Opinion ID: 789693
Heading Depth: 3
Heading Rank: 1

Heading: Olmstead Prong Three

Text: 36
37 PP & A argues that the District Court erred as a matter of law in endorsing DPW's fundamental alteration defense solely on the basis of its analysis of budgetary constraints. We agree. 38 Writing before the publication of our Frederick L. opinion, the District Court understandably could not divine the dictates of that decision. It concluded that Defendant[] is entitled to summary judgment on the ADA and RA claims on the basis of that part of its fundamental-alteration defense asserting that it does not have sufficient resources to move South Mountain residents into the community and provide services for others with mental-health needs. 8 Id. (emphasis added). As discussed at Section III.A.1, supra, this basis is insufficient as a matter of law under Frederick L. Unlike the Frederick L. decision, the District Court's opinion here does not disclose additional relevant factors such as unsuccessful attempts at fund procurement, evidence that DPW responsibly spent its budgetary allocations, evidence of a favorable bed closure rate, defendants' ability to increase the number of community care placements in light of community opposition to further expansion, or the potential diminution of services for institutionalized persons. The presence of these additional factors (or other similar factors) is required in order to credit an agency's fundamental alteration defense. Without consideration of these factors, the District Court's grant of summary judgment on the basis of the fundamental alteration defense lacks sufficient underpinning. 39
40 The District Court also failed to require DPW to demonstrate a reviewable commitment to action. On the basis of our independent review of the record, we conclude as a matter of law that DPW cannot show that such a commitment exists in this case and thus DPW's fundamental alteration defense must fail. 41 Admissions made by DPW during the course of this litigation foreclose the genuine contention that it has made a commitment to bring South Mountain into compliance with the ADA and RA. To begin, DPW admits that OMHSAS does not consider [South Mountain] residents — even those transferred from its state psychiatric hospitals — to be part of the mental health system. App. at 224, 245. DPW does not require the County MH/MR Offices to plan for or develop community-based services ... for [South Mountain] residents, and OMHSAS does not expect the counties to request funding to provide community-based services to residents of [South Mountain]. Id. at 225. DPW further admits that, consistent with this policy, [South Mountain] social workers no longer consider at all [county-run] community-based residential [mental health/mental retardation] programs for [South Mountain] residents because such programs are not available for [ South Mountain ] residents. Id. at 224 (emphasis added). 42 This exclusion of South Mountain residents from the county-run mental health/mental retardation programs is the result of an explicit omission of those residents from OMHSAS's Olmstead- compliance planning process. OMHSAS is in the final stages of developing a statewide plan to address Olmstead problems in its mental health system. App. at 228. This planning process resulted in the June 2000 inquiry that led the staff of South Mountain to conclude that 80% of its residents could function in the community if the necessary community support services were available to them. Despite this report, DPW concedes OMHSAS subsequently determined that the statewide plan [would] not include any provisions concerning the development of alternative community mental health services for [South Mountain] residents. Id. at 228, 246-47. DPW, through OMHSAS, decided to exclude South Mountain residents from the programs it was implementing that benefit similarly situated Pennsylvanians. 43 Despite this seemingly incontrovertible evidence, DPW urges us to find as a matter of law that it has a sufficient plan in the form of policies and procedures that demonstrate DPW's commitment to deinstitutionalization, and a history of progressive deinstitutionalization that shows that the policy is in effect. Appellees' Br. at 20. At the core of this argument, 9 DPW contends: 44 First, DPW has continually placed, and continues to place, [South Mountain] residents in alternative community programs whenever and wherever appropriate for the resident, as determined by the resident's interdisciplinary team of treatment professionals. Second, ... the treatment professionals at [South Mountain] are required to re-assess each resident of [South Mountain] every sixty (60) days to determine whether they continue to require a nursing home level of care. 45 Id. at 22-23. 46 South Mountain's routine, individualized review of patients does not amount to a sufficient deinstitutionalization plan, notwithstanding any past success it has had in discharging patients. In Frederick L. we explained that it [is] unrealistic (or unduly optimistic) [to] assum[e] past progress is a reliable prediction of future programs. Frederick L., 364 F.3d at 500. We also stressed that policies and procedures ... utilized for ongoing review of patients from the minute they come in and for discharge planning for each patient individually ... fall[ ] far short of the type of plan ... the Court referred to in Olmstead. Id. Thus DPW's first two contentions are legally insufficient to establish a compliance plan. 47 DPW's third and last contention in support of its claim that it has a plan is that each resident's team of treatment professionals reassesses the resident at least every ninety (90) days to determine if he or she can live in a more integrated setting, based on how well the resident is, and has been, functioning in each treatment team member's area of specialty.... Appellees' Br. at 23. This argument misleads. DPW makes this claim after i) describing its various treatment programs and the different settings in which DPW provides its services, including its county-run community-based programs, and ii) asserting that individuals who are medically frail and elderly liv[e] in all of [the] settings in which DPW provides services for over 320,000 mentally disabled individuals. Appellees' Br. at 20. A natural implication of its assertion in this context is that South Mountain treatment professionals regularly determine whether each resident can be placed in DPW's community programs and that they do so even if a patient requires nursing facility-level care. Yet, as PP & A persuasively argues, South Mountain staff evaluations consider only the patients' potential for discharge to a nursing facility or generic home care. No plan exists for the integration of South Mountain residents into community treatment programs. 48 In short, we find no evidence of a commitment to bring South Mountain into compliance with the integration mandate of the ADA and RA. To the contrary, DPW has chosen not to make integration provisions for the residents of South Mountain by excluding them from participation in its varied, successful community treatment programs. We thus hold that PP & A is entitled to summary judgment with respect to the insufficiency of DPW's fundamental alteration defense. Because we do not agree with the District Court that DPW is entitled to summary judgment based on Olmstead prong three, we turn to the first two Olmstead prongs.