The lawsuit alleges that the City and County of San Francisco, as well as several state agencies, are discriminating against people with disabilities by failing to utilize existing Medicaid funding and other funding sources for home and community-based services, instead committing the vast majority of available funding to institutional care. A de facto policy bias toward institutional care persists at the expense of home and community based alternatives. The plaintiffs reside at Laguna Honda Hospital in San Francisco, or are at risk of institutionalization there, and represent a class of people in the same situation. Laguna Honda is a 1200-bed nursing institution, the largest of its kind in the United States.
Plaintiffs complain of being warehoused and isolated from their own communities.
They have been given no option but to remain institutionalized, where the loss of dignity is their chief complaint. Millions of Americans need some form of long term assistance with routine, daily living tasks such as bathing, dressing, eating, shopping, cooking and housework. Others also need home health care, including nursing or hospice care. The overwhelming majority prefer to stay out of institutions. Developments in Medicaid laws and a recent United States Supreme Court decision in Olmstead v. L.C. confirm the right of people with disabilities who need long term care to choose to receive the services they need in their own homes and communities instead of in an institution.