do have serious concerns about the quality of the services being provided.…From our perspective, many of the quality issues arise from the low wages paid to Disability Service Professionals or DSPs. The main issues for our clients are: Lack of person-centered planning to allow our clients to live in the most integrated setting…; difficulty placing and supporting people in the community who have significant medical or behavioral needs…; lack of meaningful participation in the community…; lack of integrated, competitive employment opportunities as providers are often taking a one-size fits all approach…because they don’t have sufficient staff to support more customized and integrated employment opportunities.”
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The Monitor acknowledged the State’s success in meeting the numeric benchmarks in the Consent Decree and highlighted a few of the sections of the Fourth Annual Report as well as the reasons for the finding of noncompliance. The Monitor stated therein that “when committed providers are admitting that their available staff have to focus primarily on safety, it cannot be assumed that the entitlements of those protected by the Consent Decree are being guaranteed or that the expectations of the beneficiaries of the Decree and their families are being met.” The Monitor’s full testimony is not included herein as the excerpts presented above from service providers and family members eloquently express many of the Monitors’ concerns related to the inadequate funding and resulting, unprecedented staffing crisis.
The service providers spoke in detail about the difficulties in maintaining the quality and consistency of services while experiencing: the highest staff vacancy levels in their histories and inability to recruit new staff due to low wages; lack of increase in wages for DSPs in nine years; unprecedented costs of overtime and staff training; staff unable to address individuals’ needs. In addition, other written testimony was submitted to this Senate Committee and one of these documents provided to the Monitor noted:
“Of issue is that I/DD provider agencies are having an extremely difficult time hiring and retaining Direct Support Professionals, or DSPs. Specifically, for Ligas Class Members, the inability to hire and retain DSPs has meant there are fewer group home options for those individuals wishing to move out of ICFs/DD as well as a lack of DSPs to help those individuals at home or in a group home receive access to the community-based supports and services that are required
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under the Consent Decree. For the roughly 34,000 DSPs working across Illinois, the major issue is that their average hourly wage is $9.35 or about $19,488.00 per year. This is less than the federal poverty level for a family of three which has led to over half of the DSPs utilizing public benefits even though they work full time. Without a living wage, there has been and continues to be high turnover among these caregivers, which leads to instability.”
All of this mirrors the individual concerns reported to the Monitor by families, guardians and service providers, as reported herein.
The most compelling testimony at the hearing was provided by the DSP who discussed her ongoing fifteen years of working at a job she loves but in the midst of extremely high staff turnover rates and staff vacancies resulting in inadequate staffing and unsafe situations. She talked about working double shifts for weeks at a time, trying to meet the needs of six individuals at the same time when all have health and other significant needs requiring personal attention “24/7.” She now earns less, after fifteen years of exemplary and personally valued work, than her previous wage of ten dollars per hour which she earned when working for a different State department. Her clearly heartfelt narrative about her own struggles to meet living expenses and medical costs while being unwilling to give up the work to which she is devoted was more illustrative of the crisis than any statistics that might be provided.
As is indicated repeatedly above in this section as well as in paragraphs 4, 5 and 26 of the Consent Decree, the availability and quality of services are critical to
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beneficiaries of the Consent Decree. Paragraph 4 refers to the Defendants’ obligation to “implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such individuals…” This points to the need for quality monitoring as well as sufficient funding.
Paragraph 5 states that “Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members.” The statements above in this section clearly refer to lack of availability of certain chosen opportunities and activities for individuals, as well as providers’ inability to maintain services and structures due to inadequate wages resulting in staff shortages.
Paragraph 26 requires that the “Implementation Plan must, at a minimum: (c) describe necessary resource development activities… to implement the Decree” and (e) identify, based on information known at the time the Implementation Plan is prepared, any services or supports required in Transition Service Plans formulated pursuant to the Decree that are not currently available in the appropriate quantity, quality or geographic location…” This indicates that resource development efforts are a critical component of the Plan and that quality as well as quantity of services must be monitored in order to conduct meaningful reviews of the adequacy of service provision.
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Following the Monitor’s review of all available documents used by the Bureau of Quality Management (BQM) within DDD, the Monitor expressed concerns that DDD survey protocols had been abbreviated during the past two years and that the process for following up on survey citations was not clear. Therefore, at the Monitor’s request, the Monitor, Plaintiffs and DDD met on a conference call in early January, 2017 to discuss the current system of monitoring the quality of services provided in CILAs and day programs. The discussion was informative, addressed questions raised by the Monitor and explained initiatives that will be rolled out through the Life Choices project which are intended to improve the way in which ISC agencies, CILAs and day services are monitored. The Monitor will review a sample of surveys previously conducted by the Bureau of Quality Management, along with any required Corrective Action Plans and follow-ups, to explore the efficacy of current practices as well as make recommendations if it appears that any needed enhancements to the system are not being addressed through current planning.
Problems related to the monitoring of CILAs and the investigation of incidents in some of these homes were brought to public attention during November and December, 2016 when the Chicago Tribune published several articles alleging abuse and neglect occurring primarily in CILAs over the past three or four years. While documenting intolerable treatment of individuals with developmental disabilities who live in CILAs, these articles also brought forth the roles played by inadequate funding, insufficient staff availability and inconsistent, untrained staff in such tragic situations. In addition, it became evident that more effective
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oversight on many levels is an absolute necessity. For example, the process and outcomes of quality surveys, quarterly notes by ISCs and investigations must be further evaluated, either as part of the ongoing work of the Life Choices teams and the Quality Committee or as discrete efforts. On a positive note, sessions hosted by the Quality Committee are in process at the time of this writing and are planned statewide to train ISCs specifically in person-centered planning and practices, which is certainly a necessary component of Ligas Transition Service Plans, Individual Service Plans, ISCs’ notes and all oversight efforts.
On 12/13/2016, the Joint State Senate and House Human Services Committee held a Subject Matter Hearing to hear testimony regarding abuse and neglect taking place in group homes for individuals with developmental disabilities. DHS Secretary James Dimas acknowledged that the State takes such allegations very seriously and described DHS’ efforts, beginning in 2015, “to improve quality for people.” He spoke of improvements within the Office of the Inspector General, such as increasing the number of investigators, enhancing the supervision of investigations and discontinuing the participation of providers in their own investigations. An assessment is required of whether or not such improvements are having the desired outcomes and what additional measures are still needed to protect those living in CILAs, including Class Members. Secretary Dimas also outlined a plan to develop “report cards” of the performance of individual service providers to inform the choices of families and advocates in making selections of the most appropriate agencies to provide needed services. There was comprehensive questioning by the legislators and testimony on behalf of Equip
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for Equality, The Institute on Public Policy for People with Disabilities, The Arc of Illinois, IARF (Illinois Association of Rehabilitation Facilities) and from the sibling of a woman who lives in a CILA. Some of this testimony, as well as other written comments received thereafter, included:
• “Illinois’ network of community-based services and supports is not operating under the best of circumstances, with reimbursement rates having been frozen by the state for nearly a decade. The single most critical issue facing the provision of community-based services and supports is the inability to recruit and retrain frontline staff. For years, our community has been sounding the alarm about this growing crisis.”
• “It is our hope that these articles will be the catalyst for the changes that need to be made in Illinois.”
• “The widely discussed direct support wage crisis is having a substantial impact on the quality of care delivered in community residences. Agencies are facing unprecedented challenges in recruiting and retaining a direct support workforce which is the backbone of the community residential system.”
• “The problems highlighted in the Tribune article are not an indictment of community living for people with disabilities. There is powerful and unequivocal support for community living in a large body of research that has consistently documented positive experiences of people with developmental disabilities living in the community.”
• “The fact that anyone is hurt or, worse, dies of anything besides natural causes in a group home is unacceptable. I support thorough investigation, corrective action and when appropriate, sanctions. We must also acknowledge that individuals with I/DD are often challenging, and even the best trained staff will never be able to prevent all incidents from occurring.
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That said, we are not on a level playing field with community housing (CILA). Reimbursement rates are horrendously inadequate…There is no way that community provider agencies can compete with other minimum wage jobs that are easier and less stressful. Recruitment and retention of quality staff is next to impossible, especially north and west of the city, and the ability to do proper training and implement retention strategies and ongoing training is not possible with the current reimbursement rates…To create living environments in which the health and safety bars are set at the highest possible level, we need the resources to do it.”
One of the provider agencies cited in the first Tribune article had its license revoked prior to the Joint Committee’s hearing. This agency had been surveyed or otherwise reviewed by DDD eight times between 5/17/2011 and 11/14/2016 and there were repeat citations noted in all of the surveys or follow-ups after the one in 5/2012. There were follow-up visits between a few of the surveys and Corrective Action Plans were required at least three times, including during their 11/2016 survey, less than a month prior to the license revocation. Further, EFE’s Abuse Investigation Unit, in 2003, issued a special report entitled “Why Does an Agency That Profited from Exploiting People with Disabilities Remain Taxpayer Funded?” The subject of this report was the same agency, though using a different name, whose license was recently revoked. This report stated that the investigation “revealed extremely serious concerns about the services provided by this agency to individuals with disabilities and the failure of this agency to meet and maintain minimum quality residential and day programming standards.” The conclusion stated, in part: “Only through interventions at the highest level of government and the commitment of sufficient resources to support truly effective oversight, monitoring, investigative, and enforcement mechanisms will the
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system by which we protect our most vulnerable citizens, both old and young, become anything other than an illusion of safety and humane care.” Comprehensive recommendations are contained therein which might be useful to consider in addressing current issues.
The Monitor is not making any generalizations based upon having reviewed only one such situation, but the current situation involving this provider does illustrate that even when an established process for quality monitoring is followed and there are uncorrected citations over several years, it can take too long to result in a revoked license. In order to close this loop, the Monitor recommends that BQM explore whether or not there was any documentation in ISCs’ quarterly notes that referred to such problems. Upon learning of the revocation of this agency’s license, the Monitor requested from the Defendants information regarding the Class Members involved and has asked for ongoing updates.
As was the case in January, 2016 and based upon all of the material included in this section, most significantly the escalating impact of the crises upon the quality of services provided to those protected by the Consent Decree, the Monitor once again finds noncompliance with this compliance standard. The Monitor has informed the Parties and Intervenors of the likelihood of this finding.
It is worthy of note that the Ligas Implementation Team continues to include eighteen positions and that the only vacancies at the time of the current report’s
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preparation is one position that was vacated on 12/31/2016 and is in the process of being filled and another that will be filled as of 2/1/2017. Members of this team are clearly critical to the Monitor’s day-to-day activities and their insights and responsiveness to requests are greatly appreciated.
There is also some positive news included in the Implementation Plan 2016 Revisions document that describes some of DHS’ new initiatives such as: increasing the number of Behavior Therapy hours an individual may receive annually under the Waiver; engaging a consultant through a State Mentoring Grant with the Federal Department of Labor to explore opportunities to enhance access to employment services; developing a web-based reporting and search mechanism for tracking vacancies in residential and day programs as well as providers’ willingness to develop new service capacity.
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II. Class Member Lists
Paragraphs 8 and 9 of the Consent decree require that the Defendants maintain a statewide database in which all Class Members are enrolled and which, along with waiting list data, is promptly revised. The Implementation Plan is required to include information regarding the adequacy of the PUNS (Prioritization of Urgency of Needs for Services) database.
Paragraph 2 of the Consent Decree requires a list of Class Members who qualify for Medicaid Waiver services, live in an ICF/DD with nine or more residents and have affirmatively requested community-based services or placement in a community-based setting. Another list is required of Class members who qualify for Medicaid Waiver services, live in a family home and are in need of and have affirmatively requested home and community-based services or services in a community-based setting. The individuals on this list are known as Waiting List Class Members and this list is considered a subset of the PUNS list.
As indicated in the Fourth Annual Report, the DDD had at that time established an automated process to add new Class Members to the PUNS list as well as remove those who are no longer eligible. In addition, as reflected in the Implementation Plan 2016 Revisions, DDD conducted, between 5/1/15 and 6/30/16, a special initiative “to ensure information and data on individuals enrolled is accurate, complete and current.” This PUNS Integrity Project involved providing targeted funds to the ISC agencies “to work with individuals and families to bring records
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up to date.” It is reported that as of 9/1/2016 96.8% of the PUNS records statewide were current within one year and this exceeded the 95% benchmark that had been established for the end of this initiative.

Prior to the completion of the PUNS Integrity Project, the Parties had begun discussing the need for a more efficient way to track the progression of Class Members who are seeking services to the point of initiation of waiver services. A new comprehensive list was developed, with input from the Plaintiffs and the Monitor and the first such list was disseminated on 7/29/2016. At the request of the Monitor, DDD promptly provided an unscheduled update on 1/13/2017. This new list served as the basis for a discussion regarding further clarification of both the information included and how Class Members move off the list as well as move back on if necessary. The Monitor’s review of this updated list indicated 442 class members to be actively seeking services. In addition, this update provides information as to how long class members have remained on the list following selection from the PUNS waiting list.

Ligas Class Members Seeking Services (1/13/17)

N=442

PUNS Selection Date

# of Class Members Seeking Services

2012

40

2013

6

2014

47

2016

248

Residing in ICF/DD

101

In the Fourth Annual Report the Monitor had noted delays in initiation of waiver services for class members following selection from the PUNS waiting list. Discussions are ongoing regarding the content of the new list to provide
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additional details regarding class members’ progression toward placement. The efforts of those involved in this process are integral to the Monitor’s ability to identify potential barriers to achieving transitions and to determine Class Members’ status toward receiving desired services.
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III. Transition Service Plans
Beginning in February 2016 and continuing into FY 2017, the Monitor selected a sample of the transition plans completed since January 2015, at which time the most recent version of the plans was consistently in use. The Monitor’s Data and Program Analyst, Melanie Reeves Miller, assisted in reviewing and evaluating these plans to determine whether further revisions or training are needed and whether the plans are facilitating provision of appropriate services and supports chosen by the class members, families or guardians with whom the plans were developed.
The Monitor, along with Ms. Miller, reviewed transition plans and service plans for fifty-three (53) class members with a focus on assessing the adequacy of LTSPs as well as whether the class member’s preferences and service/support needs were reflected in the initial service plan. It was noted that there had been improvement in the quality of LTSPs over the past year. The Monitor found that service plans reflected the class member’s transition plan and for the most part, transitions occurred in a timely manner.
In many instances, the service plan provided to the Monitor was an initial 30-day staffing and therefore did not reflect whether services/supports were fully implemented. The Monitor then requested from DDD additional documents to include the most recent Individual Support Plan and the most recent Individual Service and Support Advocacy (ISSA) Visiting Note completed by the Independent
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Service Coordinator (ISC). For those class members who had a new ISP developed since transition, that ISP was provided to the Monitor as documentation of one of the required four ISC visits per year for 31 class members (58%) and ISC visit notes were provided for 35 class members (67%). For some class members, both types of documents were provided.
As set forth in the ISSA Guidelines issued by DHS, Independent Service Coordinators are expected to conduct a minimum of four visits per year: one annual visit for participation in the development of the class member’s ISP; one annual visit to assist the class member in completing the Consumer Satisfaction Survey; one annual visit to the class member’s day program site; and one annual visit to the class member’s residence. As indicated in the Guidelines, “Besides participating in the development of the annual service plan, ISCs will review the service plan for adequacy in meeting the needs and preferences of the individual...The priority goal is that issues of health, safety, and meaningful programming are receiving attention.” Based on review of the ISC visit notes, the Monitor determined that only 14 (40%) of the 35 visit notes provided contained a substantive description of whether, per the Guidelines, “the ISP contains identified outcomes for the person that substantially meet all of the person’s needs; services are being provided in accord with the ISP; and progress toward outcomes is evident (or if not evident, the team is revising the ISP in order to promote progress toward outcomes).” For example, many visit notes contained general statements without reference to specific outcomes, such as:
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• “Goals are reviewed monthly and revisions are made as necessary. In addition, the ISP team meets annually to discuss goal performance and recommendations are made based on goal performance.”
• “[Class Member] is making some progress on objectives. Data was somewhat limited, however [Class Member] reported working on many of them and continues to need to work on possible medication side effects and following a budget.”
• “[Class Member] has a monthly progress note in his file for each month. His goals are updated every three months. His plan is being revised as needed.”
On a positive note, in at least one case, the visit note reflected “monthly summaries were not provided so progress could not be assessed. Data for September and October was collected during the visit by the facilitator. She met her objectives for both of these months.” The ISC flagged the lack of monthly summaries as a need for follow-up action. For another individual, visit note indicated that provider agency Qualified Intellectual Disability Professional (QIDP) monthly notes were missing for February 2016 through April 2016. The ISC flagged this for follow-up.
As noted above, this project was initiated to evaluate the adequacy of LTSPs, to determine whether or not they serve as foundations upon which individual service plans are developed, and assess whether services are being provided as described in the ISP and whether progress toward outcomes is evident. In order to review implementation of service plans, the Monitor requested ISC visit notes for each person in the sample to determine whether these monthly notes serve
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as a measure of achievement of outcomes identified in class members’ ISPs. Overall, the Monitor found that while visit forms expect the ISC to indicate whether progress is being made towards outcomes, there was absence of an analysis or a comparison of progress to the previous quarter(s) on which to base the determination of progress or lack thereof. Therefore, based on the finding that only 40% of the visit notes contained the necessary information on which to measure implementation and progress toward personal outcomes, it is recommended that emphasis be placed on addressing this issue as part of ongoing initiatives to enhance quality monitoring as described in section I above.
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IV. Transition for Class Members in ICFs/DD
Paragraph 17 of the Consent Decree requires that within six years after the approval of the Decree, all Class Members residing in ICFs/DD as of the date of the approval of the Decree will transition to Community-Based settings consistent with their Transition Service Plans if, at the time of the transition, the Class Member requests placement in a Community-Based setting as confirmed and documented in accordance with the Decree.
It is required that one-third of the Class Members in this category transition to the community by 12/15/2013, two-thirds by 12/15/2015 and all by 6/15/2017. The actual target numbers are fluid, based upon the list defining this category. To date, the Defendants have consistently exceeded the target numbers with placements totaling more than 300 beyond the target for 12/1/2015, by which time 1255 of 1446 then active Ligas ICF/DD Class Members had transitioned to the community. As of 12/31/2016, 1363 of 1481 active Ligas ICF/DD Class Members had transitioned to the community. Of these 1363 Class Members, 1332 went to CILAs and the Monitor has requested additional details related to the transitions.
The Monitor applauds the efforts involved in exceeding the benchmarks and will continue to work with the Plaintiffs and Defendants to facilitate the transitions of Ligas ICF/DD Class Members who choose to move to the community. All Class
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Members must be offered a variety of options and opportunities in order to make informed decisions about where, how and with whom they choose to receive services and supports. The Monitor will continue to work closely with the Parties in tracking how such choices are facilitated, particularly in consideration of the obstacles, as discussed in section I. Resources and Capacity herein, related to both the maintenance of existing community services and further development.
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V. Crisis Services
As indicated in ¶21(a)-(b) of the Ligas Consent Decree, “an individual is in a situation of “Crisis” if he or she is at imminent risk of abuse, neglect, or homelessness. The provision of interim emergency services (including interim placement in an ICF-DD where no placement in a Community-Based Setting was immediately available) will not necessarily exclude the Individual from being deemed to be in a situation of Crisis. If, following a screening, the Individual who is determined to be in Crisis requests appropriate Community-Based Services to be provided in the Family Home or requests placement in a Community-Based Setting, Defendants will promptly develop, in conjunction with the Class Member, a Transition Service Plan.”
State Defendants are required to serve expeditiously class members who meet the above-described criteria and who request community services or placement in a community-based setting. A review of crisis requests from July 1, 2015 through June 30, 2016 indicated that 506 crisis services requests were received and reviewed by DDD with 482 requests approved. Denials of crisis services requests were due to crisis criteria not being met and/or determination of lack of clinical eligibility. According to the crisis data, between 7/1/15 and 6/30/16, one hundred seventeen (117) crisis requests received were classified as abuse, 240 were classified as neglect, and 125 were due to the individual being homeless.
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ClassiﬁcaWon of Approved Crisis Requests July 1, 2015-June 30, 2016

125

117

240

Abuse Neglect Homeless

ClassiﬁcaWon of Approved Crisis Requests July 1, 2014-June 30, 2015

116

100

245

Abuse Neglect Homeless

ClassiﬁcaWon of Approved Crisis Requests July 1, 2013-June 30, 2014

93

71

233

Abuse Neglect Homeless

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Services provided to class members in crisis included four types of CILA (Community Integrated Living Arrangement) options: 24-Hour CILA, Host Family CILA, Intermittent CILA, and Family CILA, in addition to Home-Based Support Services (HBS). Of the 482 crisis requests approved, 261 were approved to receive 24-Hour CILA, 9 were approved to receive Host Family CILA, 19 were approved to receive Intermittent CILA, and 23 were approved to receive Family CILA. Home-Based Support Services were approved for 170 class members:
Services Authorized July 1, 2015 - June 30, 2016

170
23 9 19

24-Hour CILA

Host Family CILA

Intermirent CILA

261

Family CILA

Home-Based Services

Services Authorized July 1, 2014 - June 30, 2015

178 244
17 19 3

24-Hour CILA Host Family CILA Intermirent CILA Family CILA Home-Based Services

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Case: 1:05-cv-04331 Document #: 646 Filed: 01/20/17 Page 44 of 57 PageID #:12275

Services Authorized July 1, 2013 - June 30, 2014

180

177

20

13

7

24-Hour CILA Host Family CILA Intermirent CILA Family CILA Home-Based Services

Combining the three reporting years (7/1/13-6/30/16), a total of 1340 crisis requests out of 1415 requests received have been approved by DDD.

ClassiﬁcaWon of Approved Crisis Requests July 1, 2013 - June 30, 2016

334

288

718

Abuse Neglect Homeless

For this same reporting period (7/1/13-6/30/16), services were provided to class members in crisis within four types of CILA (Community Integrated Living Arrangement) options:
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Services Authorized July 1, 2013 - June 30, 2016

358 421
39 30
10

24-Hour CILA Host Family CILA Intermittent CILA Family CILA Home-Based Services

During the 2013/2014 reporting period, the Monitor established, with the agreement of the parties, that the timeframe to receive services for class members in crisis will be 24-72 hours, although this timeframe may vary, depending on individual circumstances, or if temporary services are in place to address the immediate crisis. For the past three years, the Monitor has analyzed class member information and data from all crisis requests received and reviewed by the Defendants and determined to meet the requirements for crisis services. From the Monitor’s analysis, improvement was noted in the timely review of the crisis packets upon receipt by the Defendants.

After crisis status was confirmed, 40% (545) of the Class Members who were found to be in crisis received some service within a 24-72 hour period. The following two charts represent the Monitor’s analysis with a view of the three years in comparison and the three years in summary.
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Case: 1:05-cv-04331 Document #: 646 Filed: 01/20/17 Page 46 of 57 PageID #:12277

Timeliness of Authorization of
Crisis Services 24-72 hours 4-9 days 10-19 days 20-29 days 30-39 days 40+ Insufficient Data

FY 2013-2014 N=397
107 27% 122 31% 74 19% 36 9% 15 4% 35 8%
8 2%

FY 2014-2015 N=461
218 47% 151 33% 64 14% 15 3%
6 1% 5 1% 2 1%

FY 2015-2016 N=482
220 46% 175 36% 60 12% 15 3%
3 1% 6 1% 3 1%

Overall 2013-2016 N=1,340

545

40%

448

33%

198

15%

66

5%

24

3%

46

3%

13

1%

Timeliness of AuthorizaWon of Crisis Services 7/1/13 - 6/30/16

3% 3% 1%

5%

15%

40%

33%

≤3 days 4-9 days 10-19 days 20-29 days 30-39 days 40+ days Unable To Determine

As presented above, data from the most recent reporting period (July 1, 2015 to June 30, 2016) shows that 46% of the class members who were found to be in crisis, received some service within a 24-72 hour period after their crisis status was confirmed; for (36%) services were initiated between 4 and 9 days; 12% received services between 10-19 days; 3% received services between 20 and 29 days; services were not initiated for 2% of the class members for more than a month; and for three class members, data was insufficient to include in the
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Case: 1:05-cv-04331 Document #: 646 Filed: 01/20/17 Page 47 of 57 PageID #:12278
analysis. While the past two years show improvement over FY 13/14, there are still fewer than one-half of the individuals who were found to be in crisis receiving some services within the 24-72 hours agreed upon timeline. The Monitor recommends that the Parties address this situation at an upcoming Parties’ meeting.
Review of the data associated with the 1,340 crisis requests received and reviewed between July 1, 2013 and June 30, 2016 revealed that, in nearly all cases, a “safety plan” had been determined to be in place for the class member in order to ensure safety and reduction of risk while awaiting approval of services. In the Fourth Annual Report, it is noted that the Monitor raised concerns as to the adequacy of safety plans wherein the class member in crisis is not in a permanent or stable situation (e.g., jail, psychiatric hospital, nursing home). It was recommended that the Defendants and Monitor confer to clarify criteria for determining adequacy of a safety plan. Discussions have taken place during Parties’ Meetings and on other occasions throughout the past year during which DDD reported that this issue is being addressed and progress will be reported at upcoming Parties’ meetings.
The Fourth Annual Report reflects an analysis of crisis data to determine the relationship between crisis applicants and the PUNS list. As noted in that report, some individuals in crisis situations were not selected for services because their PUNS enrollment was out of date and/or did not reflect current circumstances. Also included therein, the PUNS Integrity Project had been implemented to bring
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and maintain PUNS enrollments current. That project has been concluded successfully.

As noted in the Ligas Implementation Plan 2016 Revisions (filed on November 16, 2016), in addition to raising the question of the adequacy of crisis safety plans in the Fourth Annual Report, the Monitor also expressed concern that nearly half (49%) of the individuals with approved crisis placements were on the PUNS waiting list for three years or more. Per the Monitor’s recommendation in the Fourth Annual Report, DHS began during 2016 to discuss criteria for determining adequacy of a safety plan and considering the relationship between the PUNS waiting time and crisis requests. Conversations among the Parties will be initiated during the second half of fiscal year 2017. The chart below reflects the length of time of PUNS enrollment prior to receipt of the crisis request for fiscal year 2015/16.

FY15 and FY16 Approved Crisis Placements and

Length of time on PUNS Waiting List

Time Period

Number of Placements

% of Total

One Month or Less

69

7%

Over 1 Month to 1 Year

212

22%

1 to 2 Years

107

11%

2 to 3 Years

82

9%

3 to 4 Years

57

6%

4 Years or More

326

34%

No Data Report

98

10%

N=951

As presented in the chart above, 40% of individuals with approved crisis services were on the PUNS waiting list for 3 years or more. This demonstrates a 9% improvement over the previous year.

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The Monitor greatly appreciates the assistance of Melanie Reeves Miller, the Monitor’s Data and Program Analyst, in conducting this review of Crisis Services.
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VI. Transition for Class Members on Waiting List
The Consent Decree requires that Class Members described in ¶22 of the Decree will transition to the community and be referred to as Waiting List Class Members. A specific schedule for such transitions to community services or community-based settings is delineated in ¶22 which requires the following:
Ø 1000 by June 15, 2013 Ø Additional 500 by June 15, 2014 Ø Additional 500 by June 15, 2015 Ø Additional 500 by June 15, 2016 Ø Additional 500 by June 15, 2017
The Implementation Plan incorporates criteria for the prioritization of selections of Waiting List Class Members and within each prioritized category selections are to be made according to the length of time the Class Member has been on the PUNS list.
¶23 of the Consent Decree requires that following June 15, 2017, Waiting List Class Members “shall receive appropriate Community-Based Services and/or placement in a Community-Based Setting such that they move off the Waiting List at a reasonable pace.” During the past year, the Plaintiffs, Defendants and the Monitor have initiated the process to define this “reasonable pace.” Discussions are ongoing in order for implementation to begin by the required date.
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VII. Outreach
Paragraph 25 of the Consent Decree requires that Defendants “maintain a fair and accessible process by which individuals with developmental disabilities or their legal guardians can affirmatively request in writing to receive CommunityBased Services and/or placement in a Community-Based Setting or to receive ICFMR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests.”
The Defendant’s outreach efforts are defined comprehensively in the Implementation Plan 2016 Revisions and are divided into a “Community Outreach” section and a section titled “Outreach to Persons in ICFs/DD.” In order to address the issue of identifying Potential Class Members residing in ICFs/DD (excluding those living in ICFs/DD who had already submitted written requests to be excluded from the Class), the Defendants secured the services of the Council on Quality Leadership (CQL) and the completion of that project resulted in a report that was shared with the Monitor and Parties in April, 2016. In that report, CQL identified 123 individuals who chose to become Class Members and were added to Class Members List. In addition, 55 individuals who had requested extra time to consider their options were given information regarding the appropriate ISC agencies to contact if desired if the future. Upon request of the Monitor, DDD staff agreed to contact the 55 individuals noted above and to provide follow-up information regarding the 123 individuals who were added to the Class list.
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It is important to note that in order to become a member of the Waiting List Class, people need to make a record with the State confirming their desire for community services. People who are already on the PUNS list are deemed to have made such a record and are part of the Class.
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VIII. Implementation Plan
¶26 of the Consent Decree requires that “the Defendants, with the input of the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel shall create and implement an Implementation Plan to accomplish the obligations set forth in the Decree,” and ¶28 requires that this plan be “updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate.”
At each scheduled Parties’ meeting, the Defendants provide verbal updates of the Plan’s activities, as requested by the Parties, Intervenors and Monitor, and discussions are focused upon the areas deemed most significant at a given time.
The Implementation Plan updates and proposed revisions are provided by the Defendants to the Plaintiffs, Intervenors and Monitor for Consideration. Each year, through 2015, negotiations have taken place and resulted in jointly developed revisions being agreed upon before being submitted to the Court. However in 2016, despite significant efforts by all involved, the Parties could not reach agreement as to some of the Plan’s content. As referred to in section I (Resources and Capacity) herein, the Consent Decree requires at ¶26 that a list of items that must be included in the Implementation Plan. Two of the required items are:
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(c) describe necessary resource development activities…to implement the Decree;
(e) identify, based on information known at the time the Implementation Plan is prepared, any services or supports required in Transition Service Plans formulated pursuant to the Decree that are not currently available in the appropriate quantity, quality or geographic location;
The Monitor did not recall the requirement of ¶26(c) until preparing the current report and therefore did not bring it to the Parties’ attention. This is not being cited as noncompliance with the Decree. Rather, it is illustrative of why there was no joint submission to the Court of the 2016 Revisions. The Plaintiffs and Intervenors agreed to disagree with the Defendants on the topic of including information therein regarding necessary “resource development activities.”
Regarding ¶26(e), the Monitor has initiated discussions related to Quality Monitoring and, while Defendants have agreed to participate in such conversations, there has been some disagreement as to whether the Consent Decree includes any requirements related to this area. In order to identify a lack of services available of the appropriate quality, there would need to be a robust system to measure the quality of existing services. This matter is also discussed in the above section I.
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Whether or not issues are included in the Implementation Plan or agreed upon, the Monitor appreciates the cooperation of the Parties and Intervenors in thoroughly addressing issues upon which implementation of the Consent Decree depends.
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IX. Data Reports
Paragraph 33 of the Consent Decree requires that the Defendants, not less than every six months, “provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress toward achieving compliance.” The Monitor acknowledges that the Ligas Data Reports are submitted timely and that interim data requested by the Monitor is also provided promptly. DDD staff are consistently available to answer the Monitor’s questions, clarify data and address concerns related to documents they have prepared.
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CLOSING COMMENTS
The Monitor remains indebted to her predecessor, Tony Records, who worked with the Parties to create the systems for ensuring compliance with the Consent Decree and shared with the current Monitor his expertise and experience. Gratitude is also expressed to the Parties, families, Class Members, Intervenors, advocates, providers of services, colleagues and others who have shared their insights, intelligence and inspiration. The Monitor looks forward to engaging in continued shared efforts to assure that all of those who benefit from the Consent Decree achieve their chosen goals.

Respectfully Submitted:

Ronnie Cohn Court Monitor ligas.monitor@gmail.com

57

 
 Case: 1:05-cv-04331 Document #: 680 Filed: 06/21/17 Page 1 of 3 PageID #:12721

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

Stanley Ligas, et al., Plaintiffs,
v. Felicia Norwood, et al.,
Defendants.

)

)

)

)

Case No. 05 C 4331

)

)

Judge Sharon Johnson Coleman

)

)

)

AGREED ORDER TO MAINTAIN COMPLIANCE WITH CONSENT DECREE1

This case is before the Court on the parties’ Joint Motion to Approve Agreed Order. The

parties have advised the Court that the State of Illinois has not yet passed a budget appropriation

for the State Fiscal Year beginning on July 1, 2017 (the “FY 2018 budget”). In the absence of a

FY 2018 budget appropriation, Defendants will continue to provide all resources, programs,

services and personnel required by the Consent Decree (Dkt. #549), including without limitation

any Implementation Plans issued pursuant to Section XIII of the Consent Decree approved by

this Court on June 15, 2011 (Dkt. #549). It is the position of the Illinois State Comptroller that,

without an appropriation, the Comptroller does not have the authority to continue to make

payments for services, programs and personnel that are necessary to maintain compliance with

the Consent Decree unless specifically ordered to do so by the Court.

In order to maintain compliance with the Consent Decree, IT IS HEREBY ORDERED

THAT:

1 On April 7, 2017, Plaintiffs and Intervenors filed a Joint Motion to Enforce the Consent Decree (Dkt. # 666-1). As of the date of the instant Order, that motion remains pending. Neither Party nor the Intervenors waives any argument related to the Motion to Enforce the Consent Decree in this filing.
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1. “Beneficiaries” of the Consent Decree and covered by this Order include Class Members (as defined in the Consent Decree), Individuals with Developmental Disabilities (as defined in the Consent Decree) who have chosen to reside in Intermediate Care Facilities for the Developmentally Disabled (“ICF-DDs”), Individuals with Developmental Disabilities receiving Community-Based Services (as defined in the Consent Decree), and Individuals with Developmental Disabilities receiving services in Community-Based Settings (as defined in the Consent Decree) throughout the State of Illinois.
2. Until the FY 2018 budget takes effect, the Comptroller shall continue to timely make all payments for all services, programs and personnel, within the time period that such payments were made and at a level no less than the levels paid in Fiscal Year 2015, 2016, and 2017, that are necessary to comply with the Consent Decree and any enforceable Implementation Plans and Supplemental Orders related to the Consent Decree or Implementation Plan(s). The Court’s previous Orders of June 30, 2015 (Dkt. #597), August 18, 2015 (Dkt. #610), September 1, 2015 (Dkt. #624) and June 28, 2016 (Dkt. # 637) are incorporated herein and shall continue in effect. This order shall remain in effect until the earlier of the effective date of the FY 2018 budget, July 1, 2018, or until further order of the Court.
3. On or before July 1, 2017, Defendants shall publish this Order by (i) posting it on the DHS website, and (ii) transmitting a copy of the Order to all personnel and to all contractors and providers of services under the Consent Decree via email where available and by such other additional means as the Defendants employ for communications to the foregoing persons and entities in their usual course of business.
4. The Illinois Department of Healthcare and Family Services, the Department of Human Services, and the Illinois State Comptroller shall provide such information to the Court
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Monitor on a monthly basis to enable her to evaluate and to advise the Court and the Parties regarding the State’s compliance with the Consent Decree and the Orders entered by this Court.
5. If at any time the State believes that it may not be able to comply with any provision of the Consent Decree or this Order, the State must immediately bring the State’s potential non-compliance to the attention of the Court, the Monitor, the Plaintiffs, and the Intervenors before such non-compliance occurs.
6. The State shall maintain its expedited payments consistent with the terms and conditions that existed during FY 2015.

Date: June 21, 2017

SO ORDERED

BY: Judge Andrea R. Wood

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 Case: 1:05-cv-04331 Document #: 695 Filed: 08/11/17 Page 1 of 3 PageID #:12954

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs,
v. FELICIA NORWOOD, et al.,
Defendants.

)

)

)

)

Case No. 05 cv 4331

)

)

Judge Sharon Johnson Coleman

)

)

)

ORDER
Coming before the Court for hearing is plaintiffs’ and intervenors’ Joint Motion to Enforce the Consent Decree [666-1]. The instant motion stems from a Consent Decree entered into by the parties on June 15, 2011, after the Court certified a class and approved the Consent Decree. Defendants, officials of Illinois Department of Healthcare and Family Services and the Illinois Department of Human Services, assert that the State is in substantial compliance with the Consent Decree. For the reasons stated herein, this Court grants the motion.
Statement Plaintiffs are individuals with developmental disabilities living at home or in intermediate care facilities for the developmentally disabled (“ICF-DD”) who want to live in community integrated living arrangements (“CILAs) or other community settings. The intervenors are individuals with developmental disabilities living in ICF-DDs and want to remain in those facilities. Plaintiffs and intervenors assert that the State is in violation of the Consent Decree by failing to provide resources of sufficient quality, scope, and variety to provide developmentally disabled individuals with community-integrated care to the highest degree possible. The plaintiffs and intervenors must demonstrate a violation of the court order by clear and convincing evidence. See Bailey v. Roob, 567 F.3d 930, 934 (7th Cir. 2009). Since the United States Supreme Court’s decision in Olmstead v. L.C. ex rel. Zimring, “[s]tates are required to provide community-based treatment for persons with mental disabilities when the State’s treatment professionals determine that such placement is appropriate, the affected persons do not oppose such treatment, and the placement can be reasonably accommodated, taking into

Case: 1:05-cv-04331 Document #: 695 Filed: 08/11/17 Page 2 of 3 PageID #:12955
account the resources available to the State and the needs of others with mental disabilities.” 527 U.S. 581, 607 (1999). In Section 4 of the 2011 Consent Decree at issue here, Illinois committed to providing these services.
Plaintiffs and intervenors presented evidence in the form of a report by economist, Elizabeth T. Powers, declarations from ICF-DD and CILA providers, and representatives of developmentally disabled individuals impacted by the Consent Decree. The State pays private organizations with state and federal money to provide CILA and ICF-DD services. In Illinois, approximately 11,000 individuals with developmental disabilities live in CILAs and 5,000 in ICFDDs. The evidence presented demonstrates that the actual costs of operating CILA and ICF-DD facilities has increased substantially since the entry of the Consent Decree and wages for Direct Support Professionals (“DSPs”) has stagnated causing a staffing crisis that is inhibiting care and negatively impacting the individuals protected by the Consent Decree.
Defendants assert that the provision of services has not been reduced by the State and thus the State contends that it remains in substantial compliance. Further, defendants assert that the FY 2018 budget allocates an additional $53.4 million to these services. Plaintiffs’ economist, Powers, advises that a 25% wage increase for DSPs would reduce turnover by a third. Defendants contend that such an increase is not financially feasible considering the State is facing $14 billion in bills that are in arrears after the two year budget impasse.
Relying on O.B. v. Norwood, 838 F.3d 837 (7th Cir. 2016), defendants argue that this Court is does not have the authority to order an increase in wages. This Court agrees. In that case, the Seventh Circuit Court of Appeals stated that “if the shortage is of nurses willing to work at the reimbursement rates set by HFS, we could not order the agency to eliminate the shortage by raising those rates.” O.B., 838 F.3d at 842. Plaintiffs and intervenors seemed to recognize this limitation, albeit reluctantly, asserting instead that the relief they are seeking is a plan from defendants to bring the State into compliance with the Consent Decree.
At the hearing, the Court also heard from the Court Monitor, who reports that defendants are not in substantial compliance with the Consent Decree. The Monitor reports that budget impasse of the preceding two years has resulted in a tangible reduction of services to plaintiffs and intervenors due to the rising costs and frozen funding. Moreover, the State has not presented any plan for compliance beyond a $0.75 hourly wage increase for DSPs for FY2018 (from the allocation of $53.4 million in the new budget).

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The Monitor referred to a State working group that had been established in 2014 to address this very issue. This Court believes that reaching a mutually agreeable long-term plan accounting for both the resources of the State and the needs of those with developmental disabilities would benefit from a revival of a State working group to devise creative solutions to the issue of compliance with the Consent Decree.
Accordingly, this Court finds that defendants are not in compliance with the Consent Decree by failing to provide the resources of sufficient quality, scope, and variety based on the ample evidence presented to the Court that individuals protected by the decree have experienced a reduction of services and have suffered substantially as a result. The dire financial situation of the State of Illinois and the attendant competing demands for resources are not lost on the Court. The Court directs that State to devise a plan to address the issues causing the reduction in services and to bring the State into substantial compliance. IT IS SO ORDERED.
ENTERED:

Dated: August 11, 2017

____________________________________ SHARON JOHNSON COLEMAN United States District Judge

 
 Case: 1:05-cv-04331 Document #: 710 Filed: 06/06/18 Page 1 of 3 PageID #:13056

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs,
v. FELICIA NORWOOD, et al.,
Defendants.

)

)

)

)

Case No. 05 cv 4331

)

)

Judge Sharon Johnson Coleman

)

)

)

ORDER
Coming before the Court on the proposed plan for compliance with the Consent Decree submitted by the defendants, officials of Illinois Department of Healthcare and Family Services and the Illinois Department of Human Services. This Court entered an Order on August 18, 2017, finding that defendants were not in substantial compliance with the Consent Decree entered on June 15, 2011. This Court directed defendants to establish a plan for compliance. This Court finds that the proposed plan does not adequately address the shortcomings that the Court identified in its previous Order.
Statement In its August 18, 2017, Order this Court found that defendants were not in compliance with the Consent Decree by failing to provide the resources of sufficient quality, scope, and variety. This Court acknowledged the State of Illinois’ significant budgetary issues in its Order. Although the Illinois legislature passed a budget today, the Court is under no illusion that Illinois’ financial difficulties persist. Defendants’ proposed compliance plan contains four major strategies: (1) defendants have started a pilot program to expand the pool of candidates for service providers to seeking to fill open direct support professional (“DSP”) positions; (2) defendants have significantly increased funding for DSP wages, amounting to a 14% increase from FY2017 through FY2020; (3) defendants are enhancing and adding to their monitoring of service delivery; (4) working on several additional programmatic changes and enhancements. The Court finds that this is a good faith effort and a

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reasonable start, but doubts that the proposal is adequate to address the issue of wages, staffing, and retention.
At the April 4, 2018, hearing on this matter the Court expressed uncertainty over the defendants’ pilot project to expand the pool of potential candidates by coordinating with the Division of Family and Community Services to recruit able-bodied adults with no dependents who receive public assistance benefits from the Temporary Assistance for Needy Families (“TANF”) and Supplemental Nutrition Assistance Program (“SNAP”). It is unclear that this pilot program will expand the candidate pool at all. It is also unclear to this Court whether it will address the corollary problem of retention of well-qualified employees when the wages continue to remain low.
Defendants’ plan for wages falls woefully short, amounting only to a $0.38 per hour per year increase for between FY2017 and FY2020. Defendants acknowledged that their proposal is particularly inadequate for DSPs working in Chicago, who will need a greater increase to keep pace with the minimum wage increases passed by the Chicago City Council. As both the Court Monitor and the plaintiffs point out, defendants have not always viewed DSP as a minimum wage job. Historically, DSPs were paid twice the minimum wage. It may not be feasible for the State to raise wage rates to that level, but this Court hesitates to affirm the devaluing of the role of caregivers for some of the more vulnerable members of our society. At the same time, this Court is not in the position to act as super-legislator by dictating how the State should allocate funds and administer its budget.
One of the criticisms of the defendants’ proposal levied by the Court Monitor is that the proposal is too short-sighted and does not have a long-term plan. This Court agrees. However, it has been nearly seven years since the entry of the Consent Decree and this Court sees no end to the Court’s oversight. For the defendants to truly comply and provide adequate services, the parties and stakeholders will have to come together to formulate a long-term plan to address these issues.
This Court believes that convening a work group that includes the Monitor and other independent stakeholders to study the wage rates for DSPs, the funding methodology for CILAs and ICFs for individuals with Intellectual and Developmental Disabilities, and develop a monitoring tool to assess adequacy of services, funding, and administration. Ideally the monitoring tool would include an independent review component. The Court also takes the Court Monitor’s recommendation that the parties pursue expeditiously their discussion for developing the criteria for moving individuals from the Prioritization for Urgency of Need for Services (“PUNS”) waiting list at a reasonable pace.

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This Court concludes that ultimately it must be the parties that develop adequate solutions to the problems at issue. This Court lacks the expertise and the budgetary authority to impose measures to resolve the issues here. The Court directs the parties to continue to develop a plan to address the issues causing the reduction in services and to bring the State into substantial compliance. IT IS SO ORDERED.
ENTERED:

Dated: 6/6/18

____________________________________ SHARON JOHNSON COLEMAN United States District Judge

 
 Case: 1:05-cv-04331 Document #: 717 Filed: 12/31/18 Page 1 of 77 PageID #:13216
Stanley Ligas, et al. v.
Felicia Norwood, et al. No. 05-4331
Sixth Annual Report of the Monitor
December 31, 2018
Respectfully Submitted: Ronnie Cohn Monitor
Iigas.monitor@gmail.com

Case: 1:05-cv-04331 Document #: 717 Filed: 12/31/18 Page 2 of 77 PageID #:13217

Stanley Ligas, et al. v. Felicia Norwood, et al.
Sixth Annual Report of the Monitor December 31, 2018
Table of Contents
I. Introduction II. Review of Compliance Findings to Date
A. Summary of 4th and 5th Annual Reports B. Findings for 1/20/2017 through 12/30/2018
Resources & Capacity Class Member Lists Transition Service Plans Transition for Class Members in ICFs/DD Crisis Services Transitions for Class Members on Waiting List Outreach Implementation Plan Data Reports III. Actions Toward Compliance Parties’ Meetings Status Conferences in Court Oversight Committee Meetings Ligas Compliance Measures IV. Communications & Implementation Activities V. Closing Remarks
Attachments

3 6 6 11 11 21 22 23 25 35 36 38 39 41 41 41 50 51 53 55
57-77

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Case: 1:05-cv-04331 Document #: 717 Filed: 12/31/18 Page 3 of 77 PageID #:13218
Stanley Ligas, et al. v. Felicia Norwood, et al.
Sixth Annual Report of the Monitor
December 31, 2018
I. INTRODUCTION
This Sixth Annual Report of the Monitor is respectfully submitted to the Court, Parties, and Intervenors in accordance with Paragraph 34 of the Ligas Consent Decree (Decree), which was approved and filed by the Court on June 15, 2011. The Decree requires that:
“The Monitor shall file annual reports to the Court, which shall be made publicly available. Such reports shall include the information necessary, in the Monitor’s professional judgment, for the Court, Plaintiffs and Intervenors to evaluate Defendants’ compliance or non-compliance with the terms of the Decree.”
As described in the Plaintiffs’ current Fact Sheet:
“Ligas v. Norwood (formerly Ligas v. Maram) is a lawsuit filed in 2005 by nine people with developmental disabilities (Plaintiffs) who reside in large private State-funded facilities (ICFs-DD) or who were likely to be placed in such facilities if they did not get community services. Plaintiffs wanted to receive community services, but their requests had been denied by the State of Illinois. In 2006, a Judge certified the case as a class action. (Note that people living in State-operated Developmental Centers are not part of the class action.) Prior to trial, the parties reached an agreement, but at a Fairness Hearing in July of 2009, the Judge found that the class definition was too broad as it included people
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who did not desire to live in the community. Accordingly, the Judge did not approve the agreement and de-certified the class. In January of 2011, the Plaintiffs, Defendants and the Intervenors (representing those who wished to remain in ICFs-DD) reached a new agreement that all could support. The Judge held a Fairness Hearing on June 15, 2011 and approved the proposed Consent Decree.”
The first Ligas Monitor, Tony Records, was appointed by the Court on July 19, 2011. Upon his retirement, the current Monitor’s appointment was effective on July 1, 2015. The first three Annual Reports of the Monitor were submitted by Mr. Records in 2012, 2013 and 2014. Based upon the mid-year timing of the current Monitor’s appointment, the fourth and fifth Annual Reports were submitted by the current Monitor in 2016 and 2017. All of these reports are available on the website of the Department of Human Services (DHS). http://www.dhs.state.il.us/page.aspx?item=64489
The Monitor recognizes, with gratitude, that ongoing collaboration with the Defendants; Plaintiffs’ counsel and representatives; Counsel for the Intervenors; family and advocacy associations; service providers and provider organizations; the Illinois Council on Developmental Disabilities; service coordinators and others has been critical to the completion of the current report. Communication with beneficiaries of the Decree and their families has also been of great value to the Monitor in evaluating the Decree’s effectiveness at each stage of its implementation.
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In addition, it is worthy of note that although the Defendants have remained out of compliance in the areas described herein, there has been some progress following the Court’s Order in June, 2018. Similarly, although there have been recent significant changes within the Ligas Implementation Team at the Division of Developmental Disabilities, those remaining on the team continue to reply promptly to the Monitor’s requests and all vacancies are scheduled to be filled in early January.
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II. REVIEW OF COMPLIANCE FINDINGS TO DATE
A. Summary of the Monitor’s Fourth and Fifth Annual Reports
The Monitor’s Fourth and Fifth Annual Reports cite the lack of a State Budget for Fiscal Years (FY) 2016 and 2017 in Illinois and describe the uncertainties this created for beneficiaries of the Consent Decree and their families as well as for advocates, staff and providers of all types of services received by the Decree’s beneficiaries. The joint efforts of the Plaintiffs, Defendants, Intervenors and Monitor in 2015 and 2016 resulted in Court Orders approved by United States District Judge Sharon Johnson Coleman which required, in part:
“The Comptroller shall continue to timely approve and make payments for services, programs and personnel, at a level and within the time period that such payments were made in Fiscal Year 2016, that are necessary to comply with the Consent Decree and Implementation Plans. The Court’s previous orders of June 30, 2015 (Dkt. #597), August 18, 2015 (Dkt. #610) and September 1, 2015 (Dkt. #624) are incorporated herein and shall continue in effect. This Order shall remain in effect until the earlier of the effective date of the Fiscal Year 2017 budget or July 1, 2017, or until further order of this Court.”
This Order also required monthly reports to the Monitor “to enable her to evaluate and to advise the Court and the Parties regarding the State’s compliance with the Consent Decree and Orders entered by this Court” and that “if at any time the State believes that it may not be able to comply with any provision of the Consent Decree or this Order, the State must immediately bring the State’s potential non-compliance to the attention of
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the Court, the Monitor, the Plaintiffs and the Intervenors before such noncompliance occurs.”
At the time that the Fifth Annual Report of the Monitor was issued, the Defendants had continued to maintain funding at the same level paid in FY 2015 which, though in compliance with the Court Orders and clearly necessary to continue services, remained inadequate as reported in both the Fourth and Fifth Annual Reports.
Both the Fourth and Fifth Annual Reports of the Monitor emphasize the fact that low wages, particularly those paid to Direct Support Professionals (DSPs) but including those paid to others providing services to beneficiaries of the Consent Decree, resulted in a staffing crisis for providers of services in their efforts to recruit, train and maintain adequate staff. At the time of the writing of the Fifth Annual Report in January, 2017 there had been no relief in terms of salary increases, DSP vacancy rates or increases in rates paid to providers since 2008 while operating costs continued to increase.
Other issues, which were first noted in the Fourth Annual Report and continued into the following year include, but were not limited to:
1. Delays in initiation of services for Class Members once they have been selected from the Prioritization of Urgency of Need for Services (PUNS) list;
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Case: 1:05-cv-04331 Document #: 717 Filed: 12/31/18 Page 8 of 77 PageID #:13223
2. Limited availability of small Community Integrated Living Arrangements (CILAs) in some geographic areas as well as for individuals with more intense medical, behavioral or physical needs;
3. Inadequate availability of flexible, person-centered, integrated day activities or employment for individuals seeking such opportunities; and
4. Inadequate monitoring of the quality of services provided to beneficiaries of the Consent Decree.
The negative impact upon beneficiaries of the Consent Decree of the inadequacy of both funding of services and of the processes put in place by the Defendants to monitor the quality of services is described in detail in the Fifth Annual Report. For example, providers’ quotes therein include: “We do not have enough staff to meet the needs of the clients”; “A huge shortage in staffing … has created the need to redirect focus to maintaining personal care … rather than to skill acquisition and skill retention”; “Our group homes run with minimal staffing, which does not provide opportunities for community integration” and “Given the current residential and nursing rates, we are unable to support individuals with more advanced nursing or behavioral needs.” Quotes from parents include: “My daughter has experienced five trips to the Emergency Room over the past eighteen months, is not being provided with the opportunities included in her ISP, has only one staff member on
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most shifts to meet the needs of all four women who live together and have significantly differing levels of need, and isn’t always provided with healthy food.”; “My daughter lives is an ICF-DD. … Due to her limited communication skills and complex medical needs, it takes several months for a new staff member to get to know and understand her. More important, it takes several months for my daughter to feel comfortable with the new staff person who must help her with her most personal needs. … The constant turnover of staff and use of temporary staff has also caused her to suffer increased anxiety’”; “My son lives in a CILA and has autism, an anxiety disorder and limited verbal skills. Routine and predictability are extremely important for my son and the lack of these results in his becoming very anxious, fearful and frustrated. Until last year, my son lived in a four-person CILA, but then the operating agency had to consolidate and increase the capacity of its CILAs in order to cut costs. Moving to a new home with more residents is very confusing to him and I am concerned for his safety and the safety of the other residents because it is much more difficult for a single staff person to adequately supervise six or eight individuals with significant developmental disabilities rather than four.”
It is worthy of note that the widespread concern with the wages paid to DSPs, who provide what has been aptly described as “front line services” to those living in CILAs and ICFs, resulted in both chambers of the Illinois Legislature passing bills in the fall of 2016 to provide “livable wages” to
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DSPs. However, this legislation was vetoed by the Governor and an attempted override of the veto was unsuccessful. This issue was addressed more successfully a year later and is discussed further in Section III below.
Finally, the Fifth Annual Report repeats the Monitor’s findings of noncompliance related to Paragraphs 4 and 5 of the Consent Decree and adds information regarding the Monitor’s concerns about the Ligas 2016 Implementation Plan, which did not address the staffing crisis and was therefore filed with the Court by the Defendants alone, without a joint motion including the Plaintiffs and Intervenors.
Actions taken in response to the Monitor’s Fifth Annual Report and the Defendants’ response to that report are delineated in Section III below as well as in some of the specific subject matter areas herein.
The Ligas Consent Decree, as well as the Monitor’s Fourth and Fifth Annual Reports and the Defendants’ responses to these reports are available on the website of the Department of Human Services (DHS) http://www.dhs.state.il.us/page.aspx?item=66987. The Equip For Equality website (https://www.equipforequality.org/) also includes information related to the Ligas litigation and the Monitor’s reports.
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B. Findings for January, 2017 through December, 2018 Resources and Capacity
Paragraph 4 of the Consent Decree requires in part:
“Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such Individuals under the Decree and the Implementation Plan consistent with such choices.”
“Funding for services for each Individual with Developmental Disabilities will be based on the Individual’s needs … regardless of whether the Individual chooses to receive services in an ICF-DD or in a Community-Based setting.”
“Resources necessary to meet the needs of Individuals with Developmental Disabilities who choose to receive services in ICFs-DD shall be made available and such resources will not be affected by Defendants’ fulfillment of their obligations under the Decree. …”
Paragraph 5 of the Consent Decree requires, in part:
“Annual budgets submitted by Defendants on behalf of their agencies shall request sufficient funds necessary to develop and maintain the services, supports and structures described in the Decree, consistent with the choices of Individuals with Developmental Disabilities, including Class Members. Defendants shall take steps sufficient to implement funding mechanisms that facilitate transition among service settings.”
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The issues related to the Consent Decree’s requirements of “resources and capacity” remain unresolved during the time period of 1/2017 through the date of the current report. However, there have been significant actions taken toward achieving compliance which are detailed below in Section III. As related primarily to resources and capacity, the initial responses to the Monitor’s Fifth Annual Report and subsequent Court documents included:
Ø 2/24/2017- Defendants’ Response to Fifth Annual Report of the Monitor, in which Defendants state that “this Response focuses solely on the issues pertaining to Resources and Capacity” as “the Defendants were found to be in substantial compliance with all other aspects of the Decree.” The Monitor did find that the Defendants’ had complied with transitioning the required numbers of Class Members from the PUNS list to receiving services by the dates specified in the Consent Decree, as well as with implementing both court ordered payments to providers of services at the FY15 level and reports to the Monitor on that matter. However, there still remained the other issues of noncompliance noted above and significant areas of concern and uncertainty related to monitoring of services, provision of crisis services, and changes in the processes of person-centered planning, all of which are described below. The Defendants also indicated there was no “systemic staffing crisis or decrease in service quality for either
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CILA or ICF/DD providers”, though it was not clear how this was determined as the only monitoring of compliance completed by the Defendants was of Waiver Performance as opposed to entitlements of the Consent Decree.
Ø 4/7/2017- Plaintiffs’ and Intervenors’ Joint Motion to Enforce the Consent Decree cited breaches of the Consent Decree, the Monitor’s findings of noncompliance, declarations from providers of services as well as from subject matter experts, families of Consent Decree beneficiaries and the former Monitor. The motion highlighted the impact upon beneficiaries of the Consent Decree caused by inadequate funding of services as related to both wages and reimbursement rates, the resulting staffing crisis, issues related to person-centered services and community integration, health and wellbeing, predicted reductions and closures within the service delivery system. The Plaintiffs and Intervenors requested that the Court find the Defendants out of compliance and enter an Order to enforce the Consent Decree with a detailed schedule to develop a compliance plan followed by monthly reports to the Plaintiffs, Intervenors and Monitor regarding progress in implementing the plan.
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Case: 1:05-cv-04331 Document #: 717 Filed: 12/31/18 Page 14 of 77 PageID #:13229
Ø 6/23/17- Defendants’ Response to Plaintiffs’ and Intervenors’ Joint Motion to Enforce Consent Decree includes the argument that Paragraph 4 of the Decree “does not obligate the State nor empower this Court to increase rates based on the facts Movants allege” and that Paragraph 4 “is intended to accomplish three goals: (1) set out Defendants’ obligation to make available the resources necessary to meet the needs of Individuals with Developmental Disabilities (i.e. both Class Members and Intervenors); (2) set out Defendants’ obligation to not lessen their commitment to Intervenors residing in ICFDDs and not divert resources devoted to serving Intervenors to meeting Defendants’ new obligation to expand opportunities for Class Members to obtain community-based services; and (3) make obligations (1) and (2) explicitly linked to and consonant with Defendants’ obligation to comply with the Decree and existing Federal Law.” It is further stated that “during the negotiations of the Decree, Defendants insisted that the Decree would not obligate them to provide new or a higher level of services than are required to comply with federal law” and that Defendants will be in compliance with the Decree- as to both the types of services and the funding for those services-so long as Defendants remain in compliance with Federal law.”
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Ø 7/14/17-Plaintiffs’ and Intervenors’ Reply in Support of Their Joint Motion to Enforce the Consent Decree also quotes Paragraph 4 of the Decree in describing the Defendants’ service obligations, as follows: “The choices of Individuals with Developmental Disabilities, including Class Members, to receive Community-Based Services or placement in a Community-Based Setting or to receive ICF/MR services in an ICF-DD will be honored; … Defendants shall implement sufficient measures to ensure the availability of services, supports and other resources of sufficient quality, scope and variety to meet their obligations to such Individuals under the Decree and the Implementation Plan consistent with such choices.” It is noted that while Paragraph 4 “does not explicitly provide for court-ordered rate increases … consent decrees need not contain or limit the remedies that a court can order upon its violation.” Further, it is stated: “By agreeing to maintain the services provided under the Consent Decree, Defendants took on the obligation of paying the cost of those services knowing that, like all costs, they would not remain stagnant over time. By refusing to pay the actual cost of the services, Defendants are pushing those costs onto private providers, most of which are non-profit organizations with little capacity to absorb the costs that the State refuses to pay. That shifting of the financial burden has caused a reduction of the services required by the Decree.”
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Ø 7/27/17- Defendants’ Response to Plaintiffs’ and Intervenors’ Reply in Support of Their Joint Motion to Enforce Consent Decree refutes, among other issues raised, the arguments made by Plaintiffs and Intervenors regarding: interpretations of Paragraph 4 of the Consent Decree; the statement that “the stagnation of DSP rates has led to increased DSP vacancies and turnover, which in turn has resulted in decreased services”; the Movants’ asking for “an increase in rates that ranges from $207 million to over a billion dollars in additional spending each year. Although there is now a budget for FY18, the existence of a budget does not change the impact of the State’s overall fiscal condition on this case, and does not include additional funds amounting to hundreds of millions or up to more than a billion additional dollars to satisfy Movants’ demand for increased rates.”
Ø 8/2/17- Defendants’ Supplemental Response to Plaintiffs’ and Intervenors’ Reply in Support of Their Joint Motion to Enforce Consent Decree indicates an effort to address the “Movants’ demand” that “the Court order Defendants to increase the rates paid to providers, particularly the rates that cover the wages paid to direct support professionals. … Yet, as Movants acknowledge, the recently passed state budget does just that: the budget allocates an additional $53.4 million to increase the
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rates for DSP wages, and that increase exceeds the rate of inflation over the relevant time period. Thus, Movants no longer have a basis for their essential claim that Defendants are out of compliance with the Decree. The overall DSP wage is $10.71/hour. The additional $53.4 million included in the FY18 budget will increase by $0.75/hour the DSP wage component of the provider reimbursement rate … an increase of 7%. That 7% increase exceeds the inflation rate over the relevant time period, which is 2014 to 2017, and which has seen a cumulative inflation rate of 3.5%.” Additional details of the inflation calculations and the significance of the 2014-2017 time period are provided and the conclusion drawn is that “even if one goes back to 2012, when Defendants had just begun implementing the Decree, the 7% increase in the DSP rate still exceeds the cumulative inflation rate, which was 6.7% between 2012 and 2017. … Defendants respectfully request that the Court deny Plaintiffs’ and Intervenors’ Joint Motion to Enforce Consent Decree.”
Ø 8/11/17- Judge Sharon Johnson Coleman entered the following Order:
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Ø 8/12/17- Plaintiffs’ Counsel issued a statement indicating that “Federal Judge orders Illinois to develop a plan to provide critical resources for people with developmental disabilities.” (Attached to the end of this report.)
Class Member Lists
Paragraphs 8 and 9 of the Consent Decree require that the defendants maintain a statewide database in which all Class Members are enrolled and which, along with waiting list data, is promptly revised. The Implementation Plan is required to include information regarding the adequacy of the PUNS (Prioritization of Urgency of Needs for Service) database.
Paragraph 2 of the Consent Decree requires a list of Class Members who qualify for Medicaid Waiver services, live in an ICF-DD with nine or more residents and have affirmatively requested community-based services or placement in a community-based setting. Another list is required of Class Members who qualify for Medicaid Waiver services, live in a family home and are in need of and have affirmatively requested home and communitybased services or services in a community based setting. The individuals on this list are known as Waiting List Class Members and this list is considered a subset of the PUNS list.
As indicated in the Monitor’s Fifth Annual Report, improvements have been made in both accuracy of the data on the PUNS list and the efficiency of
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tracking the progression of Class Members who have been selected from the PUNS list to the point of initiation of waiver services. With the development of the most recent and most comprehensive “Seeking Services” list, the Monitor has easier access to additional information and DDD (Division of Developmental Disabilities) promptly provides even unscheduled updates. Those involved in maintaining this information are essential to the Monitor’s identifying both potential barriers to achieving transitions and Class Members’ status toward receiving desired services.
Transition Service Plans
Paragraphs 11 through 15 of the Consent Decree set forth the requirements for developing Ligas Transition Service Plans and for the content of these plans. These plans were designed to “focus on the Class Member’s personal vision, preferences, strengths and needs in home, community and work environments” and to “reflect the value of supporting the Class Member with relationships, productive work, participation in community life and personal decision making”. It was required that these plans “not be limited by the current availability of services” and that they must be “consistent with the choices of the Class Member and the Class Member’s legal guardian.” In 2017, however, as part of DDD’s Life Choices Initiative and being aware of Federal guidelines for Person-Centered Planning, DDD developed the Discovery Tool and Personal Plan Tool to assess needs and preferences for all individuals included in the Medicaid Waiver. Collaboration among DDD, the Plaintiffs and Monitor to insure
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that Class Members would not be losing any of the benefits of the Ligas Transition Service Plans resulted in the Discovery Tool and Personal Plan together replacing the Ligas Transition Service Plan as of January 1, 2018.
The quality and implementation of Personal Plans will be monitored as part of a larger, newly created Compliance Monitoring process which will likely be piloted in February, 2019. The Monitor remains concerned about the quality of services, as noted in the Fourth and Fifth Annual Reports and reflected in the section 1 above. More information regarding the new Compliance Measures is included in Section III below.
Transition for Class Members in ICFs-DD
Paragraph 17 of the Consent Decree requires that within six years after the approval of the Decree, all Class Members residing in ICFs-DD as of the date of approval of the Decree will transition to Community-Based settings consistent with their Transition Service plans if, at the time of the transition, the Class Member requests placement in a Community-Based setting as confirmed and documented in accordance with the Decree.
The Consent Decree required that all Class Members in this category transition to the community by 6/15/2017, with one-third of these individuals moving by 12/15/2013, two-thirds by 12/15/2015 and all by 6/15/ 2017. The actual target number for each of these benchmarks was fluid based upon the list defining this category, but in all cases the
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Defendants exceeded the target numbers through 6/15/2017. However, the Plaintiffs have expressed concern regarding the outreach to individuals living in ICFs-DD as to whether all have been afforded sufficient information regarding their rights under the Decree related to moving out of ICFs and into the community. This remains an issue for resolution which has been on the active agenda of Parties’ meetings since 2016.
Based upon the most recent semi-annual data, which was submitted to the Monitor on August 15, 2018, 1,437 of 1,608 active Ligas ICF-DD Class Members had transitioned to the community, with 1,410 receiving CILA services, 24 receiving Home-Based services and 3 receiving CLF (Community Living Facility) services. The number of active Ligas ICF-DD Class Members includes 209 individuals represented by the Office of the State Guardian for whom assessments are being completed as to whether or not they choose to move to the community.
As was indicated in the Monitor’s Fifth Annual Report, the Monitor applauds the efforts involved in exceeding the benchmarks and will continue to work with the Plaintiffs and Defendants to facilitate the transitions of ICF-DD Class Members who choose to move to the community. All Class Members and beneficiaries of the Decree must be offered a variety of options and opportunities in order to make informed decisions about where, how and with whom they choose to receive services and supports. The Monitor will continue to work closely with the
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Parties in tracking how such choices are facilitated, particularly in consideration of the obstacles described in the section above regarding resources and capacity, related to both the maintenance of existing community services and further development in the community.
Crisis Services
As indicated in Paragraph 21(a)-(b) of the Ligas Consent Decree, “an individual is in a situation of “Crisis” if he or she is at imminent risk of abuse, neglect, or homelessness. The provision of interim emergency services (including interim placement in an ICF-DD where no placement in a Community-Based Setting was immediately available) will not necessarily exclude the Individual from being deemed to be in a situation of Crisis. If, following a screening, the Individual who is determined to be in Crisis requests appropriate Community-Based Services to be provided in the Family Home or requests placement in a Community-Based Setting, Defendants will promptly develop, in conjunction with the Class Member, a Transition Service Plan.”
State Defendants are required to serve expeditiously class members who meet the above-described criteria and who request community services or placement in a community-based setting. A review of crisis requests from July 1, 2016 through June 30, 2017 indicated that 467 crisis services requests were received and reviewed by DDD with 447 requests approved.
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Denials of crisis services requests were due to crisis criteria not being met and/or determination of lack of clinical eligibility. Of the approved crisis requests, ninety-seven (97) were classified as abuse, 170 were classified as neglect, and 178 were due to the individual being homeless.

For the period of July 1, 2017 through June 30, 2018, 373 crisis services requests were received and reviewed by DDD with 339 requests approved. Again, denials of crisis services requests were due to crisis criteria not being met and/or determination of lack of clinical eligibility. Of these approved crisis requests, sixty-two (62) were classified as abuse, 187 were classified as neglect, and 90 were due to the individual being homeless.

Classification of Approved Crisis Requests July 1, 2017-June 30, 2018

62 90
187

Abuse Neglect Homeless

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Classification of Approved Crisis Requests July 1, 2016-June 30, 2017

99 178
170

Abuse Neglect Homeless

Classification of Approved Crisis Requests July 1, 2015-June 30, 2016

125

117

240

Abuse Neglect Homeless

Classification of Approved Crisis Requests July 1, 2014-June 30, 2015

116

100

245

Abuse Neglect Homeless

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Classification of Approved Crisis Requests July 1, 2013-June 30, 2014

93

71

233

Abuse Neglect Homeless

Services provided to class members in crisis included four types of CILA (Community Integrated Living Arrangement) options: 24-Hour CILA, Host Family CILA, Intermittent CILA, and Family CILA, in addition to Home-Based Support Services (HBS). For the period of July 1, 2016 through June 30, 2017, of the 447 crisis requests approved, 226 were funded to receive 24Hour CILA, 6 were funded to receive Host Family CILA, 16 were funded to receive Intermittent CILA, and 15 were funded to receive Family CILA. Home-Based Support Services were authorized for 184 class members. For the period of July 1, 2017 through June 30, 2018, of the 339 approved crisis requests, 226 were funded to receive 24-Hour CILA, 5 were funded to receive Host Family CILA, 18 were funded to receive Intermittent CILA, and 16 were funded to receive Family CILA. 74 class members were authorized to receive Home-Based Support Services.

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Services Authorized July 1, 2017 - June 30, 2018

74
16 18
226 5

24-Hour CILA Host Family CILA Intermittent CILA Family CILA Home-Based Services

Services Authorized July 1, 2016 - June 30, 2017

184 15 16

24-Hour CILA
Host Family CILA
Intermittent CILA 226
Family CILA
Home-Based Services
6

Services Authorized July 1, 2015 - June 30, 2016

170
23 9 19

24-Hour CILA

Host Family CILA

Intermittent CILA

261

Family CILA

Home-Based Services

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Services Authorized July 1, 2014 - June 30, 2015

178 244
19 3 17

24-Hour CILA Host Family CILA Intermittent CILA Family CILA Home-Based Services

Services Authorized July 1, 2013 - June 30, 2014

180

177

20

13

7

24-Hour CILA Host Family CILA Intermittent CILA Family CILA Home-Based Services

Combining the reporting years of 7/1/13-6/30/18, a total of 2126 crisis requests received have been approved by DDD.

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Classification of Approved Crisis Requests July 1, 2013 - June 30, 2018

449 602
1075

Abuse Neglect Homeless

For this same reporting period, services were provided to class members in crisis within four types of CILA (Community Integrated Living Arrangement) options:

Services Authorized July 1, 2013 - June 30, 2018

786
84 92

1134 30

24-Hour CILA Host Family CILA Intermittent CILA Family CILA Home-Based Services

During the 2013/2014 reporting period, the Monitor established, with the agreement of the parties, that the timeframe to receive services for class members in crisis will be 24-72 hours, although this timeframe may vary, depending on individual circumstances, or if temporary services are in place to address the immediate crisis. Since this agreement, the Monitor has

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analyzed class member information and data from all crisis requests received and reviewed by the Defendants and determined to meet the requirements for crisis services. From the Monitor’s analysis, the majority of crisis requests were reviewed by the region within an adequate timeframe. As can be seen in the chart below, for the past 2 years, the timeliness of review occurred, for the most part, within the 24-72 hours as established:

Timeliness of Review
Within 1 day Within 2-3 days 4-6 days Insufficient Data

FY 2016-2017 N=447
391 87% 42 9% 10 2% 4 <1%

FY 2017-2018

N=339

301 89%

37 11%

1

<1%

n/a

n/a

Data from the most recent reporting period (July 1, 2017 to June 30, 2018) shows that 52% of the class members who were found to be in crisis, received some service within a 24-72 hour period after their crisis status was confirmed; for 31%, services were initiated between 4 and 9 days; 8% received services between 10-19 days; 4 individuals received services between 20 and 29 days; services were not initiated for 12 of the class members for more than a month; and for 16 class members, data was insufficient to include in the analysis. As noted in the chart below, while the past three years show improvement over FY 13/14, only one-half of the individuals who were found to be in crisis received some services within the 24-72 hours agreed upon timeline:

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Timeliness of Authorization of
Crisis Services

FY 20132014 N=397

24-72 hours 4-9 days 10-19 days 20-29 days 30-39 days 40+ days Insufficient Data

107 27% 122 31% 74 19% 36 9% 15 4% 35 8%
8 2%

FY 20142015 N=461
218 47% 151 33% 64 14% 15 3%
6 1% 5 1% 2 1%

FY 20152016 N=482
220 46% 175 36% 60 12% 15 3%
3 1% 6 1% 3 1%

FY 20162017 N=447
229 51% 164 37% 43 10%
8 2% 2 <1% 1 <1% n/a n/a

FY 20172018 N=339
175 52% 106 31% 26 8%
4 <1% 8 <2% 4 <1% 16 5%

Overall 2013-2018
N=2126
949 45% 718 34% 267 13% 78 4% 34 2% 51 2% 29 1%

Review of the data associated with the crisis requests reviewed and approved revealed that, in nearly all cases, a “safety plan” had been determined to be in place for the class member in order to ensure safety and reduction of risk while awaiting approval of services. In the Fourth and Fifth Annual Reports, the Monitor raised concerns as to the adequacy of safety plans wherein the class member in crisis is not in a permanent or stable situation (e.g., jail, psychiatric hospital, nursing home), and with this report continues to raise such concerns.

In addition to raising the question of the adequacy of crisis safety plans in the Fourth and Fifth Annual Reports, the Monitor also expressed concern that nearly half (49%) of the individuals with approved crisis placements were on the PUNS waiting list for three years or more. This report continues to provide an analysis of crisis data to determine the relationship between crisis applicants and the PUNS list and as can be seen in the charts below for the period of 7/1/16-6/30/18, again nearly half (44%) of the

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individuals with approved crisis placements were on the PUNS waiting list for three years or more.

Approved Crisis Placements and Length of time on PUNS Waiting List

July 1, 2016-June 30, 2018

Time Period

Number of Placements

% of Total

One Month or Less

38

5%

Over 1 Month to 1 Year

219

28%

1 to 2 Years

103

13%

2 to 3 Years

50

6%

3 to 4 Years

62

8%

4 Years or More

281

36%

Insufficient Data

33

4%

N=786

It should be noted that as reported by DDD, the accuracy of PUNS data depends on the timeliness of the ISC’s entry into the PUNS database of the date an individual began receiving services (and therefore no longer seeking services).

Approved Crisis Placements and Length of time on PUNS Waiting List

July 1, 2017-June 30, 2018

Time Period

Number of Placements

% of Total

One Month or Less

14

4%

Over 1 Month to 1 Year

102

30%

1 to 2 Years

45

13%

2 to 3 Years

24

7%

3 to 4 Years

23

7%

4 Years or More

128

38%

Insufficient Data

3

<1%

N=339

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Approved Crisis Placements and Length of time on PUNS Waiting List

July 1, 2016-June 30, 2017

Time Period

Number of Placements

% of Total

One Month or Less

24

5%

Over 1 Month to 1 Year

117

26%

1 to 2 Years

58

13%

2 to 3 Years

26

6%

3 to 4 Years

39

9%

4 Years or More

153

34%

Insufficient Data

30

7%

N=447

The Monitor greatly appreciates the assistance of Melanie Reeves Miller, the Monitor’s Data and Program Analyst, in conducting this review of Crisis Services.

Transitions for Class Members on the Waiting List
Paragraph 22 of the Consent Decree defines the numeric requirements for transitions of Class Members on the Waiting List to the community for the period 6/15/11- 6/15/2017 and paragraph 23 states that after 6/15/2017 Class Members who remain on the Waiting List “shall receive appropriate Community-Based Services and/or placement in a Community-Based Setting such that they move off the Waiting List at a reasonable pace.”

Over the first six years of the Decree’s implementation, DDD was required to serve 3000 of these Class Members under the Medicaid Waiver and this numeric benchmark was exceeded by the Defendants. It is worthy of note that as of 6/30/2018, 5,924 Class Members had been selected from the PUNS waiting list and that 3,590 had begun receiving Waiver services.

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Since 2016, the Plaintiffs, Defendants and Monitor have been engaged in a process to both define a “reasonable pace” for moving Class Members off the Waiting List following 6/15/2017 and decrease the amount of time that Class Members remain on the Waiting List prior to receiving desired services. Two of the steps taken already to clarify how priorities are established for these transitions are to simplify the categories related to those waiting for services to “Seeking Services” and “Planning for Services” and to consider the amount of time for which an individual has been waiting on the PUNS list since reaching the age of 18. In addition, in order to facilitate the PUNS selection process for individuals and their families, DDD will now be notifying those who are anticipated to be part of a PUNS pull in advance of the actual pull to allow families to have more time to explore service options.
Outreach
Paragraph 25 of the Consent Decree requires that “Defendants shall maintain a fair and accessible process by which Individuals with Developmental Disabilities or their legal guardians can affirmatively request in writing to receive Community-Based Services and/or placement in a Community-Based Setting or to receive ICF-MR services in an ICF-DD, and Defendants shall maintain up-to-date records of those requests.”
As described by the Monitor in the Fifth Annual Report, the Defendants’ outreach efforts, which were intended to identify individuals living in ICFs-
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DD who wanted to move to the community but had either not been informed of this option or not yet expressed this desire, were concluded and the findings shared with the Monitor and Parties in April, 2016. At that time, it was noted that 123 individuals had been identified who chose to become Class Members and were added to the list of Class Members in ICFs-DD.
It is important to note herein that Class Members in ICFs-DD who had expressed (by themselves or their guardians) in writing by June 15, 2017 a desire to receive Community-Based Services and/or placement in a Community Setting were entitled to do so without having to wait on the Waiting List (in accordance with the Decree’s original benchmarks as explained above). The Monitor, Defendants and Plaintiffs have continued to discuss the Plaintiffs’ concerns regarding individuals living in ICFs-DD who learned about this right too late to benefit from this entitlement and whether this entitlement could thus be extended on a case-by-case basis.
Counsel for the Intervenors have stated that they are concerned about whether everyone who is selected from the Waiting List is offered a choice including ICFs-DD. However, in order to become a member of the Waiting List Class it is required that individuals make a record with the State confirming their desire for community services.
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Implementation Plan
Paragraph 26 of the Consent Decree requires that “the Defendants, with the input of the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel shall create and implement an Implementation Plan to accomplish the obligations set forth in the Decree,” and paragraph 28 requires that this plan be “updated and amended annually, or at such earlier intervals as Defendants deem necessary or appropriate.”
As has been the case for the past three years, at each scheduled Parties’ meeting, the Defendants provide updates of the Plan’s activities, as requested by the Parties, Intervenors and Monitor, and discussions are focused upon the areas deemed most significant at a given time. An agenda is set in advance to facilitate productive conversations.
Through 2015, the Implementation Plan updates and proposed revisions were provided by the Defendants to the Plaintiffs, Intervenors and Monitor for consideration and negotiations took place during parties’ meetings which resulted in jointly developed revisions being agreed upon before being submitted to the Court.
However, as reported in the Fifth Annual Report, in 2016 the Parties could not reach agreement as to the Plan’s content in areas required in paragraph 26: “necessary resource development activities to implement the Decree” and “services and supports required in Transition Service Plans
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formulated pursuant to the Decree that are not currently available in the appropriate quantity, quality or geographic locations.” There has been no joint submission to the Court since the 2016 Revisions filed only by the Defendants. On a positive note, at the December, 2018 Parties’ Meeting, the Plaintiffs, Defendants, Intervenors and Monitor made significant progress and it is likely that an Implementation Plan will be jointly filed with the Court in early 2019.
Data Reports
Paragraph 33 of the Consent Decree requires, in part: “Not less than every six months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors’ Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants’ compliance with the Decree and Defendants’ progress toward achieving compliance.”
The most recent Ligas Data Report is the fourteenth since the Decree was approved and is dated August 15, 2018. These reports are provided, in compliance with the Consent Decree, every six months and typically on February 15th and August 15th. The 8/15/2018 Report reflects data collected for FY 2018, which ended on 6/30/2018.
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As reported in the Fifth Annual Report as well, the Monitor acknowledges that the Ligas Data Reports are submitted timely and that Defendants have also created additional reports as requested by the Monitor. DDD staff continue to be available to answer the Monitor’s questions, clarify data and address concerns related to documents they have prepared.
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III. ACTIONS TOWARD COMPLIANCE
Parties Meetings
Between 2/8/2017 and 12/19/2018, sixteen Parties’ meetings were convened. Although agenda items varied based upon the most pressing issues at any given time, the topics of most ongoing discussions included: Ligas Data Reports; Ligas Transition Service Plans; the newly developed Discovery Tool and Personal Plans; Status Conferences with Judge Coleman; Defendants’ proposed Compliance Plans and responses thereto from Plaintiffs, Intervenors and the Monitor; Reasonable Pace; Ligas Implementation Plan revisions; development of draft Compliance Measures to monitor services provided to Class Members receiving Waiver services. In addition to full Parties’ meetings, there were several meetings convened among Plaintiffs, Defendants and the Monitor specifically to address how to define a reasonable pace for moving Class Members off the Waiting List.
Status Conferences and Court Filings
Ø Between 2/15/2017 and 11/15/2018, Plaintiffs’ Counsel, Defendants, Counsel for the Intervenors, and the Monitor appeared in Court thirteen times for twelve Status Conferences/ Updates and for Oral Arguments at a lengthy hearing on 8/4/2017, following the filings of Plaintiffs, Intervenors and Defendants and prior to the Court’s Order of 8/11/2017 as described in Section II.B above.
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Ø Following the 8/11/2017 Court Order, there were Status Conferences on 11/27/2017 and 2/28/2018.
Ø On 3/30/2018, the Defendants filed a “Status Report Regarding Proposed Compliance Plan in Response to August 11, 2017 Order.” On the same day, Plaintiffs and Intervenors filed their “Response to Defendants’ Compliance Proposals” as did the Monitor. All three of these documents, as well as Exhibit A to the Defendants’ filing, are attached to the current Report.
The Defendants Proposed Compliance Plan includes four strategies: (1) A pilot program that will “create a new pool of candidates for service providers to consider hiring for open direct support professional (DSP) positions. … Able-bodied adults with no dependents who receive public assistance benefits … are required to seek employment/education and training and have timelimited benefits available to them. The Department of Human Service (DHS) Division of Family and Community Services (FCS) has an office of workforce development that assists recipients with job searches. Over half of the individuals receiving SNAP (Supplemental Nutrition Assistance Program) or TANF (Temporary Assistance for Needy Families) have high school diplomas, which is the same education level required for DSP positions. Defendants intend to implement a program wherein providers of
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both ICF-DD and CILA services can hire qualified TANF and SNAP applicants to fill vacant DSP positions.”
(2) “Defendants have significantly increased funding so as to increase the hourly rates paid to DSPs, have proposed additional increases in such funding, and have proposed increases in funding for class members who will be selected from the waiting list. The already proposed and approved increased funding for DSP rates are intended to respond directly to Plaintiffs’ and Intervenors’ contentions that service providers have reduced services because they are unable to pay DSPs sufficient wages so as to recruit and retain a sufficient number of DSPs. The DSP rate increases are significant, amounting to a 14% increase from FY 2017 FY 2020.”
(3) “Defendants are enhancing and adding to their on-going monitoring of service delivery. … To date, the provision of services and supports identified in an individual class member’s Service Plan or Implementation Strategy has not been part of the annual provider review process. Therefore, the Department will begin a separate review of a statistically significant number of Ligas Class Members in CILA settings to assess the implementation of the agreed-upon services and supports by the individuals’ providers.”
(4) “Defendants are working on several additional programmatic changes and enhancements, all of which are intended to increase
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available services for individuals with developmental disabilities and better monitor whether services are being delivered as needed and intended.” Further details of the Defendants’ proposed strategies are included in Exhibit A, which is attached to the current report.
The Response from the Plaintiffs and Intervenors states in part that “The proposals to reduce staffing shortages and increase rates are insufficient.” It goes on to say: “The proposed increase is woefully inadequate, as it would only bring the DSP rate to $12.22 per hour by Fiscal Year 2020. As a result, the staffing crisis and insufficient services to class members and beneficiaries, well-documented in the Motion to Enforce, would continue. … Defendants need a long-term plan to address the inadequate resources and resulting decline in services.” The Plaintiffs and Intervenors then “respectfully request that this Court: (1) find Defendants’ Proposals inadequate to remedy the finding of non-compliance, (2) order the Defendants to submit a new compliance plan, and (3) order the State to form a workgroup consisting of counsel for the Plaintiffs and Intervenors, providers, consumers, and representatives of the State to recommend revisions to the rate methodologies for CILAs and ICF-DDs.”
The Monitor’s Response to each of the Defendants’ strategies includes in part:
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• On reducing staffing shortages: The proposed pilot project “cannot be expected to resolve this pervasive problem. Recent data from the DSP Workforce Coalition indicates that when the CILA program began in Illinois over twenty years ago, the wages paid to DSPs were nearly double the minimum wage, thus recognizing the value of their work. As of July 1, 2018, the minimum wage of $12.00 per hour in Chicago will exceed the average hourly reimbursement rate to DSPs.”
• On modifications to the current funding rates: “The Defendants’ proposals fail to specifically address rates paid to providers of CILAs or of ICFs-IDD … for whom rates have not been increased for approximately a decade while costs have significantly increased.” The Court’s Order of 8/11/2017 is referenced as follows: “This Court believes that reaching a mutually agreeable long term plan accounting for both the resources of the State and the needs of those with developmental disabilities would benefit from a revival of a State working group to devise creative solutions to the issue of compliance with the Consent Decree.” The Monitor recommends that “such a workgroup be convened and include the Monitor as well as other independent stakeholders with appropriate expertise and experience.”
• On compliance measurement: “The most recent draft is more comprehensive than earlier versions and references a ‘draft
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concept’ of a monitoring tool. The Monitor recommends that shared work begin promptly to develop such a tool and looks forward to an active role in advancing this process. … It is the Monitor’s recommendation that while it is anticipated that the Bureau of Quality Management (BQM) will be conducting reviews and reporting findings to the Parties and the Monitor, there must also be an independent aspect of the review process which does not include the Division or BQM.” • On programmatic modifications and enhancements: “These proposals are consistent with discussions held among the Plaintiffs, Defendants, Intervenors and Monitor and require no comment at this time.” Ø On 6/6/ 2018, Judge Sharon Johnson Coleman entered the following Order:
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Ø Following the 6/6/2018 Court Order, there were Status Conferences on 7/10/2018, 9/12/2018 and 11/15/2018. The next scheduled
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Status Conference is scheduled for 2/14/2019, following a Parties’ meeting and an Oversight Committee meeting on 2/13/2019.
Oversight Committee Meetings
The 6/6/2018 Court Order states in part that the Court recommends “convening a work group that includes the Monitor and other independent stakeholders to study the wage rates for DSPs, the funding methodology for CILAs and ICFs for individuals with Intellectual and Developmental Disabilities, and develop a monitoring tool to assess adequacy of services, funding and administration. Ideally the monitoring tool would have an independent review component. The Court also takes the Monitor’s recommendation that the parties pursue expeditiously their discussion for developing the criteria for moving individuals from the Prioritization of Urgency of Need for Services (“PUNS”) waiting list at a reasonable pace.”
As a result, the Defendants, with input from the Plaintiffs, Intervenors and Monitor, established not only a Rate Methodologies Oversight Committee to implement the Court’s Order but also Subcommittees to gather information and report to the Oversight Committee. The Subcommittees include: Employment and Training, Staffing, Technology, Behavior, Transportation, Nursing/ Medical and ICF-DD Rate Methodologies. The first meeting of the Oversight Committee, which includes the chairpersons of the Subcommittees, was held on 8/29/2018 and monthly meetings have been convened on 10/17/2018, 11/14/2018 and 12/19/2018, with the next
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meetings scheduled for 1/16/2019 and 2/13/2019. Subcommittees have begun to develop recommendations for presentation to the Oversight Committee.
Ligas Compliance Measures
In the Fifth Annual Report, the Monitor indicated that a conference call had been held with Plaintiffs and DDD to discuss the current system of monitoring the quality of services provided to Class Members in CILAs and day programs. The Monitor stated in that report that there would be a review of a sample of surveys previously conducted by the Bureau of Quality Management (BQM), along with any required Corrective Action Plans and follow-ups, to explore the efficacy of current practices as well as to make recommendations if it appeared that any enhancements to the system were necessary and not being addressed. After several months of trying to obtain the anticipated material, it became apparent that the surveys being done were measuring only Waiver compliance. It is interesting to note that the CMS, the Center for Medicare and Medicaid Services, noted in 2017 that “CMS approval of a State’s Transition Plan solely addresses the state’s compliance with the applicable Medicaid authorities” and “does not address the state’s independent and separate obligations under the Americans with Disabilities Act, Section 504 of the Rehabilitation Act or the Supreme Court’s Olmstead v. LC decision.”
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At that point, the Monitor and Monitor’s Data and Program Analyst, in consultation with the Plaintiffs, Defendants and others experienced in measuring compliance began working to develop a monitoring tool and protocol for reviewing services received by Class Members who live in CILAs. A tool to monitor compliance with the Consent Decree has now been drafted and, as discussed in the Monitor’s responses to the Defendants’ proposed compliance plans and in the Court’s 6/6/2018 Order, the process will be independent of DHS but is intended to include as reviewers four staff members of the State’s Bureau of Quality Management, along with eight reviewers who are independent of the State system. The Monitor, Data and Program Analyst and the contractor will oversee the project. The contract for this project is expected to be finalized within days of the issuance of the current report and training of reviewers is being planned for February, 2019.
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IV. COMMUNICATIONS & IMPLEMENTATION ACTIVITIES
Ø The Monitor communicates regularly with the Defendants, Plaintiffs and Intervenors and participates in monthly conference calls with the Plaintiffs and Defendants regarding individual Class Member issues.
Ø The Monitor responds promptly to inquiries from Class Members and their families, guardians and advocates.
Ø The Monitor frequently addresses Parents’ associations, ISC agencies, providers and provider organizations, advocacy groups, and community organizations to share requested information regarding Ligas matters.
Ø The Monitor receives and reviews newsletters, updates and other documents from a variety of organizations and individuals who provide or evaluate services for beneficiaries of the Decree.
Ø The Monitor participates in the Arc’s conventions, Executive Forums, “Know Your Options” and other informational sessions.
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Ø The Ligas Class Member/Family Advisory Council asks that the Monitor participate in their quarterly meetings and this has been the practice since its inception in 2013. For the past five years, meetings were held in two locations- Chicago and Springfield- connected by videoconferencing and telephone. DDD staff, Class Counsel, the Monitor, family advocates and self-advocates regularly attend and guest speakers are invited to meetings upon request of the members or as suggested by DDD or the Monitor. Over the past year, there have been discussions about modifying the format of the meetings and most recently there have been conversations suggesting that there be two Ligas Town Hall meetings and two regular committee meetings per year. The Town Hall meetings would be open to the public. As of the writing of the current report, the Monitor is working with the chairperson of the Council and the DDD staff person who supports this group to plan for an initial Ligas Town Hall Meeting.
Ø There are several new initiatives that have recently been or will soon be implemented by the Defendants and that have been discussed with the Plaintiffs, Intervenors and Monitor as part of the drafting of the 2019 Implementation Plan Revisions. The Monitor is looking forward to the draft being finalized shortly so that all of this information can be shared.
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V. Closing Remarks
The monitor remains indebted to all of those who provide expertise and insights to inform the Annual Reports. A special note of appreciation is due to the current Acting Director of the DDD who, in her brief return to DHS, has done so much more than what she describes as “keeping the train on the track.” Her participation particularly in the development of both the Oversight Committee and the draft Ligas Compliance Measures has been invaluable.
In looking forward to continued shared efforts with the beneficiaries of the Consent Decree and their families; Plaintiffs, Defendants and Intervenors; advocates, providers of services and other colleagues, the Monitor would like to share recent good news. The DDD has recently received authorization to develop six Long Term Stabilization Homes, each of which will be able to serve four people at a time. More information will be shared as available.
While much remains to be accomplished, issues of concern will be addressed at upcoming Parties’ meetings to facilitate corrective actions. It is clear that collaboration is the best approach to insure that all beneficiaries of the Consent Decree achieve their chosen goals.
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ATTACHMENTS
(1) Plaintiffs’ Counsel 8/12/17 Statement: “Federal Judge orders Illinois to develop a plan to provide critical resources for people with developmental disabilities.”
(2) Defendants’ “Status Report Regarding Proposed Compliance Plan in Response to August 11, 2017 Order”
(3) Exhibit A: Defendants’ Compliance Plan Proposals (4) Plaintiffs’ and Intervenors’ “Response to Defendants’ Compliance
Proposals” (5) Monitor’s “Response to Defendants’ Compliance Proposals”
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UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

Stanley Ligas, et al., Plaintiffs,
v. Felicia Norwood, et al.,
Defendants.

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Case No. 05 C 4331

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Judge Sharon Johnson Coleman

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DEFENDANTS’ STATUS REPORT REGARDING PROPOSED COMPLIANCE PLAN IN RESPONSE TO AUGUST 11, 2017 ORDER

Defendants, through their attorney, Lisa Madigan, Illinois Attorney General, hereby

submits this status report regarding their proposed compliance plan in response to this Court’s

August 11, 2017 Order (Doc. No. 695), and state as follows:

In its August 11, 2017 Order, this Court found that “defendants are not in compliance

with the Consent Decree by failing to provide the resources of sufficient quality, scope, and

variety based on the ample evidence presented to the Court that individuals protected by the

decree have experienced a reduction in services and have suffered substantially as a result.” Doc.

No. 695 at 3. As the parties have advised the Court, the parties and Monitor have met numerous

times to discuss a proposed compliance plan and have exchanged numerous draft proposals.

Despite best efforts and good faith negotiations, the parties have failed to agree on a compliance

plan to submit to the Court. Defendants, therefore, submit their proposed compliance plan for the

Court’s consideration and approval.

Attached hereto as Exhibit A is Defendants’ detailed compliance plan, which Defendants

have previously provided to the parties and Monitor. In summary, Defendants’ plan includes four

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major strategies, all of which respond to this Court’s specific findings regarding non-compliance. First, Defendants have started a pilot program that will create a new pool of candidates for service providers to consider hiring for open direct support professional (DSP) positions. The pilot is modeled on a similar state program that has successfully provided new candidates for child care positions with agencies through state child care programs. This pilot responds directly to Plaintiffs’ and Intervenors’ contentions that service providers have reduced services because of being unable to recruit and retain a sufficient number of DSPs.
Second, Defendants have significantly increased funding so as to increase the hourly rates paid to DSPs, have proposed additional increases in such funding, and have proposed increases in funding for class members who will be selected from the waiting list. The already approved and proposed increased funding for DSP rates are intended to respond directly to Plaintiffs’ and Intervenors’ contentions that service providers have reduced services because they are unable to pay DSPs sufficient wages so as to recruit and retain a sufficient number of DSPs. The DSP rate increases are significant, amounting to a 14% increase from FY2017 through FY2020. And, the proposed increases in funding for services for class members on the waiting list demonstrate that Defendants are not avoiding their other obligations under the Decree or addressing the DSP funding issue by shifting funds from other priorities.
Third, Defendants are enhancing and adding to their on-going monitoring of service delivery, all in an effort to better determine whether individuals are receiving services of sufficient quality, scope, and variety, consistent with the needs, choices and preferences of individuals receiving services. These monitoring enhancements also are intended specifically to help the parties and Monitor determine the impact the other compliance strategies described in
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the proposed plan will have on staffing recruitment and retention, and more generally on whether services are being provided at the necessary levels.
Fourth, Defendants are working on several additional programmatic changes and enhancements, all of which are intended to increase available services for individuals with developmental disabilities and better monitor whether services are being delivered as needed and intended. These changes, like those described above, are all intended to address the Court’s findings of non-compliance.
As described more fully in Exhibit A, these strategies are all of a nature where it will take time to determine the full effect these financial and programmatic modifications have on those who benefit from the Ligas Decree. As such, and in light of the fiscal constraints presented by what the Court acknowledged is the “dire financial situation of the State of Illinois and the attendant competing demands for resources” (Doc. No. 695 at 3), the compliance strategies described above and set out in greater detail in Exhibit A are the best approaches to address the areas of non-compliance the Court identified in its August 11, 2017 Order. Defendants believe that once these strategies are fully implemented, they will be successful, and Defendants will be in compliance with their obligations under the Decree.

Dated: March 30, 2018

Respectfully submitted,
By: /s/ Brent D. Stratton
Brent D. Stratton Office of the Illinois Attorney General 100 W. Randolph Street, 12th Floor Chicago, Illinois 60601 (312) 814-4499
ATTORNEY FOR DEFENDANTS
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EXHIBIT A
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Ligas v. Norwood, 05-4331
DEFENDANTS’ COMPLIANCE PLAN PROPOSALS
Pursuant to the Court’s order of August 11, 2017, Defendants are to prepare and submit to the Court a plan to achieve compliance with the Ligas Consent Decree. The following represents the Defendants’ plan to ensure compliance with the mandates of the Decree.
Defendants plan on ensuring compliance through four main types of activities: The first, and in Defendants’ opinion most important, directly address the staffing shortages reported by providers. The second group of activities involves recent modifications to the funding for the hourly rates for Direct Support Professionals (DSPs), as well as funding to further the goals of moving individuals from the Prioritization for Urgency of Need for Services (PUNS) waiting list at a reasonable pace. The third represents compliance measurement tools, and the fourth category includes various programmatic and management changes to increase oversight and ensure compliance with individual Class Member service plans.
I. Reducing Staffing Shortages
Address DSP vacancies through coordination with Division of Family and Community Services
Able-bodied adults with no dependents who receive public assistance benefits – Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) – are required to seek employment/education and training and have time-limited benefits available to them. The Department of Human Services (DHS or Department) Division of Family and Community Services (FCS) has an office of workforce development that assists recipients with job searches. Over half of the individuals receiving SNAP or TANF benefits have high school diplomas, which is the same education level required for DSP positions.
Defendants intend to implement a program wherein providers of both ICF/DD and CILA services can hire qualified TANF and SNAP applicants to fill vacant DSP positions. A similar program has already been implemented successfully with respect to child care workers. Defendants have already begun to formulate the process for a referral system for DSP positions and have held meetings with various program areas to work on a pilot program.
As of the date of this submission, Defendants plan on an employment referral pilot to take place as follows: FCS local offices will begin screening new applicants or current applicants whose benefits are being redetermined for suitability for the pilot employment program. This screening will be an initial screening designed to ensure potential candidates have the proper educational background and an interest in working as DSPs.
Once the initial screening is completed, all suitable candidates will be provided a second level screening and training to focus on general “soft” skills needed to ensure a successful transition to the workforce. This training will not focus on direct DSP skills per se, but rather on more basic professionalism and interpersonal skills that are needed not only for DSP work but other
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potential employment opportunities. Upon completion of this training, individuals who have demonstrated the appropriate professional and interpersonal skills to suggest they would be successful as DSPs will continue through the referral process.
Once the candidates are determined to be appropriate for DSP positions through the various screenings and training aspects of the pilot program, a referral process will be put in place for providers to consider the candidates for open DSP positions. Defendants anticipate the pilot program will be able to demonstrate its effectiveness within 6 months following implementation, at which time DHS will determine whether to continue the program.
Efforts have already begun to implement this Pilot, including a webinar conducted on December 18, 2017 with various stakeholders to seek input into the process, including providers, advocates, the Illinois Council on Developmental Disabilities, and others. Defendants are in the process of finalizing the protocols and processes for the pilot to begin employment referrals. Screening for the first class of applicants is underway, and we anticipate the first class of approximately 100 DSP applicants will be matched with employers beginning in April 2018.
Defendants will provide updates to the parties and Monitor, seeking additional feedback throughout the process, and will report on the progress of the referral program during the pilot period.
II. Modifications to the Current Funding Rates
Funding for Ligas services, both CILA and ICF/DD is part of a larger system serving Illinois residents with developmental disabilities and cannot be examined without considering the larger picture. The State’s fiscal condition is, and has been for a number of years, under extreme financial pressure, which will not be materially reduced by the tax increase that was enacted in 2017. However, the Defendants remain committed to the goals of the Ligas Decree, and as such, have requested, and obtained initial approval from the Office of the Governor and the Governor’s Office of Management and Budget to include additional funding for rates and PUNS placements (under the “reasonable pace” requirement) in the proposed budgets for FY2019 and FY2020.
Looking at funding from a global perspective, given that rates and reasonable pace funding both come from the same funding source, Defendants will request the following increases in funding: For FY2019, the total request for increased funding will be approximately $110 million above the FY2017 level, and for FY2020, the total request for increased funding will be approximately $160 million above the FY2017 level. The breakdown and allocation of this increased funding for rates and PUNS services/reasonable pace is as follows:
Rates
As of FY2017, DSP rates averaged $10.71 per hour. The Illinois General Assembly approved an increase of $0.75 per hour as part of the FY2018 budget. This increase totaled $56.4 million and went into effect on August 1, 2017. To ensure providers are able to both recruit and retain staff, Defendants have obtained initial approval for additional increases to the DSP hourly rates over
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the next two fiscal years, FY2019 and FY2020. DSP rates will again increase by $0.38 per hour each year, for a total of an additional $0.76 per hour over the two-year period, which will increase total spending by $31.1 million for FY2019 and an additional $62.2 million for FY2020. By FY2020, the total spending on DSP rates will be $118.6 million more than in FY2017, and represents a more than 14% increase in the hourly rate.1 In addition, the Department will seek an additional $0.18 per hour add on for FY2019 and an additional $0.78 per hour add on for FY2020 for DSPs working in the City of Chicago, which will increase total spending on DSP rates by more than $1 million in FY2019 and more than $5 million in FY2020.
Reasonable Pace
Per the requirements of the Ligas Decree, after year 6, individuals are to be moved from the PUNS waiting list into services “at a reasonable pace.” The parties have been in continued discussions on what “reasonable pace” requires. Defendants propose the following for FY2019 and FY2020: For FY2019, Defendants will request an additional $21.1 million in funding for PUNS services. This funding, in conjunction with anticipated attrition of individuals currently receiving services, will permit the Department to send 900 individuals selection letters for services, with the anticipation that approximately 630 individuals will begin receiving services as a result of that selection. This assumes that an additional 450 individuals will receive funding through crisis applications. For FY2020, the same rate of funding increases will be maintained (an additional $21.1 million), again allowing an additional 900 selection letters and 630 more individuals served from the PUNS list and another 450 served though crisis. Further discussion is needed between the parties to determine the selection criteria for the PUNS selections.
Modification of Crisis Criteria
When they began implementing the Ligas Decree, Defendants anticipated that the level of attrition of recipients of services would have a positive impact on serving those on the PUNS list, i.e., that there would be enough normal attrition to allow an increase in serving those on the PUNS list without increasing overall funding. However, crisis applications and approvals have continued to increase and as a result there has not been funding available to address issues such as rates and movement of individuals off of PUNS at a reasonable pace. As evidenced by the funding totals and service assumptions above, a significant portion of the funding that could be utilized to serve individuals on the PUNS waiting list is instead utilized for crisis services. Clarifying the application of crisis criteria might alleviate some of that pressure and allow funding to be directed to other areas.
Currently, individuals who are deemed to be in “crisis” may receive immediate services (within 24-72 hours) or receive supports through a Temporary Safety Plan until long-term arrangements are implemented. Crisis services are currently approved if the individual is at risk of abuse, neglect or homelessness. Despite the increase in services to individuals on the PUNS list over the span of the Ligas Decree, crisis applications have continued to increase year after year (with the exception of FY17, where applications were down from the prior year). Significant resources are expended serving individuals deemed to be in crisis.
1 These figures remain under internal discussion and are subject to change.
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While the Department recognizes the need to initiate immediate services for individuals in a crisis situation, there are instances where individuals are approved for crisis services in the absence of imminent risk. To address this issue, the Division of Developmental Disabilities (DDD) will work closely with Independent Service Coordination (ISC) agencies to ensure that applications are carefully screened and will review approved crisis packets to confirm the individual is at imminent risk for abuse, neglect or homelessness.

III. Compliance Measurements

Monitor the delivery of services to ensure individuals in CILAs are receiving the supports and services identified in their Personal Planning Documents

To date, the provision of services and supports identified in an individual class member’s Service Plan or Implementation Strategy has not been a part of the annual provider review process. Therefore, the Department will begin a separate review of a statistically significant number of Ligas class members in CILA settings to assess the implementation of the agreed-upon services and supports by the individuals’ providers. The survey will focus on items outlined in the last page of the Personal Plan containing overall outcomes, services and strategies and the Implementation Strategy document, which represents the services, supports and goals the individual, their family and/or guardian and provider have agreed upon.

There are currently 2,029 Ligas class members residing in Ligas-eligible residential waiver settings, of which the vast majority (2,021) reside in CILA settings). A statistically significant sample would require a review of 324 transition plans. The survey would be conducted by DDD staff to ensure independent and unbiased analysis.
The survey will evaluate class members’ services under both the waiver2 standards currently in use in the Annual BQM Waiver Review, as well as focusing on the actual delivery of services and supports in three main settings and three areas:

Home

Needs/Strengths Preferences Personal Vision/Outcomes

Community

Work

Embedded in assessing the services and supports provided in each of these areas will be an assessment of the overall Waiver quality elements. These areas will therefore be reviewed not just in terms of the actual services and supports being provided, but will also include how those services and supports align with nine specific outcome measures for each individual:

1. Connection to natural support networks;

2 “Waiver” refers to the State’s Medicaid waiver program wherein the State funds home-based services and community settings such as CILAs.
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2. Presence of friends (either in home, programs, or other); 3. Choice in where to work; 4. Choice of personal goals; 5. Participate in the life of the community; 6. Safe in his or her home; 7. Best possible health; 8. Ability to exercise his or her rights; and 9. No abuse or neglect.
Examples of services and supports in each setting and category are as follows:
Home: Needs/Strengths: level of independence/need for staff assistance (i.e., requires direct supervision in community), physical needs (accessible home, chair in shower, etc.), behavioral needs, mental health needs, occupational therapy, behavioral therapy, assistance with activities of daily life (ADLs), etc.
Preferences: Interested in music – provision of radio, etc.; enjoys video games – provide gaming console; location of home, holiday celebrations, meal choice, etc.
Personal Vision: Long term goals, i.e., independent employment, work, etc.
Community: Needs/Strengths: Ability to independently access community opportunities with or without staff assistance, ability to use public transportation, behavioral/sensory concerns in community settings, etc.
Preferences: Preferred community activities, such as movies, shopping, visits to the library, etc. (with understanding that the compliance measure will be to demonstrate that the person is able to access community activities that are of interest to them).
Personal Vision: Long term community goals such as accessing opportunities more independently.
Work: Needs/Strengths: Physical and/or Emotional/Behavioral supports needed in a workplace setting, ADL limitations, need for Vocational Assessment, etc.
Preferences: Type of work preferred, amount and duration, scope of work-full time, part time, volunteer, etc.
Personal Vision: Long term employment goals.
The review will include a review of the relevant documents as described below, but will also include a face-to-face meeting with the individual at the CILA, input from the family/guardian,
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information from the provider (including day programming providers), as well as other potential sources of information. A tool will be developed with input from the Court Monitor to both measure and weigh various aspects of the transition plans and implementation thereof. A draft concept of a tool document has been provided to the parties and Monitor, and will be the subject of additional discussions. A compliance threshold will also need to be developed and agreed upon, and would focus on a two-pronged analysis: (1) the percentage on the scoring tool for implementation of each individual Implementation Strategy document needed to be considered compliant; (2) the required overall percentage of compliant reviews from the sample.
Preferences, Needs/Strengths are identified in the body of the Personal Plan. The individual’s Personal Vision and desired Outcomes are summarized on the Signature/Summary Page of the Personal Plan. Services and Supports agreed upon between the individual and provider are found in the Implementation Strategy document. In addition to the above, DDD reviewers will also review case notes or “Q notes” when viewing progress towards personal outcomes. The ISC agency should retain the Discovery Tool, Personal Plan, and a copy Implementation Strategy, as well as documents addressing provision of services and supports and progress toward outcomes for review by DDD staff.
Beginning in FY2019, DDD will initiate a formal review involving half of the statistically valid sample, with the goal being that all participants in CILA will have gone through the Personal Plan process, so that the review process will remain consistent. The additional half of the sample will be reviewed in the following fiscal year. DDD will address any deficiencies that are discovered through a corrective action plan process. Information on the progress of the reviews will be provided at Ligas Parties meetings.
Require the Staff Stability Survey to be mandatory for all residential providers funded through DDD
DDD requested that providers participate voluntarily in the 2016 National Core Indicator Staff Stability Survey to obtain information on staff recruitment, wages, vacancies, turnover, etc. Seventy-five percent of providers participated, and a report is anticipated in the spring of 2018.
As a contractual condition of funding, DDD will require that all residential and day program providers complete the 2017 Staff Stability Survey. Obtaining data from all providers will better enable DDD to analyze trends and concerns regarding staffing, both on a systemic and individual provider level.
IV. Programmatic Modifications and Enhancements
Partnering with Medical/Dental Schools
DDD will continue to work to identify medical and dental clinics that accept Medicaid and determine if any are able to serve individuals with developmental disabilities. However, dental care is not covered under the Waiver program; it is covered only under the State’s Medicaid Plan. Utilization of student services would require specific consent from parents/guardians for treatment. A number of universities have been identified that accept Medicaid, and additional
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exploration is ongoing to determine what services may be able to be provided to individuals receiving services in either a waiver setting or an ICF/DD.
Integrate Assistive Technology into Personal Planning Process
DDD will issue an Informational Bulletin to accompany the Personal Plan assessment instructions to emphasize consideration of adaptive technology/equipment currently available and part of the Ligas Transition Service Plans. Training will also be conducted on assistive technology provided by DDD’s training department to ISC agencies and providers to encourage consideration of currently available resources. A workgroup has also been formed to explore expanding the options of technology available to individuals.
Supportive Housing Possibilities/Self Directed Living Options
An internal workgroup has been created to examine self-directed living options. As a part of this workgroup, an RFI was recently issued seeking input on Self Directed Options. A copy of the RFI can be found at http://www.dhs.state.il.us/page.aspx?item=100000. DDD will report the response to the RFI at a later date and will continue to keep the parties and Monitor informed as this work progresses.
Capacity Management Application
Funds from the Balancing Incentive Program were used to contract with an outside vendor to create Phase I of a web-based application of all open vacancies – CILA, day program and ICF vacancies. Phase I of the application went live at the end of September 2017 and can be found at http://www.dhs.state.il.us/page.aspx?item=81789. Data is based on agency self-reporting. Families and ISC agencies can search by various data fields, including type (CILA, day training, ICF/DD, etc.), demographics (i.e., capacity by gender type) and provider’s name with contact, by zip code, county and city (locator search).
There is a possibility of a Phase II, which would allow reporting and utilization of data to BQM for the expansion of additional types of quality reviews. The process will be streamlined through use of iPads by BQM so that data will be recorded and managed during the site reviews. The manner in which BQM data is utilized and released will not change. Phase II has not yet been approved.
Convert the current Ligas Transition Services Plan process into the new PersonCentered Planning process to better meet the needs of Class Members
To ensure consistency and to further ensure Ligas Class Members receive person-centered planning, Defendants have begun to utilize the new person-centered Personal Plan process in lieu of Ligas Transition Services Plan for all new transitions as well as all yearly service plans. This is addressed in the current draft of the Implementation Plan.
8
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IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs, v.
JULIE HAMOS, et al., Defendants.

) ) ) No. 05 C 4331 ) ) Judge Sharon Johnson Coleman ) ) ) )

PLAINTIFFS’ AND INTERVENORS’ RESPONSE TO DEFENDANTS’ COMPLIANCE PROPOSALS

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This Court found that Defendants “are not in compliance with the Consent Decree by failing to provide the resources of sufficient quality, scope, and variety based on the ample evidence presented to the Court that individuals protected by the decree have experienced a reduction of services and have suffered substantially as a result.” (Dkt # 695) The Court ordered Defendants to “devise a plan to address the issues causing the reduction in services and to bring the State into substantial compliance.” Id. Today, Defendants filed a document entitled “Defendants’ Compliance Proposals” that falls far short of what is required to remedy the yearslong violations. (“Proposals” Dkt #704) Only Sections I and II of the Proposals purport to “address the issues causing the reduction in services,” as the Court required, and even then, the proposals in these two sections fail to bring the State into compliance with the Decree.1
The Proposals to Reduce Staffing Shortages and Increase Rates are Insufficient Section I: Defendants propose reducing staffing shortages by recruiting people currently receiving public assistance. This may help attract a small number of new Direct Support Professionals (DSPs), but is a longer term effort and will not make a significant impact without an adequate increase in wages to reduce turnover. (See Section II below)
Section II: Defendants have obtained “initial approval” to increase the hourly pay for DSPs by $0.38 in each of the next two years. The proposed increase is woefully inadequate, as it would only bring the DSP rate to $12.22 per hour by Fiscal Year 2020.2 As a result, the staffing crisis and insufficient services to class members and beneficiaries, well-documented in the Motion to Enforce, would continue. The proposed increase would raise reimbursement rates only
1 Plaintiffs and Intervenors have additional comments about the Proposals beyond Sections I and II including related to compliance measurement, employment, short term stabilization homes and psychiatric services which can be discussed further during the April 4th status conference. 2 At 3:37 pm today, after months of negotiations, Defendants added a new provision indicating they will seek an additional wage increase for DSPs working in Chicago. Plaintiffs and Intervenors need to review this change more carefully, but upon quick reflection, such a change (1) will make it even more difficult for providers near Chicago to recruit DSPs from Chicago and (2) does not help providers throughout the State to recruit and retain DSPs.
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approximately 10% over 2008 rates, which were frozen for almost a decade. Using the change in the consumer price index, the proposed increase would bring reimbursement rates to only 2014 levels. Thus, in 2020, rates will still be at least six years behind. Providers will be required to meet 2020 costs with 2014 dollars, a clear impossibility. Also, the Proposals make no provision for the years beyond 2020. The Proposals are but a prescription for continuing the violation of the Decree by failing to provide adequate resources. Moreover, Defendants’ budget figures are misleading. The $0.38 per hour increase in each of the next two years will cost the state $15.5 million each year because the federal government will cover half the cost. The larger numbers in the Proposals include the $0.75 increase in place at the time of the Court’s finding of noncompliance and the amount the State has allocated for reasonable pace (a separate part of the Decree unrelated to the Court’s finding of non-compliance), while ignoring the fact that the State receives 50% federal reimbursement.
When Illinois developed its disability service system, the State did not view the DSP role as one that should be filled by an entry level, minimum wage employee, but rather by people with experience and maturity. As DSP rates remained stagnant and market wages increased, DSPs are now being paid as if it were a minimum wage job, albeit with much greater responsibilities. In 2001, the average DSP rate ($9.92) was nearly double the minimum wage ($5.15). Defendants’ long-time failure to increase rates is a major reason why Defendants are out of compliance and their proposed increases are insufficient to remedy the non-compliance.3
Defendants need a long-term plan to address the inadequate resources and resulting decline in services. The Court suggested that Defendants reconvene a 2014 rates workgroup that made numerous recommendations. However, the Proposals make no reference to reconvening
3 Defendants know the market wage for DSP work. After the initial training period, Defendants pay $15.00 an hour to new DSP’s in the seven state-operated developmental centers (“SODC’s”) and as a result SODCs have only a 10% turnover rate in contrast to the 30 to 40% turnover in CILAs and ICF/DDs.
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the workgroup, which could update the antiquated rate methodology, adopted almost 20 years

ago. For example, the methodology currently in use assumes nurses’ wages that are half what the average nurse earns today.4 Illinois currently ranks 47th nationally and spends only 55% of

the U.S. average on developmental disability services, so significant change is desperately

needed. While true compliance with the resource and service provisions of the Decree may not

be achieved in the near-term, Defendants should not be able to evade the non-compliance finding

without at least committing to a comprehensive plan that is reasonably likely to achieve compliance in the future.5

WHEREFORE, Plaintiffs and Intervenors respectfully request this Court: (1) find

Defendants’ Proposals inadequate to remedy the finding of non-compliance, (2) order the

Defendants to submit a new compliance plan, and (3) order the State to form a workgroup

consisting of counsel for the Plaintiffs and Intervenors, providers, consumers, and representatives

of the State to recommend revisions to the rate methodologies for CILAs and ICF/DDs.

Respectfully submitted,

For Plaintiffs By: /s/ Barry C. Taylor Barry C. Taylor Laura J. Miller Equip for Equality 20 N. Michigan Ave., Ste. 300 Chicago, IL 60602
Benjamin S. Wolf Roger Baldwin Foundation of ACLU, Inc. 180 N. Michigan Ave., Ste. 2300 Chicago, IL 60601

For Intervenors Scott M. Mendel K&L Gates LLP 70 W. Madison, Ste. 3100 Chicago, IL 60602
William Choslovsky Ginsberg Jacobs LLC 300 S. Wacker, Ste. 2750 Chicago, IL 60606

4 Inadequate support for nurses was the focus of a recent Chicago Tribune article focusing on abuse and neglect in group homes. http://www.chicagotribune.com/news/watchdog/grouphomes/ct-met-group-home-murray-20180123story.html 5 The Plan also does not contemplate re-balancing the allocation of current resources, which disproportionately support expensive state-operated developmental centers. Plaintiffs strongly believe that re-balancing must be part of Defendants’ long-term Plan to ensure sufficient resources are provided to class members and beneficiaries.

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IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS
EASTERN DIVISION

STANLEY LIGAS, et al., Plaintiffs, v.
JULIE HAMOS, et al., Defendants.

) ) ) No. 05 C 4331 ) ) Judge Sharon Johnson Coleman ) ) ) )

LIGAS MONITOR’S RESPONSE TO DEFENDANTS’ COMPLIANCE PROPOSALS

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Ligas Monitor’s Response to the Defendants’ Compliance Proposals
Following is the Monitor’s response to the above named document which was submitted to the Plaintiffs, Intervenors and Monitor on March 28, 2018. These Proposals resulted from an Order entered on August 11, 2017 by Judge Sharon Johnson Coleman in response to the Plaintiffs’ and Intervenors’ Joint Motion to Enforce the Consent Decree. It is recognized that extensive efforts by all involved are reflected in these Proposals.
On January 20, 2017, the Fifth Annual Report of the Monitor was filed and cited therein areas of the State’s noncompliance with the Ligas Consent Decree in regard to resources, capacity and quality monitoring. More specifically, areas of noncompliance included: inadequate wages for Direct Support Professionals (DSPs); inadequate rates for CILA (Community Integrated Living Arrangements) and ICFs/IID (Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities) providers; an unprecedented statewide staffing shortage resulting in diminished quality and consistency of services leading to negative impacts upon beneficiaries of the Consent Decree; inadequate quality monitoring of plans for and implementation of services provided in CILAs as well as of progress toward individuals’ personal outcomes; lack of timeliness of crisis services and inadequacy of crisis service plans. The current Proposals from the Defendants address most of these issues and Defendants’ section titles are being used below for ease of reference:
Reducing Staffing Shortages Defendants continue to refer to “alleged” staffing shortages although these shortages have been substantiated as not only existing, but also being detrimental to beneficiaries of the Consent Decree. Nevertheless, a pilot project has been initiated to recruit Direct Support Professionals (DSPs) from a previously untapped group of applicants. This appears to be a worthwhile effort, but cannot be expected to resolve this pervasive problem. Recent data from the DSP Workforce Coalition indicates that when the CILA (Community Integrated Living Arrangements) program began in Illinois over twenty years ago, the wages paid to DSPs were nearly double the minimum wage, thus recognizing the value of their work. As of July 1, 2018, the minimum wage of $12.00 per hour in Chicago will exceed the average hourly reimbursement rate to DSPs. In addition, a recent national staff stability survey of twenty-two states reported Illinois’ statewide full-time vacancy level to be 14.6% as opposed to the 9.8% average for all of the states represented in the survey.
Modifications to the Current Funding Rates The Defendants’ Proposals fail to specifically address rates paid to providers of CILAs or ICFs/IID (Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities) for whom rates have not been increased for approximately a decade while costs have significantly increased. The Court Order entered on August 11, 2017 includes a reference to the Monitor’s statement regarding a work group convened by the State in 2014 to address CILA rates. The Order states: “This Court believes that reaching a mutually agreeable long term plan accounting for both the resources of the State and the needs of those with developmental disabilities would benefit from a revival of a State working group to devise creative solutions to the issue of compliance with the Consent Decree.” It is recommended that such a workgroup be convened and include the Monitor as well as other independent stakeholders with appropriate
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expertise and experience. In addition, any impact of the recent increase of seventy-five cents per hour for DSPs has not yet been demonstrated and adding only another seventy-six cents per hour over the next two years (paid as thirty-eight cents per hour per year) as suggested in the State’s Proposals will, as noted above, result in DSPs earning less than minimum wage in some parts of Illinois and is also unlikely to solve the problems created by the unprecedented staffing shortage.
Reasonable Pace The Defendants’ Proposals recognize that criteria for the PUNS waiting list selections remain to be determined by the parties. The Monitor recommends that this discussion be completed as soon as possible in order that the process can be monitored as required by the Consent Decree.
Modification of Crisis Criteria It is not recommended that crisis criteria be modified, but that any necessary training take place if there are misunderstandings between Independent Support Coordination (ISC) agencies and the Division of Developmental Disabilities as to the content of crisis packets sent to the Division. The Monitor has initiated several conversations with the Division regarding the adequacy of the crisis safety plans which are developed and implemented while services are being initiated to address crises. Compliance Evaluation Standards agreed upon in July of 2012 also indicate specific expectations for timeliness of initiation of crisis services and inclusion of a monitoring component and follow-up activities as part of a crisis transition plan once the crisis has been addressed. The previous Monitor also cited compliance concerns in this area in his First Annual Report. Further discussions are required to insure these requirements are being met.
Compliance Measurement Defendants have revised this section several times based upon input from the Plaintiffs, Intervenors, and Monitor and this is appreciated. The most recent draft is more comprehensive than earlier versions and references a “draft concept” of a monitoring tool. The Monitor recommends that shared work begin promptly to develop such a tool and looks forward to an active role in advancing this process. It is premature to fully evaluate this newly revised section of the Proposals, but a few comments are nevertheless critical to the completion of this effort:
− There is no indication of monitoring Home Based Services, though these are provided to a majority of Class Members and are also funded by the Waiver.
− Part of the proposed monitoring system depends upon documents developed through a recently implemented Person-Centered Planning Process. As the implementation of this planning process is in its infancy and concerns have been expressed by many of those involved in its implementation, caution must be exercised in measuring implementation of services provided against a plan that may not be accurately reflecting individuals’ preferences and needs or supports and services upon which the planning team has agreed.
− It is the Monitor’s recommendation that while it is anticipated that the Bureau of Quality Management (BQM) will be conducting reviews and reporting findings to the Parties and the Monitor, there must also be an independent aspect of the review process which does not include the Division or BQM. As has been done successfully in several other states, it is recommended that the Monitor and others comprising an independent team conduct
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Programmatic Modifications and Enhancements These proposals are consistent with discussions held among the Plaintiffs, Defendants, Intervenors and Monitor and require no comment at present.
77

 
 Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 1 of 82
COLE,PROTO,TERMED
United States District Court Northern District of Illinois − CM/ECF LIVE, Ver 6.3.2 (Chicago)
CIVIL DOCKET FOR CASE #: 1:05−cv−04331

Ligas et al v. Eagleson et al Assigned to: Honorable Sharon Johnson Coleman Case in other court: 06−01327 Cause: 42:1983 Civil Rights Act
Plaintiff

Date Filed: 07/28/2005 Date Terminated: 06/15/2011 Jury Demand: None Nature of Suit: 440 Civil Rights: Other Jurisdiction: Federal Question

Stanley Ligas next of friend Gina Foster

represented by Barry Charlton Taylor Equip for Equality 20 North Michigan Suite 300 Chicago, IL 60602 (312) 895−7317 Email: barryt@equipforequality.org LEAD ATTORNEY ATTORNEY TO BE NOTICED

Amanda C Antholt Equip For Equality 20 N. Michigan Avenue Suite 300 Chicago, IL 60602 (312) −895−7330 Email: amanda@equipforequality.org ATTORNEY TO BE NOTICED

Barry G. Lowy Equip for Equality Inc 235 South 5th Street PO Box 276 Springfield, IL 62705 217−544−0464 Email: barryl@equipforequality.org TERMINATED: 03/15/2017

Benjamin S. Wolf Roger Baldwin Foundation of ACLU, Inc. 150 N. Michigan Ave. Suite 600 Chicago, IL 60601−7401 (312) 201−9740 Email: bwolf@aclu−il.org ATTORNEY TO BE NOTICED

Corey M. Shapiro Dentons US LLP 233 South Wacker Drive Suite 5900 Chicago, IL 60606 312 876 8000 Email: corey.shapiro@dentons.com ATTORNEY TO BE NOTICED

Edward B. Mullen , III Ed Mullen, Esq. 2129 N. Western Ave Chicago, IL 60647 312−342−8972

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 2 of 82
Email: ed_mullen@mac.com ATTORNEY TO BE NOTICED
Heidi Dalenberg Roger Baldwin Foundation of ACLU, Inc. 150 N. Michigan Ave. Ste. 600 Chicago, IL 60601 312−201−9740 Email: hdalenberg@aclu−il.org ATTORNEY TO BE NOTICED
John I. Grossbart Dentons US LLP 233 South Wacker Drive Suite 5900 Chicago, IL 60606 (312)876−8000 Email: john.grossbart@dentons.com ATTORNEY TO BE NOTICED
John Warren Whitcomb Monahan Law Group, LLC 55 W. Monroe St. Suite 3700 Chicago, IL 60603 (312) 419−0252 Email: jwhitcomb@monahanlawllc.com TERMINATED: 01/20/2015
Judith A. Gran Public Interest Law Center of Philadelphia 125 South 9th Street Suite 700 Philadelphia, PA 19107 (212) 627−7100 TERMINATED: 01/28/2010
Kendra Kekelis Hartman Equip for Equality 20 North Michigan Avenue Suite 300 Chicago, IL 60602 773−343−9393 Email: kkhartman@aya.yale.edu ATTORNEY TO BE NOTICED
Kenneth M Walden Access Living 115 West Chicago Avenue Chicago, IL 60654 (312) 640 − 2136 Email: kwalden@accessliving.org ATTORNEY TO BE NOTICED
Laura J. Miller Equip for Equality 20 North Michigan Suite 300 Chicago, IL 60602 (312) 895−7316 Email: laura@equipforequality.org ATTORNEY TO BE NOTICED
Max P Lapertosa

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 3 of 82

Plaintiff
Lorene Bierman TERMINATED: 08/31/2009 next of friend Darlene Bierman TERMINATED: 08/31/2009 next of friend Joseph Bierman TERMINATED: 08/31/2009

U.S. Department of Justice 1800 G Street NW Room 7119 Washington, DC 20006 (202) 305−1077 Email: Max.Lapertosa@usdoj.gov TERMINATED: 05/22/2008
Patricia A. Werner Access Living 115 West Chicago Ave. Chicago, IL 60654 312/640−2148 Email: pwerner@accessliving.org TERMINATED: 02/24/2014
Samuel Phillip Linsenmaier Dentons US LLP 233 South Wacker Drive Suite 5900 Chicago, IL 60606 (312) 876−2848 Email: slinsenmaie@sonnenschein.com
Wendy N Enerson Cozen O'Connor 123 N. Wacker Dr. Suite 1800 Chicago, IL 60606 (312)−382−3100 Email: wenerson@cozen.com ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
Corey M. Shapiro (See above for address) ATTORNEY TO BE NOTICED
Edward B. Mullen , III (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 4 of 82

Plaintiff
David Childers TERMINATED: 04/26/2006

(See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Kenneth M Walden (See above for address) ATTORNEY TO BE NOTICED
Laura J. Miller (See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Samuel Phillip Linsenmaier (See above for address)
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran (See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Kenneth M Walden (See above for address) ATTORNEY TO BE NOTICED

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 5 of 82

Plaintiff
Isaiah Fair next of friend Lutricia Fair

Laura J. Miller (See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Amanda C Antholt (See above for address) ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
Corey M. Shapiro (See above for address) ATTORNEY TO BE NOTICED
Edward B. Mullen , III (See above for address) ATTORNEY TO BE NOTICED
Heidi Dalenberg (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran (See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Kenneth M Walden (See above for address)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 6 of 82

Plaintiff
Adam Kulig TERMINATED: 08/31/2009 next of friend Norb Kulig TERMINATED: 08/31/2009

ATTORNEY TO BE NOTICED
Laura J. Miller (See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Samuel Phillip Linsenmaier (See above for address)
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
Corey M. Shapiro (See above for address) ATTORNEY TO BE NOTICED
Edward B. Mullen , III (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran (See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Kenneth M Walden (See above for address) ATTORNEY TO BE NOTICED
Laura J. Miller

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 7 of 82

Plaintiff
Jamie McElroy next of friend Patricia McElroy

(See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Samuel Phillip Linsenmaier (See above for address)
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Amanda C Antholt (See above for address) ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
Corey M. Shapiro (See above for address) ATTORNEY TO BE NOTICED
Edward B. Mullen , III (See above for address) ATTORNEY TO BE NOTICED
Heidi Dalenberg (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran (See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 8 of 82

Plaintiff
Tiffany McFadden TERMINATED: 04/26/2006 next of friend Deborah McFadden TERMINATED: 04/26/2006

Kenneth M Walden (See above for address) ATTORNEY TO BE NOTICED
Laura J. Miller (See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Samuel Phillip Linsenmaier (See above for address)
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran (See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Kenneth M Walden (See above for address) ATTORNEY TO BE NOTICED
Laura J. Miller (See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 9 of 82

Plaintiff Alex Tyner TERMINATED: 04/26/2006
Plaintiff Jennifer Wilson on behalf of themselves and all others similarly situated next of friend

Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran (See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Kenneth M Walden (See above for address) ATTORNEY TO BE NOTICED
Laura J. Miller (See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Barry Charlton Taylor (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 10 of 82

Nancy Wilson next of friend Richard Wilson
Plaintiff

Amanda C Antholt (See above for address) ATTORNEY TO BE NOTICED
Barry G. Lowy (See above for address) TERMINATED: 03/15/2017
Benjamin S. Wolf (See above for address) ATTORNEY TO BE NOTICED
Corey M. Shapiro (See above for address) ATTORNEY TO BE NOTICED
Edward B. Mullen , III (See above for address) ATTORNEY TO BE NOTICED
Heidi Dalenberg (See above for address) ATTORNEY TO BE NOTICED
John I. Grossbart (See above for address) ATTORNEY TO BE NOTICED
John Warren Whitcomb (See above for address) TERMINATED: 01/20/2015
Judith A. Gran (See above for address) TERMINATED: 01/28/2010
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Kenneth M Walden (See above for address) ATTORNEY TO BE NOTICED
Laura J. Miller (See above for address) ATTORNEY TO BE NOTICED
Max P Lapertosa (See above for address) TERMINATED: 05/22/2008
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Samuel Phillip Linsenmaier (See above for address)
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 11 of 82

David Cicarelli next of friend James Cicarelli next of friend Julianne Cicarelli
Plaintiff Burton A. Brown Objector

represented by Amanda C Antholt (See above for address) ATTORNEY TO BE NOTICED
Corey M. Shapiro (See above for address) ATTORNEY TO BE NOTICED
Edward B. Mullen , III (See above for address) ATTORNEY TO BE NOTICED
Heidi Dalenberg (See above for address) ATTORNEY TO BE NOTICED
Kendra Kekelis Hartman (See above for address) ATTORNEY TO BE NOTICED
Patricia A. Werner (See above for address) TERMINATED: 02/24/2014
Samuel Phillip Linsenmaier (See above for address)
Wendy N Enerson (See above for address) ATTORNEY TO BE NOTICED
represented by Amanda C Antholt (See above for address) ATTORNEY TO BE NOTICED
Heidi Dalenberg (See above for address) ATTORNEY TO BE NOTICED

V.
Defendant
Barry S Maram in his official capacity as Director of the Illinois Department of Healthcare and Family Services TERMINATED: 01/13/2011

represented by Karen Elaine Konieczny Illinois Attorney General's Office 160 North LaSalle Street Suite N−1000 Chicago, IL 60601 (312)793−2380 Email: karen.konieczny@illinois.gov LEAD ATTORNEY
Brent Douglas Stratton Office of the Attorney General 100 West Randolph Street Chicago, IL 60601 (312)814−2560 Email: bstratton@atg.state.il.us ATTORNEY TO BE NOTICED
Christopher Samuel Gange Illinois Attorney General's Office 160 North LaSalle Street

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 12 of 82

Defendant Grace Hou in her official capacity as Secretary of the Illinois Department of Human Services
Defendant Eric E Whitaker in his official capacity as Director of the Illinois Department of Public Health TERMINATED: 10/14/2005

Suite N−1000 Chicago, IL 60601 (312)793−2380 Email: Christopher.Gange@illinois.gov
John E. Huston Illinois Attorney General's Office 160 North LaSalle Street Suite N−1000 Chicago, IL 60601 (312)793−2380 Email: John.Huston@illinois.gov
Kathleen Kreisel Flahaven Illinois Attorney General's Office 100 West Randolph Street 13th Floor Chicago, IL 60601 (312)814−3313 Email: kflahaven@atg.state.il.us ATTORNEY TO BE NOTICED
Thomas A. Ioppolo Illinois Attorney General's Office (100 West Randolph) 100 West Randolph Street 13th Floor Chicago, IL 60601 (312)814−7198 Email: tioppolo@atg.state.il.us ATTORNEY TO BE NOTICED
represented by Brent Douglas Stratton (See above for address) ATTORNEY TO BE NOTICED
Kathleen Kreisel Flahaven (See above for address) ATTORNEY TO BE NOTICED
Michael D. Arnold Illinois Attorney General's Office 100 W. Randolph St. Suite 1300 Chicago, IL 60601 312 814 3720 Email: marnold@atg.state.il.us ATTORNEY TO BE NOTICED
Thomas A. Ioppolo (See above for address) ATTORNEY TO BE NOTICED
represented by Brent Douglas Stratton (See above for address)
Kathleen Kreisel Flahaven (See above for address)
Thomas A. Ioppolo (See above for address)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 13 of 82

Defendant
Theresa Eagleson Director of the Illinois Department of Healthcare and Family Services

represented by Michael D. Arnold (See above for address) ATTORNEY TO BE NOTICED

V. Respondent Carthage Terrace
Respondent Chamness Square
Respondent Curtis Court
Respondent Davies Square
Respondent Freeport Terrace

represented by William Choslovsky Ginsberg Jacobs LLC 300 S. Wacker Drive Suite 2750 Chicago, IL 60606 312−660−2202 Email: wchoslovsky@ginsbergjacobs.com LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker DLA Piper LLP (US) 444 W. Lake Street Suite 900 Chicago, IL 60606−0089 (312) 368−7911 Email: eric.walker@dlapiper.com ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 14 of 82

Respondent Lawrence Place
Respondent Lincoln Terrace
Respondent Matteson Court
Respondent Prairie House
Respondent Quincy Terrace
Respondent Schultz House

LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 15 of 82

Respondent Seborg Terrace
Respondent St. Mary's Square Living Center
Respondent Stevens House
Respondent Trulson House
Respondent Wetheraell Place
Respondent Parents and Friends of the Specialized Living Center

ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 16 of 82

Respondent Aspire on Eastern Respondent Misericordia Home North
Respondent Progressive Housing, Inc.
Respondent Mt. St. Joseph
Intervenor Plaintiff John McDermott Service List

Eric E. Walker (See above for address) ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) TERMINATED: 09/16/2008
represented by Robert J. Bingle Corboy & Demetrio 33 North Dearborn Street Suite 2100 Chicago, IL 60602 (312) 346−3191 Email: rjb@corboydemetrio.com LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Jeffrey Mark Monberg Krieg DeVault LLP 30 N. LaSalle Street #3516 Chicago, IL 60602 (312)423−9300 Email: jeff.monberg@quarles.com ATTORNEY TO BE NOTICED
represented by Alexandra C. Relias Laureate Education Inc., 900 N. North Branch Street Chicago, IL 60642 312 752−2107 Email: arelias@gmail.com TERMINATED: 07/22/2008
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Colin M. Haley Thomas, Mamer & Haughey, LLP 30 E. Main Street Champaign, IL 61824 217−531−6407 Email: chaley@tmh−law.com ATTORNEY TO BE NOTICED
Daniel Francis Gallagher Vrdolyak Law Group, LLC 100 North Riverside Suite 2400 Chicago, IL 60606 (312) 482−8200 Email: dangallagher@vrdolyak.com ATTORNEY TO BE NOTICED

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 17 of 82
Erik Joseph Anderson Fidelity National Law Group 20 S. Clark Street Suite 1510 Chicago, IL 60603 (312)223−3900 Email: erik.anderson@fnf.com ATTORNEY TO BE NOTICED
James Wallace Ducayet Sidley Austin LLP (Chicago) One South Dearborn Street Chicago, IL 60603 (312) 853−7000 Email: jducayet@sidley.com ATTORNEY TO BE NOTICED
Jason T. Lundy Polsinelli Shughari PC 161 North Clark Street, Suite 4200 Chicago, IL 60601 (312) 873−3604 Email: jlundy@polsinelli.com ATTORNEY TO BE NOTICED
Kevin Francis Burke Attorney at Law 278 Poplar Camp Road Makanda, IL 62958−2004 618 457 4335
Matthew Joseph Murer Polsinelli Shughart PC 161 North Clark St. Suite 4200 Chicago, IL 60601 (312) 819−1900 Email: mmurer@polsinelli.com ATTORNEY TO BE NOTICED
Melissa A. Thomas Thomas, Mamer & Haughey, LLP 30 E. Main Street Suite 500 Champaign, IL 61820 217−351−1500 Email: mat@tmh−law.com ATTORNEY TO BE NOTICED
Warren von C. Baker Gardner Carton & Douglas LLP 191 North Wacker Drive Suite 3700 Chicago, IL 60606−1698 (312)569−1000 Email: warren.baker@dbr.com
William P Crain Crain, Miller & Wernsman, Ltd. 623 East Broadway PO Box 867 Centralia, IL 62801 (618) 532−4744 Email: wcrain@crainmiller.com

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 18 of 82 ATTORNEY TO BE NOTICED

V. Amicus United States of America

V. Movant Riverside Foundation
Movant Golfview Developmental Center Movant Lauren Axelrod
Movant Craig Miller

represented by Judith Schwartz Sherwin Lewis Brisbois Bisgaard & Smith, LLP 550 West Adams Suite 300 Chicago, IL 60661 (312) 580−1200 Email: JSherwin@ralaw.com ATTORNEY TO BE NOTICED
Thomas J. Kiser Taft Stettinius & Hollister LLP 111 East Wacker Drive Suite 2800 Chicago, IL 60601 (312) 840−4309 Email: tkiser@shefskylaw.com
represented by Judith Schwartz Sherwin (See above for address) ATTORNEY TO BE NOTICED
Thomas J. Kiser (See above for address)
represented by Scott M. Mendel K&L Gates LLP 70 West Madison Suite 3300 Chicago, IL 60602 (312) 372−1121 Email: scott.mendel@klgates.com LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jason Michael Marks K&L Gates LLP 70 West Madison Suite 3300 Chicago, IL 60602 (312) 372−1121 Email: jmarks@bellboyd.com
represented by Scott M. Mendel (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jason Michael Marks

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 19 of 82

Movant Karmen Razman
Movant Genevieve Benner
Movant Matthew Nilson
Movant Maggie Murphy
Movant Stacie Athansopoulos
Movant The United States of America Movant The United States of America

(See above for address)
represented by Scott M. Mendel (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jason Michael Marks (See above for address)
represented by Scott M. Mendel (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jason Michael Marks (See above for address)
represented by Scott M. Mendel (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jason Michael Marks (See above for address)
represented by Scott M. Mendel (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jason Michael Marks (See above for address)
represented by Scott M. Mendel (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Jason Michael Marks (See above for address)

V.
Intervenor
Illinois Health Care Association TERMINATED: 12/22/2005

represented by John T. Schriver Duane Morris LLC 190 S. LaSalle St.

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 20 of 82

Intervenor Camille Baranchik TERMINATED: 12/22/2005
Intervenor Maureen Bradish TERMINATED: 12/22/2005

Suite 3700 Chicago, IL 60603 (312) 499−6785 Email: jtschriver@duanemorris.com LEAD ATTORNEY
James D. Arden Sidley Austin LLP 787 Seventh Avenue New York, NY 10019 (212)839−5300 Email: jarden@sidley.com
Nicholas James Lynn Duane Morris LLP 190 South LaSalle Street Suite 3700 Chicago, IL 60603 (312) 499−6700 Email: njlynn@duanemorris.com
Patrick E. Mahoney Mahoney Crowe & Goldrick, P.C. 36 West Wabash Avenue Suite 1300 Chicago, IL 60603 (312) 782−4554
represented by James Wallace Ducayet (See above for address)
Michael Rato Sidley Asutin Brown & Wood LLP 787 Seventh Avenue New York, NY 10019 (212)839−5300
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley Sidley Austin LLP (Chicago) One South Dearborn Street Chicago, IL 60603 (312) 853−7000 Email: romalley@sidley.com
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 21 of 82

Intervenor Daniel Brown TERMINATED: 12/22/2005
Intervenor Deborah Brown TERMINATED: 12/22/2005
Intervenor Anne Golden TERMINATED: 12/22/2005
Intervenor Samuel Golden TERMINATED: 12/22/2005

represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 22 of 82

Intervenor Edward Grossman TERMINATED: 12/22/2005
Intervenor Marianna Grossman TERMINATED: 12/22/2005
Intervenor Timothy Kiesow TERMINATED: 12/22/2005
Intervenor Becky Levy TERMINATED: 12/22/2005

(See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 23 of 82

Intervenor Diane Levy TERMINATED: 12/22/2005
Intervenor Edward Levy TERMINATED: 12/22/2005
Intervenor Rosemary Lopez TERMINATED: 12/22/2005
Intervenor Anne Marie McKee TERMINATED: 12/22/2005

Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 24 of 82

Intervenor Wendy Schuppan TERMINATED: 12/22/2005
Intervenor David Swain TERMINATED: 12/22/2005
Intervenor Douglas Swain TERMINATED: 12/22/2005
Intervenor Jennifer Westberg TERMINATED: 12/22/2005

Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
James Wallace Ducayet (See above for address)
Michael Rato

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 25 of 82

Intervenor Thomas Patrick Arundel by and through his father and natural guardian Thomas Arundel TERMINATED: 12/22/2005
Intervenor Gregory Boland by and through his parents and natural guardians Frederick and Mary Boland TERMINATED: 12/22/2005
Intervenor Timothy Bolin by and through his mother and natural guardian Patricia Bolin TERMINATED: 12/22/2005
Intervenor Jeffrey Dralle TERMINATED: 12/22/2005
Intervenor

(See above for address)
Patrick E. Mahoney (See above for address)
Richard Francis O'Malley (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
Robert J. Bingle (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 26 of 82

Chris Hanley TERMINATED: 12/22/2005
Intervenor Kirk Hartemayer TERMINATED: 12/22/2005
Intervenor Thomas Kerrigan TERMINATED: 12/22/2005
Intervenor Craig Miller TERMINATED: 12/22/2005
Intervenor Kevin O'Boyle TERMINATED: 12/22/2005

James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 27 of 82

Intervenor Jennifer Turry TERMINATED: 12/22/2005
Intervenor John Ward TERMINATED: 12/22/2005
Intervenor Kristin Ward TERMINATED: 12/22/2005
Intervenor Elizabeth Flesch
Intervenor Residents of Misericordia TERMINATED: 12/22/2005 Intervenor

(See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by James D. Arden (See above for address)
Michael Rato (See above for address)
Patrick E. Mahoney (See above for address)
William Choslovsky (See above for address)
represented by Patrick E. Mahoney (See above for address)
Robert J. Bingle (See above for address)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 28 of 82

Andrew Battle
Intervenor Ernest Stark
Intervenor Britton Rickerson
Intervenor Lucas Gaynor
Intervenor Mr Burton A Brown

represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by William Choslovsky (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
represented by Burton A Brown Law Offices of Burton A. Brown 161 N. Clark St. Suite 1600 Chicago, IL 60601 312−236−5582 Email: babrown@burtonabrown.com PRO SE

Date Filed 07/28/2005 07/28/2005 07/28/2005 07/28/2005
07/28/2005
08/01/2005
08/04/2005

# Docket Text
1 COMPLAINT FOR DECLARATORY AND INJUNCTIVE RELIEF filed by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman.(jmm, ) (Entered: 07/29/2005)
2 CIVIL Cover Sheet. (jmm, ) (Entered: 07/29/2005)
5 SUMMONS Issued, six originals and six copies as to Defendants Barry S Maram, Carol L Adams, Eric E Whitaker. (jmm, ) (Entered: 07/29/2005)
7 SUMMONS Returned Executed by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman as to Barry S Maram on 7/28/2005, answer due 8/17/2005. (jmm, ) (Entered: 08/04/2005)
3 ATTORNEY Appearance for Plaintiffs David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman by Barry G. Lowy, Benjamin S. Wolf, Kenneth M Walden, Max P Lapertosa, Kendra Kekelis Hartman, John I. Grossbart, Laura J. Miller, Barry Charlton Taylor, John Warren Whitcomb. (jmm, ) (Entered: 08/24/2005)
8 SUMMONS Returned Executed by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman as to Carol L Adams on 7/28/2005, answer due 8/17/2005. (jmm, ) (Entered: 08/04/2005)
6 SUMMONS Returned Executed by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman as to Eric E Whitaker on 7/28/2005, answer due 8/17/2005. (jmm, ) (Entered:

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 29 of 82

08/05/2005 08/05/2005
08/08/2005 08/08/2005 08/08/2005 08/15/2005 08/15/2005 08/15/2005 08/18/2005
08/18/2005 09/13/2005 09/13/2005
09/15/2005
09/20/2005 09/21/2005 09/27/2005 09/27/2005

08/04/2005)
12 ATTORNEY Appearance for Defendant Barry S Maram by Christopher Samuel Gange, John E. Huston, Karen Elaine Konieczny. (jmm, ) (Entered: 08/09/2005)
16 APPLICATION for Leave to Appear Pro Hac Vice on behalf of David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman by Judith A. Gran; Order entered granting leave by James F. Holderman. Filing fee $ 100 paid, receipt number 10636760. (jmm, ) (Entered: 09/07/2005)
9 MOTION by Plaintiffs for class certification(gma, ) (Entered: 08/09/2005)
10 NOTICE of Motion by all plaintiffs for presentment of MOTION by Plaintiffs for class certification 9 before Honorable James F. Holderman on 8/18/2005 at 09:00 AM. (gma, ) (Entered: 08/09/2005)
11 MEMORANDUM OF LAW by plaintiffs in support of MOTION by Plaintiffs for class certification 9 (gma, ) (Entered: 08/09/2005)
13 MOTION by Defendant to enlarge time to answer or otherwise plead (gma, ) (Entered: 08/16/2005)
14 NOTICE of Motion by all defendants for presentment of MOTION by Defendant to enlarge time to answer or otherwise plead 13 before Honorable James F. Holderman on 8/18/2005 at 09:00 AM. (gma, ) (Entered: 08/16/2005)
15 ATTORNEY Appearance for Defendants Barry S Maram, Carol L Adams, Eric E Whitaker by Kathleen Kreisel Flahaven, Brent Douglas Stratton, Thomas A. Ioppolo. (jmm, ) Modified on 5/7/2008 (ef, ). (Entered: 08/17/2005)
17 MINUTE entry before Judge James F. Holderman : Status held. Defendant's motion for extension of time to answer or otherwise plead 13 is granted. Defendants to answer or otherwise plead on or before 09/14/05. Response to motion to certify class 9 due 09/14/05. No reply date is being set at this time. Case set for further status 09/15/05 at 9:00 a.m. for either setting a reply date and entering a discovery schedule. No notice − parties advised in open court. (mak, ) (Entered: 09/13/2005)
Set Deadlines/Hearings Status hearing set for 9/15/2005 at 09:00 AM. (mak, ) (Entered: 09/13/2005)
18 UNOPPOSED MOTION by Defendant Barry S. Maram to enlarge time to answer or otherwise plead and to respond to motion for class certification. (vcf, ) (Entered: 09/14/2005)
19 NOTICE of Motion by Barry S Maram for presentment of unopposed motion to to enlarge time to answer or otherwise plead and to respond to motion for class certification 18 before Honorable James F. Holderman on 9/15/2005 at 09:00 AM. (vcf, ) (Entered: 09/14/2005)
20 MINUTE entry before Judge James F. Holderman: Defendant's motion for extension of time to answer or otherwise plead and to respond to motion for class certification 18 is granted. Defendants to answer or otherwise plead by 09/21/05. Defendants to respond to motion for class certification 9 by 9/28/2005. Status hearing set for 10/04/05 at 9:00 a.m. No notice (mak, ) (Entered: 09/20/2005)
Set Deadlines/Hearings Status hearing set for 10/4/2005 at 09:00 AM. (mak, ) (Entered: 09/20/2005)
21 ANSWER and affirmative defenses to Complaint for declaratory and injunctive relief by Barry S Maram, Carol L Adams.(jmm, ) (Entered: 09/23/2005)
22 MOTION by Defendants for enlargement of time to respond to motion for class certification(gma, ) (Entered: 09/27/2005)
23 NOTICE of Motion by Brent Douglas Stratton for presentment of MOTION by Defendants for enlargement of time to respond to motion for class certification 22 before Honorable James F. Holderman on 9/29/2005 at 09:00 AM. (gma, ) (Entered: 09/27/2005)

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09/28/2005
09/30/2005 10/04/2005 10/04/2005 10/04/2005 10/06/2005 10/06/2005 10/11/2005 10/11/2005 10/12/2005 10/14/2005
10/18/2005 10/18/2005 10/18/2005
10/18/2005 10/18/2005
10/18/2005 10/18/2005

24 MINUTE entry before Judge James F. Holderman: Defendant's motion for enlargement of time to respond to motion for class certification 22 is granted. Defendant's response to motion for class certification 9 is to be filed and served no later than 10/18/05. Status hearing reset for 10/27/05 at 9:00 a.m. No notice (jmm, ) (Entered: 09/30/2005)
Set Deadlines/Hearings Status hearing reset for 10/27/2005 at 09:00 AM. (mak, ) (Entered: 09/30/2005)
25 ATTORNEY Appearance (Schriver, John) (Entered: 10/04/2005)
26 MOTION by Intervenor Illinois Health Care Association to intervene (Schriver, John) (Entered: 10/04/2005)
27 NOTICE of Motion by John T. Schriver for presentment of motion to intervene 26 before Honorable James F. Holderman on 10/11/2005 at 09:00 AM. (Schriver, John) (Entered: 10/04/2005)
28 ATTORNEY Appearance for Intervenor Illinois Health Care Association by Nicholas James Lynn (Lynn, Nicholas) (Entered: 10/06/2005)
29 ATTORNEY Appearance for Intervenor Illinois Health Care Association by Nicholas James Lynn (Lynn, Nicholas) (Duplicate Filing of Document# 28) Modified on 10/7/2005 (gma, ). (Entered: 10/06/2005)
31 MINUTE entry before Judge James F. Holderman: Responses to Motion to Intervene by Illinois Health Case Association 26 due 10/25/05. Status hearing set for 10/27/05 at 9:00 a.m. to see what needs to be briefed. Mailed notice (mak, ) (Entered: 10/14/2005)
Set Deadlines/Hearings Status hearing set for 10/27/2005 at 09:00 AM. (mak, ) (Entered: 10/14/2005)
30 STIPULATION of Dismissal of Defendant Eric E. Whitaker (Hartman, Kendra) (Entered: 10/12/2005)
32 MINUTE entry before Judge James F. Holderman : Pursuant to stipulation of voluntary dismissal without prejudice of defendant Eric E. Whitaker 30 , Eric E. Whitaker is dismissed without prejudice and without costs to any party. Eric E Whitaker terminated. Mailed notice (ar, ) (Entered: 10/17/2005)
33 ATTORNEY Appearance (O'Malley, Richard) (Entered: 10/18/2005)
34 MEMORANDUM by Barry S Maram, Carol L Adams in Opposition to Plaintiffs' Motion for Class Certification (Attachments: # 1)(Stratton, Brent) (Entered: 10/18/2005)
35 ATTORNEY Appearance for Intervenor Parties Camille Baranchik, Maureen Bradish, Daniel Brown, Deborah Brown, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Wendy Schuppan, David Swain, Douglas Swain, Jennifer Westberg by James Wallace Ducayet (Ducayet, James) (Entered: 10/18/2005)
36 NOTICE by all defendants re memorandum in opposition to motion 34 re filing and certificate of service (Stratton, Brent) (Entered: 10/18/2005)
37 MOTION by Intervenor Parties Camille Baranchik, Maureen Bradish, Daniel Brown, Deborah Brown, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Wendy Schuppan, David Swain, Douglas Swain, Jennifer Westberg to intervene (Ducayet, James) (Entered: 10/18/2005)
38 NOTICE of Motion by James Wallace Ducayet for presentment of motion to intervene, 37 before Honorable James F. Holderman on 10/27/2005 at 09:00 AM. (Ducayet, James) (Entered: 10/18/2005)
39 MEMORANDUM by Camille Baranchik, Maureen Bradish, Daniel Brown, Deborah Brown, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Wendy Schuppan, David Swain, Douglas Swain, Jennifer Westberg in

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10/20/2005 10/20/2005 10/21/2005 10/21/2005 10/24/2005 10/25/2005 10/25/2005 10/25/2005 10/25/2005 10/25/2005
10/25/2005
10/27/2005 11/17/2005 11/17/2005 11/17/2005

Support of motion to intervene, 37 Pursuant to Fed. R. Civ. P. 24 (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit B−1)(Ducayet, James) (Entered: 10/18/2005)
40 MEMORANDUM by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman in Opposition to Petition to Intervene by Illinois Health Care Association (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C)(Lapertosa, Max) (Entered: 10/20/2005)
41 NOTICE by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman re memorandum in opposition to motion, 40 to intervene by Illinois Health Care Association (Lapertosa, Max) (Entered: 10/20/2005)
49 APPLICATION for Leave to Appear Pro Hac Vice on behalf of proposed intervenors by James D. Arden; Order entered granting leave by James F. Holderman. Filing fee $50.00 paid, receipt number 10423687. (ar, ) (Entered: 10/31/2005)
50 APPLICATION for Leave to Appear Pro Hac Vice on behalf of proposed intervenors by Michael Rato; Order entered granting leave by James F. Holderman. Filing fee $50.00 paid, receipt number 10423687 (ar, ) (Entered: 10/31/2005)
42 RESPONSE ANSWER to Complaint by Illinois Health Care Association(Schriver, John) (Entered: 10/24/2005)
43 MOTION to intervene (Choslovsky, William) (Entered: 10/25/2005)
44 NOTICE of Motion by William Choslovsky for presentment of motion to intervene 43 before Honorable James F. Holderman on 10/27/2005 at 09:00 AM. (Choslovsky, William) (Entered: 10/25/2005)
45 ATTORNEY Appearance for Intervenor Parties Thomas Patrick Arundel, Gregory Boland, Timothy Bolin, Jeffrey Dralle, Chris Hanley, Kirk Hartemayer, Thomas Kerrigan, Craig Miller, Kevin O'Boyle, Jennifer Turry, John Ward, Kristin Ward, Elizabeth Flesch by William Choslovsky (Choslovsky, William) (Entered: 10/25/2005)
46 RESPONSE by Barry S Maram, Carol L Adams in Opposition to MOTION by Intervenor Illinois Health Care Association to intervene 26 (Stratton, Brent) (Entered: 10/25/2005)
47 MEMORANDUM by Thomas Patrick Arundel, Gregory Boland, Timothy Bolin, Jeffrey Dralle, Chris Hanley, Kirk Hartemayer, Thomas Kerrigan, Craig Miller, Kevin O'Boyle, Jennifer Turry, John Ward, Kristin Ward, Elizabeth Flesch in Support of motion to intervene 43 (Attachments: # 1 Exhibit 1−Part 1# 2 Exhibit 1−Part 2# 3 Exhibit 2)(Choslovsky, William) (Entered: 10/25/2005)
48 RESPONSE by Intervenor Parties Thomas Patrick Arundel, Gregory Boland, Timothy Bolin, Jeffrey Dralle, Chris Hanley, Kirk Hartemayer, Thomas Kerrigan, Craig Miller, Kevin O'Boyle, Jennifer Turry, John Ward, Kristin Ward, Elizabeth Flesch to motion to certify class 9 (Attachments: # 1 Exhibit 1−Part 1# 2 Exhibit 1−Part 2)(Choslovsky, William) (Entered: 10/25/2005)
51 MINUTE entry before Judge James F. Holderman : Status hearing held on 10/27/2005. Plaintiffs' motion cor class certification 9 is moot at this time. On the pending motions to intervene 43 37 26 , responses due by 11/15/2005; Replies due by 12/1/2005. Mailed notice (am) (Entered: 10/31/2005)
52 MEMORANDUM by Barry S Maram, Carol L Adams in Opposition to motion to intervene, 37 , filed by Golden Intervenors (Stratton, Brent) (Entered: 11/17/2005)
53 MEMORANDUM by Barry S Maram, Carol L Adams in Opposition to motion to intervene 43 , filed by the Residents of Misericordia (Stratton, Brent) (Entered: 11/17/2005)
54 MEMORANDUM by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman in Opposition to Motions to Intervene of Misericordia and Golden Parents (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D)(Lapertosa, Max) (Entered: 11/17/2005)

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11/17/2005 11/30/2005
12/01/2005
12/01/2005 12/16/2005 12/20/2005 12/22/2005
01/10/2006 01/10/2006 01/10/2006 01/10/2006 01/12/2006

55 NOTICE by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman re memorandum in opposition, 54 to motions to intervene of Misericordia and Golden parents (Lapertosa, Max) (Entered: 11/17/2005)
58 ATTORNEY Appearance for Intervenor Parties Illinois Health Care Association, Camille Baranchik, Maureen Bradish, Daniel Brown, Deborah Brown, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Wendy Schuppan, David Swain, Douglas Swain, Jennifer Westberg, Thomas Patrick Arundel, Gregory Boland, Timothy Bolin, Jeffrey Dralle, Chris Hanley, Kirk Hartemayer, Thomas Kerrigan, Craig Miller, Kevin O'Boyle, Jennifer Turry, John Ward, Kristin Ward, Elizabeth Flesch, Residents of Misericordia by Patrick E. Mahoney. (cem, ) (Entered: 12/02/2005)
56 REPLY by Camille Baranchik, Maureen Bradish, Daniel Brown, Deborah Brown, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Wendy Schuppan, David Swain, Douglas Swain, Jennifer Westbergin Support of MOTION by Intervenor Parties Camille Baranchik, Maureen Bradish, Daniel Brown, Deborah Brown, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Wendy Sc 37 (Attachments: # 1 Exhibit A)(Ducayet, James) (Entered: 12/01/2005)
57 MEMORANDUM by Residents of Misericordia in Support of motion to intervene 43 (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Certificate of Service)(Choslovsky, William) (Entered: 12/01/2005)
59 ATTORNEY Appearance for Intervenor Parties Thomas Patrick Arundel, Residents of Misericordia by Robert J. Bingle (ar, ) (Entered: 12/20/2005)
MAILED Rule 83.17 letter to Robert J. Bingle (ar, ) (Entered: 12/20/2005)
60 MINUTE entry before Judge James F. Holderman : The petitions to intervene by intervenors Illinois Health Care Association 26 , the Golden Intervenors 37 , and the Residents of Misericordia 43 are denied. This case is set for further status on 01/12/06 at 9:00 Am. Proposed Golden Intervenors Daniel Brown, Deborah Brown, Anne Golden. Samuel Golden, Edward Grossman, Marianna Grossman, Illinois Health Care Association, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Residents of Misericordia, Wendy Schuppan, David Swain, Douglas Swain, Jennifer Westberg, Camille Baranchik, and Maureen Bradish are terminated. Mailed notice (ar, ) Modified on 12/27/2005 (ar, ). (Entered: 12/27/2005)
61 MOTION by Plaintiffs David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman to certify class (renewed) (Hartman, Kendra) Text edited by Clerk's Office on 1/10/2006 (ntf, ). (Entered: 01/10/2006)
62 MEMORANDUM by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman in Support of motion to certify class 61 (Hartman, Kendra) (Entered: 01/10/2006)
63 NOTICE of Correction regarding MOTION by Plaintiffs David Childers, Isaiah Fair, Samuel Golden, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman to certify class (renewed) 61 (ntf, ) (Entered: 01/10/2006)
64 NOTICE of Motion by Kendra Kekelis Hartman for presentment of motion to certify class, 61 before Honorable James F. Holderman on 1/17/2006 at 09:00 AM. (Hartman, Kendra) (Entered: 01/10/2006)
65 MINUTE entry before Judge James F. Holderman : Status hearing held. Parties to conduct a Rule 26(f) conference and prepare a jointly signed Form 35. Form 36 to be filed on or before 02/02/06 with a copy delivered to chambers on the day filed. Case set for further status 02/09/06 at 9:00 a.m. (mak, ) (Entered: 01/20/2006)

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01/12/2006 01/23/2006 01/23/2006 01/26/2006
01/26/2006 01/27/2006 01/31/2006 02/02/2006 02/06/2006 02/06/2006 02/08/2006 02/09/2006 02/16/2006 02/16/2006 02/23/2006

66 MINUTE entry before Judge James F. Holderman: Defendants' response to plaintiffs' renewed motion to certify class 61 due 02/02/06; Plaintiffs' reply due 02/23/06. Motion will be taken under advisement and ruling will be by mail. (mak, ) (Entered: 01/20/2006)
67 MOTION by Intervenor Residents of Misericordia for leave to file A Brief As Amicus Curiae On The Issue Of Class Certification (Attachments: # 1 Exhibit A# 2 Exhibit B)(Choslovsky, William) (Entered: 01/23/2006)
68 NOTICE of Motion by William Choslovsky for presentment of motion for leave to file 67 before Honorable James F. Holderman on 1/26/2006 at 09:00 AM. (Choslovsky, William) (Entered: 01/23/2006)
69 NOTICE of appeal by Samuel Golden, Camille Baranchik, Maureen Bradish, Daniel Brown, Deborah Brown, Anne Golden, Edward Grossman, Marianna Grossman, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Wendy Schuppan, David Swain, Douglas Swain, Jennifer Westberg regarding orders 60 ; Filing fee $ 255.00 paid; Receipt number 10715387 (dj, ) (Pursuant to the March 2011 Judicial Conference Policy requiring that remote access restrictions be implemented when placing scanned versions of previously filed paper documents on the record, this document is restricted to allow public access only at the Clerk's Office public access terminals.). (yap, ). Modified on 7/11/2018 (yap, ). (Entered: 01/27/2006)
71 MINUTE entry before Judge James F. Holderman : The Residents of Misericordia Motion for leave to file a brief as Amicus Curiae on the Issue of Class Certification [67} is denied. Previous details in order of 12/22/05 to stand. (mak, ) (Entered: 01/29/2006)
70 TRANSMITTED to the 7th Circuit the short record on 1/27/06 notice of appeal, 69 . Notified counsel (dj, ) (Entered: 01/27/2006)
72 ACKNOWLEDGEMENT of receipt of short record on appeal regarding notice of appeal 69 ; USCA Case No. 06−1327. (ar, ) (Entered: 02/02/2006)
73 MEMORANDUM by Barry S Maram, Carol L Adams in Opposition to motion to certify class, 61 (Attachments: # 1 Exhibit Unreported decision# 2 Exhibit Unreported decision)(Stratton, Brent) (Added Filing Party) Modified on 2/8/2006 (gma, ). (Entered: 02/02/2006)
74 REPORT of Rule 26(f) Planning Meeting by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman (Hartman, Kendra) (Entered: 02/06/2006)
75 NOTICE by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman re report of rule 26(f) planning meeting 74 (Hartman, Kendra) (Entered: 02/06/2006)
76 NOTICE of Correction regarding memorandum in opposition to motion 73 (Filing party missing) (gma, ) (Entered: 02/08/2006)
77 MINUTE entry before Judge James F. Holderman : Status hearing held. Form 35 will not be entered at this time. Case set for further status 03/30/06 at 9:00 a.m. Parties to submit revised Form 35 after ruling on Motion for Class Certification. Mailed notice (mak, ) (Entered: 02/10/2006)
78 TRANSMITTED to the USCA for the 7th Circuit the long record on appeal 69 (USCA no. 06−1327) consisting of 2 volumes of pleadings. (dj, ) (Entered: 02/16/2006)
79 USCA RECEIVED on 2/16/06 the long record on appeal (06−1327) (dj, ) (Entered: 02/21/2006)
80 REPLY by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Biermanin Support of MOTION by Plaintiffs David Childers, Isaiah Fair, Samuel Golden, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman to certify class (renewed) 61 (Hartman, Kendra) (Entered: 02/23/2006)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 34 of 82

02/23/2006 02/28/2006 03/01/2006 03/03/2006 03/07/2006
03/07/2006 03/20/2006 03/30/2006 03/30/2006 04/04/2006
04/26/2006

81 NOTICE by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman re reply to response to motion, 80 (Hartman, Kendra) (Entered: 02/23/2006)
82 TRANSCRIPT of proceedings for the following dates: 01/26/06 before the Honorable James F. Holderman. (Pursuant to the March 2011 Judicial Conference Policy requiring that remote access restrictions be implemented when placing scanned versions of previously filed paper documents on the record, this document is restricted to allow public access only at the Clerk's Office public access terminals.) (ar, ) . Modified on 7/11/2018 (yap, ). (Entered: 03/01/2006)
83 TRANSMITTED to the USCA for the 7th Circuit supplemental record on appeal 69 (USCA no. 06−1327) consisting of one transcript 82 . Copies of transmittal letter to counsel of record. (ar, ) (Entered: 03/01/2006)
84 USCA RECEIVED on 03/01/06 the supplement record regarding notice of appeal 69 . (ar, ) (Entered: 03/03/2006)
85 MINUTE entry before Judge James F. Holderman : Plaintiffs' renewed motion for class certification under Federal Rule of Civil Procedure 23(b)(3) for injunctive relief 61 is granted. This court certifies as class representatives stanley Ligas, by his sister and next friend, Gina Foster; Lorene Bierman, by her guardians, Darlene and Joseph Bierman; Isaiah Fair, by his guardian Lutricia Fair, Adam Kulig, by his guardian, Norb Kulig; Jamie McElroy, by his guardian, Patricia McElroy; and Jennifer Wilson, by her guardians, Nancy and Richard Wilson. This court appoints plaintiffs' counsel as class counsel. − The class is defined as: A class for injunctive relief consisting of all persons in Illinois with disabilities who (1) have mental retardation and/or other developmental disabilities and who qualify for long−term care services; (2) with appropriate supports and services, could live in the community and who would not oppose community placement; and (3) either are institutionalized in private ICF−DDs with nine or more residents or are living in a home−based setting and are at risk for institutionalization because of their need for services. − Parties are to submit a revised Form 35 on or before 03/20/06. Counsel are requested to submit a courtesy copy of Form 35 to Chambers on the day of filing. This case is set for a report on status and entry of a scheduling order at 9:00 AM on 04/04/06. The status report set for 03/30/06 is vacated. Mailed notice (ar, ) (Entered: 03/10/2006)
86 MEMORANDUM Opinion and Order Regarding Class Certification, signed by Judge James F. Holderman on 3/7/2006 85 .Judge's staff mailed notice(ar, ) (Entered: 03/10/2006)
87 REPORT of Rule 26(f) Planning Meeting by David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Barry S Maram, Carol L Adams, Lorene Bierman (Hartman, Kendra) (Entered: 03/20/2006)
88 MOTION by Plaintiffs David Childers, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Lorene Bierman for leave to file First Amended Complaint (Attachments: # 1 Exhibit A)(Hartman, Kendra) (Entered: 03/30/2006)
89 NOTICE of Motion by Kendra Kekelis Hartman for presentment of motion for leave to file 88 before Honorable James F. Holderman on 4/4/2006 at 09:00 AM. (Hartman, Kendra) (Entered: 03/30/2006)
90 MINUTE entry before Judge James F. Holderman : Plaintiffs' motion for leave to file first amended complaint 88 is granted. Plaintiffs are given until 10/31/06 to join additional parties and to amend the pleadings. Defendants are given until 11/15/06 to join additional parties and to amend the pleadings. All fact discovery to be completed by 12/15/06. Plaintiffs' experts' reports due by 02/13/07. Defendants' experts' reports due by 04/16/07. Dispositive motions to be filed by 07/16/2007. Replies by 08/20/07. Plaintiffs' final lists of witnesses due by 09/30/06. Defendants' final lists of witnesses due by 11/01/07. Final pretrial Order due by 11/21/2007. Final pretrial conference set for 11/27/07 at 3:00 PM. Trial set for 01/21/2008 at 09:00 AM. Mailed notice (ar, ) (Entered: 04/06/2006)
91 FIRST AMENDED complaint by David Cicarelli, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, Lorene Bierman against Barry S Maram, Carol L Adams and terminating Alex Tyner; David Childers and Tiffany McFadden

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04/27/2006 05/02/2006 05/04/2006 05/08/2006 05/08/2006 05/15/2006 05/15/2006 07/21/2006 11/16/2006
11/16/2006 11/20/2006
02/20/2007 02/20/2007 02/23/2007 02/26/2007
02/27/2007

(Hartman, Kendra) (Entered: 04/26/2006)
92 CERTIFICATE of Service by Kendra Kekelis Hartman on behalf of Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman regarding amended complaint, 91 (Hartman, Kendra) (Entered: 04/27/2006)
93 Defendants' ANSWER to amended complaint by Barry S Maram, Carol L Adams(Stratton, Brent) (Entered: 05/02/2006)
94 CERTIFICATE by Barry S Maram, Carol L Adams of Service of Defendants' Answer to First Amended Complaint (Stratton, Brent) (Entered: 05/04/2006)
95 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman for protective order (agreed) (Attachments: # 1 Exhibit A)(Hartman, Kendra) (Entered: 05/08/2006)
96 NOTICE of Motion by Kendra Kekelis Hartman for presentment of motion for protective order 95 before Honorable James F. Holderman on 5/16/2006 at 09:00 AM. (Hartman, Kendra) (Entered: 05/08/2006)
97 MINUTE entry before Judge James F. Holderman dated 5/15/06: Plaintiffs' motion for protective Order (95) is granted. Enter Agreed Protective Order. The motion hearing set for 5/16/06 is stricken. Judicial staff mailed notice (gl, ) (Entered: 05/15/2006)
98 Enter Agreed PROTECTIVE Order Signed by Judge James F. Holderman on 5/15/2006:Judicial staff mailed notice(gl, ) (Entered: 05/15/2006)
99 ATTORNEY Appearance for Plaintiffs by Wendy N Enerson (ar, ) (Entered: 07/25/2006)
100 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman, Defendants Barry S Maram, Carol L Adams to amend/correct order on motion for leave to file, set deadlines/hearings,,,,,, 90 (Joint Motion to Modify Existing Discovery Schedule) (Hartman, Kendra) (Entered: 11/16/2006)
101 NOTICE of Motion by Kendra Kekelis Hartman for presentment of motion to amend/correct, motion for relief,,,, 100 before Honorable James F. Holderman on 11/21/2006 at 09:00 AM. (Hartman, Kendra) (Entered: 11/16/2006)
102 MINUTE entry before Judge James F. Holderman : Parties' joint Motion to Modify Existing Discovery Schedule 100 is granted. Plaintiff shall comply with FRCP(26)(a)(2) by 5/11/2007. Defendant shall comply with FRCP(26)(a)(2) by 7/13/2007. Fact Discovery ordered extended until 3/16/2007. All other previously set dates remain firm. Mailed notice (am) (Entered: 11/20/2006)
103 MOTION by Plaintiff Stanley Ligas to compel document and answers to interrogatories (Attachments: # 1 Exhibit A# 2 Exhibit B)(Enerson, Wendy) (Entered: 02/20/2007)
104 NOTICE of Motion by Wendy N Enerson for presentment of motion to compel 103 before Honorable James F. Holderman on 2/27/2007 at 09:00 AM. (Enerson, Wendy) (Entered: 02/20/2007)
105 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel (Amended) (Attachments: # 1 Exhibit A and B)(Hartman, Kendra) (Entered: 02/23/2007)
106 RESPONSE by Barry S Maram, Carol L Adamsin Opposition to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel (Amended) 105 (Stratton, Brent) (Entered: 02/26/2007)
107 MINUTE entry before Judge James F. Holderman : Plaintiffs' motion and amended motion to compel 103 105] are moot. By agreement of the parties, fact discovery is extended until 6/11/2007. The time for plaintiffs to comply with FRCP(26)(a)(2) is extended until 6/11/2007. All other dates remain in effect. Defendants shall continued to search for the documents requested by plaintiffs and report to plaintiffs by 3/21/2007. Defendants are to continue to provide the discovery information in the

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02/27/2007 03/01/2007 03/07/2007
03/07/2007 03/09/2007 03/09/2007 03/09/2007 03/16/2007 04/04/2007 04/16/2007 04/18/2007 04/18/2007
04/18/2007 04/19/2007 04/19/2007 04/20/2007 04/20/2007

manner that they are capable of and continue trying to retrieve the electronic information. This cause will be referred to Magistrate Judge Ashman for discovery disputes; parties are to meet with Magistrate Judge Ashman before the end of March, 2007. Mailed notice (am) (Entered: 02/28/2007)
108 Pursuant to Local Rule 72.1, this case is hereby referred to the calendar of Magistrate Judge Martin C. Ashman for the purpose of holding proceedings related to: discovery disputes and settlement conference. (am) Mailed notice. (Entered: 02/28/2007)
109 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing set for 3/19/2007 at 10:00 AM., in courtroom 1386. Mailed notice. (is, ) (Entered: 03/01/2007)
110 MINUTE entry before Judge James F. Holderman : ENTER ORDER: By agreement of the parties, plaintiffs' amended motion to compel responses to second setof interrogatories and first request for production of documents 105 is granted in part and denied in part. [For further detail see separate order.] Mailed notice (ar, ) (Entered: 03/08/2007)
111 ORDER, signed by Judge James F. Holderman on 3/7/2007 110 . Mailed notice(ar, ) (Entered: 03/08/2007)
112 MANDATE of USCA dated 02/15/07 regarding notice of appeal 69 , USCA No. 06−1327: "...The judgment of the District Court is affirmed, with costs, in accordance with the decision of this court entered this date." (ar, ) (Entered: 03/12/2007)
113 LETTER from the Seventh Circuit returning the record on appeal in USCA no. 05−4331 consisting of two volumes of pleadings and one transcript. (ar, ) (Entered: 03/12/2007)
114 OPINION from the USCA for the 7th Circuit; Argued 10/30/07, Decided 02/15/07 in USCA case no. 06−1327. (ar, ) (Entered: 03/12/2007)
115 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing reset to 4/4/2007 at 10:00 AM. Mailed notice. (is, ) (Entered: 03/16/2007)
116 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 4/4/2007 and continued to 4/16/2007 at 10:00 AM. Mailed notice. (is, ) (Entered: 04/04/2007)
117 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 4/16/2007 and continued to 5/10/2007 at 10:00 AM. Plaintiffs to submit draft order. Mailed notice. (is, ) (Entered: 04/16/2007)
118 ATTORNEY Appearance for Riverside Foundation and Golfview Developmental Center as Respondents to Subpoena (Kiser, Thomas) (Entered: 04/18/2007)
119 MOTION by Unknown Riverside Foundation to quash Subpoena Respondents Riverside Foundation and Golfview Developmental Center Motion to Quash Subpoenas (Attachments: # 1 Exhibit Exhibits 1−3)(Kiser, Thomas) (Entered: 04/18/2007)
120 NOTICE of Motion by Thomas J. Kiser for presentment of motion to quash 119 before Honorable Martin C. Ashman on 4/24/2007 at 10:30 AM. (Kiser, Thomas) (Entered: 04/18/2007)
121 MINUTE entry before Judge Martin C. Ashman :Subpoena respondents' motion to quash subpoenas 119 is reset to 5/1/2007 at 10:30 AM. Mailed notice. (is, ) (Entered: 04/19/2007)
122 ATTORNEY Appearance for Riverside Foundation, Golfview Developmental Center by Judith Schwartz Sherwin. (ar, ) (Entered: 04/20/2007)
123 ATTORNEY Appearance for Movant Golfview Developmental Center by Thomas J. Kiser for Respondent to Subpoena Golfview Developmental Center (Kiser, Thomas) (Entered: 04/20/2007)
124 MOTION by Defendant Carol L Adams for protective order regarding production of electronic documents (Stratton, Brent) (Entered: 04/20/2007)

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04/20/2007 04/20/2007 04/20/2007 04/23/2007 04/25/2007 04/25/2007 04/25/2007 04/27/2007 04/27/2007
04/27/2007 04/27/2007
04/30/2007 04/30/2007 04/30/2007
04/30/2007 04/30/2007 04/30/2007

125 NOTICE of Motion by Brent Douglas Stratton for presentment of motion for protective order 124 before Honorable Martin C. Ashman on 4/24/2007 at 10:30 AM. (Stratton, Brent) (Entered: 04/20/2007)
127 MINUTE entry before Judge Martin C. Ashman : Enter order regarding defendants' production of responsive materials maintained in electronic form and in native format. (For further detail see separate order). Mailed notice (ar, ) (Entered: 04/24/2007)
128 ORDER, signed by Judge Martin C. Ashman on 4/20/2007 127 . Mailed notice(ar, ) (Entered: 04/24/2007)
126 MINUTE entry before Judge Martin C. Ashman :Defendant Carol Adams' motion for protective order regarding production of electronic documents 124 is reset to 5/1/2007 at 10:30 AM. Mailed notice. (is, ) (Entered: 04/23/2007)
129 ATTORNEY Appearance for Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman by Samuel Phillip Linsenmaier (Linsenmaier, Samuel) (Entered: 04/25/2007)
130 SUPPLEMENT by Riverside Foundation, Golfview Developmental Center to Motion to Quash Subpoenas (Kiser, Thomas) (Entered: 04/25/2007)
131 NOTICE by Riverside Foundation, Golfview Developmental Center Notice of Filing of Supplement to Motion to Quash Subpoenas (Kiser, Thomas) (Entered: 04/25/2007)
132 ATTORNEY Appearance (Choslovsky, William) (Entered: 04/27/2007)
133 MOTION by Respondents Carthage Terrace, Chamness Square, Curtis Court, Davies Square, Freeport Terrace, Lawrence Place, Lincoln Terrace, Matteson Court, Prairie House, Quincy Terrace, Schultz House, Seborg Terrace, St. Mary's Square Living Center, Stevens House, Trulson House, Wetheraell Place, Parents and Friends of the Specialized Living Center to quash Subpoenas (Joint) (Attachments: # 1 Exhibit A − E)(Choslovsky, William) (Entered: 04/27/2007)
134 (With Certificate of Service) NOTICE of Motion by William Choslovsky for presentment of motion to quash, 133 before Honorable Martin C. Ashman on 5/1/2007 at 10:30 AM. (Choslovsky, William) (Entered: 04/27/2007)
135 ATTORNEY Appearance for Respondents Carthage Terrace, Chamness Square, Curtis Court, Davies Square, Freeport Terrace, Lawrence Place, Lincoln Terrace, Matteson Court, Prairie House, Quincy Terrace, Schultz House, Seborg Terrace, St. Mary's Square Living Center, Stevens House, Trulson House, Wetheraell Place, Parents and Friends of the Specialized Living Center by Eric Emerson Walker (Walker, Eric) (Entered: 04/27/2007)
136 MOTION by Defendants Barry S Maram, Carol L Adams to quash subpoenas or for protective order (Stratton, Brent) (Entered: 04/30/2007)
137 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel subpoenas (Attachments: # 1 Affidavit)(Lapertosa, Max) (Entered: 04/30/2007)
138 MEMORANDMUM by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman in Opposition to motion to quash, 133 , motion to quash 119 , motion to compel 137 and in Support of Plaintiffs' Motion to Compel Subpoenas (Attachments: # 1 Exhibit A)(Lapertosa, Max) (Entered: 04/30/2007)
139 NOTICE of Motion by Max P Lapertosa for presentment of motion to compel 137 before Honorable Martin C. Ashman on 5/7/2007 at 10:30 AM. (Lapertosa, Max) (Entered: 04/30/2007)
140 NOTICE of Motion by Brent Douglas Stratton for presentment of motion to quash 136 before Honorable Martin C. Ashman on 5/8/2007 at 10:30 AM. (Stratton, Brent) (Entered: 04/30/2007)
141 Corrected NOTICE of Motion by Max P Lapertosa for presentment of motion to compel 137 before Honorable Martin C. Ashman on 5/8/2007 at 10:30 AM. (Lapertosa, Max) (Entered: 04/30/2007)

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05/01/2007
05/07/2007 05/07/2007 05/08/2007 05/08/2007 05/08/2007 05/10/2007
05/10/2007 05/14/2007 05/16/2007 05/21/2007 05/22/2007 05/22/2007

142 MINUTE entry before Judge Martin C. Ashman :Oral argument held on 5/1/2007 regarding motion for protective order 124 , motion to quash 119 . Responses and replies to motion for protective order 124 , motions to quash 119 , 133 , 136 , and motion to compel 137 due by 5/22/2007. Oral argument on motion for protective order, motions to quash 119 , 133 , 136 and motion to compel 137 set for 6/11/2007 at 11:00 AM. Magistrate Judge Status hearing set for 5/16/2007 at 10:00 AM., regarding electronic discovery. Mailed notice. (is, ) (Entered: 05/02/2007)
143 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, David Cicarelli, Lorene Bierman to amend/correct Scheduling Order and Continue Trial (Attachments: # 1 Exhibit A−F# 2 Exhibit G−H)(Linsenmaier, Samuel) (Entered: 05/07/2007)
144 NOTICE of Motion by Samuel Phillip Linsenmaier for presentment of motion to amend/correct 143 before Honorable James F. Holderman on 5/10/2007 at 09:00 AM. (Linsenmaier, Samuel) (Entered: 05/07/2007)
145 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman, Defendants Barry S Maram, Carol L Adams for leave to file replies in support of Plaintiffs' Motion to Compel Subpoenas and Defendants' Motion to Quash Subpoenas or for Protective Order (Stratton, Brent) (Entered: 05/08/2007)
146 NOTICE of Motion by Brent Douglas Stratton for presentment of motion for leave to file, 145 before Honorable Martin C. Ashman on 5/15/2007 at 10:30 AM. (Stratton, Brent) (Entered: 05/08/2007)
147 RESPONSE by Barry S Maram, Carol L Adams to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, David Cicarelli, Lorene Bierman to amend/correct Scheduling Order and Continue Trial 143 (Stratton, Brent) (Entered: 05/08/2007)
148 MINUTE entry before Judge James F. Holderman : Motion hearing held on 5/10/2007. Plaintiffs' motion to amend Scheduling Order and Continue Trial 143 is granted. Plaintiff shall comply with FRCP(26)(a)(2) by 10/11/2007. Defendant shall comply with FRCP(26)(a)(2) by 12/12/2007.Discovery ordered closed by 1/18/2008. Dispositive motions with supporting memoranda due by 2/1/2008; responses due by 2/29/2008. Replies due by 3/14/2008. Final Pretrial Order due by 5/12/2008. Motions in limine with supporting memoranda due by 5/12/2008; responses due by 5/19/2008. Final Pretrial Conference set for 6/12/2008 at 4:00 PM. Bench Trial set for 7/14/2008 at 9:00 AM. Parties are encouraged to discuss settlement. Mailed notice (am) (Entered: 05/14/2007)
149 AMENDED SCHEDULING ORDER.Signed by Judge James F. Holderman on 5/10/2007: Mailed notice(am) (Entered: 05/14/2007)
150 MINUTE entry before Judge Martin C. Ashman :Plaintiffs and defendants' joint motion for leave to file replies in support of plaintiffs' motion to compel and defendants' motion to quash subpoenas or for protective order on or before 6/1/2007 145 is granted. Mailed notice. (is, ) (Entered: 05/14/2007)
151 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 5/16/2007; and continued to 5/23/2007 at 10:00 AM. Mailed notice. (is, ) (Entered: 05/16/2007)
152 ATTORNEY Appearance for Respondent Aspire on Eastern by William Choslovsky (Choslovsky, William) (Entered: 05/21/2007)
153 RESPONSE by Misericordia Home Northin Opposition to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel subpoenas 137 (Bingle, Robert) (Entered: 05/22/2007)
154 MEMORANDMUM by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman in Opposition to motion to quash 136 (Attachments: # 1 Exhibit A# 2 Errata B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F# 7 Exhibit G)(Lapertosa, Max) (Entered: 05/22/2007)

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05/22/2007 05/22/2007 05/22/2007 05/22/2007 05/22/2007
05/22/2007 05/22/2007 05/22/2007 05/23/2007 05/23/2007 05/29/2007 05/29/2007 05/29/2007 05/29/2007 05/31/2007

155 MOTION for leave to file Appearances and Opposition to Motion to Compel (Attachments: # 1 Exhibit A)(Marks, Jason) (Entered: 05/22/2007)
156 NOTICE of Motion by Jason Michael Marks for presentment of motion for leave to file 155 before Honorable James F. Holderman on 6/7/2007 at 09:00 AM. (Marks, Jason) (Entered: 05/22/2007)
157 REPLY by Riverside Foundation, Golfview Developmental Center to MOTION by Unknown Riverside Foundation to quash Subpoena Respondents Riverside Foundation and Golfview Developmental Center Motion to Quash Subpoenas 119 (Kiser, Thomas) (Entered: 05/22/2007)
158 NOTICE by Riverside Foundation, Golfview Developmental Center re reply to response to motion 157 and Certificate of Service (Kiser, Thomas) (Entered: 05/22/2007)
159 REPLY by Respondents Carthage Terrace, Chamness Square, Curtis Court, Davies Square, Freeport Terrace, Lawrence Place, Lincoln Terrace, Matteson Court, Prairie House, Quincy Terrace, Schultz House, Seborg Terrace, St. Mary's Square Living Center, Stevens House, Trulson House, Wetheraell Place, Parents and Friends of the Specialized Living Center to motion to quash, 133 In Support of Joint Motion to Quash Subpoenas (Attachments: # 1 Exhibit 1# 2 Exhibit 2# 3 Exhibit 3# 4 Exhibit 4# 5 Exhibit 5)(Choslovsky, William) (Entered: 05/22/2007)
160 RESPONSE by Aspire on Easternin Opposition to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel subpoenas 137 (Attachments: # 1 Exhibit 1# 2 Exhibit 2)(Choslovsky, William) (Entered: 05/22/2007)
161 ATTORNEY Appearance on behalf of Respondent Progressive Housing, Inc. (Monberg, Jeffrey) (Entered: 05/22/2007)
162 RESPONSE by Progressive Housing, Inc.in Opposition to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel subpoenas 137 (Attachments: # 1 Exhibit A)(Monberg, Jeffrey) (Entered: 05/22/2007)
163 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 5/23/2007; and continued to 5/31/2007 at 10:15 AM. Mailed notice. (is, ) (Entered: 05/23/2007)
164 Amended NOTICE of Motion by Jason Michael Marks for presentment of motion for leave to file 155 before Honorable Martin C. Ashman on 5/29/2007 at 10:30 AM. (Marks, Jason) (Entered: 05/23/2007)
165 MINUTE entry before Judge Martin C. Ashman :Interested parties' motion for leave to file appearances and joint opposition to motion to compel 155 is granted without objection. Mailed notice. (is, ) (Entered: 05/29/2007)
166 ATTORNEY Appearance for Movants Lauren Axelrod, Craig Miller, Karmen Razman, Genevieve Benner, Matthew Nilson, Maggie Murphy, Stacie Athansopoulos by Jason Michael Marks Appearance of Jason M. Marks (Marks, Jason) (Entered: 05/29/2007)
167 ATTORNEY Appearance for Movants Lauren Axelrod, Craig Miller, Karmen Razman, Genevieve Benner, Matthew Nilson, Maggie Murphy, Stacie Athansopoulos by Scott M. Mendel Appearance of Scott M. Mendel (Mendel, Scott) (Entered: 05/29/2007)
168 MEMORANDMUM by Lauren Axelrod, Craig Miller, Karmen Razman, Genevieve Benner, Matthew Nilson, Maggie Murphy, Stacie Athansopoulos in Opposition to motion to compel 137 (Attachments: # 1 Exhibit 1# 2 Exhibit 2# 3 Exhibit 3# 4 Exhibit 4# 5 Exhibit 5# 6 Exhibit 6# 7 Exhibit 7)(Marks, Jason) (Entered: 05/29/2007)
169 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 5/31/2007; and continued to 8/1/2007 at 10:00 AM. Defendants production of e−mails by 7/16/2007 as orally stated in open court, except the material by Price Childs shall be produced by 7/31/2007. Mailed notice. (is, ) (Entered: 05/31/2007)

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06/01/2007
06/01/2007 06/05/2007 06/11/2007
06/14/2007 06/14/2007 06/18/2007
06/18/2007 06/19/2007 08/01/2007 08/03/2007 08/10/2007
08/10/2007 08/13/2007 08/20/2007

170 REPLY by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to response in opposition to motion, 160 , response in opposition to motion 153 , response in opposition to motion, 162 , memorandum in opposition to motion, 168 in support of Plaintiffs' Motion to Compel (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E)(Lapertosa, Max) (Entered: 06/01/2007)
171 REPLY by Barry S Maram, Carol L Adams to memorandum in opposition to motion, 154 (Stratton, Brent) (Entered: 06/01/2007)
172 ATTORNEY Appearance for Respondent Misericordia Home North by Robert J. Bingle (Bingle, Robert) (Entered: 06/05/2007)
173 MINUTE entry before Judge Martin C. Ashman :Oral argument held on 6/11/2007 regarding motions to quash 119 , 133 , 136 , motion for protective order 124 , and motion to compel 137 . Defendants' motions to quash 119 , 133 , 136 , motion for protective order 124 and plaintiff's motion to compel 137 are taken under advisement. Ruling to be made by mail. Mailed notice. (is, ) (Entered: 06/11/2007)
174 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman for leave to file Supplement to Plaintiffs' Reply in Support of Motion to Compel (Attachments: # 1 Exhibit A# 2 Exhibit B−1# 3 Exhibit B−2)(Lapertosa, Max) (Entered: 06/14/2007)
175 NOTICE of Motion by Max P Lapertosa for presentment of motion for leave to file, 174 before Honorable Martin C. Ashman on 6/19/2007 at 10:30 AM. (Lapertosa, Max) (Entered: 06/14/2007)
176 RESPONSE by Respondents Carthage Terrace, Chamness Square, Curtis Court, Davies Square, Freeport Terrace, Lawrence Place, Lincoln Terrace, Matteson Court, Prairie House, Quincy Terrace, Schultz House, Seborg Terrace, St. Mary's Square Living Center, Stevens House, Trulson House, Wetheraell Place, Parents and Friends of the Specialized Living Center, Aspire on Eastern to motion for leave to file, 174 (Attachments: # 1 Exhibit 1)(Choslovsky, William) (Entered: 06/18/2007)
177 RESPONSE by Respondent Misericordia Home North to Plaintiff's Motion to Supplement (Bingle, Robert) (Entered: 06/18/2007)
178 MINUTE entry before Judge Martin C. Ashman :Plaintiffs' motion for leave to file supplement to plaintiffs' reply in support of motion to compel 174 is granted. Defendants are given leave to file their responses. Mailed notice. (is, ) (Entered: 06/19/2007)
179 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 8/1/2007; and continued to 8/9/2007 at 10:00 AM. Kathleen F. Howlett, counsel for Riverside Foundation and Golfview Developmental Center was present in court. Mailed notice. (is, ) (Entered: 08/01/2007)
180 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing reset to 8/13/2007 at 10:00 AM. Mailed notice. (is, ) (Entered: 08/03/2007)
181 MINUTE entry before Judge Martin C. Ashman : Enter Memorandum Opinion and Order. The court finds the subpoenas unenforceable as written. Defendants' and respondents' motions to quash subpoenas 119 , 133 , and 136 are granted. Plaintiffs' motion to compel 137 is denied. (For further detail see separate order). Mailed notice (ar, ) (Entered: 08/13/2007)
183 MEMORANDUM Opinion and Order, signed by Judge Martin C. Ashman on 8/10/2007 181 . Mailed notice (ar, ) Modified on 8/13/2007 (ar, ). (Entered: 08/13/2007)
182 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 8/13/2007; and continued to 8/20/2007 at 10:00 AM. Mailed notice. (is, ) (Entered: 08/13/2007)
184 MINUTE entry before Judge Martin C. Ashman :Defendant Adams' motion for protective order regarding production of electronic documents 124 is terminated as moot. Magistrate Judge Status hearing held on 8/20/2007; and continued to 8/28/2007 at 10:00 AM. Mailed notice. (is, ) (Entered: 08/20/2007)

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08/28/2007 09/10/2007 09/10/2007
09/10/2007 09/10/2007 09/10/2007 09/17/2007 09/17/2007 09/17/2007 09/17/2007 09/18/2007
09/20/2007
10/09/2007 10/09/2007

185 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing held on 8/28/2007; and continued to 10/12/2007 at 10:00 AM. Mailed notice. (is, ) (Entered: 08/28/2007)
186 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel compliance with subpoenas (Attachments: # 1 Exhibit A# 2 Exhibit B−1# 3 Exhibit B−2# 4 Exhibit B−3)(Lapertosa, Max) (Entered: 09/10/2007)
187 MEMORANDUM by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman in support of motion to compel, 186 compliance with subpoenas (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E# 6 Exhibit F# 7 Exhibit G)(Lapertosa, Max) (Entered: 09/10/2007)
188 NOTICE of Motion by Max P Lapertosa for presentment of motion to compel, 186 before Honorable Martin C. Ashman on 9/18/2007 at 10:30 AM. (Lapertosa, Max) (Entered: 09/10/2007)
189 MOTION by counsel for Respondent Aspire on Eastern to withdraw as attorney (Choslovsky, William) (Entered: 09/10/2007)
190 Agreed NOTICE of Motion by William Choslovsky for presentment of motion to compel, 186 before Honorable Martin C. Ashman on 9/18/2007 at 10:30 AM. (Choslovsky, William) (Entered: 09/10/2007)
191 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to amend/correct Scheduling Order (Attachments: # 1 Exhibit A)(Lapertosa, Max) (Entered: 09/17/2007)
192 NOTICE of Motion by Max P Lapertosa for presentment of motion to amend/correct 191 before Honorable James F. Holderman on 9/20/2007 at 09:00 AM. (Lapertosa, Max) (Entered: 09/17/2007)
193 ATTORNEY Appearance of Alexandra Relias for Mt. St. Joseph (Relias, Alexandra) (Entered: 09/17/2007)
194 ATTORNEY Appearance for Respondent Mt. St. Joseph by Michael Anthony Airdo (Airdo, Michael) (Entered: 09/17/2007)
195 MINUTE entry before Judge Martin C. Ashman :Motion hearing held on 9/18/2007 regarding motion to compel 186 . Any party to the lawsuit may file a response to plaintiffs' motion to compel 186 by 10/9/2007. Replies due by 10/16/2007. Oral argument on plaintiffs' motion to compel compliance with subpoenas 186 set for 10/19/2007 at 02:00 PM. Mailed notice. (is, ) (Entered: 09/18/2007)
196 MINUTE entry before Judge James F. Holderman : Plaintiffs' unopposed motion to amend scheduling order 191 is granted. Plaintiff shall comply with FRCP(26)(a)(2) by 2/15/2008. Defendant shall comply with FRCP(26)(a)(2) by 4/15/2008. Fact discovery ordered closed by 2/15/2008. Expert discovery ordered closed by 5/15/2008. Dispositive motions with supporting memoranda due by 6/20/2008; responses due by 7/25/2008. Replies due by 8/8/2008. Plaintiffs' final list of witnesses due by 7/14/2008; defendants' final list of witnesses due by 8/4/2008. Plaintiffs' rebuttal list due by 8/18/2008. Final Pretrial Order due by 9/5/2008. Motions in limine with supporting memoranda due by 9/12/2008; responses due by 9/19/2008. Final Pretrial Conference set for 10/6/2008 at 4:00 PM. Bench Trial set for 10/20/2008 at 9:00 AM. Mailed notice (am) (Entered: 09/21/2007)
197 RESPONSE by Mt. St. Joseph to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel compliance with subpoenas 186 (Relias, Alexandra) (Entered: 10/09/2007)
198 RESPONSE by Carthage Terrace, Chamness Square, Curtis Court, Davies Square, Freeport Terrace, Lawrence Place, Lincoln Terrace, Matteson Court, Prairie House, Quincy Terrace, Schultz House, Seborg Terrace, St. Mary's Square Living Center, Stevens House, Trulson House, Wetheraell Place, Parents and Friends of the Specialized Living Center to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 42 of 82

10/09/2007 10/09/2007 10/09/2007 10/09/2007
10/09/2007 10/11/2007 10/16/2007 10/19/2007
10/24/2007 11/14/2007 11/14/2007
11/27/2007
11/27/2007

compliance with subpoenas 186 (Attachments: # 1 Exhibit Facility, Name Address# 2 Exhibit Letter to Mr. Lapertosa# 3 Exhibit Affidavit of J. Michael Bibo)(Choslovsky, William) (Entered: 10/09/2007)
199 MEMORANDUM by Lauren Axelrod, Craig Miller, Karmen Razman, Genevieve Benner, Matthew Nilson, Maggie Murphy, Stacie Athansopoulos in Opposition to motion to compel, 186 (Attachments: # 1 Exhibit 1# 2 Exhibit 2# 3 Exhibit 3# 4 Exhibit 4# 5 Exhibit 5# 6 Exhibit 6# 7 Exhibit 7)(Marks, Jason) (Entered: 10/09/2007)
200 RESPONSE by Misericordia Home North to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel compliance with subpoenas 186 (Bingle, Robert) (Entered: 10/09/2007)
201 RESPONSE by Progressive Housing, Inc.in Opposition to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel compliance with subpoenas 186 (Attachments: # 1 Exhibit A)(Monberg, Jeffrey) (Entered: 10/09/2007)
202 RESPONSE by Riverside Foundation, Golfview Developmental Centerin Opposition to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel compliance with subpoenas 186 (Attachments: # 1 Exhibit Group Exhibit A)(Kiser, Thomas) (Entered: 10/09/2007)
203 NOTICE by Riverside Foundation, Golfview Developmental Center Notice of Filing, Certificate of Service (Kiser, Thomas) (Entered: 10/09/2007)
204 MINUTE entry before Judge Martin C. Ashman :Magistrate Judge Status hearing of 10/12/2007 is stricken. Mailed notice. (is, ) (Entered: 10/11/2007)
205 REPLY by Plaintiff Lorene Bierman in Support of Plaintiffs' Motion to Compel Compliance with Subpoenas (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C# 4 Exhibit D# 5 Exhibit E)(Enerson, Wendy) (Entered: 10/16/2007)
206 MINUTE entry before Judge Martin C. Ashman :Plaintiffs' motion to compel compliance with subpoenas 186 is taken under advisement. Ruling to be made by mail. Supplemental brief limited to three pages to be filed by 10/24/2007 regarding the Rule 45 cases which were just brought in today. Oral argument held on 10/19/2007 regarding motion to compel 186 . Mailed notice. (is, ) (Entered: 10/19/2007)
207 RESPONSE by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman In Support of Argument Re: Jurisdictional Limits of Rule 45 (Linsenmaier, Samuel) (Entered: 10/24/2007)
208 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to withdraw notice of motion 188 , memorandum in support of motion, 187 , motion to compel, 186 (Attachments: # 1 Exhibit A# 2 Exhibit B)(Lapertosa, Max) (Entered: 11/14/2007)
209 NOTICE by all plaintiffs re MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to withdraw notice of motion 188 , memorandum in support of motion, 187 , motion to compel, 186 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to withdraw notice of motion 188 , memorandum in support of motion, 187 , motion to compel, 186 208 (Lapertosa, Max) (Entered: 11/14/2007)
210 MINUTE entry before Judge Martin C. Ashman : Enter Memorandum Opinion and Order. Plaintiffs' motion to compel 186 is granted as to third−party respondencts Riverside Foundation and Golfview Developmental Center with the limitation that Riverside and Golfview shall produce responsive documents for the last three years only. (For further detail see separate order). Mailed notice (ar, ) (Entered: 11/29/2007)
211 MEMORANDUM Opinion and Order, signed by Judge Martin C. Ashman on 11/27/2007 210 . Mailed notice (ar, ) (Entered: 11/29/2007)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 43 of 82

11/29/2007
02/04/2008 02/04/2008 02/04/2008 02/07/2008
02/22/2008 02/22/2008 02/28/2008 04/21/2008 04/21/2008 04/22/2008
04/22/2008 04/24/2008 05/08/2008

212 TRANSCRIPT of proceedings for the following dates: 10/19/07 before the Honorable Martin C. Ashman. (ar, ). (Pursuant to the March 2011 Judicial Conference Policy requiring that remote access restrictions be implemented when placing scanned versions of previously filed paper documents on the record, this document is restricted to allow public access only at the Clerk's Office public access terminals.) Modified on 7/11/2018 (yap, ). (Main Document 212 replaced on 7/11/2018) (yap, ). (Entered: 11/29/2007)
213 ATTORNEY Appearance for Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman by Corey M. Shapiro (Shapiro, Corey) (Entered: 02/04/2008)
214 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to amend/correct set case scheduling order, order on motion to amend/correct, terminate deadlines and hearings, motion hearing,,,,,,,,,,,, 196 (Attachments: # 1 Exhibit A# 2 Exhibit B)(Shapiro, Corey) (Entered: 02/04/2008)
215 NOTICE of Motion by Corey M. Shapiro for presentment of motion to amend/correct, motion for relief,,,,,,,, 214 before Honorable James F. Holderman on 2/7/2008 at 09:00 AM. (Shapiro, Corey) (Entered: 02/04/2008)
216 MINUTE entry before Judge James F. Holderman : Plaintiffs' unopposed motion to modify scheduling order 214 is granted. The time for plaintiff to comply with FRCP(26)(a)(2) is extended until 3/1/2008. Defendant shall comply with FRCP(26)(a)(2) by 5/1/2008. Fact discovery order extended until 3/1/2008. Expert discovery ordered closed by 6/1/2008. All other dates remain in effect. Mailed notice (am) (Entered: 02/08/2008)
217 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to amend/correct order on motion to amend/correct, terminate hearings, motion hearing, set case scheduling order,,,, 216 (Unopposed) (Attachments: # 1 Exhibit A)(Lapertosa, Max) (Entered: 02/22/2008)
218 NOTICE of Motion by Max P Lapertosa for presentment of motion to amend/correct, motion for relief,,,,,,,, 217 before Honorable James F. Holderman on 2/28/2008 at 09:00 AM. (Lapertosa, Max) (Entered: 02/22/2008)
219 MINUTE entry before Judge James F. Holderman : Plaintiffs' unopposed motion to amend scheduling order 217 is granted. Plaintiffs' Rule 26(a)(2) expert disclosures are due on 3/3/2008 except for disclosures as to expert Dr. Gant, which will due on 3/10/2008. Mailed notice (am) (Entered: 02/29/2008)
220 MOTION by Defendants Barry S Maram, Carol L Adams for extension of time for disclosure of Defendants' experts (Attachments: # 1 Affidavit of Gregory Kipper)(Stratton, Brent) (Entered: 04/21/2008)
221 NOTICE of Motion by Brent Douglas Stratton for presentment of extension of time 220 before Honorable James F. Holderman on 4/24/2008 at 09:00 AM. (Stratton, Brent) (Entered: 04/21/2008)
222 RESPONSE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Biermanin Opposition to MOTION by Defendants Barry S Maram, Carol L Adams for extension of time for disclosure of Defendants' experts 220 (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C)(Lapertosa, Max) (Entered: 04/22/2008)
223 NOTICE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman re response in opposition to motion, 222 of Defendants for Extension of Time for Disclosure of Experts (Lapertosa, Max) (Entered: 04/22/2008)
224 MINUTE entry before Judge Honorable James F. Holderman: Defendants Barry S Maram, Carol L Adams' motion for extension of time for disclosure of Defendants' experts 220 is denied. Mailed notice (am) (Entered: 04/29/2008)
225 MINUTE entry before Judge Honorable Martin C. Ashman: Settlement Conference set for 7/16/2008 at 02:00 PM., in chambers 1366. All clients and parties with full authority to settle are to be physically present. Failure to have parties with full

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 44 of 82

05/14/2008
05/14/2008 05/16/2008 05/16/2008 05/16/2008
05/16/2008 05/16/2008 05/20/2008 05/22/2008 05/30/2008
06/06/2008 06/09/2008 06/09/2008

authority to settle present may result in the imposition of severe sanctions. (For further details see standing order on the court's web site at www.ilnd.uscourts.gov.) Mailed notice. (is, ) (Entered: 05/08/2008)
226 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel Responses To Plaintiffs' Requests For Production Of Documents And Interrogatories And For Leave To Seek Additional Third−Party Discovery (Attachments: #(1) Exhibit A (deleted), #(2) Exhibit B, #(3) Exhibit C, #(4) Exhibit D, #(5) Exhibit E, #(6) Exhibit F. #(7) Replaced Exhibit A). (Shapiro, Corey). (Text edited by Clerk's Office.) (ar, ). Modified on 7/2/2008 (ar, ). (Entered: 05/14/2008)
227 NOTICE of Motion by Corey M. Shapiro for presentment of motion to compel, 226 before Honorable Martin C. Ashman on 5/20/2008 at 10:30 AM. (Shapiro, Corey) (Entered: 05/14/2008)
228 MOTION by counsel for Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, David Cicarelli, Lorene Bierman to withdraw as attorney for Plaintiffs (Lapertosa, Max) (Entered: 05/16/2008)
229 NOTICE of Motion by Max P Lapertosa for presentment of motion to withdraw as attorney 228 before Honorable James F. Holderman on 5/22/2008 at 09:00 AM. (Lapertosa, Max) (Entered: 05/16/2008)
230 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to amend/correct MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel Responses To Plaintiffs' Requests For Production Of Documents And Interrogatories And For Leave To Seek Additi 226 (Attachments: # 1 Exhibit Exhibit A)(Shapiro, Corey) (Entered: 05/16/2008)
231 NOTICE of Motion by Corey M. Shapiro for presentment of motion to amend/correct, motion for relief,, 230 before Honorable Martin C. Ashman on 5/20/2008 at 10:30 AM. (Shapiro, Corey) (Entered: 05/16/2008)
232 RESPONSE by Barry S Maram, Carol L Adamsin Opposition to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel Responses To Plaintiffs' Requests For Production Of Documents And Interrogatories And For Leave To Seek Additi 226 (Stratton, Brent) (Entered: 05/16/2008)
233 MINUTE entry before the Honorable Martin C. Ashman: Plaintiffs' motion to compel 226 is granted in part and denied in part per the oral rulings stated in open court. Order to be submitted by the parties. Motion hearing held on 5/20/2008 regarding motion to compel 226 . Mailed notice. (is, ) (Entered: 05/20/2008)
234 MINUTE entry before the Honorable James F. Holderman: Attorney Max Lapertosa's motion to withdraw as attorney for the plaintiffs 228 is granted. Attorney Max P Lapertosa terminated. Mailed notice (am) (Entered: 05/23/2008)
235 TRANSCRIPT of proceedings for the following dates: 5/20/08; Before the Honorable Martin C. Ashman. (Pursuant to the March 2011 Judicial Conference Policy requiring that remote access restrictions be implemented when placing scanned versions of previously filed paper documents on the record, this document is restricted to allow public access only at the Clerk's Office public access terminals.) (ef, ) Modified on 7/11/2018 (yap, ). (Entered: 05/30/2008)
236 MOTION by counsel for Respondent Mt. St. Joseph to withdraw as attorney (Relias, Alexandra) (Entered: 06/06/2008)
237 LIMITED Objection by Plaintiffs to the Magistrate Judge Ashman's May 20, 2008, Ruling 233 on Plaintiffs' Motion to Compel Supplemental Responses. (Shapiro, Corey). (Text edited by Clerk's Office). Modified on 6/10/2008 (ar, ). (Entered: 06/09/2008)
238 MEMORANDUM of Law by Plaintiffs in support of their limited objection 237 to Magistrate Judge Ashman's May 20, 2008 ruling on Plaintiffs' motion to compel supplemental response: (Attachments: #(1) Exhibit A). (Shapiro, Corey). (Text edited

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06/09/2008 06/12/2008
06/12/2008 06/12/2008 06/26/2008 06/27/2008
06/27/2008 07/03/2008 07/09/2008 07/11/2008 07/11/2008 07/14/2008 07/15/2008

by Clerk's Office). Modified on 6/10/2008 (ar, ). (Entered: 06/09/2008)
239 NOTICE of Motion by Corey M. Shapiro for presentment of Plaintiffs' limited objection 237 to Magistrate Judge Ashman's May 20, 2008, ruling on Plaintiffs' motion to compel supplemental authority, before Honorable James F. Holderman on 6/12/2008 at 09:00 AM. (Shapiro, Corey). (Text edited by Clerk's Office). Modified on 6/10/2008 (ar, ). (Entered: 06/09/2008)
240 MINUTE entry before the Honorable James F. Holderman: On plaintiffs' limited objection to the Magistrate's May 20, 2008 ruling on plaintiffs' motion to compel supplemental responses 237 , response due by 6/26/2008; reply due by 7/3/2008. The Court will rule electronically. Parties state that there is a settlement conference before Magistrate Judge Ashman on 7/16/2008. The schedule set on 9/20/2007 to stand and plaintiffs' final list of witnesses due by 7/14/2008; defendants' final list of witnesses due by 8/4/2008. Plaintiffs' rebuttal list due by 8/18/2008. Final Pretrial Order due by 9/5/2008. Motions in limine with supporting memoranda due by 9/12/2008; responses due by 9/19/2008. Final Pretrial Conference set for 10/6/2008 at 4:00 PM. Bench Trial set for 10/20/2008 at 9:00 AM. Mailed notice (am) (Entered: 06/13/2008)
241 MINUTE entry before the Honorable Martin C. Ashman: Enter Order regarding plaintiffs' motion to compel responses to plaintiffs' requests for production of documents and interrogatories and for leave to seek additional third−party discovery 226 . (For further detail see separate order). Mailed notice (ar, ) (Entered: 06/13/2008)
242 ORDER, signed by the Honorable Martin C. Ashman on 6/12/2008 241 . Mailed notice (ar, ) (Entered: 06/13/2008)
243 RESPONSE by Defendants to Plaintiff's limited objection 238 (Attachments: #(1) Exhibit A, #(2) Exhibit B, #(3) Exhibit C). (Stratton, Brent). (Text edited by Clerk's Office.) Modified on 6/27/2008 (ar, ). (Entered: 06/26/2008)
244 MINUTE entry before the Honorable Martin C. Ashman: Enter Order. Plaintiffs' motion to substitute corrected Exhibit A attached to plaintiffs' motion to compel responses to plaintiffs' requests for production of documents and interrogatories and for leave to seek additional third−party discovery 230 is granted. Exhibit A to plaintiffs' motion to compel responses to plaintiffs' request for production of documents and interrogatories and for leave to seek additional third−party discovery 226 shall be stricken and replaced with the corrected Exhibit A, as attached to the motion 230 . (For further detail see separate order.) Mailed notice (ar, ) Modified on 7/2/2008 (ar, ). (Entered: 07/02/2008)
245 ORDER, signed by the Honorable Martin C. Ashman on 6/27/2008 244 . Mailed notice (ar, ) (Entered: 07/02/2008)
246 REPLY by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to motion for miscellaneous relief 237 (Shapiro, Corey) (Entered: 07/03/2008)
247 MINUTE entry before the Honorable James F. Holderman: For the reasons set forth in the Statement section below, "Plaintiffs' Limited Objection to the Magistrate's May 20, 2008 Ruling on Plaintiffs' Motion to Compel Supplemental Responses" 237 is overruled. Mailed notice (am) (Entered: 07/10/2008)
248 MOTION by Defendants Barry S Maram, Carol L Adams to reset settlement conference (Stratton, Brent) (Entered: 07/11/2008)
249 NOTICE of Motion by Brent Douglas Stratton for presentment of motion to reset 248 before Honorable Martin C. Ashman on 7/15/2008 at 10:30 AM. (Stratton, Brent) (Entered: 07/11/2008)
250 WITNESS List by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman (Enerson, Wendy) (Entered: 07/14/2008)
251 MOTION by counsel for Respondent Mt. St. Joseph to withdraw as attorney (Attachments: # 1 Notice of Filing Notice of Motion)(Relias, Alexandra) (Entered: 07/15/2008)

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07/15/2008 07/18/2008 07/18/2008 07/18/2008 07/22/2008
08/04/2008 08/15/2008 08/18/2008

252 MINUTE entry before the Honorable Martin C. Ashman: Defendants' motion to reset settlement conference 248 is granted. Motion hearing held on 7/15/2008 regarding motion to reset 248 . Settlement Conference reset to 8/20/2008 at 01:30 PM. Mailed notice. (is, ) (Entered: 07/15/2008)
253 NOTICE of Motion by Alexandra Catherine Relias for presentment of motion to withdraw as attorney 251 before Honorable Martin C. Ashman on 7/22/2008 at 10:00 AM. (Relias, Alexandra) (Entered: 07/18/2008)
254 MINUTE entry before the Honorable Martin C. Ashman: Settlement Conference of 8/20/2008 is reset to 9/3/2008 at 01:30 PM., by agreement of the parties. Mailed notice. (is, ) (Entered: 07/18/2008)
255 MINUTE entry before the Honorable Martin C. Ashman: Mount St. Joseph's motion to withdraw attorneys of record 251 is reset to 7/22/2008 at 10:30 AM. Mailed notice. (is, ) (Entered: 07/18/2008)
256 MINUTE entry before the Honorable Martin C. Ashman: Michael A. Airdo and Alexandra C. Relias' motion for leave to withdraw as attorneys of record for subpoena respondent Mount St. Joseph 236 , 251 is granted. Motion hearing held on 7/22/2008 regarding motion to withdraw as attorney 236 , 251 . Attorneys Michael Anthony Airdo and Alexandra Catherine Relias terminated. Mailed notice. (is, ) (Entered: 07/22/2008)
257 Defendants' Witness List by Barry S Maram, Carol L Adams (Stratton, Brent) (Entered: 08/04/2008)
258 ATTORNEY Appearance for Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman by Edward B. Mullen, III (Mullen, Edward) (Entered: 08/15/2008)
259 TRANSCRIPT OF PROCEEDINGS held on 06/12/08 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

08/29/2008 08/29/2008
08/29/2008 09/03/2008 09/03/2008 09/04/2008

Redaction Request due 9/8/2008. Redacted Transcript Deadline set for 9/18/2008. Release of Transcript Restriction set for 11/17/2008. (Conway, Colleen) (Entered: 08/18/2008)
260 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Biermanin limine to Preclude Testimony of Certain Defense Witnesses (Shapiro, Corey) (Entered: 08/29/2008)
261 MEMORANDUM by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman in support of motion in limine 260 to Preclude Testimony of Certain Defense Witnesses (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C)(Shapiro, Corey) (Entered: 08/29/2008)
262 NOTICE of Motion by Corey M. Shapiro for presentment of motion in limine 260 before Honorable James F. Holderman on 9/4/2008 at 09:00 AM. (Shapiro, Corey) (Entered: 08/29/2008)
263 WITNESS List by Barry S Maram, Carol L Adams (Stratton, Brent) (Entered: 09/03/2008)
264 MINUTE entry before the Honorable Martin C. Ashman: Settlement conference held on 9/3/2008; and continued to 9/19/2008 at 02:00 PM. Mailed notice. (is, ) (Entered: 09/04/2008)
265 MINUTE entry before the Honorable James F. Holderman: Plaintiffs' motion in limine to Preclude Testimony of Certain Defense Witnesses 260 is moot by the revision of

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09/05/2008
09/05/2008 09/12/2008 09/12/2008 09/12/2008 09/12/2008 09/12/2008 09/16/2008 09/16/2008 09/19/2008 09/19/2008 09/19/2008 09/19/2008 09/25/2008

witness list by defense counsel. Mailed notice (am) (Entered: 09/05/2008)
266 PROPOSED Pretrial Order (Attachments: # 1 Exhibit A: Agreed Statement of Uncontested Facts, # 2 Exhibit C−1: Plaintiffs' Trial Exhibit List, # 3 Exhibit C−2: Defendants' Trial Exhibit List, # 4 Exhibit D−1 Plaintiffs' Witness List, # 5 Exhibit D−2: Defendants' Exhibit List, # 6 Exhibit E: Summary of Plaintiffs' Expert Testimony, # 7 Exhibit F−1: Plaintiffs' Deposition Designations, # 8 Exhibit F−2: Defendants' Deposition Designations, # 9 Exhibit K: Agreed Statement of Contested Issues of Fact and Law, # 10 Exhibit M−1: Plaintiffs' Proposed Findings of Fact and Conclusions of Law, # 11 Exhibit M−2: Defendants' Proposed Findings of Fact and Conclusions of Law)(Enerson, Wendy) (Entered: 09/05/2008)
267 NOTICE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman re proposed pretrial order,, 266 (Enerson, Wendy) (Entered: 09/05/2008)
268 MOTION by Defendants Barry S Maram, Carol L Adamsin limine to Preclude Testimony of Certain of Plaintiffs' Witnesses (Stratton, Brent) (Entered: 09/12/2008)
269 MEMORANDUM OF LAW in Support by Defendants Barry S Maram, Carol L Adamsin limine Memorandum of Law in Support of Defendants' Motion in Limine (Attachments: # 1 Exhibit A)(Stratton, Brent) Text Modified by the Clerk's Office on 9/16/2008 (mjc, ). (Entered: 09/12/2008)
270 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman Trial Witness Sequestration and Communications (Shapiro, Corey) (Entered: 09/12/2008)
271 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Biermanin limine With Respect To Max E. Chmura (Shapiro, Corey) (Entered: 09/12/2008)
272 MEMORANDUM by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman in support of motion in limine 271 re Max E. Chmura (Attachments: # 1 Exhibit A − Part 1, # 2 Exhibit A − Part 2, # 3 Exhibit A − Part 3, # 4 Exhibit A − Part 4)(Shapiro, Corey) (Entered: 09/12/2008)
273 MINUTE entry before the Honorable Martin C. Ashman: William Choslovsky's motion to withdraw as attorney 189 is set for 9/19/2008 at 02:00 PM. Mailed notice. (is, ) (Entered: 09/16/2008)
274 MINUTE entry before the Honorable Martin C. Ashman:William Choslovsky motion to withdraw as attorney for respondent Aspire on Eastern 189 is granted per the oral argument of 10/19/2007. Attorney William Choslovsky terminated. Mailed notice. (is, ) (Entered: 09/16/2008)
275 RESPONSE by Barry S Maram, Carol L Adams to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Biermanin limine With Respect To Max E. Chmura 271 (Stratton, Brent) (Entered: 09/19/2008)
276 RESPONSE by Barry S Maram, Carol L Adams to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman Trial Witness Sequestration and Communications 270 (Stratton, Brent) (Entered: 09/19/2008)
277 RESPONSE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Biermanin Opposition to MOTION by Defendants Barry S Maram, Carol L Adamsin limine to Preclude Testimony of Certain of Plaintiffs' Witnesses 268 (Shapiro, Corey) (Entered: 09/19/2008)
278 MINUTE entry before the Honorable Martin C. Ashman: Settlement conference held on 9/19/2008; and continued to 9/26/2008 at 01:00 PM. Mailed notice. (is, ) (Entered: 09/19/2008)
279 MINUTE entry before the Honorable James F. Holderman: Defendants' Motion In Limine to Preclude Testimony of Certain of Plaintiffs' Witnesses 268 is denied. Mailed notice (am) (Entered: 09/25/2008)

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09/25/2008
09/25/2008 09/26/2008
09/29/2008 09/29/2008 10/02/2008 10/06/2008 10/06/2008 10/06/2008 10/08/2008
10/08/2008 10/09/2008 10/14/2008

280 MINUTE entry before the Honorable James F. Holderman: Plaintiffs' Motion Regarding Trial Witness Sequestration and Communications 270 is granted to the extent that Fed.R.Evid. 615 will be followed. Counsel are to survey the courtroom during the trial to ensure compliance with Fed.R.Evid. 615. The Court finds that of the plaintiffs' proposed expert witnesses, only Dr. Sue Gant has been shown to come within the exclusion set out in Fed.R.Evid. 615(3). Mailed notice (am) (Entered: 09/25/2008)
281 MINUTE entry before the Honorable James F. Holderman: Plaintiffs' Motion In Limine With Respect to Max E. Chmura 271 is granted to the extent that Mr. Chmura will not be permitted to opine under Fed.R.Evid. 702, 703 or 705, but may, upon a proper foundational showing, be allowed to testify under Fed.R.Evid. 701. Mailed notice (am) (Entered: 09/25/2008)
282 MINUTE entry before the Honorable Martin C. Ashman: The Court was informed by the parties that progress has been made for settlement and they can proceed further without intervention by the Court. Accordingly, the referral is now complete. All matters relating to the referral of this action having been resolved, the case is returned to the assigned judge. Judge Honorable Martin C. Ashman no longer referred to the case. Mailed notice. (is, ) (Entered: 09/26/2008)
283 MOTION by Intervenor Parties Thomas Patrick Arundel, Jeffrey Dralle, Kirk Hartemayer, Thomas Kerrigan, Craig Miller, Kristin Ward, Elizabeth Flesch to intervene − Misericordia Residents' Motion For Intervention Pursuant To FED. R. CIV. P. 24 (Attachments: # 1 Exhibit 1)(Choslovsky, William) (Entered: 09/29/2008)
284 NOTICE of Motion by William Choslovsky for presentment of motion to intervene, 283 before Honorable James F. Holderman on 10/2/2008 at 09:00 AM. (Choslovsky, William) (Entered: 09/29/2008)
287 MINUTE entry before the Honorable James F. Holderman: Misericordia Residents' Motion for intervention pursuant to Fed.R.Civ.P. 24 283 is denied. Plaintiffs' counsel to provide the expert report that Ms. Gant has prepared; the confidentiality agreement shall be maintained by residents' counsel. Mailed notice (am) (Entered: 10/06/2008)
285 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to compel Production of Documents Withheld on the Basis of Insufficient Claims of Deliberative Process Privilege (Attachments: # 1 Exhibit A)(Shapiro, Corey) (Entered: 10/06/2008)
286 NOTICE of Motion by Corey M. Shapiro for presentment of motion to compel, 285 before Honorable James F. Holderman on 10/9/2008 at 09:00 AM. (Shapiro, Corey) (Entered: 10/06/2008)
288 MINUTE entry before the Honorable James F. Holderman: Final pretrial conference held on 10/6/2008. Mailed notice (am) (Entered: 10/08/2008)
289 MOTION by Intervenor Parties Thomas Patrick Arundel, Jeffrey Dralle, Kirk Hartemayer, Thomas Kerrigan, Craig Miller, Kristin Ward, Elizabeth Flesch for reconsideration regarding order on motion to intervene, terminate hearings, motion hearing, add and terminate parties,,,, 287 − Misericordia Residents' Motion For Reconsideration For Intervention Pursuant To Fed.R.Civ.P. 24 (Attachments: # 1 Exhibit A)(Choslovsky, William) (Entered: 10/08/2008)
290 NOTICE of Motion by William Choslovsky for presentment of motion for reconsideration, motion for relief,,,,,,,, 289 before Honorable James F. Holderman on 10/14/2008 at 09:00 AM. (Choslovsky, William) (Entered: 10/08/2008)
291 MINUTE entry before the Honorable James F. Holderman: Plaintiffs' motion to compel Production of Documents Withheld on the Basis of Insufficient Claims of Deliberative Process Privilege 285 is moot; the issues will be addressed at trial. Trial will commence on 10/20/2008 at 9:00 AM. Mailed notice (am) (Entered: 10/10/2008)
292 TRANSCRIPT OF PROCEEDINGS held on 10/02/08 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 49 of 82

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

10/14/2008 10/22/2008

Redaction Request due 11/4/2008. Redacted Transcript Deadline set for 11/14/2008. Release of Transcript Restriction set for 1/12/2009. (Conway, Colleen) (Entered: 10/14/2008)
293 MINUTE entry before the Honorable James F. Holderman: Misericordia Residents' Motion For Reconsideration For Intervention Pursuant To Fed.R.Civ.P. 24 289 is denied. In chambers conference held on 10/14/2008. Counsel for the parties have reported an agreement in principal and request thirty (30) days to resolve case. To accommodate parties, bench trial date of 10/20/2008 is reset for 11/17/2008 at 9:00 AM. Status hearing set for 11/13/2008 at 9:00 AM. Mailed notice (am) (Entered: 10/16/2008)
294 TRANSCRIPT OF PROCEEDINGS held on 10/14/08 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

11/13/2008 11/13/2008 11/13/2008 11/20/2008
11/20/2008 11/20/2008 12/01/2008

Redaction Request due 11/12/2008. Redacted Transcript Deadline set for 11/24/2008. Release of Transcript Restriction set for 1/20/2009. (Conway, Colleen) (Entered: 10/22/2008)
295 Proposed Consent Decree by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman (Hartman, Kendra) (Entered: 11/13/2008)
296 NOTICE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman re other 295 Notice of Filing of Proposed Consent Decree (Hartman, Kendra) (Entered: 11/13/2008)
297 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 11/13/2008 and is continued for 12/4/2008 at 9:00 AM. Parties to submit settlement materials by 11/25/2008. Trial date of 11/17/2008 is stricken. Mailed notice (am) (Entered: 11/14/2008)
298 JOINT Motion by Plaintiffs and Defendants Barry Maram and Carol Adams for modification of class definition and prelimary approval of consent decree: (Attachments: #(1) Exhibit A (Proposed Consent Decree); #(2) Exhibit B (Notice Plan); #(3) Exhibit B−1 (Proposed Publication Notice); #(4) Exhibit B−2 (Proposed Mailed Notice); #(5) Exhibit C (Proposed Order)). (Hartman, Kendra). (Text edited by Clerk's Office) Modified on 12/3/2008 (ar, ). (Entered: 11/20/2008)
299 MEMORANDUM by Plaintiffs in support of joint motion for modification of class definition and preliminary approval of consent decree 298 . (Hartman, Kendra). (Text edited by Clerk's Office.) Modified on 12/3/2008 (ar, ). (Entered: 11/20/2008)
300 NOTICE of Motion by Kendra Kekelis Hartman for presentment of joint motion for for modification of class definition and preliminary approval of consent decree 298 before Honorable James F. Holderman on 12/4/2008 at 09:00 AM. (Hartman, Kendra). (Text edited by Clerk's Office.) Modified on 12/3/2008 (ar, ). (Entered: 11/20/2008)
301 TRANSCRIPT OF PROCEEDINGS held on 11/13/08 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

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IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

12/03/2008 12/03/2008 12/03/2008 12/03/2008
12/03/2008 12/04/2008 12/15/2008 12/17/2008 12/17/2008
12/17/2008 12/18/2008

Redaction Request due 12/22/2008. Redacted Transcript Deadline set for 1/2/2009. Release of Transcript Restriction set for 3/2/2009. (Conway, Colleen) (Entered: 12/01/2008)
302 Objection to Proposed Notice Plan and Schedule for Filing Objections by Samuel Golden on behalf of Anne Golden (Attachments: # 1 Exhibit A)(Ducayet, James) (Entered: 12/03/2008)
303 MEMORANDUM by Lauren Axelrod, Craig Miller, Karmen Razman, Genevieve Benner, Matthew Nilson, Maggie Murphy, Stacie Athansopoulos in Opposition to motion for miscellaneous relief, 298 (Mendel, Scott) (Entered: 12/03/2008)
304 ATTORNEY Appearance for Proposed Interveners (Choslovsky, William) (Entered: 12/03/2008)
305 OBJECTIONS by Andrew Battle, Ernest Stark, John McDermott, Britton Rickerson, Lucas Gaynor to MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Biermanfor Preliminary Approval of Consent Decree and Modification of Class Definition (Joint)MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Biermanfor Preliminary Approval of Consent Decree and Modification of Class Definition (Joint) 298 , notice of filing 296 , memorandum in support of motion 299 , notice of motion, 300 , other 295 , terminate hearings, status hearing, set/reset hearings 297 − Objection To Proposed Settlement, Notice Procedures, And Preliminary Approval Of Consent Decree (Attachments: # 1 Exhibit 1, # 2 Exhibit 2)(Choslovsky, William) (Entered: 12/03/2008)
306 ATTORNEY Appearance Legal Guardians − Objectors − CORRECTED (Choslovsky, William) (Entered: 12/03/2008)
307 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 12/4/2008 and is continued for 12/18/2008 at 9:00 AM. On plaintiffs' motion for modification of class definition and preliminary approval of consent decree 298 , reply to any remaining objections due by 12/15/2008. Mailed notice (am) (Entered: 12/08/2008)
308 REPLY by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to motion for miscellaneous relief, 298 In Support of Joint Motion for Modification of Class Definition And Preliminary Approval of Consent Decree (Attachments: # 1 Exhibit A, # 2 Exhibit A−1, # 3 Exhibit A−2, # 4 Exhibit B, # 5 Exhibit C)(Shapiro, Corey) (Entered: 12/15/2008)
309 JOINT Response to Revised Notice Plan by Movants Lauren Axelrod, Craig Miller, Karmen Razman, Genevieve Benner, Matthew Nilson, Maggie Murphy, Stacie Athansopoulos: (Attachments: #(1) Exhibit A). (Mendel, Scott). (Text edited by Clerk's Office.) Modified on 12/18/2008 (ar, ). (Entered: 12/17/2008)
310 RESPONSE by Objectors Andrew Battle, Ernest Stark, John McDermott, Britton Rickerson, Lucas Gaynor to motion for miscellaneous relief, 298 , memorandum in support of motion 299 , reply, 308 −Joint Response Of Misericordia Waiting List Residents To The Revised Notice Plan, Modification Of Class Definition, And Preliminary Approval Of Proposed Settlement (Attachments: # 1 Exhibit 1)(Choslovsky, William) (Entered: 12/17/2008)
311 REPLY by Defendants Barry S Maram, Carol L Adams to motion for miscellaneous relief, 298 in support of joint motion for modification of class definition and preliminary approval of consent decree (Stratton, Brent) (Entered: 12/17/2008)
312 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 12/18/2008 and is continued for 2/19/2009 at 9:00 AM. Parties' joint motion for

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12/19/2008 12/30/2008

modification of class definition and preliminary approval of consent decree 298 will be referred by lot to a Magistrate Judge for report and recommendation. Mailed notice (am) (Entered: 12/18/2008)
313 EXECUTIVE COMMITTEE ORDER:Case referred to the Honorable Jeffrey Cole to conduct necessary proceedings and issue Report and Recommendation on dispositive motion, specifically, parties' joint motion for modification of class definition and preliminary approval of consent decree 298 , signed by Executive Committee on 12/19/08. (For further detail see Order.) Mailed notice(ar, ) Modified on 1/15/2009 (ar, ). (Entered: 12/22/2008)
314 TRANSCRIPT OF PROCEEDINGS held on 12/04/08 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

02/10/2009 02/19/2009 03/05/2009
03/20/2009
03/24/2009 03/24/2009 03/25/2009 03/26/2009 03/26/2009 03/26/2009

Redaction Request due 1/20/2009. Redacted Transcript Deadline set for 1/30/2009. Release of Transcript Restriction set for 3/30/2009. (Conway, Colleen) (Entered: 12/30/2008)
315 NOTICE by William Choslovsky of Change of Address (Choslovsky, William) (Entered: 02/10/2009)
316 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 2/19/2009. Parties to file a written status report by 3/5/2009. Mailed notice (am) (Entered: 02/19/2009)
317 STATUS Report by Andrew Battle, Ernest Stark, John McDermott, Britton Rickerson, Lucas Gaynor, Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, Barry S Maram, Carol L Adams, David Cicarelli, Lorene Bierman (Attachments: # 1 Exhibit Revised Mailed Notice)(Enerson, Wendy) (Entered: 03/05/2009)
318 MINUTE entry before the Honorable James F. Holderman: The court, having reviewed the parties' agreed "NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING," submits to counsel suggested changes for counsel's consideration. (See attached redlined version.) The court requests that counsel review the changes and submit through the Proposed_Order_Holderman@ilnd.uscourts.gov e−mail address their final draft of the Notice by March 26, 2009, so the court may issue the order no later than March 27, 2009. Judicial staff mailed notice (Attachments: # 1 Redlined version) (gl, ) (Entered: 03/20/2009)
319 MINUTE entry before the Honorable Jeffrey Cole:Status hearing set for 3/25/2009 at 11:00 AM.Mailed notice (cdh, ) (Entered: 03/24/2009)
320 STATUS Report in response to Court Order Dated March 20, 2009 by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, Barry S Maram, Carol L Adams, David Cicarelli, Lorene Bierman (Hartman, Kendra) (Entered: 03/24/2009)
321 MINUTE entry before the Honorable Jeffrey Cole:Status hearing held. Mailed notice (cdh, ) (Entered: 03/25/2009)
322 MINUTE entry before the Honorable James F. Holderman: Status hearing set for 4/7/2009 at 9:00 AM. Mailed notice (am) (Entered: 03/26/2009)
323 MINUTE entry before the Honorable James F. Holderman: Status hearing date of 4/7/2009 is reset for 3/31/2009 at 9:00 AM. Mailed notice (am) (Entered: 03/26/2009)
324 JOINT Status Report by Objectors in response to court order dated 03/20/09. (Choslovsky, William). (Text edited by Clerk's Office.) Modified on 3/27/2009 (ar, ). (Entered: 03/26/2009)

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03/31/2009 03/31/2009
03/31/2009 04/01/2009 04/01/2009 04/01/2009 04/06/2009

325 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 3/31/2009. Mailed notice (am) (Entered: 03/31/2009)
326 MINUTE entry before the Honorable James F. Holderman: The proposed class action settlement and proposed consent decree in this case have been preliminarily approved. A hearing on the fairness of the proposed settlement is set for 9:30 a.m. on July 1, 2009. Any class member's objection and request to speak at the hearing must be post−marked no later than June 15, 2009 and be in accordance with the requirements set forth in the "NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING" approved by the court on March 31, 2009. (For further detail see separate order.) Mailed notice (ar, ) (Entered: 03/31/2009)
327 NOTICE of Proposed Class Action Settlement and Hearing, signed by the Honorable James F. Holderman on 3/31/2009 326 . Mailed notice (ar, ) (Entered: 03/31/2009)
328 MINUTE entry before the Honorable James F. Holderman: To reduce the paper necessary to providing the "Notice" approved by the court on March 31, 2009, that "Notice" may be sent using a two−sided printing format.Judicial staff mailed notice (gl, ) (Entered: 04/01/2009)
329 MINUTE entry before the Honorable Jeffrey Cole:In light of Judge Holderman's Order of 3/31/09, the purpose of the referral is moot. All matters relating to the referral of this action having been resolved, the case is returned to the assigned judge. Mailed notice (cdh, ) (Entered: 04/01/2009)
330 MINUTE entry before the Honorable James F. Holderman: To reduce the paper necessary to providing the "Notice" approved by the court on March 31, 2009, that "Notice" may be sent using a two−sided printing format. Mailed notice (am) (Entered: 04/01/2009)
331 TRANSCRIPT OF PROCEEDINGS held on 03/31/09 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

04/13/2009 04/16/2009
04/16/2009
04/29/2009 05/18/2009 05/27/2009 05/28/2009 06/02/2009

Redaction Request due 4/27/2009. Redacted Transcript Deadline set for 5/7/2009. Release of Transcript Restriction set for 7/6/2009. (Conway, Colleen) (Entered: 04/06/2009)
332 MINUTE entry before the Honorable James F. Holderman: Status hearing set for 4/16/2009 at 9:00 AM. Mailed notice (am) (Entered: 04/13/2009)
333 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 4/16/2009. ENTER LEGAL NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING. Mailed notice (am) (Entered: 04/16/2009)
334 LEGAL NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING. Signed by the Honorable James F. Holderman on 4/16/2009: Mailed notice (am) (Entered: 04/16/2009)
335 LETTER to Judge Holderman from Barbara J. Fitzgerald dated 04/27/09. (ar, ) (Entered: 05/06/2009)
336 ELECTRONIC message from Jody Welch to Judge Holderman dated 5/18/09. (tlm) (Entered: 05/28/2009)
340 LETTER from Steven R. Decker dated 5/26/09. (mb, ) (Entered: 06/05/2009)
341 LETTER from William and Sally Thomas. (mb, ) (Entered: 06/05/2009)
337 Objection to Proposed Settlement by Burton A. Brown (Bakhtiari, Babak) (Entered: 06/02/2009)

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06/02/2009 06/04/2009
06/04/2009 06/05/2009 06/09/2009
06/09/2009
06/11/2009
06/11/2009 06/11/2009
06/11/2009
06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/15/2009
06/15/2009 06/15/2009 06/15/2009 06/15/2009
06/15/2009 06/15/2009

338 NOTICE by Burton A. Brown re other 337 Objection to Proposed Settlement (Bakhtiari, Babak) (Entered: 06/02/2009)
339 MINUTE entry before the Honorable James F. Holderman: By request of the parties, status hearing is set for 6/9/2009 at 9:00 AM. Mailed notice (am) (Entered: 06/04/2009)
345 OBJECTION to Proposed Settlement and Notice of intention to appear a the fairness hearing by Wayne Ryerson for Joyce Ryerson. (tlm) (Entered: 06/11/2009)
346 LETTER from Wendy Love Schuppan dated 5/28/09. (tlm) (Entered: 06/11/2009)
342 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 6/9/2009 and is continued for 6/11/2009 at 9:30 AM. Mailed notice (am) (Entered: 06/09/2009)
343 NOTICE by Lauren Axelrod, Craig Miller, Karmen Razman, Genevieve Benner, Matthew Nilson, Maggie Murphy, Stacie Athansopoulos (Mendel, Scott) (Entered: 06/09/2009)
344 NOTICE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D)(Hartman, Kendra) (Entered: 06/11/2009)
347 ATTORNEY Appearance (Sherwin, Judith) (Entered: 06/11/2009)
348 MINUTE entry before the Honorable James F. Holderman:Status hearing held on 6/11/2009. For the reasons stated in open court on 6/11/09, the text of paragraph 10 of the Proposed Consent Decree is denied by court order. Judicial staff mailed notice (gl, ) (Entered: 06/11/2009)
349 MINUTE entry before the Honorable James F. Holderman: A revised Consent Decree Order is to be submitted to the Court. Objectors' counsel's oral motion to file response by 6/22/09 is granted. The 6/29/09 remain as reply date.Judicial staff mailed notice (gl, ) (Entered: 06/12/2009)
350 Amended Objection to Proposed Class Action Settlement by Burton A. Brown (Bakhtiari, Babak) (Entered: 06/15/2009)
351 Notice of Intent to Appear at Fairness Hearing by Burton A. Brown (Bakhtiari, Babak) (Entered: 06/15/2009)
352 ATTORNEY Appearance on behalf of Certain Class Member Objectors (Baker, Warren) (Entered: 06/15/2009)
353 ATTORNEY Appearance for Objector Class Member Objectors by Erik Joseph Anderson (Anderson, Erik) (Entered: 06/15/2009)
354 ATTORNEY Appearance for Michael J. Gallagher, as Legal Guardian for Mary Anne Gallagher, Objector (Gallagher, Daniel) (Entered: 06/15/2009)
355 OBJECTIONS to Proposed Settlement and Notice of Intention to Appear at Fairness Hearing on behalf of Michael J. Gallagher, as Legal Guardian for Mary Anne Gallagher (Gallagher, Daniel) (Entered: 06/15/2009)
356 NOTICE by Michael J. Gallagher re objections 355 to Proposed Settlement and Notice of Intention to Appear at Fairness Hearing (Gallagher, Daniel) (Entered: 06/15/2009)
357 ATTORNEY Appearance (Ducayet, James) (Entered: 06/15/2009)
358 ATTORNEY Appearance (Lynn, Nicholas) (Entered: 06/15/2009)
359 ATTORNEY Appearance for Objector Parents and Friends of the Specialized Living Center by Nicholas James Lynn Notice of Intent to Appear at Fairness Hearing (Lynn, Nicholas) (Entered: 06/15/2009)
360 ATTORNEY Appearance for Objector Parents and Friends of the Specialized Living Center by Neville Maherji Bilimoria (Bilimoria, Neville) (Entered: 06/15/2009)
361 ATTORNEY Appearance for Objector Parents and Friends of the Specialized Living Center by Neville Maherji Bilimoria Notice of Intent to Appear at Fairness Hearing

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06/15/2009 06/15/2009
06/15/2009 06/15/2009 06/15/2009
06/15/2009
06/15/2009 06/15/2009
06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/15/2009 06/16/2009 06/16/2009

(Bilimoria, Neville) (Entered: 06/15/2009)
362 ATTORNEY Appearance (Lynn, Nicholas) (Entered: 06/15/2009)
363 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn John Hilgert, guardian for over 100 wards residing at Beverly Farm, Notice of Intent to Appear at Fairness Hearing (Lynn, Nicholas) (Entered: 06/15/2009)
364 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn Notice of Intent to Appear by Sara Giancola, guardian for Teresa Giancola, residing at Beverly Farm (Lynn, Nicholas) (Entered: 06/15/2009)
365 ATTORNEY Appearance for Objector Class Member Objectors by Erik Joseph Anderson Notice of Intent to Appear at Fairness Hearing (Anderson, Erik) (Entered: 06/15/2009)
366 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn Notice of Intent to Appear at Fairness Hearing by Patricia Downey, guardian for Catherine J. Wieberg, residing at Beverly Farm (Lynn, Nicholas) (Entered: 06/15/2009)
367 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn Notice of Intent to Appear at Fairness Hearing of Steven Decker, guardian for Alan Decker, residing at Beverly Farm (Lynn, Nicholas) (Entered: 06/15/2009)
368 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn Notice of Intent to Appear by Ann Siegler, sister of Patricia Seigler, residing at Beverly Farm (Lynn, Nicholas) (Entered: 06/15/2009)
369 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn Notice of Intent to Appear at Fairness Hearing by Edward A. Seigler, Jr., guardian for Patricia Seigler, residing at Beverly Farm (Lynn, Nicholas) (Entered: 06/15/2009)
370 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn Notice of Intent to Appear at Fairness Hearing by Nicholas J. Lynn, counsel for Beverly Class Members (Lynn, Nicholas) (Entered: 06/15/2009)
371 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Nicholas James Lynn Notice of Intent to Appear at Fairness Hearing by Neville Bilimoria, counsel for Beverly Class Members (Lynn, Nicholas) (Entered: 06/15/2009)
372 ATTORNEY Appearance for Objector Beverly Farm Foundation Class Members by Neville Maherji Bilimoria (Bilimoria, Neville) (Entered: 06/15/2009)
376 ATTORNEY Appearance by Jason T. Lundy on behalf of a class member objectors and their guardians. (tlm) (Entered: 06/16/2009)
377 ATTORNEY Appearance Matt J. Murer on behalf of a class member objectors and their guardians. (tlm) (Entered: 06/16/2009)
378 ATTORNEY Appearance Katheryn M. Stalmack on behalf of a class member objectors and their guardians. (tlm) (Entered: 06/16/2009)
379 OBJECTION to Proposed Settlement by Barbara A. Riley for class member, Elizabeth Ann Bartlett. (tlm) (Entered: 06/16/2009)
392 OBJECTIONS to Proposed settlement and notice of intention to appear at the fairness hearing by Mary Wessel for Anne L. Peterhans. (tlm) (Entered: 06/24/2009)
393 LETTER from Donna L. Free for Heather J. Dean dated 6/10/09. (tlm) (Entered: 06/24/2009)
373 ATTORNEY Appearance for The Misericordia Waiting List Objectors (Choslovsky, William) (Entered: 06/16/2009)
374 ATTORNEY Appearance Melissa Thomas (Attachments: # 1 Exhibit)(Thomas, Melissa) (Entered: 06/16/2009)

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06/16/2009 06/16/2009 06/17/2009 06/17/2009 06/17/2009 06/18/2009 06/18/2009 06/22/2009
06/22/2009 06/22/2009
06/22/2009
06/22/2009 06/22/2009

375 ATTORNEY Appearance Colin Haley (Attachments: # 1 Exhibit)(Haley, Colin) (Entered: 06/16/2009)
380 MOTION for Leave to Appear Pro Hac Vice Filing fee $ 50, receipt number 07520000000003846705. (Attachments: # 1 List of Clients)(Crain, William) (Entered: 06/16/2009)
381 MOTION for Leave to Appear Pro Hac Vice Filing fee $ 50, receipt number 07520000000003850801. (Attachments: # 1 Exhibit)(Thomas, Melissa) (Entered: 06/17/2009)
382 MOTION for Leave to Appear Pro Hac Vice Filing fee $ 50, receipt number 07520000000003850897. (Attachments: # 1 Exhibit)(Haley, Colin) (Entered: 06/17/2009)
383 ATTORNEY Appearance for Objector Class Member Objectors by William P Crain (Attachments: # 1 Exhibit A − List of Clients)(Crain, William) (Entered: 06/17/2009)
384 OBJECTIONS 139 Objections and 19 Objections Pursuant to Notice of Proposed Class Action Settlement and Hearing (Crain, William) (Entered: 06/18/2009)
394 OBJECTION to Proposed settlement and Notice of Intention to Appear at the Fairness Hearing by Robert L. Barr for Clarence Barr. (tlm) (Entered: 06/25/2009)
385 NOTICE by Stanley Ligas of Filing of Objections Received in Response to the Proposed Consent Decree (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D (1−61), # 5 Exhibit D (62−121), # 6 Exhibit D (122−181), # 7 Exhibit D (182−228), # 8 Exhibit D (229−279), # 9 Exhibit D (280−338), # 10 Exhibit D (339−404), # 11 Exhibit D (405−520), # 12 Exhibit D (521−630), # 13 Exhibit D (631−710), # 14 Exhibit D (711−780), # 15 Exhibit D (781−840), # 16 Exhibit D (841−905), # 17 Exhibit D (906−921), # 18 Exhibit D (922−1041), # 19 Exhibit D (1042−1055), # 20 Exhibit D (1056−1125), # 21 Exhibit D (1126−1190), # 22 Exhibit D (1191−1249), # 23 Exhibit D (1250−1318), # 24 Exhibit D (1319−1392), # 25 Exhibit D (1393−1460), # 26 Exhibit D (1461−1504), # 27 Exhibit D (1505−1560), # 28 Exhibit D (1561−1634), # 29 Exhibit D (1635−1750), # 30 Exhibit D (1751−1806), # 31 Exhibit D (1810−1871), # 32 Exhibit D (1872−1936), # 33 Exhibit D (1937−2015), # 34 Exhibit D (2016−2100), # 35 Exhibit D (2101−2189), # 36 Exhibit D (2190−2242), # 37 Exhibit D (2243−2291), # 38 Exhibit D (2292−2319), # 39 Exhibit D (2320−2370), # 40 Exhibit D (2371−2382), # 41 Exhibit E)(Hartman, Kendra) (Entered: 06/22/2009)
386 OBJECTIONS First Amended PFSLC Class Members' Objections to Proposed Consent Decree (Attachments: # 1 Exhibit Exhibit A (1 of 2), # 2 Errata Exhibit A (2 of 2), # 3 Exhibit Exhibit B, # 4 Exhibit Exhibit C, # 5 Exhibit Exhibit D)(Bilimoria, Neville) (Entered: 06/22/2009)
387 OBJECTIONS First Amended Beverly Class Members' Objections to Proposed Consent Decree (Attachments: # 1 Exhibit A (1 of 7), # 2 Exhibit A (2 of 7), # 3 Exhibit A (3 of 7), # 4 Exhibit A (4 of 7), # 5 Exhibit A (5 of 7), # 6 Exhibit A (6 of 7), # 7 Exhibit A (7 of 7), # 8 Exhibit B (1 of 5), # 9 Exhibit B (2 of 5), # 10 Exhibit B (3 of 5), # 11 Exhibit B (4 of 5), # 12 Exhibit B (5 of 5), # 13 Exhibit C, # 14 Exhibit D, # 15 Exhibit E, # 16 Exhibit F)(Lynn, Nicholas) (Entered: 06/22/2009)
388 MEMORANDUM by Misericordia Home North, Mt. St. Joseph Resident Objectors in Support of Objections to Proposed Consent Decree (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E, # 6 Exhibit F, # 7 Exhibit G, # 8 Exhibit H, # 9 Exhibit I, # 10 Exhibit J, # 11 Exhibit K, # 12 Exhibit L, # 13 Exhibit M, # 14 Exhibit N, # 15 Exhibit O, # 16 Exhibit P, # 17 Exhibit Q, # 18 Exhibit R, # 19 Exhibit S, # 20 Exhibit T)(Ducayet, James) (Entered: 06/22/2009)
389 OBJECTIONS Joinder and Memorandum of Misericordia Waiting List Objectors in Support of Objections to Proposed Consent Decree (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3, # 4 Certificate of Service)(Choslovsky, William) (Entered: 06/22/2009)
390 OBJECTIONS Joinder to Objections to Consent Decree (Attachments: # 1 Exhibit A)(Anderson, Erik) (Entered: 06/22/2009)

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06/22/2009 06/24/2009 06/24/2009 06/25/2009 06/25/2009 06/25/2009 06/26/2009 06/26/2009
06/26/2009 06/26/2009
06/29/2009 06/29/2009
06/29/2009 06/29/2009 06/30/2009

391 OBJECTIONS to Proposed Consent Decree by Guardians, Parents and Family Members of residents in state operated develipmental centers (SODCs). (tlm) (Entered: 06/23/2009)
399 JOINDER of 366 Class Member Objectors to Objections to Proposed Consent Decree ; Notice. (ef, ) (Entered: 06/26/2009)
400 JOINDER of 202 Class Member Objections to Otjections to proposed consent decree; Notice. (tlm) (Entered: 06/26/2009)
395 ATTORNEY Appearance by Misericordia Resident Objectors (Mendel, Scott) (Entered: 06/25/2009)
396 ATTORNEY Appearance for Objector Judith S. Sherwin by Judith Schwartz Sherwin Supplemental (Sherwin, Judith) (Entered: 06/25/2009)
397 OBJECTIONS Amendment to Exhibit A to First Amended Beverly Class Members' Objections to Proposed Consent Decree (Attachments: # 1 Exhibit A (Amended Document 387−7, Page 6 of 22))(Lynn, Nicholas) (Entered: 06/25/2009)
398 MOTION by Objector Colin M. Haley for joinder and memorandum of one hundred sixty two objectors and guardians of objectors in support of objections to proposed consent decree (Attachments: # 1 Exhibit)(Haley, Colin) (Entered: 06/26/2009)
401 NOTICE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman Supplemental Notice of Filing of Objections Received in Response to Proposed Consent Decree (Attachments: # 1 Exhibit Exhibit A, # 2 Exhibit Exhibit B, # 3 Exhibit Exhibit C, # 4 Exhibit Exhibit D (2383−2452))(Shapiro, Corey) (Entered: 06/26/2009)
402 MOTION by Objector Judith S. Sherwin for joinder Joinder and Memorandum (Sherwin, Judith) (Entered: 06/26/2009)
407 ATTORNEY Appearance for the 485 guardians, parents and family members of developmentally disabled persons presently served in the Nine State Operated Developmental Centers who wish to object to the proposed consent decree in the above−captioned case at the fairness hearing held on 7/1/2009 by Kevin Francis Burke. (tlm) (Entered: 06/30/2009)
403 RESPONSE by Defendants Barry S Maram, Carol L Adams to objections 389 , objections,, 387 , objections 391 , objections, 386 , memorandum,, 388 , objections 390 to Proposed Consent Decree (Attachments: # 1 Exhibit A, # 2 Exhibit B)(Stratton, Brent) (Entered: 06/29/2009)
404 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to file instanter memorandum (in response to objections and in support of final approval of consent decree) in excess of page limits (Attachments: # 1 Exhibit 1: Plaintiffs' Response to Objections and Memorandum in Support of Final Approval of Consent Decree, # 2 Exhibit A to Plaintiffs' Response, # 3 Exhibit B to Plaintiffs' Response, # 4 Exhibit C to Plaintiffs' Response, # 5 Exhibit D to Plaintiffs' Response, # 6 Exhibit E to Plaintiffs' Response, # 7 Exhibit F to Plaintiffs' Response, # 8 Exhibit G to Plaintiffs' Response, # 9 Exhibit H to Plaintiffs' Response, # 10 Exhibit I to Plaintiffs' Response, # 11 Exhibit J to Plaintiffs' Response, # 12 Exhibit K to Plaintiffs' Response, # 13 Exhibit L to Plaintiffs' Response, # 14 Exhibit M to Plaintiffs' Response)(Hartman, Kendra) (Entered: 06/29/2009)
405 NOTICE of Motion by Kendra Kekelis Hartman for presentment of motion to file instanter,,,, 404 before Honorable James F. Holderman on 7/1/2009 at 09:30 AM. (Hartman, Kendra) (Entered: 06/29/2009)
406 MINUTE entry before the Honorable James F. Holderman: Motions for Leave to Appear Pro Hac Vice [380, 381, 382] and Motion by Objector Colin M. Haley for Joinder 398 are granted. Mailed notice (am) (Entered: 06/30/2009)
408 MINUTE entry before the Honorable James F. Holderman: Plaintiffs' motion for leave to file memorandum in excess of page limits instanter 404 is granted. Mailed notice (am) (Entered: 06/30/2009)

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06/30/2009 06/30/2009 06/30/2009 07/01/2009
07/01/2009 07/02/2009 07/02/2009 07/02/2009 07/02/2009 07/02/2009 07/04/2009 07/06/2009
07/06/2009 07/07/2009
07/10/2009 07/10/2009 07/10/2009

409 MINUTE entry before the Honorable James F. Holderman: ENTER COURT'S PRELIMINARY COMMENTS ON WRITTEN OBJECTIONS FILED PRIOR TO FAIRNESS HEARING. Mailed notice (am) (Entered: 06/30/2009)
410 COURT'S PRELIMINARY COMMENTS ON WRITTEN OBJECTIONS FILED PRIOR TO FAIRNESS HEARING. Signed by the Honorable James F. Holderman on 6/30/2009: Mailed notice (am) (Entered: 06/30/2009)
411 CLASS Action Fairness Hearing Agenda, 07/01/2009. (tlm) (Entered: 06/30/2009)
412 RESPONSE by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman to objections 391 , objections, 386 , objections 384 , objections 389 , objections,, 387 , memorandum,, 388 , objections 390 and Memorandum in Support of Final Approval of Consent Decree (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E, # 6 Exhibit F, # 7 Exhibit G, # 8 Exhibit H, # 9 Exhibit I, # 10 Exhibit J, # 11 Exhibit K, # 12 Exhibit L, # 13 Exhibit M)(Hartman, Kendra) (Entered: 07/01/2009)
416 MINUTE entry before the Honorable James F. Holderman: Fairness hearing held on 7/1/2009. Mailed notice (am) (Entered: 07/02/2009)
413 NOTICE by Misericordia Resident Objectors Hearing Exhibits 1 and 2 (Mendel, Scott) (Entered: 07/02/2009)
414 NOTICE by all defendants of filing (Attachments: # 1 Exhibit A)(Stratton, Brent) (Entered: 07/02/2009)
415 NOTICE by Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman of filing (Hartman, Kendra) (Entered: 07/02/2009)
417 COMMENTARY to the Chicago Tribune on on the Ligas Fairness Hearing on 7/1/09 by Sally A. Kitt Chappell, PHD; Notices. (tlm) (Entered: 07/06/2009)
418 MINUTE entry before the Honorable James F. Holderman: Objector Judith S. Sherwin's motion for joinder and memorandum 402 is granted. Mailed notice (tlm) (Entered: 07/06/2009)
421 LETTER dated 07/04/09 on the Rigas fairness hearing to Judge Holderman by Sally Chappell (Exhibit). (tlm) (Entered: 07/13/2009)
419 MINUTE entry before the Honorable James F. Holderman:The court has received further e−mail communications from Sally Chappel, Ph.D. The most recent e−mails are dated July 4, 2009. Just as was done with Ms. Chappell's July 2, 2009 e−mail [Dkt. No. 417], these July 4, 2009 e−mails must be and are being filed in the record. The court reminds the parties, counsel, and all persons interested in the outcome of the fairness hearing that no person is to have ex parte communications with the court. All parties must be apprised of all communications with Chief Judge Holderman about this case. The issues concerning the proposed consent decree have been fully presented to the court. No further communication with the court is necessary unless brought by motion of counsel. The court will rule electronically.Judicial staff mailed notice (gl, ) (Entered: 07/06/2009)
422 LETTER from John Reed dated 4/13/09 (Exhibits). (tlm (Entered: 07/13/2009)
420 MINUTE entry before the Honorable James F. Holderman:For the reasons set forth in the Statement section below, the class certification order 85 is vacated and approval of the proposed consent decree is denied. Plaintiffs' counsel are to notify the class members as efficiently and inexpensively as possible of the change in status of this lawsuit. See Culver v. City of Milwaukee, 277 F.3d 908 (7th Cir. 2002) (requiring notice to class members when class is decertified). The case is set for a status report as to the continued litigation of the individual plaintiffs' claims on July 30, 2009, at 9:00 a.m.Judicial staff mailed notice (gl, ) (Entered: 07/07/2009)
423 LETTER from Nancy & James Miller dated 7/8/09. (tlm) (Entered: 07/14/2009)
424 LETTER from Marla and Sandy Berke dated 7/9/09. (tlm) (Entered: 07/14/2009)
425 LETTER from Sherry Scauffas dated 7/10/09. (tlm) (Entered: 07/15/2009)

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07/14/2009 07/21/2009
07/21/2009
07/30/2009
07/30/2009 07/30/2009 08/05/2009

426 LETTER from Dan & Patty Walsh dated 7/14/09. (tlm) (Entered: 07/17/2009)
427 MOTION by Plaintiffs Isaiah Fair, Adam Kulig, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli, Lorene Bierman for approval of notice regarding class decertification (Hartman, Kendra) (Entered: 07/21/2009)
428 NOTICE of Motion by Kendra Kekelis Hartman for presentment of motion for miscellaneous relief 427 before Honorable James F. Holderman on 7/30/2009 at 09:00 AM. (Hartman, Kendra) (Entered: 07/21/2009)
429 MINUTE entry before the Honorable James F. Holderman: Status hearing held and is continued for 9/1/2009 at 9:00 AM. ENTER ORDER: Plaintiffs' motion for approval of notice regarding class decertification 427 is granted. Mailed notice (am) (Entered: 07/31/2009)
430 ORDER. Signed by the Honorable James F. Holderman on 7/30/2009: Mailed notice (am) (Entered: 07/31/2009)
431 NOTICE by USDC of Decertification of Class Action.(ber, ) (Entered: 08/04/2009)
432 TRANSCRIPT OF PROCEEDINGS held on 06/09/09 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435−5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

08/05/2009

Redaction Request due 8/26/2009. Redacted Transcript Deadline set for 9/8/2009. Release of Transcript Restriction set for 11/3/2009. (Conway, Colleen) (Entered: 08/05/2009)
433 TRANSCRIPT OF PROCEEDINGS held on 06/11/09 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

08/18/2009

Redaction Request due 8/26/2009. Redacted Transcript Deadline set for 9/8/2009. Release of Transcript Restriction set for 11/3/2009. (Conway, Colleen) (Entered: 08/05/2009)
434 TRANSCRIPT OF PROCEEDINGS held on 07/01/09 before the Honorable James F. Holderman. Fairness Hearing. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

08/31/2009

Redaction Request due 9/8/2009. Redacted Transcript Deadline set for 9/18/2009. Release of Transcript Restriction set for 11/16/2009. (Conway, Colleen) (Entered: 08/18/2009)
435 MINUTE entry before the Honorable James F. Holderman: Status hearing is reset for 9/1/2009 at 9:30 AM instead of 9:00 AM. Mailed notice (am) (Entered: 08/31/2009)

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08/31/2009 08/31/2009 09/01/2009
10/01/2009 10/01/2009 10/13/2009
10/28/2009 10/29/2009
12/01/2009 12/11/2009 12/21/2009 12/21/2009 12/21/2009 12/21/2009 12/21/2009 12/22/2009

436 Second AMENDED complaint by Isaiah Fair, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli against Barry S Maram, Carol L Adams and terminating Lorene Bierman and Adam Kulig (Hartman, Kendra) (Entered: 08/31/2009)
437 NOTICE by Isaiah Fair, Jamie McElroy, Stanley Ligas, Jennifer Wilson, David Cicarelli re amended complaint 436 (Hartman, Kendra) (Entered: 08/31/2009)
438 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 9/1/2009 and continued for 10/15/2009 at 9:00 AM. Plaintiffs are given leave to file second amended complaint; defendants are given until 10/1/2009 to respond to the second amended complaint. If there is a need for further discovery, parties are to meet and prepare Form 52 for filing by 10/13/2009. If no further discovery is needed, parties are to file a status report by 10/13/2009. Mailed notice (am) (Entered: 09/04/2009)
439 MOTION by Defendants Barry S Maram, Carol L Adams for extension of time to file answer regarding amended complaint 436 (Stratton, Brent) (Entered: 10/01/2009)
440 NOTICE of Motion by Brent Douglas Stratton for presentment of motion for extension of time to file answer, motion for relief 439 before Honorable James F. Holderman on 10/15/2009 at 09:00 AM. (Stratton, Brent) (Entered: 10/01/2009)
441 MINUTE entry before the Honorable James F. Holderman: By request of the parties, status hearing date of 10/15/2009 is reset for 10/29/2009 at 9:00 AM. Defendants Barry S Maram, Carol L Adams's motion for extension of time to file answer regarding amended complaint 439 is entered and continued to 10/29/2009 at 9:00 AM. Mailed notice (am) (Entered: 10/13/2009)
442 STATUS Report Joint Status Report by Isaiah Fair, Jamie McElroy, Stanley Ligas, Jennifer Wilson, Barry S Maram, Carol L Adams, David Cicarelli (Stratton, Brent) (Entered: 10/28/2009)
443 MINUTE entry before the Honorable James F. Holderman:Status and motion hearing held on 10/29/09. Defendants Barry S. Maram, Carol L. Adam's motion for extension of time to file answer 439 regarding amended complaint is continued to 12/1/09 at 9:00 a.m. Status hearing is continued to 12/1/09 at 09:00 AM., for further status and report on settlement.Judicial staff mailed notice (gl, ) (Entered: 10/29/2009)
444 MINUTE entry before the Honorable James F. Holderman: Status hearing held on 12/1/2009 and is continued for 12/22/2009 at 9:00 AM. Mailed notice (am) (Entered: 12/01/2009)
445 NOTICE by Kendra Kekelis Hartman of Change of Address (Hartman, Kendra) (Entered: 12/11/2009)
446 MOTION by Intervenor Parties Burton A Brown, Burton A Brown to intervene (Attachments: # 1 Exhibit A, # 2 Exhibit B)(Bakhtiari, Babak) (Entered: 12/21/2009)
447 NOTICE by Burton A Brown re MOTION by Intervenor Parties Burton A Brown, Burton A Brown to intervene 446 (Bakhtiari, Babak) (Entered: 12/21/2009)
448 MOTION by Intervenor Burton A Brown to disqualify counsel (Attachments: # 1 Exhibit A)(Bakhtiari, Babak) (Entered: 12/21/2009)
449 NOTICE by Burton A Brown re MOTION by Intervenor Burton A Brown to disqualify counsel 448 (Bakhtiari, Babak) (Entered: 12/21/2009)
451 MOTION by counsel for Plaintiffs to withdraw appearance. (ber, ) (Entered: 12/23/2009)
450 MINUTE entry before Honorable James F. Holderman: Status hearing held on 12/22/2009 and is continued for 1/28/2010 at 9:00 AM. On intervenor Burton A. Brown's motion to disqualify counsel 448 , response due by 1/12/2010; reply due by 1/22/2010. Intervenor Burton A. Brown's motion to intervene 446 is entered and continued to 1/28/2010 at 9:00 AM. Plaintiffs to file motion for preliminary approval of consent decree for presentment on 1/28/2010 at 9:00 AM. Mailed notice (am) (Entered: 12/22/2009)

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01/05/2010 01/12/2010 01/22/2010 01/25/2010 01/25/2010
01/25/2010 01/26/2010 01/27/2010

452 NOTICE by Jason T. Lundy of Change of Firm Address. (ber, ) (Entered: 01/07/2010)
453 RESPONSE by Carol L Adams, Barry S Maramin Opposition to MOTION by Intervenor Burton A Brown to disqualify counsel 448 (Attachments: # 1 Exhibit Exhibit A)(Stratton, Brent) (Entered: 01/12/2010)
454 REPLY by Intervenor Burton A Brown to response in opposition to motion 453 to disqualify (Bakhtiari, Babak) (Entered: 01/22/2010)
455 MOTION by Defendants Carol L Adams, Barry S Maram, Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson to certify class , preliminarily approve consent decree, and approve notice plan (Shapiro, Corey) (Entered: 01/25/2010)
456 MOTION by Defendants Carol L Adams, Barry S Maram, Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson for leave to file excess pages (Attachments: # 1 Exhibit Memorandum in Support of Motion for Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan, # 2 Exhibit A − Consent Decree, # 3 Exhibit B − Notice Plan and Notices, # 4 Exhibit C − Proposed Order)(Shapiro, Corey) (Entered: 01/25/2010)
457 NOTICE of Motion by Corey M. Shapiro for presentment of motion for leave to file excess pages, 456 before Honorable James F. Holderman on 1/28/2010 at 09:00 AM. (Shapiro, Corey) (Entered: 01/25/2010)
458 STATEMENT by United States of America Statement of Interest of the United States of America (Attachments: # 1 Exhibit A part 1, # 2 Exhibit A part 2, # 3 Exhibit B, # 4 Exhibit C, # 5 Exhibit D, # 6 Exhibit E, # 7 Exhibit F part 1, # 8 Exhibit F part 2)(Laser, Joan) Modified on 1/27/2010 (ber, ). (Entered: 01/26/2010)
459 ATTORNEY Appearance for Objectors Kris Absalonsen, Suzanne C. Allison, Kathleen Alsobrook, Aldo Azzolin, Andrea Rae Azzolin, June M. Azzolin, James F. Bachman, Mary Lou Bachman, Diane Banks, Thomas J. Boltz, Marie Bonynge, Camden Bouschard, Patricia Bowles, Judith Ann Brandt, Ann Terese Breitenbeck, Joseph T. Breitenbeck, David Brockmann, Sheri Lynn Brockmann, Valerie Brockmann, Debbie Campbell, Mary L. Carden, Mary Carol Carden, Alfred A. Ceragioli, Donna Marie Ceragioli, Emily Ceragioli, Elaine Christiansen, Kathleen M. Christiansen, Keith W. Christiansen, Kathleen Cooney, Beth Ellen Covington, Theresa M. Covington, Linda G. Croke, Mary Dattis, Andrea DeFrancesco, J. DeFrancesco, Julia A. Dodge, Patricia E. Doyle, John Drews, Judith Drews, Karen M. Drews, Margaret L. Duffey, Christine E. Duffy, James E. Ehrhardt, Marjorie Ehrhardt, Mary Ann Ehrhardt, Sandra Elesh, William Elesh, Judi Farr, Charles D. Fitz−Hugh, Jr, Jean M. Fitz−Hugh, Mildred Fitzpatrick, Mary Terese Foley, Julia Ann Framarin, Darlene Glaser, Madeline M. Glaser, Anne Ruth Golden, Paula A. Golden, Samuel Golden, Rebecca R. Goldkuhle, Dale T. Gomez, Lisa M. Gomez, Janice A. Griffin, George J. Grimelli, Lisa Grimelli, Sally Hanley, Gloria V. Heffernan, Janet Heisse, Marilyn Heisse, James Hill, Yolanda V. Hoffmann, Dolores Horan, Akira Iriye, Keiko Iriye, Jean Ivaska, Paul J. Ivaska, Elizabeth Kaufman, Michelle Keacher, John J. Knych, Linda Knych, Nancy Kolinen, Anne Kuldanek, Shirley LaBeau, Mary E. LaMaster, Nancy Covington Langsdale, Kerry M. Lavelle, Shannon Lavelle, Arlene Ledebuhr, Renee Leone, Dorothy E. Lind, David Lindsay, Daniel Litwicki, Gina Litwicki, Mary Christine Mangos, Rosella M. McCarthy, Mary McDaniel, Simone McDaniel, Daniel V. McDevitt, Elizabeth J. McDevitt, Thomas McEvy, J. Milton McGinnis, Nona McGinnis, Susan McMahon, Patricia J. Menges, Kathleen L. Merker, Richard S. Merker, Sandra L. Merker, Sherry Morena, James P. Napoleon, Karen Napoleon, Mark Napoleon, Teresa C. Newsom, Gina Novak, Laura Novak, Kathleen O'Brien, John J. O'Connell, Rita E. O'Connell, Karen Olker, Diane Paulus, Neal Paulus, Kirsten Peak, Lorraine Pewnicki, Doris Pfrenger, Eugene A. Philipp, Kathleen Philipp, Anne N. Pierce, Peter J. Pustorino, Ruth Pustorino, Christine T. Radgowski, Jessie Radgowski, Marian Radgowski, Rita Raggi, Lisa Maria Ramos, Santiago V. Ramos, Alverna Ricke, James D. Rieck, Mary C. Rieck, Megan K. Rieck, Alan Ritter, Ashley Ritter, Barbara Ritter, Jackie Romolo, Margaret M. Rowley, Maura A. Rowley, Christina Lynn Rud, Donald R. Rud, Kathleen Marie Rychlick, Marlene P. Rychlick, Janet M. Scahill, Edward J. Schnitzius, Mary C. Schnitzius, Judy Mangos Schomer, Michael Schomer, Richard Forrest Sloan, Mary Stein, Virginia Sullivan, James R. Swiat, Molly Swiat, Lynn Tomaszkiewicz, Patricia Volini, Julie Vowinkel, Rebecca Vowinkel, Scott G. Vowinkel, Jeanne M. Wadhams, Donald Waldvogel, Jill

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01/28/2010
01/29/2010
02/01/2010
02/11/2010
02/11/2010 02/11/2010 02/11/2010 02/25/2010 02/25/2010
03/11/2010 03/11/2010 03/11/2010 03/16/2010

Waldvogel, Karolyn K. Wasserman, Hope Weaver, Raymond A. Weaver, Colette Wiemer, Edward Wiemer, Arlene William, Marlene Zajack by Christopher A. Ripple (Ripple, Christopher) (Entered: 01/27/2010)
460 MINUTE entry before Honorable James F. Holderman: Status hearing held on 1/28/2010. Plaintiffs' motion to withdraw Judith Gran as attorney 451 is granted. Defendants' motion to certify class 455 is entered and continued generally. Defendants' motion for leave to file excess pages 456 is granted. Defendants' counsel to provide a list of people who have requested services as stated in open court. Any further motions to intervene to be filed by 2/11/2010; responses to all motions to intervene due by 2/25/2010. Replies due by 3/11/2010. The Court to rule electronically and will set further dates at time of ruling. Mailed notice (am) (Entered: 01/29/2010)
461 MINUTE entry before Honorable James F. Holderman: For the reasons set forth in the Statement section of this order, Burton A. Brown and Barbara A. Reillys Motion to Disqualify 448 is denied. Additionally, the Clerk of Court is directed to amend the case caption to reflect that Michelle R.B. Saddler has succeeded defendant Carol L. Adams as the Secretary of the Illinois Department of Human Services. [For further details see minute order.] Mailed notice (ber, ) (Entered: 02/01/2010)
462 MEMORANDUM by David Cicarelli, Isaiah Fair, Stanley Ligas, Barry S Maram, Jamie McElroy, Michelle R.B. Saddler, Jennifer Wilson in support of motion to certify class 455 , preliminarily approve consent decree, and approve notice plan (Attachments: # 1 Exhibit A − Consent Decree, # 2 Exhibit B − Notice Plan and Proposed Notices, # 3 Exhibit C − Proposed Order)(Shapiro, Corey) (Entered: 02/01/2010)
463 OBJECTIONS by The Misericordia Waiting List Objectors to MOTION by Defendants Carol L Adams, Barry S Maram, Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson to certify class , preliminarily approve consent decree, and approve notice plan 455 (Choslovsky, William) (Entered: 02/11/2010)
464 MOTION by Objectors Misericordia Resident Objectors, Misericordia Resident Objectors to intervene (Mendel, Scott) (Entered: 02/11/2010)
465 MEMORANDUM by Misericordia Resident Objectors in support of motion to intervene 464 (Mendel, Scott) (Entered: 02/11/2010)
466 ANSWER to amended complaint by Misericordia Resident Objectors(Mendel, Scott) (Entered: 02/11/2010)
467 RESPONSE by Barry S Maram, Michelle R.B. Saddlerin Opposition to MOTION by Intervenor Parties Burton A Brown, Burton A Brown to intervene 446 , MOTION by Objectors Misericordia Resident Objectors, Misericordia Resident Objectors to intervene 464 (Stratton, Brent) (Entered: 02/25/2010)
468 RESPONSE by David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilsonin Opposition to MOTION by Intervenor Parties Burton A Brown, Burton A Brown to intervene 446 , MOTION by Objectors Misericordia Resident Objectors, Misericordia Resident Objectors to intervene 464 (Attachments: # 1 Exhibit A)(Shapiro, Corey) (Entered: 02/25/2010)
469 STATUS Report Regarding Potential Class Members by Barry S Maram, Michelle R.B. Saddler (Stratton, Brent) (Entered: 03/11/2010)
470 REPLY by Misericordia Resident Objectors to MOTION by Objectors Misericordia Resident Objectors, Misericordia Resident Objectors to intervene 464 (Mendel, Scott) (Entered: 03/11/2010)
471 Joinder by Burton A Brown and Barbara A. Riley in Motion for Limited Intervention and Memoranda in Support (Bakhtiari, Babak) (Entered: 03/11/2010)
472 RESPONSE by Objector The Misericordia Waiting List Objectors to status report 469 Objectors' Response to Defendants' Status Report Regarding Potential Class Members (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3, # 4 Exhibit 4, # 5 Exhibit 5)(Choslovsky, William) (Entered: 03/16/2010)

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03/19/2010 03/19/2010 03/22/2010 03/26/2010

473 MOTION by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson to set a briefing schedule To File Reply Brief In Support Of Motion For Settlement Class Certification, Preliminary Approval Of Consent Decree, And Approval Of Notice Plan (Shapiro, Corey) (Entered: 03/19/2010)
474 NOTICE of Motion by Corey M. Shapiro for presentment of motion by filer to set a briefing schedule, 473 before Honorable James F. Holderman on 3/30/2010 at 09:00 AM. (Shapiro, Corey) (Entered: 03/19/2010)
475 MOTION by Defendants Barry S Maram, Michelle R.B. Saddler for joinder in Motion Requesting a Briefing Schedule to File Reply Brief in Support of Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan (Stratton, Brent) (Entered: 03/22/2010)
476 TRANSCRIPT OF PROCEEDINGS held on 01/28/10 before the Honorable James F. Holderman. Court Reporter Contact Information: Colleen Conway @ 312.435.5594 or colleen_conway@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

03/29/2010 04/07/2010 04/07/2010 04/08/2010
04/15/2010

Redaction Request due 4/16/2010. Redacted Transcript Deadline set for 4/26/2010. Release of Transcript Restriction set for 6/24/2010. (Conway, Colleen) (Entered: 03/26/2010)
477 MINUTE entry before Honorable James F. Holderman: On the court's own motion, plaintiffs' motion to set a briefing schedule To File Reply Brief In Support Of Motion For Settlement Class Certification, Preliminary Approval Of Consent Decree, And Approval Of Notice Plan 473 and defendants' motion for joinder in Motion Requesting a Briefing Schedule to File Reply Brief in Support of Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan 475 are entered and continued for 4/8/2010 at 9:00 AM. Mailed notice (am) (Entered: 03/29/2010)
478 MINUTE entry before Honorable James F. Holderman:For the reasons set forth in the accompanying Memorandum Opinion and Order, Burton A. Brown and Barbara A. Reilly's "Motion to Intervene" 446 is dismissed as moot and "Proposed Intervenors' Motion for Limited Intervention Pursuant to Fed. R. Civ. P. 24" 464 is granted. Hearing on "Plaintiffs' Motion Requesting a Briefing Schedule to File Reply Brief in Support of Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan" 473 remains set for 4/8/10 at 9:00 a.m. Counsel for all interested parties are once again encouraged to discuss settlement. Mailed notice (am) (Entered: 04/07/2010)
479 Memorandum Opinion and Order. Signed by the Honorable James F. Holderman on 4/7/2010: Mailed notice (am) (Entered: 04/07/2010)
480 MINUTE entry before Honorable James F. Holderman: Defendants Carol L Adams, Barry S Maram, Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson's motion to certify class, preliminarily approve consent decree, and approve notice plan 455 is denied. Plaintiffs' motion to set a briefing schedule To File Reply Brief In Support Of Motion For Settlement Class Certification, Preliminary Approval Of Consent Decree, And Approval Of Notice Plan 473 is denied. Defendants Barry S Maram, Michelle R.B. Saddler's motion for joinder in Motion Requesting a Briefing Schedule to File Reply Brief in Support of Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan 475 is granted. Status hearing set for 5/13/2010 at 9:00 AM. Parties are encouraged to discuss settlement. Mailed notice (am) (Entered: 04/09/2010)
481 MOTION by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson to clarify (Shapiro, Corey) (Entered: 04/15/2010)

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04/15/2010 04/19/2010
04/20/2010 04/20/2010 04/26/2010
04/26/2010 04/28/2010 05/03/2010
05/04/2010 06/14/2010 06/14/2010 06/16/2010 06/21/2010

482 NOTICE of Motion by Corey M. Shapiro for presentment of motion to clarify 481 before Honorable James F. Holderman on 4/20/2010 at 09:00 AM. (Shapiro, Corey) (Entered: 04/15/2010)
483 MINUTE entry before Honorable James F. Holderman: Plaintiffs' "Motion for Clarification" 481 is granted insofar as the court hereby clarifies that its April 8, 2010 dismissal of Plaintiff's "Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan" 480 was made without prejudice, for the purpose of allowing all interested parties sufficient time to focus on reaching an appropriate settlement, if they can, to end this litigation. Status hearing remains set for 5/13/2010 at 9:00 a.m. Mailed notice (am) (Entered: 04/19/2010)
484 JOINT MOTION for Referral to Magistrate Judge by David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson (Shapiro, Corey) Modified on 4/20/2010 (cdy, ). (Entered: 04/20/2010)
485 NOTICE of Motion by Corey M. Shapiro for presentment of motion for miscellaneous relief 484 before Honorable James F. Holderman on 4/27/2010 at 09:00 AM. (Shapiro, Corey) (Entered: 04/20/2010)
486 MINUTE entry before Honorable James F. Holderman: The parties' "Joint Motion for Referral to Magistrate Judge" 484 is granted. This case is referred to Magistrate Judge Jeffrey Cole for purposes of supervising settlement discussions among the plaintiffs, defendants, and intervenors. Status hearing remains set for 5/13/2010 at 9:00 a.m. Mailed notice (am) (Entered: 04/26/2010)
487 Pursuant to Local Rule 72.1, this case is hereby referred to the calendar of Honorable Jeffrey Cole for the purpose of holding proceedings related to: supervisions settlement discussions among the plaintiffs, defendants, and intervenors. (am) Mailed notice. (Entered: 04/26/2010)
488 MINUTE entry before Honorable Jeffrey Cole:Status hearing is set for 5/3/2010 at 8:30 a.m. Mailed notice (cdh, ) (Entered: 04/28/2010)
489 MINUTE entry before Honorable Jeffrey Cole: Status hearing held. Settlement conference is set for June 28, 2010 at 10:00 a.m. in courtroom 1838. Parties' shall submit a joint submission to chambers (room 1828) by June 18, 2010. The joint submission shall contain an explanation of the areas and issues on which the parties agree there is disagreement. They are also requested to submit a list of cases they deem relevant to a comprehensive understanding of the case. Mailed notice (ber, ) (Entered: 05/04/2010)
490 MINUTE entry before Honorable James F. Holderman: Status hearing date of 5/13/2010 is reset for 6/29/2010 at 9:00 AM. Mailed notice (am) (Entered: 05/04/2010)
491 MOTION by Movant The United States of America for leave to appear as participant in settlement conference (Johnson, Patrick) (Entered: 06/14/2010)
492 NOTICE of Motion by Patrick Walter Johnson for presentment of motion for leave to appear 491 before Honorable Jeffrey Cole on 6/21/2010 at 08:30 AM. (Johnson, Patrick) (Entered: 06/14/2010)
493 RESPONSE by Misericordia Resident Objectorsin Opposition to MOTION by Movant The United States of America for leave to appear as participant in settlement conference 491 (Mendel, Scott) (Entered: 06/16/2010)
494 MINUTE entry before Honorable Jeffrey Cole: Motion hearing held. The United States of America's Motion for Leave to Appear as Participant in Settlement Conference 491 is granted over the objection of the intervenors. The objection that Judge Holderman's referral, being for the purpose of holding settlement discussions "among the plaintiffs, defendants, and intervenors" by its terms, precludes the Government from "participa[ting]"in the conference reads too much into the text of the minute order of 4/26/2010. "Judges expect their pronunciamentos to be read in context,"Wisehart v. Davis, 408 F.3d 321, 326 (7th Cir. 2005)(Posner, J.); see also Penry v. Lynaugh, 492 U.S. 302, 358 (1989)(Scalia, J., concurring and dissenting in part); McCready v. Jesse White, 417 F.3d 700, 702−703 (7th Cir. 2005)(Easterbrook, J.); United States v. Corey, 232 F.3d 1132, 1166 (9th Cir. 2000), and the issue

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06/28/2010
06/28/2010
07/22/2010 07/23/2010 08/03/2010 08/03/2010 08/05/2010 08/06/2010 09/24/2010 10/04/2010 10/04/2010 10/05/2010 10/06/2010

presented by the motion to participate was not remotely before the Chief Judge when he referred the case here. The intervenors' concern that the Government may well frustrate rather than further settlement has more weight. But the Government has not asked to intervene as a party, but merely to participate, and the scope of that participation is easily canalized within bounds that can be set by the court. As discussed in court today, the government's role is advisory only, and if it becomes clear that the Government's participation becomes obstructive rather than ameliorative the permission granted by this Order can be withdrawn. As things now stand, however, participation by the Government may bring a perspective to the issues that has not occurred to the parties and the intervenors, but which they may find unobjectionable and perhaps even informative. In that event, there would be no need for the Government to file a formal objection at the time when a settlement agreement is presented for approval to Judge Holderman. That result would husband scarce judicial resources, to say nothing of conserving the time and energies of counsel for the intervenors and the parties. Mailed notice (cdh, ) (Entered: 06/21/2010)
495 MINUTE entry before Honorable James F. Holderman: Magistrate Judge Cole stated that the parties are making progress towards a resolution and need more time. Parties will be before Magistrate Judge Cole on 7/22/2010. Therefore, status hearing date of 6/29/2010 is reset for 7/27/2010 at 9:00 AM. Mailed notice (am) (Entered: 06/28/2010)
496 MINUTE entry before Honorable Jeffrey Cole: Settlement conference held and continued to 7/22/10 at 1:30 p.m. I wish to thank counsel for the parties and the intervenors for the diligence, patience, cooperativeness and professionalism manifested in their interactions with each other and in our discussions today. Mailed notice (cdh, ) (Entered: 06/29/2010)
497 MINUTE entry before Honorable Jeffrey Cole: Settlement conference held and continued to 8/6/10 at 1:30 p.m. Mailed notice (cdh, ) (Entered: 07/22/2010)
498 MINUTE entry before Honorable James F. Holderman: In light of the ongoing settlement discussions, status hearing date of 7/27/2010 is reset for 8/17/2010 at 9:00 AM. Mailed notice (am) (Entered: 07/23/2010)
499 MOTION by Defendants Barry S Maram, Michelle R.B. Saddler to reset settlement conference (Stratton, Brent) (Entered: 08/03/2010)
500 NOTICE of Motion by Brent Douglas Stratton for presentment of motion to reset 499 before Honorable Jeffrey Cole on 8/6/2010 at 08:30 AM. (Stratton, Brent) (Entered: 08/03/2010)
501 MINUTE entry before Honorable Jeffrey Cole:Defendant's motion to reset the settlement conference 499 is granted. Settlement Conference date of 8/6/2010 is reset for 10/5/2010 at 02:00 PM.Mailed notice (jms, ) (Entered: 08/05/2010)
502 MINUTE entry before Honorable James F. Holderman: Status hearing reset to 10/7/2010 at 9:00 AM. Status hearing set for 8/17/2010 is vacated.Mailed notice (rao, ) (Entered: 08/06/2010)
503 MINUTE entry before Honorable James F. Holderman: Defendants' motion for extension of time to answer 439 is terminated without prejudice to renewal. Mailed notice (am) (Entered: 09/24/2010)
504 NOTICE by Corey M. Shapiro of Change of Address Notice of Firm Name Change. (Shapiro, Corey) (Entered: 10/04/2010)
505 MOTION by Objector Misericordia Resident Objectors to reset Joint Motion to Reset Settlement Conference (Mendel, Scott) (Entered: 10/04/2010)
506 MINUTE entry before Honorable Jeffrey Cole:Misericordia Resident Objectors' motion to reset the settlement conference 505 is granted. Status hearing is set for 10/25/2010 at 08:30 AM.Mailed notice (jms, ) (Entered: 10/05/2010)
507 MINUTE entry before Honorable James F. Holderman: Status hearing date of 10/7/2010 is reset for 10/28/2010 at 9:00 AM. Mailed notice (am) (Entered: 10/06/2010)

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10/20/2010 10/25/2010 10/26/2010 11/08/2010 11/08/2010 11/22/2010
11/24/2010 12/13/2010 12/14/2010 12/16/2010 12/16/2010
12/16/2010
12/23/2010 01/11/2011 01/11/2011

508 MINUTE entry before Honorable Jeffrey Cole: Sua sponte, the status hearing set for 10/25/10 at 8:30 a.m. is reset to 10/25/10 at 9:45 a.m. Mailed notice (gmr, ) (Entered: 10/20/2010)
509 MINUTE entry before Honorable Jeffrey Cole: Status hearing held and continued to 11/8/2010 at 8:30 a.m. The parties report that settlement discussions are progressing positively. Mailed notice (gmr, ) (Entered: 10/25/2010)
510 MINUTE entry before Honorable James F. Holderman: At the request of the parties and on the recommendation of Magistrate Judge Cole, status hearing date of 10/28/2010 is reset for 11/9/2010 at 9:00 AM. Mailed notice (am) (Entered: 10/26/2010)
511 MINUTE entry before Honorable James F. Holderman: Status hearing date of 11/9/2010 is reset for 12/23/2010 at 9:00 AM. Mailed notice (am) (Entered: 11/08/2010)
512 MINUTE entry before Honorable Jeffrey Cole: Status hearing held and continued to 11/22/2010 at 8:30 a.m. Settlement conference set for 12/20/2010 at 11:00 a.m. Mailed notice (gmr, ) (Entered: 11/08/2010)
513 MINUTE entry before Honorable Jeffrey Cole:Magistrate Judge Status hearing held on 11/22/2010. Parties report to the Court that settlement is progressing. Settlement conference set for 12/20/10 at 11:00 a.m. is stricken. Parties are directed to meet and confer on agreeable date for resetting the settlement conference date and jointly contact Chambers at 312−435−5601 no later than 11/23/10 to set the settlement conference before 12/17/10 at 7:00 a.m. Mailed notice (yp, ) (Entered: 11/23/2010)
514 MINUTE entry before Honorable Jeffrey Cole: By agreement of the parties, settlement conference set for 12/16/2010 at 7:00 a.m. Mailed notice (gmr, ) (Entered: 11/24/2010)
515 DOCUMENT REMOVED PER COURT ORDER (Mendel, Scott) Modified on 12/16/2010 (mb, ). (Entered: 12/13/2010)
516 RESPONSE by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson to status report 515 (Shapiro, Corey) (Entered: 12/14/2010)
517 MOTION by Objector Misericordia Resident Objectors to strike Joint Motion to Remove Status Report from Docket (Mendel, Scott) (Entered: 12/16/2010)
518 MINUTE entry before Honorable Jeffrey Cole: The parties' Joint Motion to Remove Intervenors' Status Report from the Docket 517 is granted. The Clerk of the Court is directed to immediately replace Intervenors' Status Report 515 with the Clerk's pdf that specifies "Document Withdrawn/Removed Per Court Order." Mailed notice (gmr, ) (Entered: 12/16/2010)
519 MINUTE entry before Honorable Jeffrey Cole: Settlement conference held. The parties have reached an agreement and will present the appropriate consent decree for preliminary approval to the Chief Judge at their next scheduled status hearing on 12/23/2010. The Court wishes to extend its wishes to thank all counsel involved in the case for their courtesy, flexibility and the spirit of genuine cooperativeness with which they approached the difficult issues in this case. All matters relating to the referral of this action having been resolved, the case is returned to the assigned judge. Mailed notice (gmr, ) (Entered: 12/20/2010)
520 MINUTE entry before Honorable James F. Holderman:Status hearing held on 12/23/2010 and is continued for 1/13/2011 at 9:00 AM. Parties are to submit proposed order by 1/11/2011. Mailed notice (am) (Entered: 12/23/2010)
521 MOTION by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson, Defendants Barry S Maram, Michelle R.B. Saddler to certify class (Joint Motion for Settlement Class Certification, Preliminary Approval of Consent Decree, and Approval of Notice Plan) (Enerson, Wendy) (Entered: 01/11/2011)
522 MOTION by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson, Defendants Barry S Maram, Michelle R.B. Saddler for leave to file excess pages (Joint Motion for Leave to File Memorandum in Excess of Page Limits Instanter) (Attachments: # 1 Exhibit 1−Proposed Memo, # 2 Exhibit A−Consent Decree, # 3 Exhibit B, B1, & B2−Notice Plan, # 4 Exhibit C−Proposed

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01/11/2011 01/13/2011
01/13/2011 01/13/2011 01/13/2011 01/27/2011 01/27/2011 02/03/2011 02/15/2011 02/15/2011 02/15/2011 02/15/2011 03/14/2011

Order)(Enerson, Wendy) (Entered: 01/11/2011)
523 NOTICE of Motion by Wendy N Enerson for presentment of before Honorable James F. Holderman on 1/13/2011 at 09:00 AM. (Enerson, Wendy) (Entered: 01/11/2011)
524 MINUTE entry before Honorable James F. Holderman: Status and motion hearing held on 1/13/11. Joint Motion for settlement class certification, preliminary approval of consent decree, and approval of notice plan 521 is granted. The proposed class action settlement and proposed consent decree in this case has been preliminarily approved. Joint motion for leave to file memorandum in excess of page limit, instanter (522) is granted. In accordance with Fed. R. Civ. P. 25(d), the Court grants the parties' request to substitute Julie Hamos as a party defendant. The Clerk is directed to amend the case caption to reflect that Julie Hamos has succeeded Defendant Barry Maram as the Director of the Illinois Department of Healthcare and Family Services since this lawsuit was filed. Party Julie Hamos added. Barry S Maram terminated. All class members, parents, or guardians who wish to participate in the fairness hearing, comment on or object to the Consent Decree, shall send the objection, comment, and/or notice of intent to appear by May 13, 2011. Plaintiffs shall file with the Court all such submissions received in connection with the fairness hearing by May 27, 2011. Plaintiffs, Defendants and/or Intervenors may file responses to any objections to the Decree by May 27, 2011. Fairness Hearing is set for 6/10/2011 at 09:30 AM. (For further details, see Order in separate docket entry). Judicial staff mailed notice (gl, ) (Entered: 01/20/2011)
525 ORDER Signed by the Honorable James F. Holderman on 1/13/2011:Judicial staff mailed notice(gl, ) (Entered: 01/20/2011)
526 Legal Notice of proposed class action settlement and hearing Signed by the Honorable James F. Holderman on 1/13/2011:Judicial staff mailed notice(gl, ) (Entered: 01/20/2011)
527 Notice of Proposed class action settlement and hearing. Signed by the Honorable James F. Holderman on 1/13/2011:Judicial staff mailed notice(gl, ) (Entered: 01/20/2011)
528 MINUTE entry before Honorable James F. Holderman: Status hearing set for 2/3/2011 at 9:00 AM to discuss fairness hearing schedule. Mailed notice (am) (Entered: 01/27/2011)
529 ATTORNEY Appearance for Plaintiffs Lorene Bierman, Burton A. Brown, David Childers, David Cicarelli, Isaiah Fair, Adam Kulig, Stanley Ligas, Jamie McElroy, Tiffany McFadden, Alex Tyner, Jennifer Wilson by Patricia A. Werner (Werner, Patricia) (Entered: 01/27/2011)
530 MINUTE entry before Honorable James F. Holderman: Status hearing held on 2/3/2011. Fairness hearing is reset for 6/15/2011 at 9:30 AM. Mailed notice (am) (Entered: 02/07/2011)
531 MINUTE entry before Honorable James F. Holderman: ENTER NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING. Mailed notice (am) (Entered: 02/15/2011)
532 NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING. Signed by the Honorable James F. Holderman on 2/15/2011: Mailed notice (am) (Entered: 02/15/2011)
533 MINUTE entry before Honorable James F. Holderman: ENTER LEGAL NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING. Mailed notice (am) (Entered: 02/15/2011)
534 LEGAL NOTICE OF PROPOSED CLASS ACTION SETTLEMENT AND HEARING. Signed by the Honorable James F. Holderman on 2/15/2011: Mailed notice (am) (Entered: 02/15/2011)
535 MOTION by Defendants Julie Hamos, Michelle R.B. Saddler for order granting agreed motion to approve corrective letters regarding class notice (Attachments: # 1 Exhibit A, # 2 Exhibit B)(Stratton, Brent) (Entered: 03/14/2011)

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03/14/2011 03/16/2011 05/27/2011 05/27/2011 06/01/2011 06/01/2011 06/03/2011
06/06/2011 06/06/2011 06/09/2011
06/09/2011 06/15/2011
06/15/2011

536 NOTICE of Motion by Brent Douglas Stratton for presentment of motion for order 535 before Honorable James F. Holderman on 3/17/2011 at 09:00 AM. (Stratton, Brent) (Entered: 03/14/2011)
537 MINUTE entry before Honorable James F. Holderman: Defendants' agreed motion to approve corrective letters regarding class notice 535 is granted. Mailed notice (am) (Entered: 03/16/2011)
538 NOTICE by David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson (notice of filing of the written submissions their attorneys have received in response to the Notice of Proposed Class Action Settlement and Hearing) (Attachments: # 1 Exhibit A − J, # 2 Exhibit K pt 1, # 3 Exhibit K pt 2, # 4 Exhibit K pt 3, # 5 Exhibit L − U)(Shapiro, Corey) (Entered: 05/27/2011)
539 RESPONSE by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson, Defendants Julie Hamos, Michelle R.B. Saddler to notice of filing, 538 of Written Submissions (Enerson, Wendy) (Entered: 05/27/2011)
540 MOTION by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson for hearing Joint Motion for Status Conference of June 15, 2011 Fairness Hearing (Enerson, Wendy) (Entered: 06/01/2011)
541 NOTICE of Motion by Wendy N Enerson for presentment of motion for hearing 540 before Honorable James F. Holderman on 6/9/2011 at 09:00 AM. (Enerson, Wendy) (Entered: 06/01/2011)
542 MINUTE entry before Honorable James F. Holderman: In response to the parties' "Joint Motion for Status Conference Regarding Conduct of June 15, 2011 Fairness Hearing" 540 , the court has prepared a draft agenda for the June 15, 2011 fairness hearing, which is attached to this order. Counsel should be prepared to discuss the draft agenda at the motion call previously scheduled for 6/9/2011 at 9:00 a.m. Mailed notice (am) (Entered: 06/03/2011)
543 MOTION by Objector Mount St. Joseph Objectors to amend/correct Motion to Alter/Amend Consent Decree to Include Mt. Joseph Intervenors as Parties to the Proposed Consent Decree (Ripple, Christopher) (Entered: 06/06/2011)
544 NOTICE of Motion by Christopher A. Ripple for presentment of motion to amend/correct 543 before Honorable James F. Holderman on 6/9/2011 at 09:00 AM. (Ripple, Christopher) (Entered: 06/06/2011)
545 MINUTE entry before Honorable James F. Holderman:Plaintiffs' joint motion for status conference regarding conduct of June 15, 2011 fairness hearing 540 is granted. Mt. St. Joseph Intervenors' motion to alter or amend consent decree to include Mr. St. Joseph Intervenors as parties to the proposed consent decree 543 is granted. Motion hearing and status conference held on 6/9/2011. Mailed notice (am) (Entered: 06/13/2011)
546 REVISED Class Action Fairness Hearing Agenda June 15, 2011. (ber, ) (Entered: 06/14/2011)
547 MINUTE entry before Honorable James F. Holderman: Fairness hearing held. The court finds that reasonable notice of the proposed Consent Decree and of today's fairness hearing has been provided to all class members and potential class members in accordance with due process and governing law. Having considered all written submissions and the presentations made in open court, the court finds the proposed Consent Decree to be a fair, reasonable, and adequate resolution of this class action litigation, made at arms length between the parties and taking into account the benefits of litigation to the Plaintiffs as compared with the benefits offered by the proposed Consent Decree, the resources of the State of Illinois, and the needs of the Intervenors and other Individuals with Developmental Disabilities. The court hereby approves the proposed Consent Decree pursuant to Federal Rule of Civil Procedure 23. Decree to issue by separate court order. Mailed notice (am) (Entered: 06/15/2011)
548 MINUTE entry before Honorable James F. Holderman: ENTER CONSENT DECREE. Mailed notice (am) (Entered: 06/15/2011)

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06/15/2011 06/29/2011 06/29/2011 07/05/2011
07/05/2011 07/06/2011 07/06/2011 07/11/2011
07/19/2011 07/19/2011 12/15/2011 12/15/2011 02/02/2012 02/02/2012 02/15/2012
02/15/2012 09/27/2012 02/22/2013 02/22/2013

549 Consent Decree. Signed by the Honorable James F. Holderman on 6/15/2011: Mailed notice (am) (Entered: 06/15/2011)
550 MOTION by Plaintiffs David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson for judgment (Agreed Motion for the Entry of Judgment Order) (Attachments: # 1 Text of Proposed Order)(Enerson, Wendy) (Entered: 06/29/2011)
551 NOTICE of Motion by Wendy N Enerson for presentment of motion for judgment 550 before Honorable James F. Holderman on 7/5/2011 at 09:00 AM. (Enerson, Wendy) (Entered: 06/29/2011)
554 MINUTE entry before Honorable James F. Holderman: Plaintiffs agreed motion for entry of judgment order 550 is granted. ENTER JUDGMENT ORDER: In accordance with this Courts Consent Decree entered June 15, 2011 (Doc. No. 549), judgment is entered against the Defendants. Mailed notice (am) (Entered: 07/06/2011)
555 Judgment Order. Signed by the Honorable James F. Holderman on 7/5/2011: Mailed notice (am) (Entered: 07/06/2011)
552 MOTION by Plaintiff Stanley LigasJOINT MOTION TO APPOINT MONITOR (Attachments: # 1 Exhibit A)(Enerson, Wendy) (Entered: 07/06/2011)
553 NOTICE of Motion by Wendy N Enerson for presentment of motion for miscellaneous relief 552 before Honorable James F. Holderman on 7/12/2011 at 09:00 AM. (Enerson, Wendy) (Entered: 07/06/2011)
556 MINUTE entry before Honorable James F. Holderman: Parties' joint motion to appoint monitor 552 is granted. Counsel are requested to submit a proposed order to effectuate, in written detail as agreed to by the parties' counsel, this Court's granting of the joint motion to appoint monitor. The proposed order to be submitted no later than July 18, 2011 at 5:00 PM. Mailed notice (am) (Entered: 07/11/2011)
557 MINUTE entry before Honorable James F. Holderman: ENTER ORDER: It is hereby ordered that J. Anthony Records is appointed to be the Monitor in this case. Mailed notice (am) (Entered: 07/26/2011)
558 ORDER. Signed by the Honorable James F. Holderman on 7/19/2011: Mailed notice (am) (Entered: 07/26/2011)
559 Implementation Plan by Julie Hamos, Michelle R.B. Saddler (Stratton, Brent) (Entered: 12/15/2011)
560 NOTICE by Julie Hamos, Michelle R.B. Saddler re other 559 Implementation Plan (Stratton, Brent) (Entered: 12/15/2011)
561 MOTION by Defendants Julie Hamos, Michelle R.B. Saddler for order regarding implementation plan (Attachments: # 1 Exhibit)(Stratton, Brent) (Entered: 02/02/2012)
562 NOTICE of Motion by Brent Douglas Stratton for presentment of motion for order 561 before Honorable James F. Holderman on 2/16/2012 at 09:00 AM. (Stratton, Brent) (Entered: 02/02/2012)
563 MINUTE entry before Honorable James F. Holderman: Defendants' agreed motion to enter order regarding implementation plan 561 is granted. ENTER ORDER: It is hereby ordered that the Implementation Plan, attached hereto and previously filed by Defendants on December 15, 2011 (Doc. No. 559), is hereby filed as a supplement to the Consent Decree (Doc. No. 549).Mailed notice (am) (Entered: 02/15/2012)
564 ORDER. Signed by the Honorable James F. Holderman on 2/15/2012: Mailed notice (am) (Entered: 02/15/2012)
565 Annual Report of Monitor by Julie Hamos, Michelle R.B. Saddler (Stratton, Brent) (Entered: 09/27/2012)
566 MOTION by Defendants Julie Hamos, Michelle R.B. SaddlerApprove Amendments to Implementation Plan (Attachments: # 1 Exhibit Proposed Amended Implementation Plan, # 2 Exhibit Proposed Order)(Stratton, Brent) (Entered: 02/22/2013)
567 NOTICE of Motion by Brent Douglas Stratton for presentment of motion for miscellaneous relief 566 before Honorable James F. Holderman on 3/5/2013 at 09:00

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 69 of 82

03/05/2013
03/05/2013 04/01/2013 10/01/2013 02/24/2014 02/24/2014 02/24/2014
03/25/2014
03/25/2014 03/26/2014 03/26/2014
03/26/2014 03/27/2014

AM. (Stratton, Brent) (Entered: 02/22/2013)
568 MINUTE entry before Honorable James F. Holderman: Motion hearing held. Parties' agreed motion to approve amendments to implementation plan 566 is granted. Enter Order. [For further details see separate order.] Notice mailed by judge's staff (ntf, ) (Entered: 03/05/2013)
569 ORDER. Signed by the Honorable James F. Holderman on 3/5/2013:Notice mailed by judge's staff (ntf, ) (Entered: 03/05/2013)
570 Notice of Firm Name Change by Stanley Ligas (Grossbart, John) (Entered: 04/01/2013)
571 Second Annual Report of the Monitor by Julie Hamos, Michelle R.B. Saddler (Stratton, Brent) (Entered: 10/01/2013)
572 MOTION by counsel for Plaintiff Stanley Ligas to withdraw as attorney (Werner, Patricia) (Entered: 02/24/2014)
573 NOTICE of Motion by Patricia A. Werner for presentment of motion to withdraw as attorney 572 before Honorable James F. Holderman on 2/27/2014 at 09:00 AM. (Werner, Patricia) (Entered: 02/24/2014)
574 MINUTE entry before the Honorable James F. Holderman: Plaintiffs' motion to withdraw as class counsel 572 is granted. Attorney Patricia A. Werner is given leave to withdraw as counsel for Plaintiffs. Motion hearing date of 2/27/14 is stricken. Notice mailed by judge's staff (ntf, ) (Entered: 02/24/2014)
575 AGREED MOTION to Approve Amendments to Implementation Plan by Julie Hamos, Michelle R.B. Saddler (Attachments: # 1 Exhibit 1, # 2 Exhibit 2)(Stratton, Brent) (Docket Text Modified by Clerk's Office). Modified on 3/26/2014 (et, ). (Entered: 03/25/2014)
576 NOTICE of Motion by Brent Douglas Stratton for presentment of before Honorable James F. Holderman on 4/3/2014 at 09:00 AM. (Stratton, Brent) (Entered: 03/25/2014)
577 NOTICE of Correction regarding 575 . (et, ) (Entered: 03/26/2014)
578 MINUTE entry before the Honorable James F. Holderman: Parties' agreed motion to approve amendments to implementation plan 575 is granted. Enter Order. Motion hearing date of 4/3/14 is stricken. [For further details see separate order.] Notice mailed by judge's staff (ntf, ) (Entered: 03/26/2014)
579 ORDER. Signed by the Honorable James F. Holderman on 3/26/2014. Notice mailed by judge's staff (ntf, ) (Entered: 03/26/2014)
580 MOTION by counsel for Objectors Kris Absalonsen, Suzanne C. Allison, Kathleen Alsobrook, Aldo Azzolin, Andrea Rae Azzolin, June M. Azzolin, James F. Bachman, Mary Lou Bachman, Diane Banks, Thomas J. Boltz, Marie Bonynge, Camden Bouschard, Patricia Bowles, Judith Ann Brandt, Ann Terese Breitenbeck, Joseph T. Breitenbeck, David Brockmann, Sheri Lynn Brockmann, Valerie Brockmann, Debbie Campbell, Mary L. Carden, Mary Carol Carden, Alfred A. Ceragioli, Donna Marie Ceragioli, Emily Ceragioli, Elaine Christiansen, Kathleen M. Christiansen, Keith W. Christiansen, Kathleen Cooney, Beth Ellen Covington, Theresa M. Covington, Linda G. Croke, Mary Dattis, Andrea DeFrancesco, J. DeFrancesco, Julia A. Dodge, Patricia E. Doyle, John Drews, Judith Drews, Karen M. Drews, Margaret L. Duffey, Christine E. Duffy, James E. Ehrhardt, Marjorie Ehrhardt, Mary Ann Ehrhardt, Sandra Elesh, William Elesh, Judi Farr, Charles D. Fitz−Hugh, Jr, Jean M. Fitz−Hugh, Mildred Fitzpatrick, Mary Terese Foley, Julia Ann Framarin, Darlene Glaser, Madeline M. Glaser, Anne Ruth Golden, Paula A. Golden, Samuel Golden, Rebecca R. Goldkuhle, Dale T. Gomez, Lisa M. Gomez, Janice A. Griffin, George J. Grimelli, Lisa Grimelli, Sally Hanley, Gloria V. Heffernan, Janet Heisse, Marilyn Heisse, James Hill, Yolanda V. Hoffmann, Dolores Horan, Akira Iriye, Keiko Iriye, Jean Ivaska, Paul J. Ivaska, Elizabeth Kaufman, Michelle Keacher, John J. Knych, Linda Knych, Nancy Kolinen, Anne Kuldanek, Shirley LaBeau, Mary E. LaMaster, Nancy Covington Langsdale, Kerry M. Lavelle, Shannon Lavelle, Arlene Ledebuhr, Renee Leone, Dorothy E. Lind, David Lindsay, Daniel Litwicki, Gina Litwicki, Mary Christine Mangos, Rosella M. McCarthy, Mary McDaniel, Simone McDaniel, Daniel V. McDevitt, Elizabeth J.

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 70 of 82

03/27/2014 04/02/2014 10/01/2014 01/16/2015 01/16/2015 01/20/2015 06/05/2015 06/16/2015 06/16/2015 06/17/2015
06/17/2015 06/18/2015

McDevitt, Thomas McEvy, J. Milton McGinnis, Nona McGinnis, Susan McMahon, Patricia J. Menges, Kathleen L. Merker, Richard S. Merker, Sandra L. Merker, Sherry Morena, James P. Napoleon, Karen Napoleon, Mark Napoleon, Teresa C. Newsom, Gina Novak, Laura Novak, Kathleen O'Brien, John J. O'Connell, Rita E. O'Connell, Karen Olker, Diane Paulus, Neal Paulus, Kirsten Peak, Lorraine Pewnicki, Doris Pfrenger, Eugene A. Philipp, Kathleen Philipp, Anne N. Pierce, Peter J. Pustorino, Ruth Pustorino, Christine T. Radgowski, Jessie Radgowski, Marian Radgowski, Rita Raggi, Lisa Maria Ramos, Santiago V. Ramos, Alverna Ricke, James D. Rieck, Mary C. Rieck, Megan K. Rieck, Alan Ritter, Ashley Ritter, Barbara Ritter, Jackie Romolo, Margaret M. Rowley, Maura A. Rowley, Christina Lynn Rud, Donald R. Rud, Kathleen Marie Rychlick, Marlene P. Rychlick, Janet M. Scahill, Edward J. Schnitzius, Mary C. Schnitzius, Judy Mangos Schomer, Michael Schomer, Richard Forrest Sloan, Mary Stein, Virginia Sullivan, James R. Swiat, Molly Swiat, Lynn Tomaszkiewicz, Patricia Volini, Julie Vowinkel, Rebecca Vowinkel, Scott G. Vowinkel, Jeanne M. Wadhams, Donald Waldvogel, Jill Waldvogel, Karolyn K. Wasserman, Hope Weaver, Raymond A. Weaver, Colette Wiemer, Edward Wiemer, Arlene William, Marlene Zajack to withdraw as attorney (Ripple, Christopher) (Entered: 03/27/2014)
581 NOTICE of Motion by Christopher A. Ripple for presentment of motion to withdraw as attorney,,,,,,,,,,,, 580 before Honorable James F. Holderman on 4/15/2014 at 09:00 AM. (Ripple, Christopher) (Entered: 03/27/2014)
582 MINUTE entry before the Honorable James F. Holderman: Mt. St. Josheph's Residents' motion to withdraw Christopher A. Ripple as attorney 580 is granted. Motion hearing date of 4/15/14 is stricken. Notice mailed by judge's staff (ntf, ) (Entered: 04/02/2014)
583 Third Annual Report of the Monitor by Julie Hamos, Michelle R.B. Saddler (Stratton, Brent) (Entered: 10/01/2014)
584 MOTION by counsel for Plaintiff Stanley Ligas to withdraw as attorney (Attachments: # 1 Text of Proposed Order)(Whitcomb, John) (Entered: 01/16/2015)
585 NOTICE of Motion by John Warren Whitcomb for presentment of before Honorable James F. Holderman on 1/22/2015 at 09:30 AM. (Whitcomb, John) (Entered: 01/16/2015)
586 MINUTE entry before the Honorable James F. Holderman: Plaintiffs' motion to withdraw as counsel 584 is granted. Attorney John Warren Whitcomb is given leave to withdraw as counsel for Plaintiffs. Motion hearing date of 1/22/15 is stricken. Notice mailed by judge's staff (ntf, ) (Entered: 01/20/2015)
587 NOTICE by William Choslovsky of Change of Address (Choslovsky, William) (Entered: 06/05/2015)
588 MOTION by Plaintiff Stanley Ligas to Appoint Successor Monitor (JOINT MOTION) (Attachments: # 1 Exhibit A)(Taylor, Barry) (Entered: 06/16/2015)
589 (JOINT MOTION) NOTICE of Motion by Barry Charlton Taylor for presentment of motion for miscellaneous relief 588 before Honorable James F. Holderman on 6/18/2015 at 09:30 AM. (Taylor, Barry) (Entered: 06/16/2015)
590 EXECUTIVE COMMITTEE ORDER: It appearing that further judicial action is required in 05 C 4331, Ligas et al., v. Hamos et al., before the Hon. James F. Holderman, who is no longer sitting; and It further appearing that the Executive Committee has determined that the above−referenced case should be reassigned by lot; therefore It is hereby ordered that the Clerk of Court is to reassign 05 C 4331, Ligas et al., v. Hamos et al., by lot to another district judge of this Court. Case reassigned to the Honorable Sharon Johnson Coleman for all further proceedings. Signed by Executive Committee on 6/17/2015.(mr, ) (Entered: 06/17/2015)
591 (JOINT MOTION) NOTICE of Motion by Barry Charlton Taylor for presentment of motion for miscellaneous relief 588 before Honorable Sharon Johnson Coleman on 6/23/2015 at 08:45 AM. (Taylor, Barry) (Entered: 06/17/2015)
592 (Joint Motion) Second Amended NOTICE of Motion by Barry Charlton Taylor for presentment of motion for miscellaneous relief 588 before Honorable Sharon Johnson

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06/24/2015 06/30/2015
06/30/2015 06/30/2015
06/30/2015 07/20/2015 07/20/2015 07/22/2015 07/22/2015 08/06/2015 08/06/2015 08/07/2015 08/11/2015
08/14/2015

Coleman on 6/25/2015 at 08:45 AM. (Taylor, Barry) (Entered: 06/18/2015)
593 MINUTE entry before the Honorable Sharon Johnson Coleman: Plaintiff's motion to apapoint successor monitor 588 is granted. The Court appoints Ronnie Cohn toserve as the Monitor in the case. No appearance required on 6/25/2015.Mailed notice (rth, ) (Entered: 06/24/2015)
594 MOTION by Plaintiffs Lorene Bierman, Burton A. Brown, David Childers, David Cicarelli, Isaiah Fair, Adam Kulig, Stanley Ligas, Jamie McElroy, Tiffany McFadden, Alex Tyner, Jennifer Wilson for order to Maintain Compliance with Consent Decree (JOINT EMERGENCY MOTION) (Attachments: # 1 Exhibit 1 − Proposed Agreed Order)(Wolf, Benjamin) (Entered: 06/30/2015)
595 NOTICE of Motion by Benjamin S. Wolf for presentment of (Wolf, Benjamin) (Entered: 06/30/2015)
596 MINUTE entry before the Honorable Sharon Johnson Coleman: Joint emergency motion for order requiring the Illinois State Comptroller to continue to make payments for the current programs, services and personnel that are required by the Consent Decree approved by this Court on June 15, 2011 594 is granted. Enter Agreed Order. No appearance required on 7/1/2015.Mailed notice (rth, ) (Entered: 06/30/2015)
597 AGREED ORDER TO MAINTAIN COMPLIANCE WITH CONSENT DECREE Signed by the Honorable Sharon Johnson Coleman on 6/30/2015:Mailed notice(rth, ) (Entered: 06/30/2015)
598 MOTION by Defendants Julie Hamos, Michelle R.B. Saddler to amend/correct Agreed motion to approve amendments to implementation plan (Attachments: # 1 Exhibit Amended Implementation Plan, # 2 Exhibit Proposed Order)(Stratton, Brent) (Entered: 07/20/2015)
599 NOTICE of Motion by Brent Douglas Stratton for presentment of motion to amend/correct 598 before Honorable Sharon Johnson Coleman on 7/23/2015 at 08:45 AM. (Stratton, Brent) (Entered: 07/20/2015)
600 MINUTE entry before the Honorable Sharon Johnson Coleman: Defendants' agreed motion to approve amendments to implementation plan 598 is granted. Enter Order. No appearance required on 7/23/2015.Mailed notice (rth, ) (Entered: 07/22/2015)
601 ORDER Signed by the Honorable Sharon Johnson Coleman on 7/22/2015:Mailed notice(rth, ) (Entered: 07/22/2015)
602 MOTION by Plaintiff Stanley Ligas to enforce consent decree and agreed order (JOINT MOTION OF PLAINTIFFS AND INTERVENORS) (Attachments: # 1 Exhibit 1−14)(Miller, Laura) (Entered: 08/06/2015)
603 NOTICE of Motion by Laura J. Miller for presentment of motion to enforce 602 before Honorable Sharon Johnson Coleman on 8/11/2015 at 08:45 AM. (Miller, Laura) (Entered: 08/06/2015)
604 EXHIBIT by Plaintiff Stanley Ligas CORRECTED EXHIBIT 14 regarding MOTION by Plaintiff Stanley Ligas to enforce consent decree and agreed order (JOINT MOTION OF PLAINTIFFS AND INTERVENORS) 602 (Wolf, Benjamin) (Entered: 08/07/2015)
605 MINUTE entry before the Honorable Sharon Johnson Coleman: Motion hearing held on 8/11/2015 on Plaintiffs' Motion to Enforce the Consent Decree 602 . The Court heard arguments and the parties agree that the matter is substantively not in dispute. The Court allows the parties 48 hours to provide the Court with a proposed Order for entry resolving enforcement of the consent decree and agreed order. Mailed notice (rth, ) (Entered: 08/11/2015)
606 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 8/14/2015. Status hearing set for 8/18/2015 at 02:00 PM. The parties shall submit either an agreed draft order or their individual draft orders at the next hearing. If no agreement is reached on the language, the court will draft and enter an order as it deems appropriate.Mailed notice (rth, ) (Entered: 08/14/2015)

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08/17/2015 08/17/2015 08/18/2015 08/18/2015 08/21/2015 08/21/2015 08/21/2015
08/25/2015
08/25/2015 08/26/2015

607 MOTION by Movants Stacie Athansopoulos, Lauren Axelrod, Genevieve Benner, Craig Miller, Maggie Murphy, Matthew Nilson, Karmen Razman to withdraw as Counsel for Jason Marks (Mendel, Scott) (Entered: 08/17/2015)
608 NOTICE of Motion by Scott M. Mendel for presentment of motion to withdraw 607 before Honorable Sharon Johnson Coleman on 9/9/2015 at 08:45 AM. (Mendel, Scott) (Entered: 08/17/2015)
609 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 8/18/2015. 1.Plaintiffs' and Intervenors' Joint Motion to Enforce Consent Decree and Agreed Order 602 is granted. This Order shall remain in effect until the State enacts a budget for FY 2016 or until further order of this Court. This matter is set for a status hearing on September 9, 2015 at 9:00 a.m. At that time the parties shall report to the Court on the State's compliance with this Order. Enter Order.Mailed notice (rth, ) (Entered: 08/18/2015)
610 ORDER Signed by the Honorable Sharon Johnson Coleman on 8/18/2015:Mailed notice(rth, ) (Entered: 08/18/2015)
611 NOTICE OF EMAIL NOTIFICATION FAILURE, for document #604 sent to Attorney Warren von C. Baker returned as: Unknown Address. The Clerk telephoned Warren von C. Baker, no contact made. Document 604 mailed to attorney Warren von C. Baker with Letter re: bounce back email and a Notification of Change of Address form. Notices have been set to No. Counsel must email the Clerk's Office at Docketing_ILND@uscourts.gov when a Notification of Change of Address has been filed to ensure electronic notification is reset. (ea, ) (Entered: 08/21/2015)
612 NOTICE OF EMAIL NOTIFICATION FAILURE, for document #604 sent to Attorney Thomas J. Kiser returned as: Unknown Address Error. The Clerk telephoned Thomas J. Kiser, no contact made. Document 604 mailed to attorney Thomas J. Kiser with Letter re: bounce back email and a Notification of Change of Address form. Notices have been set to No. Counsel must email the Clerk's Office at Docketing_ILND@uscourts.gov when a Notification of Change of Address has been filed to ensure electronic notification is reset. (ea, ) (Entered: 08/21/2015)
613 NOTICE OF EMAIL NOTIFICATION FAILURE, for document #604 sent to Attorney Samuel Phillip Linsenmaier returned as: Unknown Address. The Clerk telephoned Samuel Phillip Linsenmaier, no contact made. Document 604 mailed to attorney Samuel Phillip Linsenmaier with Letter re: bounce back email and a Notification of Change of Address form. Notices have been set to No. Counsel must email the Clerk's Office at Docketing_ILND@uscourts.gov when a Notification of Change of Address has been filed to ensure electronic notification is reset. (ea, ) (Entered: 08/21/2015)
614 MOTION by Intervenor Parties Thomas Patrick Arundel, Camille Baranchik, Andrew Battle, Gregory Boland, Timothy Bolin, Maureen Bradish, Burton A Brown, Daniel Brown, Deborah Brown, Jeffrey Dralle, Elizabeth Flesch, Lucas Gaynor, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Chris Hanley, Kirk Hartemayer, Illinois Health Care Association, Thomas Kerrigan, Timothy Kiesow, Becky Levy, Diane Levy, Edward Levy, Rosemary Lopez, Anne Marie McKee, Craig Miller, Kevin O'Boyle, Residents of Misericordia, Britton Rickerson, Wendy Schuppan, Ernest Stark, David Swain, Douglas Swain, Jennifer Turry, John Ward, Kristin Ward, Jennifer Westberg, Plaintiffs Lorene Bierman, Burton A. Brown, David Childers, David Cicarelli, Isaiah Fair, Adam Kulig, Stanley Ligas, Jamie McElroy, Tiffany McFadden, Alex Tyner, Jennifer Wilson, Intervenor Plaintiff John McDermott for rule to show cause Why Defendants Should Not Be Held In Contempt Of Court (Emergency Joint Motion Of Plaintiffs and Intervenors) (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3, # 4 Exhibit 4)(Taylor, Barry) (Entered: 08/25/2015)
615 (Joint Motion) NOTICE of Motion by Barry Charlton Taylor for presentment of motion for rule to show cause,,,, 614 before Honorable Sharon Johnson Coleman on 8/26/2015 at 09:45 AM. (Taylor, Barry) (Entered: 08/25/2015)
616 MINUTE entry before the Honorable Sharon Johnson Coleman:Motion hearing held on 8/26/2015 on Plaintiffs/Intervenors Motion for Rule to Show Cause 614 . After hearing arguments on the motion and an update on the defendants' position, the Court directs the defendants to file a response by 12:00 p.m. (noon) on Friday 8/28/2015 to

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08/28/2015 08/31/2015
08/31/2015 09/01/2015
09/01/2015 09/04/2015 09/04/2015 09/28/2015

the motion that includes an affidavit setting forth what efforts have been made to comply with this Court's Order of 8/18/2015, what payments have been made, what payments remain to bring the defendants into compliance with this Court's Order enforcing the Consent Decree. Additionally, defendants must provide a list of payments that have been made since 8/18/2015 to any other entity (not the beneficiaries here) that may have impacted payments due under this Consent Decree. The defendants are further directed to provide both an explanation of any continued non−compliance as well as a timeline for expected compliance. Plaintiffs/intervenors may reply in support of their motion by 5:00 p.m. on Monday 8/31/2015. Nothing in this Court's Order or previous Order was intended to mandate payments be made on a faster schedule than they would have been made, as the parties agreed, in FY 2015. Status hearing set for 9/1/2015 at 10:00 a.m. Mailed notice (air, ) (Entered: 08/26/2015)
617 RESPONSE by Julie Hamos, Michelle R.B. Saddler to MOTION by Intervenor Parties Thomas Patrick Arundel, Camille Baranchik, Andrew Battle, Gregory Boland, Timothy Bolin, Maureen Bradish, Burton A Brown, Daniel Brown, Deborah Brown, Jeffrey Dralle, Elizabeth Flesch, Lucas Gaynor, Anne Golden, Samuel Gold 614 (Attachments: # 1 Declaration Declaration of Robert Brock, # 2 Affidavit Affidavit of Kevin Fitzpatrick, # 3 Affidavit Affidavit of Steven Valasek, # 4 Declaration Declaration of Michael Casey)(Stratton, Brent) (Entered: 08/28/2015)
618 REPLY by Thomas Patrick Arundel, Camille Baranchik, Andrew Battle, Lorene Bierman, Gregory Boland, Timothy Bolin, Maureen Bradish, Burton A Brown, Burton A. Brown, Daniel Brown, Deborah Brown, David Childers, David Cicarelli, Jeffrey Dralle, Isaiah Fair, Elizabeth Flesch, Lucas Gaynor, Anne Golden, Samuel Golden, Edward Grossman, Marianna Grossman, Chris Hanley, Kirk Hartemayer, Illinois Health Care Association, Thomas Kerrigan, Timothy Kiesow, Adam Kulig, Becky Levy, Diane Levy, Edward Levy, Stanley Ligas, Rosemary Lopez, John McDermott, Jamie McElroy, Tiffany McFadden, Anne Marie McKee, Craig Miller, Kevin O'Boyle, Residents of Misericordia, Britton Rickerson, Wendy Schuppan, Ernest Stark, David Swain, Douglas Swain, Jennifer Turry, Alex Tyner, John Ward, Kristin Ward, Jennifer Westberg to MOTION by Intervenor Parties Thomas Patrick Arundel, Camille Baranchik, Andrew Battle, Gregory Boland, Timothy Bolin, Maureen Bradish, Burton A Brown, Daniel Brown, Deborah Brown, Jeffrey Dralle, Elizabeth Flesch, Lucas Gaynor, Anne Golden, Samuel Gold 614 , response to motion,, 617 (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E, # 6 Exhibit F, # 7 Exhibit G, # 8 Exhibit H, # 9 Exhibit I, # 10 Exhibit J)(Taylor, Barry) (Entered: 08/31/2015)
619 EXHIBIT by Plaintiff Stanley Ligas (Corrected Exhibit I) regarding reply to response to motion,,,,, 618 (Taylor, Barry) (Entered: 08/31/2015)
620 MINUTE entry before the Honorable Sharon Johnson Coleman: Motion hearing held on 9/1/2015. Plaintiffs' motion for rule to show cause 614 is denied without prejudice. The Court having considered the submissions of the parties and the arguments made in court finds that defendants are in substantial compliance with the Consent Decree and this Court's Orders as of the 9/1/2015 hearing. The parties are directed to submit an agreed order setting forth the payment plan going forward in light of the ongoing state budget impasse and to include language addressing the role of the new court monitor as to payment plan implementation and compliance. Status hearing set for 10/16/2015 at 9:30 a.m.Mailed notice (rth, ) (Entered: 09/01/2015)
624 ORDER Signed by the Honorable Sharon Johnson Coleman on 9/1/2015:Mailed notice(rth, ) (Entered: 09/28/2015)
621 MINUTE entry before the Honorable John J. Tharp, Jr: Motion to Withdraw Counsel 607 is granted with no appearance necessary on 9/9/2015. Mailed notice(air, ) (Entered: 09/04/2015)
622 MINUTE entry before the Honorable Sharon Johnson Coleman: Minute entry 621 is stricken. Motion to Withdraw Counsel 607 is granted with no appearance necessary on 9/9/2015. Mailed notice (air, ) (Entered: 09/04/2015)
623 MINUTE entry before the Honorable Sharon Johnson Coleman: Pursuant to minute entry dated 9/1/2015 (#620), Enter Order nunc pro tunc.Mailed notice (rth, ) (Entered: 09/28/2015)

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10/16/2015 12/14/2015 01/08/2016 01/26/2016

625 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 10/16/2015. Status hearing set for 12/14/2015 at 09:00 AM.Mailed notice (rth, ) (Entered: 10/18/2015)
626 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 12/14/2015. Defendant did not appear. Status hearing set for 3/14/2016 at 09:00 AM.Mailed notice (rth, ) (Entered: 12/15/2015)
627 Fourth Annual Report of the Monitor by Julie Hamos, Michelle R.B. Saddler (Stratton, Brent) (Entered: 01/08/2016)
628 TRANSCRIPT OF PROCEEDINGS held on 8/18/15 before the Honorable Sharon Johnson Coleman. Court Reporter Contact Information: TRACEY D. McCULLOUGH, 312−435−5570, Tracey_Mccullough@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

01/26/2016

Redaction Request due 2/16/2016. Redacted Transcript Deadline set for 2/26/2016. Release of Transcript Restriction set for 4/25/2016. (Mccullough, Tracey) (Entered: 01/26/2016)
629 TRANSCRIPT OF PROCEEDINGS held on 8/26/15 before the Honorable Sharon Johnson Coleman. Court Reporter Contact Information: TRACEY D. McCULLOUGH, 312−435−5570, Tracey_Mccullough@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

03/09/2016 03/14/2016 05/16/2016 06/13/2016

Redaction Request due 2/16/2016. Redacted Transcript Deadline set for 2/26/2016. Release of Transcript Restriction set for 4/25/2016. (Mccullough, Tracey) (Entered: 01/26/2016)
630 STATUS Report (Joint) by Stanley Ligas (Attachments: # 1 Exhibit 1, # 2 Exhibit 2)(Taylor, Barry) (Entered: 03/09/2016)
631 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 3/14/2016. Status hearing set for 5/16/2016 at 09:00 AM.Mailed notice (rth, ) (Entered: 03/16/2016)
632 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 5/16/2016. Status hearing set for 7/18/2016 at 09:00 AM.Mailed notice (rth, ) (Entered: 05/16/2016)
633 TRANSCRIPT OF PROCEEDINGS held on 3/14/16 before the Honorable Sharon Johnson Coleman. Court Reporter Contact Information: TRACEY D. McCULLOUGH, 312−435−5570, Tracey_Mccullough@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

Redaction Request due 7/4/2016. Redacted Transcript Deadline set for 7/14/2016. Release of Transcript Restriction set for 9/12/2016. (Mccullough, Tracey) (Entered: 06/13/2016)

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06/22/2016 06/22/2016 06/27/2016 06/28/2016 07/18/2016 09/19/2016 09/19/2016
11/02/2016

634 MOTION by Plaintiff Stanley Ligas for order (Joint motion for agreed order) (Attachments: # 1 Exhibit 1, Proposed Order, # 2 Exhibit 2, Order dated 6−30−2015, # 3 Exhibit 3, Order dated 8−18−2015, # 4 Exhibit 4, Order dated 9−1−2015)(Taylor, Barry) (Entered: 06/22/2016)
635 (Notice of Joint Motion) NOTICE of Motion by Barry Charlton Taylor for presentment of motion for order, 634 before Honorable Sharon Johnson Coleman on 6/28/2016 at 08:45 AM. (Taylor, Barry) (Entered: 06/22/2016)
636 MINUTE entry before the Honorable Sharon Johnson Coleman: Joint agreed motion for entry of agreed order extending the Consent Decree for the new fiscal year beginning on July 1, 2016 634 is granted. No appearance required on 6/28/2016. Order to follow upon the court's review.Mailed notice (rth, ) (Entered: 06/27/2016)
637 AGREED ORDER TO MAINTAIN COMPLIANCE WITH CONSENT DECREE Signed by the Honorable Sharon Johnson Coleman on 6/28/2016:Mailed notice(rth, ) (Entered: 06/28/2016)
638 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 7/18/2016. Status hearing set for 9/19/2016 at 09:00 AM.Mailed notice (rth, ) (Entered: 07/19/2016)
639 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 9/19/2016. Status hearing set for 12/9/2016 at 09:00 AM.Mailed notice (rth, ) (Entered: 09/19/2016)
640 NOTICE OF EMAIL NOTIFICATION FAILURE, for document # 639 sent to Attorney Karen Elaine Konieczny returned as: Unknown Address Error. Mailed to attorney Karen Elaine Konieczny a Letter re: bounce back email and a Notification of Change of Address form. Notices have been set to No. Counsel must email the Clerk's Office at Docketing_ILND@uscourts.gov when a Notification of Change of Address has been filed to ensure electronic notification is reset. (ek, ) (Entered: 09/20/2016)
641 TRANSCRIPT OF PROCEEDINGS held on 9/1/15 before the Honorable Sharon Johnson Coleman. Court Reporter Contact Information: TRACEY D. McCULLOUGH, 312−435−5570, tracey_mccullough@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

11/17/2016 12/09/2016
12/21/2016
01/18/2017
01/20/2017 02/06/2017

Redaction Request due 11/23/2016. Redacted Transcript Deadline set for 12/5/2016. Release of Transcript Restriction set for 1/31/2017. (Mccullough, Tracey) (Entered: 11/02/2016)
642 Revised Implementation Plan by Julie Hamos (Stratton, Brent) (Entered: 11/17/2016)
643 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 12/9/2016. Status hearing set for 2/10/2017 at 09:00 AM.Mailed notice (rth, ) (Entered: 12/09/2016)
645 MAIL RETURNED, for document # 643 sent to Burton A. Brown returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 161 N. Clark St. #1600, Chicago, IL 60601. (jh, ) (Entered: 01/18/2017)
644 ATTORNEY Appearance for Plaintiffs Burton A. Brown, David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson by Amanda C Antholt (Antholt, Amanda) (Entered: 01/18/2017)
646 Court Monitor Report by Julie Hamos (Stratton, Brent) (Entered: 01/20/2017)
647 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing set for 2/10/2017 is stricken and reset, sua sponte to 2/15/2017 at 09:00 AM.Mailed notice (rth, ) (Entered: 02/06/2017)

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02/15/2017 02/21/2017
02/22/2017 02/24/2017 02/27/2017 03/02/2017 03/09/2017 03/09/2017 03/13/2017 03/15/2017 03/23/2017 03/29/2017 04/05/2017 04/05/2017 04/05/2017

648 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 2/15/2017. Status hearing set for 3/3/2017 at 10:30 AM.Mailed notice (rth, ) (Entered: 02/15/2017)
649 MAIL RETURNED, for document # 647 sent to Kevin Francis Burke returned as undeliverable, return to sender. No new contact information received; therefore future mailings will not be sent until a new address is provided to the Clerk's Office using a Notification of Change of Address or Pro Se Appearance form. (jh, ) (Entered: 02/23/2017)
650 MAIL RETURNED, for document # 648 sent to Burton A. Brown returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 161 N. Clark, 16th Floor, Chicago, IL 60601. (jh, ) (Entered: 02/23/2017)
651 RESPONSE by Defendants Julie Hamos, Michelle R.B. Saddler to other 646 Fifth Annual Report of Monitor (Attachments: # 1 Exhibit A, # 2 Exhibit B)(Stratton, Brent) (Entered: 02/24/2017)
652 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing set for 3/3/2017 is stricken and reset, sua sponte to 3/2/2017 at 10:30 AM.Mailed notice (rth, ) (Entered: 02/27/2017)
653 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 3/2/2017. Plaintiffs to file its motion to enforce the judgment by 4/7/2017. Response due by 5/8/2017. Reply due by 5/22/2017.Mailed notice (rth, ) (Entered: 03/05/2017)
654 MOTION by Attorney Barry G. Lowy to withdraw as attorney for Stanley Ligas. No party information provided (Taylor, Barry) (Entered: 03/09/2017)
655 NOTICE of Motion by Barry Charlton Taylor for presentment of motion to withdraw as attorney 654 before Honorable Sharon Johnson Coleman on 3/16/2017 at 08:45 AM. (Taylor, Barry) (Entered: 03/09/2017)
656 MAIL RETURNED, for document # 652 sent to Kevin Francis Burke returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 23 Millbrook Ln., Bolton MA 01740−1347 (address found on return envelope) (cc, ) (Entered: 03/15/2017)
657 MINUTE entry before the Honorable Sharon Johnson Coleman: Motion by attorney Barry G. Lowy for leave to withdraw as attorney for plaintiffs 654 is granted. No appearance required on 3/16/2017. Attorney Barry G. Lowy terminated.Mailed notice (rth, ) (Entered: 03/15/2017)
658 MAIL RETURNED, for document # 657 sent to Burton A. Brown returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 161 N. Clark St., Ste 4700, Chicago, IL. 60601 (cc, ) (Entered: 03/29/2017)
659 MAIL RETURNED, for document # 657 sent to Kevin Francis Burke returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 23 Millbrook Ln., Bolton MA 01740−1347 (cc, ) (Entered: 03/29/2017)
660 MOTION by Plaintiff Stanley Ligas for leave to file excess pages (Unopposed) (Antholt, Amanda) (Entered: 04/05/2017)
661 NOTICE of Motion by Amanda C Antholt for presentment of motion for leave to file excess pages 660 before Honorable Sharon Johnson Coleman on 4/11/2017 at 08:45 AM. (Antholt, Amanda) (Entered: 04/05/2017)
662 TRANSCRIPT OF PROCEEDINGS held on 2/15/17 before the Honorable Sharon Johnson Coleman. Court Reporter Contact Information: TRACEY D. McCULLOUGH, 312−435−5570, tracey_mccullough@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 77 of 82

the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

04/07/2017 04/07/2017 04/07/2017
04/07/2017 04/10/2017
04/24/2017 05/01/2017 05/01/2017 05/02/2017 05/04/2017
05/04/2017 05/11/2017

Redaction Request due 4/26/2017. Redacted Transcript Deadline set for 5/8/2017. Release of Transcript Restriction set for 7/5/2017. (Mccullough, Tracey) (Entered: 04/05/2017)
663 MOTION by Plaintiff Stanley Ligas to file instanter overised brief UNOPPOSED (Attachments: # 1 Exhibit (Motion to Enforce))(Antholt, Amanda) (Entered: 04/07/2017)
664 NOTICE of Motion by Amanda C Antholt for presentment of motion to file instanter 663 before Honorable Sharon Johnson Coleman on 4/11/2017 at 08:45 AM. (Antholt, Amanda) (Entered: 04/07/2017)
665 Exhibit List In Support of Joint Motion to Enforce by Stanley Ligas. (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3, # 4 Exhibit 4, # 5 Exhibit 5, # 6 Exhibit A, # 7 Exhibit B, # 8 Exhibit C, # 9 Exhibit D, # 10 Exhibit E, # 11 Exhibit F, # 12 Exhibit G, # 13 Exhibit H, # 14 Exhibit I, # 15 Exhibit J, # 16 Exhibit K, # 17 Exhibit L, # 18 Exhibit M, # 19 Exhibit N, # 20 Exhibit O, # 21 Exhibit P, # 22 Exhibit Q, # 23 Exhibit R, # 24 Exhibit S, # 25 Exhibit T, # 26 Exhibit U)(Antholt, Amanda) (Entered: 04/07/2017)
666 MOTION by Plaintiff Stanley Ligas to file instanter (Corrected, Unopposed) (Attachments: # 1 Exhibit A)(Antholt, Amanda) (Entered: 04/07/2017)
667 MINUTE entry before the Honorable Sharon Johnson Coleman: Plaintiff's unopposed corrected motion for leave to file oversized brief instanter 666 is granted. No appearance required on 4/11/2017. Plaintiff's unopposed motions for leave to file oversized brief 660 663 are stricken as duplicative.Mailed notice (rth, ) (Entered: 04/10/2017)
668 MAIL RETURNED, for document # 667 sent to Kevin Francis Burke returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 23 Millbrook Ln Bolton MA 01740−1347. (bg, ) (Entered: 04/26/2017)
669 MOTION by Defendants Julie Hamos, Michelle R.B. Saddler for extension of time (Stratton, Brent) (Entered: 05/01/2017)
670 NOTICE of Motion by Brent Douglas Stratton for presentment of extension of time 669 before Honorable Sharon Johnson Coleman on 5/4/2017 at 08:45 AM. (Stratton, Brent) (Entered: 05/01/2017)
671 RESPONSE by Stanley Ligasin Opposition to MOTION by Defendants Julie Hamos, Michelle R.B. Saddler for extension of time 669 (Antholt, Amanda) (Entered: 05/02/2017)
672 MINUTE entry before the Honorable Sharon Johnson Coleman: Motion hearing held on 5/4/2017 on Defendants' Motion for Extension of Time to Respond to Plaintiffs' and Intervenors' Joint Motion to Enforce the Consent Decree 669 . After hearing arguments on the motion and reviewing the parties' submissions, this Court grants the motion and extends the briefing schedule as follows. Defendants to file their response on or before 6/23/2017. Plaintiffs and Intervenors to file their Replies by 6/7/2017. Once fully briefed the motion will be taken under advisement and the Court will rule expeditiously.Mailed notice (rth, ) (Entered: 05/04/2017)
673 MINUTE entry before the Honorable Sharon Johnson Coleman: Minute entry #672 is amended in part as follows: "Defendants to file their response on or before 6/23/2017. Plaintiffs and Intervenors to file their Replies by 7/7/2017." The remainder of the entry shall stand.Mailed notice (rth, ) (Entered: 05/04/2017)
674 MAIL RETURNED, for document # 672 and 673 sent to Burton a. Brown returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed 672 and 673 to Burton A. Brown, Law Office of Burton a. Brown, 161 North Clark St, STE 4700, Chicago, IL 60601−3201. (bg, ) (Entered: 05/12/2017)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 78 of 82

05/19/2017
06/19/2017 06/19/2017 06/21/2017 06/21/2017 06/21/2017 06/23/2017 06/26/2017
06/28/2017 06/28/2017 07/05/2017
07/05/2017
07/06/2017 07/10/2017 07/14/2017 07/17/2017
07/27/2017

675 MAIL RETURNED, for document # 672 and 673 sent to Kevin Francis Burke returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed 672 and 673 to 23 Millbrook Ln Bolton MA 01740−1347. (bg, ) (Entered: 05/22/2017)
676 MOTION by Plaintiff Stanley Ligas for Entry of Agreed Order (Emergency Motion) (Antholt, Amanda) (Entered: 06/19/2017)
677 NOTICE of Motion by Amanda C Antholt for presentment of motion for miscellaneous relief 676 before Honorable Andrea R. Wood on 6/22/2017 at 09:00 PM. (Antholt, Amanda) (Entered: 06/19/2017)
678 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing set for 7/5/2017 at 11:00 AM.Mailed notice (rth, ) (Entered: 06/21/2017)
679 MINUTE entry before the Honorable Andrea R. Wood: Joint Motion for Entry of Agreed Order 676 is granted. Enter order. The motion presentment date of 6/22/2017 is stricken. Parties need not appear. Mailed notice (ef, ) (Entered: 06/21/2017)
680 AGREED ORDER TO MAINTAIN COMPLIANCE WITH CONSENT DECREE signed by the Honorable Andrea R. Wood on 6/21/2017. Mailed notice(ef, ) (Entered: 06/21/2017)
681 Response to Joint Motion to Enforce Decree by Julie Hamos, Michelle R.B. Saddler (Attachments: # 1 Exhibit Declaration of Reta Hoskin)(Stratton, Brent) (Entered: 06/23/2017)
682 MAIL RETURNED, for document # 678 sent to Burton A. Brown returned as undeliverable, return to sender. No new contact information received; therefore future mailings will not be sent until a new address is provided to the Clerk's Office using a Notification of Change of Address or Pro Se Appearance form. Burton A. Brown is receiving electronic notices. (sxb, ) (Entered: 06/27/2017)
683 MOTION by Plaintiff Stanley Ligas for extension of time to file reply brief (Unopposed) (Antholt, Amanda) (Entered: 06/28/2017)
684 NOTICE of Motion by Amanda C Antholt for presentment of extension of time 683 before Honorable Sharon Johnson Coleman on 7/6/2017 at 08:45 AM. (Antholt, Amanda) (Entered: 06/28/2017)
685 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 7/5/2017. Plaintiffs' unopposed motion extension of time to file the joint reply in support of the motion to enforce the consent decree 683 is granted. No appearance necessary on 7/6/2017. Status hearing set for 7/14/2017 at 09:15 AM.Mailed notice (rth, ) (Entered: 07/05/2017)
687 MAIL RETURNED, for document # 678 sent to Kevin Francis Burke returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed 678 to 23 Millbrook Ln Bolton MA 01740−1347. (bg, ) (Entered: 07/06/2017)
686 NOTICE by Benjamin S. Wolf of Change of Address (Wolf, Benjamin) (Entered: 07/06/2017)
688 MINUTE entry before the Honorable Sharon Johnson Coleman: Minute entry #685 dated 7/5/2017 is amended in part to correct the next status date as follows: Status hearing set for 7/17/2017 at 09:15 AM.Mailed notice (rth, ) (Entered: 07/10/2017)
689 REPLY by Plaintiff Stanley Ligas In Support of Plaintiffs' and Intervenors' Joint Motion to Enforce the Consent Decree (Antholt, Amanda) (Entered: 07/14/2017)
690 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 7/17/2017. Defendants' response of no more than 7 pages to plaintiff's reply In Support of Plaintiffs' and Intervenors' Joint Motion to Enforce the Consent Decree Motion to be filed by 7/27/2017. Oral argument set for 8/4/2017 at 10:00 AM. Mailed notice (rth, ) (Entered: 07/20/2017)
691 RESPONSE by Defendant Julie Hamos to reply 689 in support of joint motion to enforce consent decree (Stratton, Brent) (Entered: 07/27/2017)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 79 of 82

08/02/2017 08/02/2017 08/04/2017 08/11/2017
08/11/2017 08/17/2017 10/26/2017 11/27/2017 01/24/2018 01/24/2018 01/25/2018 02/28/2018
03/30/2018 03/30/2018 03/30/2018

692 MOTION by Defendant Julie Hamos for leave to file supplemental response to Plaintiffs' and Intervenors' reply in support of joint motion to enforce decree (Attachments: # 1 Exhibit proposed supplemental response)(Stratton, Brent) (Entered: 08/02/2017)
693 NOTICE of Motion by Brent Douglas Stratton for presentment of motion for leave to file, 692 before Honorable Sharon Johnson Coleman on 8/4/2017 at 10:00 AM. (Stratton, Brent) (Entered: 08/02/2017)
694 MINUTE entry before the Honorable Sharon Johnson Coleman: Motion hearing held on 8/4/2017. Plaintiffs and Intervenors' Joint Motion to Enforce the Consent Decree [666−1] is taken under advisement. Mailed notice (rth, ) (Entered: 08/04/2017)
695 ORDER; Coming before the Court for hearing is plaintiffs' and intervenors' Joint Motion to Enforce the Consent Decree [666−1]. The instant motion stems from a Consent Decree entered into by the parties on June 15, 2011, after the Court certified a class and approved the Consent Decree. Defendants, officials of Illinois Department of Healthcare and Family Services and the Illinois Department of Human Services, assert that the State is in substantial compliance with the Consent Decree. For the reasons stated herein, this Court grants the motion. Signed by the Honorable Sharon Johnson Coleman on 8/11/2017. Mailed notice(rth, ) (Entered: 08/11/2017)
696 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing set for 10/27/2017 at 09:00 AM. Mailed notice (rth, ) (Entered: 08/11/2017)
697 MAIL RETURNED, for document # 694 sent to Kevin Francis Burke returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 23 Millbrook Ln., Bolton MA 01740−1347 (cc, ) (Entered: 08/21/2017)
698 MINUTE entry before the Honorable Sharon Johnson Coleman: By agreement of the parties, status hearing set for 10/27/2017 is stricken and reset to 11/27/2017 at 09:00 AM. Mailed notice (rth) (Entered: 10/26/2017)
699 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 11/27/2017. Status hearing set for 1/31/2018 at 10:00 AM to discuss the plan. Parties are to submit to the court their last best plan by 1/29/12018. Mailed notice (rth) (Entered: 11/28/2017)
700 MOTION by Defendant Barry S Maram to reset status hearing (Stratton, Brent) (Entered: 01/24/2018)
701 NOTICE of Motion by Brent Douglas Stratton for presentment of motion to reset 700 before Honorable Sharon Johnson Coleman on 1/30/2018 at 08:45 AM. (Stratton, Brent) (Entered: 01/24/2018)
702 MINUTE entry before the Honorable Sharon Johnson Coleman: Defendant's motion to reset status hearing 700 is granted. No appearance necessary on 1/30/2018. Status hearing set for 1/31/2018 is reset to 2/28/2018 at 09:00 AM. Mailed notice. (ym, ) (Entered: 01/25/2018)
703 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 2/28/2018. Parties report that they are close to reaching an agreed plan to bring the State into substantial compliance with the Consent Decree. Parties are to file a joint status report by 3/30/2018. The Court Monitor should file a separate status report by the same date. All reports should be no longer than 3 pages. Status hearing set for 4/4/2018 at 10:30 AM. Mailed notice. (ym, ) (Entered: 02/28/2018)
704 STATUS Report Regarding Proposed Compliance Plan in Response to August 11, 2018 Order by Julie Hamos (Attachments: # 1 Exhibit Defendants' Compliance Plan Proposals)(Stratton, Brent) (Entered: 03/30/2018)
705 RESPONSE by Plaintiff Stanley Ligas to status report 704 FILED ON BEHALF OF LIGAS MONITOR (Response by Monitor) (Antholt, Amanda) (Entered: 03/30/2018)
706 RESPONSE by Plaintiff Stanley Ligas to status report 704 Joint Response by Plaintiffs and Intervenors (Antholt, Amanda) (Entered: 03/30/2018)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 80 of 82

04/04/2018 04/11/2018 06/04/2018 06/06/2018
07/10/2018

707 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 4/4/2018 on the State of Illinois' proposal for compliance with the Consent Decree. The State is directed to provide the Court with the current Rate Methodology Description by 4/11/2018. The Court will issue a ruling on the State's compliance proposal prior to the next status. Status hearing set for 6/5/2018 at 9:30 a.m. Mailed notice. (ym, ) (Entered: 04/04/2018)
708 STATUS Report regarding state's current rate methodology description by Julie Hamos (Attachments: # 1 Exhibit A, # 2 Exhibit B, # 3 Exhibit C, # 4 Exhibit D, # 5 Exhibit E)(Stratton, Brent) (Entered: 04/11/2018)
709 MINUTE entry before the Honorable Sharon Johnson Coleman: On the court's own motion, the status hearing set for 6/5/2018 is stricken and reset to 7/10/2018 at 9:30 AM. Mailed notice. (ym, ) (Entered: 06/04/2018)
710 ORDER: Coming before the Court on the proposed plan for compliance with the Consent Decree submitted by the defendants, officials of Illinois Department of Healthcare and Family Services and the Illinois Department of Human Services. This Court entered an Order on August 18, 2017, finding that defendants were not in substantial compliance with the Consent Decree entered on June 15, 2011. This Court directed defendants to establish a plan for compliance. This Court finds that the proposed plan does not adequately address the shortcomings that the Court identified in its previous Order. Signed by the Honorable Sharon Johnson Coleman on 6/6/2018. Mailed notice. (ym, ) (Entered: 06/06/2018)
711 TRANSCRIPT OF PROCEEDINGS held on 4/4/18 before the Honorable Sharon Johnson Coleman. Order Number: 30878. Court Reporter Contact Information: TRACEY D. McCULLOUGH, 312−435−5570, tracey_mccullough@ilnd.uscourts.gov.

IMPORTANT: The transcript may be viewed at the court's public terminal or purchased through the Court Reporter/Transcriber before the deadline for Release of Transcript Restriction. After that date it may be obtained through the Court Reporter/Transcriber or PACER. For further information on the redaction process, see the Court's web site at www.ilnd.uscourts.gov under Quick Links select Policy Regarding the Availability of Transcripts of Court Proceedings.

07/10/2018
09/07/2018 09/12/2018

Redaction Request due 7/31/2018. Redacted Transcript Deadline set for 8/10/2018. Release of Transcript Restriction set for 10/9/2018. (Mccullough, Tracey) (Entered: 07/10/2018)
712 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 7/10/2018. The parties reported on the progress addressing four primary areas to bring the State in compliance with the Consent Decree. First, the convening of the Rate Group to examine rates for Intermediate Care Facilities and Community Based Placements. The Rate Group is on target to have its first meeting in August. Second, State is working on monitoring tools to evaluate the adequacy of the services and compliance with the Consent Decree for Community Based Placements and Intermediate Care Facilities. The Court Monitor is working with the appropriate state agencies to develop the monitoring tools. The draft of the tool for Intermediate Care Facilities is expected to be ready before the parties' meeting on August 2, 2018, with testing of the tool to follow. The tools will involve an independent review aspect to the process. Third, hourly wage rate for Direct Service Providers will be addressed as part of the Rate Group, but in the short−term the State has provided additional funding. The parties agree that the State has committed additional funding in the current fiscal year. Fourth, parties are continuing the discussion of reasonable pace for compliance. Parties to file a joint status report on the progress of the Rate Group by 9/7/2018. Status hearing set for 9/12/2018 at 10:00 AM. Mailed notice. (ym, ) (Entered: 07/11/2018)
713 STATUS Report Joint by Stanley Ligas (Taylor, Barry) (Entered: 09/07/2018)
714 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 9/12/2018 and continued to 11/15/2018 at 9:15 a.m. on the State of Illinois' voluntary Consent Decree. The Court appointed monitor reported on the progress of the parties. A Rates Methodology Oversight Committee has been established and a meeting schedule has been set. The Oversight Committee has met once. A draft tool for a quality monitoring program has been developed. A draft joint plan has been submitted

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 81 of 82

10/02/2018 11/15/2018 12/31/2018 02/14/2019
05/03/2019 05/03/2019 05/10/2019
06/07/2019 06/11/2019 08/12/2019 08/12/2019
08/22/2019 08/27/2019

by the State of Illinois and will be discussed at a meeting on 10/4/2018. The Court requests that the monitor submit a status report in advance of the hearing. Mailed notice. (ym, ) (Entered: 09/18/2018)
715 MAIL RETURNED, for document # 714 sent to Kevin Francis Burke returned as undeliverable, return to sender. Attorney contacted and directed to file a Notification of Change of Address with the Clerk's Office. Re−mailed to 23 Millbrook Ln., Bolton, MA 01740−1347 (ew, ) (Entered: 10/02/2018)
716 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 11/15/2018 and continued to 2/14/2019 at 9:15 a.m. The Court appointed monitor reports that the State of Illinois has not approved the implementation of the draft tool. The Committee will meet again in February. Mailed notice. (ym, ) (Entered: 11/20/2018)
717 Sixth Annual Court Monitor Report by Julie Hamos (Stratton, Brent) (Entered: 12/31/2018)
718 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 2/14/2019. The Court appointed monitor reports that progress has been made and expects a joint implementation plan will be filed shortly. The Court appointed monitor also reports that the monitoring compliance tool has been drafted and reviewers will begin training next week. The Court requests that the parties submit a joint status report in advance of the next status hearing. Status hearing set for 5/10/2019 at 9:15 AM. Mailed notice. (ym, ) (Entered: 02/14/2019)
719 Implementation Plan by Julie Hamos (Stratton, Brent) (Entered: 05/03/2019)
720 STATUS Report Joint Status Report by Julie Hamos (Stratton, Brent) (Entered: 05/03/2019)
721 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 5/10/2019. The Court granted defendants' oral motion to change the named defendants in the caption. The Court appointed monitor reports that the parties have made progress on most issues, including implementing the monitoring compliance tool. The Court appointed monitor also reports that concerns remain regarding the timeline for hiring the third−party vendor and securing additional wage increases for staff above minimum wage. The Court requests that the parties submit a brief joint status report on the issue of the third−party vendor by 6/7/2019. Status hearing set for 6/11/2019 at 2:00 PM. Mailed notice. (ym, ) (Entered: 05/10/2019)
722 STATUS Report Joint Status Report by Theresa Eagleson, Grace Hou (Stratton, Brent) (Entered: 06/07/2019)
723 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 6/11/2019. The Court appointed monitor reports progress. The Court invites the parties to file a motion to set a status if there are any significant developments regarding the rate developer. Status hearing set for 8/12/2019 at 1:30 PM. Mailed notice. (ym, ) (Entered: 06/11/2019)
724 ATTORNEY Appearance for Plaintiffs Burton A. Brown, David Cicarelli, Isaiah Fair, Stanley Ligas, Jamie McElroy, Jennifer Wilson by Heidi Dalenberg (Dalenberg, Heidi) (Entered: 08/12/2019)
725 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 8/12/2019. The parties were unable to report any progress. All parties are directed to come prepared for the next status hearing with specific answers and responses regarding all issues as to the rate development plan. The monitor is directed to file a status update by 8/27/2019 regarding where the parties are, especially in light of the meeting set for 8/13/2019. Any other party is welcome to file a short status report by 8/27/2019. Status hearing set for 8/29/2019 at 2:45 PM. Mailed notice. (ym, ) (Entered: 08/12/2019)
726 ATTORNEY Appearance for Defendants Theresa Eagleson, Grace Hou by Michael D. Arnold (Arnold, Michael) (Entered: 08/22/2019)
727 STATUS Report Court−Appointed Monitor's Status Report by Theresa Eagleson (Stratton, Brent) (Entered: 08/27/2019)

Case: 1:05-cv-4331 As of: 03/08/2020 07:10 PM CDT 82 of 82

08/29/2019 09/25/2019 09/27/2019
09/27/2019 10/11/2019 11/12/2019 11/14/2019
01/15/2020 01/17/2020
03/03/2020

728 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 8/29/2019. The parties were again unable to report any substantive progress from the last Court date. The monitor is directed to file a joint status update by 9/25/2019. Status hearing set for 9/27/2019 at 10:30 AM. Mailed notice. (ym, ) (Entered: 08/29/2019)
729 STATUS Report Joint Status Report by Theresa Eagleson, Grace Hou (Attachments: # 1 Exhibit Exhibit A)(Stratton, Brent) (Entered: 09/25/2019)
730 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 9/27/2019. The Court appointed monitor reported that there are deep concerns about the current status and emphasized the critical nature of resolving issues related to the 3.5% rate increases in the State's payments to the community−based DD providers and to the ICF/DD providers. The Court reminded the parties that forward movement is not occurring at the expected pace, especially given the detrimental effect these delays have on all those concerned. The Court directs defendants to file a supplemental status report by 10/11/2019. The monitor and any other party are welcome to file a short status report by 11/12/2019. Status hearing is set for 11/14/2019 at 9:45 AM. Mailed notice. (ym, ) (Entered: 09/27/2019)
731 NOTICE by Theresa Eagleson of attorney withdrawal (Ioppolo, Thomas) (Entered: 09/27/2019)
732 STATUS Report Defendants' Supplemental Status Report by Theresa Eagleson, Grace Hou (Stratton, Brent) (Entered: 10/11/2019)
733 STATUS Report by Theresa Eagleson, Grace Hou (Stratton, Brent) (Entered: 11/12/2019)
734 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 11/14/2019. The Court appointed monitor reported that the most recent parties' meeting was productive and emphasized all parties' desire to continue making forward progress. Defendants stated that federal CMS has approved the 3.5% increase for community−based providers, which will implement a rate increase to $13.00/hour, and that it expects the process for approval of the 3.5% rate increase for ICF−DD providers will continue into January 2020. The Court reminded the parties of the importance of keeping the goals of the consent decree forefront and how the current work is furthering those goals because the Court will not be overseeing these processes indefinitely. The Court requests that the parties submit a brief joint status report regarding the rate increase for the ICF−DD providers by 1/15/2020. Status hearing is set for 1/17/2020 at 1:30 PM. Mailed notice. (ym, ) (Entered: 11/14/2019)
735 STATUS Report Joint Status Report by Theresa Eagleson, Grace Hou (Attachments: # 1 Exhibit Rates Oversight Committee Final Report)(Stratton, Brent) (Entered: 01/15/2020)
736 MINUTE entry before the Honorable Sharon Johnson Coleman: Status hearing held on 1/17/2020. The Court appointed monitor and the parties reported that the most recent parties' meeting was productive. The monitor notified the Court that her report will be completed by the end of February. Additionally, the Governor of Illinois will address the state budget on 2/19/2020, which will include updates on rate adjustments and other fiscal matters impacting this case. The parties will report on both the expected impact of the Governor's budget and the Court appointed monitor's written report at the next status hearing. Status hearing is set for 3/12/20 at 10:30 AM. Mailed notice. (ym, ) (Entered: 01/21/2020)
737 Ligas 7th Annual Report by Stanley Ligas (Attachments: # 1 Attachment A, # 2 Attachment B)(Taylor, Barry) (Entered: 03/03/2020)

 
 478 F.3d 771 (2007)
Stanley LIGAS, by his sister and next friend Gina FOSTER, et al., Plaintiffs-Appellees, v.
Barry S. MARAM, et al., Defendants-Appellees, Anne Golden, by her father and guardian, Samuel Golden, et al.,
Proposed Intervenors-Appellants.
No. 06-1327.
United States Court of Appeals, Seventh Circuit.
Argued October 30, 2006. Decided February 15, 2007.
772*772 Barry C. Taylor, Equip for Equality, Inc., Max Lapertosa (argued), Access Living of Metropolitan, Chicago, IL, for Plaintiffs-Appellees.
Mary E. Welsh (argued), Office of the Attorney General, Civil Appeals Division, Chicago, IL, for Defendants-Appellees.
James W. Ducayet, Sidley Austin, Chicago, IL, Michael Rato (argued), Sidley Austin, New York, NY, for Proposed Intervenors-Appellants.
Before EASTERBROOK, Chief Judge, and KANNE and WILLIAMS, Circuit Judges.
KANNE, Circuit Judge.
The appellants are the representatives of a number of developmentally disabled people who were worried that they might have been unwilling members of a proposed class in a lawsuit filed under the Americans with Disabilities Act. Fearing that the remedy being sought by the plaintiffs was contrary to their wishes, they sought to intervene. The plaintiffs and defendants opposed the intervention, and the district court denied the petition. The intervenors appeal that decision, and we affirm.
I. BACKGROUND
This case arises in the context of a much larger debate over the proper way to provide care for the developmentally disabled. See generally Olmstead v. L.C. ex rel. 773*773 Zimring, 527 U.S. 581, 119 S.Ct. 2176, 144 L.Ed.2d 540 (1999). For some, institutionalized care is the best plan, while others are best served by integration into the community. Id. What might otherwise seem to be a question to be left to local health care officials, patients, their families, and their doctors now takes on a federal significance by operation of the Americans with Disabilities Act (ADA), among other legislation. Id.
Olmstead established that it is a violation of the ADA to force developmentally disabled patients to reside in institutionalized settings when they are able to live more fully integrated into society at large and do not oppose doing so. Olmstead, 527 U.S. at 597-602, 119 S.Ct. 2176. But with three dissenters and multiple concurrences, including a swing vote that joined in only part of the opinion, Olmstead has left the exact route to implementing this integration mandate somewhat murky.

With this background, the current suit was brought on behalf of a number of developmentally disabled people to hasten the state of Illinois down the road to community-based care. In addition to plaintiffspecific relief, the plaintiffs sought to certify a class and to require the state to provide community-based care for those class members. The class would have consisted of those who live in institutions, or are at risk of living in institutions, and who could live in the community.
There were, however, some potential members of that proposed class who did not want to live in community-based care. Enter the proposed intervenors: representatives of patients who could live in the community but do not want to, preferring instead to remain in institutional care. Worrying that they were about to become members of a class that would be forced to live in community-based care if the plaintiffs succeeded, the Golden Intervenors[1] sought to ensure that the disabled would still retain a choice in where they lived.
The Golden group petitioned the district court to grant intervention as of right under FED.R.CIV.P. 24(a), or, failing that, permissive intervention under FED.R.CIV.P. 24(b)(2). The plaintiffs and defendants opposed the petition to intervene and the district court denied the petition on December 22, 2005, a decision that the proposed intervenors now appeal.
II. ANALYSIS
A. Intervention as of Right
A party may seek intervention as of right if the party has "an interest" and is "so situated that the disposition of the action may as a practical matter impair or impede the applicant's ability to protect that interest, unless the applicant's interest is adequately represented by existing parties." FED.R.CIV.P. 24(a)(2). This court has determined that intervention as of right is required only where parties "establish[ ] that: (1) their motions to intervene were timely; (2) they possess an interest related to the subject matter of the . . . action; (3) disposition of the action threatens to impair that interest; and (4) the [parties] fail to represent adequately their interest." United States v. BDO Seidman, 337 F.3d 802, 808 (7th Cir.2003). A failure to establish any of these elements is grounds to deny the petition. Id. With the exception of timeliness, which is reviewed for abuse of discretion, the elements are reviewed de novo on appeal. Id.
Much of this dispute now centers on whether the Golden group met its burden 774*774 of proof on the third and fourth elements. The parties do not dispute that the petition was timely. We will assume without deciding that the Golden group has an interest related to the subject matter of the action.[2] The questions, then, are whether the action threatens to impair that interest and whether the parties fail to represent those interests adequately. We conclude, as did the district court, that Golden has not met its burden with respect to the third or fourth elements.
The appellants argued in the district court that the impairment to their interests stems from the proposed relief that the plaintiffs sought: a permanent injunction "requiring Defendants promptly to provide eligible Plaintiffs and class members with appropriate services sufficient to allow them to live in the most integrated setting appropriate to their needs." Compl. for Decl. and Inj. Relief. at 29; Appellee's Br. at 17. The intervenors' argument below was that this language would leave them no ability to choose to remain in institutional care if they were eligible for community-based care. The district court considered this argument in light of the language of the complaint and concluded that this interest could not be impaired by the relief sought by the complaint. We agree.
As the district court correctly noted, the complaint is "replete with language on choice." Nothing in the complaint, either on its face or as correctly construed by the district court, would require the state to force those who desire institutional care to move out. For example, the complaint alleges that the law requires the state to "offer persons . . . a choice between institutional and community services." Compl. for Decl. and Inj. Relief ¶ 7. It alleges that the state "defendants do not provide plaintiffs or class members the

choice between institutional or community settings." Id. ¶ 115. If the plaintiffs succeed in class certification and win on the merits, the relief that they seek would only require that Illinois provide that which (they allege) it does not currently provide: the existence of appropriate services tailored to the needs of the individual.
The district court also considered the question of whether the existing parties were able to adequately represent the Golden intervenors' interests. Finding that the inadequacy was "at best speculative, and at worst conclusory," the court held that the fourth element of the test for intervention as of right was not met. We agree.
A party seeking intervention as of right must only make a showing that the representation "may be" inadequate and "the burden of making that showing should be treated as minimal." Trbovich v. United Mine Workers of Am., 404 U.S. 528, 538 n. 10, 92 S.Ct. 630, 30 L.Ed.2d 686 (1972). However, when the representative party is a governmental body charged by law with protecting the interests of the proposed intervenors, the representative is presumed to adequately represent their interests unless there is a showing of gross negligence or bad faith. United States v. South Bend Cmty. Sch. Corp., 692 F.2d 623, 627 (7th Cir.1982); United States v. Bd. of Sch. Comm'rs of Indianapolis, 466 F.2d 573, 575-76 (7th Cir.1972).
The defendants are the Director of the Illinois Department of Health and Family Services and the Secretary of the 775*775 Illinois Department of Human Services in their official capacities. Compl. ¶ 1215. Both the defendants and the proposed intervenors admitted in their pleadings that the defendants are responsible for administering the Illinois Medicaid and developmental disabilities programs. The intervenors have made no effort to show gross negligence or bad faith on the part of the state defendants, and have therefore not overcome the presumption that the defendants, as governmental bodies charged with protecting the interests of the proposed intervenors, will provide adequate representation.
Nevertheless, the district court recognized that the proposed class could be narrowed somewhat to avoid the perception that the intervenors would be pulled along with the plaintiffs down the road to communitybased care. The court had previously dismissed the plaintiff's motion for class certification until the intervention question had been properly aired. In its denial of the petition to intervene, the district court encouraged the plaintiffs (if they were to seek renewed class certification) to more narrowly tailor their proposed class to "those who desire to be placed in community settings." Between the denial of the petition to intervene and the filing of this appeal, the plaintiffs renewed their motion for class certification. The language of the new proposed class was changed to those "who would not oppose community placement."
On this appeal, the Golden group makes much ado about the distinction between those who would "desire" and those would "not oppose." We believe that this is a distinction without a difference, at least as it relates to the Golden intervenors under the facts of this case. The language in the new proposed class is taken verbatim from the Supreme Court's controlling precedent. See Olmstead, 527 U.S. at 587, 119 S.Ct. 2176 (transfer appropriate where it "is not opposed by the affected individual"); id. at 603, 119 S.Ct. 2176, ("neither woman opposed such treatment"); id. at 607, 119 S.Ct. 2176 ("the affected persons do not oppose such treatment"). Either formulation of the class would require an inquiry into the mental state of the proposed class members, the appropriateness of which we will not judge here because it is beyond the scope of this appeal. Yet we believe that in this case, where the plaintiff seeks only that the class members be given a choice in living conditions, the distinction does not raise any new concerns about the impairment of the intervenors' interests or the adequacy of the state's representation of their interests that was not already addressed by the district court or in our analysis above.
B. Permissive Intervention
The Golden group also sought permissive intervention under FED.R.CIV.P. 24(b). Permissive intervention is within the discretion of the district court where the applicant's claim and the main action share common

issues of law or fact and where there is independent jurisdiction. Sec. Ins. Co. of Hartford v. Schipporeit, Inc., 69 F.3d 1377, 1381 (7th Cir.1995). The Golden group devoted little more than a paragraph to this argument in the district court, noting three areas of common fact or law. The district court acknowledged that the groups sought both permissive intervention and intervention as of right, but in ruling to deny intervention the district court did not separately analyze the requests under FED.R.CIV.P. 24(a) and 24(b), it simply denied the various intervening groups' petitions to intervene.
We review a district court's denial of leave to intervene under FED.R.CIV.P. 24(b) for abuse of discretion. Sokaogon Chippewa Cmty. v. Babbitt, 214 F.3d 941, 949 (7th Cir.2000). In arguing for permissive 776*776 intervention, the Golden group raised three areas of common fact or law. Two were related to the class action: "whether class action treatment is appropriate [and] and whether community care is desirable for all of the class members." Golden Memo at 10. They also questioned "whether the state's system of providing care for the developmentally disabled should be overhauled to favor community care at the expense of ICF-DDs [Intermediate Care Facilities for the Developmentally Disabled]." Id. In light of the district court's dismissal of the proposed class certification, and its instructions to the plaintiffs to ensure that parties such as the Golden group not be included in a future request to certify a class, the first two claimed areas of common law or fact were not relevant to the district court's analysis.
The district court's extensive consideration of the issues of impairment and adequate representation puts the other common question of fact or law to rest as well. The court clearly indicated that the main action involved giving each disabled person in Illinois the integration options mandated by Olmstead, not any effort to "favor community care at the expense of ICF-DDs." Although the district court did not explicitly break out its reasoning on the rule 24(b)(2) and rule 24(a) motions, the decision shows a thorough consideration of the interests of all the parties and concludes by denying the intervenors' motions in toto. This does not rise to the level of an abuse of discretion. See, e.g., United States v. Perry County Bd. of Educ., 567 F.2d 277, 280 (5th Cir.1978) (finding no abuse of discretion in the context of a denial of permissive intervention where the district court issued a one-sentence order, held no evidentiary hearing, and made no finding of facts).
C. Conditional Intervention
The Golden group also asks this court to "allow" the Golden intervenors conditional intervention subject to a future showing that the state defendants are not adequately representing their interests. See Solid Waste Agency of N. Cook County v. U.S. Army Corps of Eng'rs, 101 F.3d 503, 508-09 (7th Cir.1996). Because the district court was never given an opportunity to consider this argument, it is forfeited on this appeal. See Andy's Rest. & Lounge, Inc. v. City of Gary, 466 F.3d 550, 556-57 (7th Cir.2006).
III. CONCLUSION
Accordingly, the decision of the district court denying the petition to intervene is AFFIRMED.
[1] There were originally three groups of proposed intervenors. The only group that appeals the decision of the district court is the Golden group, named after one of the individuals.
[2] The appellees make a cursory and fragmented argument that the Golden group has no legally recognizable interest in the right to live in institutional settings, citing a decision from the Western District of Pennsylvania. See Richard C. ex rel. Kathy B. v. Houstoun, 196 F.R.D. 288 (W.D.Pa.1999), aff'd sub nom. Richard C. v. Snider, 229 F.3d 1139 (3d Cir. 2000) (unpublished order).