Opinion ID: 2551730
Heading Depth: 2
Heading Rank: 2

Heading: A.T.'s Application For Voluntary Admission

Text: A.T. and her older sister, L.T., were removed from their parents' home in 2002, following allegations of child abuse and neglect, and were committed to the District of Columbia Child and Family Services Agency (CFSA). During the course of neglect proceedings in Family Court, CFSA indicated that ... separating them would adversely affect their well-being. A.T. has difficulties in adaptive functioning, and her disabilities severely [affect] her capacity to understand social interactions, plan ahead, organize herself, and self-monitor. She requires supervision when doing chores such as washing clothes, doing the dishes, sweeping and cleaning [her] room.... A.T.'s doctors have stated that, because of her disabilities, A.T. is very vulnerable for exploitation. In 2005, when A.T. was sixteen, Dr. David Missar, a clinical psychologist, assessed her IQ to be 73, and diagnosed her as having Pervasive Developmental Disorder (PDD), Attention Deficit Hyperactivity Disorder (ADHD), and Combined Type Mixed Receptive-Expressive Language Disorder. Importantly for this case, Dr. Missar did not at that time diagnose her as mentally retarded. In 2007, in anticipation of L.T.'s twenty-first birthday, Superior Court Judge Linda Kay Davis ordered DDS to appear in the sisters' neglect cases for purposes of transitioning them into the DDS system, because each sister would age out of CFSA upon turning twenty-one. DDS determined that L.T. qualified for services from the Developmental Disabilities Administration (DDA), one of the agencies through which DDS provides habilitation services to eligible District residents. To avoid separating the sisters, Judge Davis ordered that L.T. remain at the CFSA-licensed group home until A.T. was ready to transition to DDS, in January 2010. In August 2008, CFSA submitted an intake application to DDS on A.T.'s behalf, seeking housing, day programming, and case management, to begin on her twenty-first birthday. A.T.'s application did not state that she had been diagnosed with mental retardation, only PDD. CFSA also submitted two psychological evaluations that had been conducted during A.T.'s neglect case. The first was Dr. Missar's 2005 evaluation, diagnosing her with, inter alia, PDD and an IQ of 73. The other evaluation was performed by clinical psychologist Dr. Michael Gilliard, in April 2008, when A.T. was nineteen. Dr. Gilliard diagnosed her with PDD, ADHD, Mixed Receptive-Expressive Language Disorder, and a mathematics disorder. Dr. Gilliard estimated A.T.'s IQ to be 98, which is considered within the average range of functioning. A.T. received a Notice of Determination on September 10, 2008, advising that she was ineligible for DDA services, but informing her that she could request a review of the decision, orally or in writing, by sending a written request to the Intake Chief within fifteen working days. At CFSA's urging, A.T. was referred to DDS's consulting psychologist, Dr. Tonya Lockwood, for an additional evaluation. Dr. Lockwood tested A.T. in December 2008, and placed her IQ score at 81, which put A.T. in the low average range of cognitive functioning. Dr. Lockwood found that A.T. had mild deficits in adaptive functioning but did not meet the diagnostic criteria ... for mental retardation. In January 2009, A.T.'s doctors sent a letter to DDS, requesting that she be made eligible for DDA services because of her difficulties in adaptive functioning that include deficits in self-care, learning, self-direction, capacity for independent living and economic self-sufficiency.... The letter listed A.T.'s diagnoses, and stated that [i]n spite [of] having normal intellectual functioning, [A.T.] has difficulty applying basic knowledge to her daily life.... At present it is not expected that [A.T.] will ever be [able] to obtain full independence. She will always need supports for daily living and for any type of employment situation. (emphasis added). A.T. received another Notice of Determination on January 12, 2009, again denying DDA services, but advising her of her right to seek review of the determination by writing to the Intake Officer. A few days later, A.T. received yet another Notice, this time explaining that the denial was based on A.T.'s scores from Dr. Lockwood's psychological exam, coupled with the fact that A.T. did not meet the diagnostic criteria for mental retardation. As Dr. Lockwood wrote, although A.T. exhibits deficits in two or more areas of adaptive functioning, her intellectual function [is] in the low average range. The notice again indicated that A.T. could appeal the decision, orally or in writing, and that a written request for review should be sent to the Intake Chief. A.T.'s guardian ad litem in the neglect case then requested a meeting with Laura Nuss, the Deputy Director of DDS. A meeting was held on August 28, 2009, with Nuss, A.T., staff from A.T.'s school, A.T.'s CFSA social worker, and various attorneys. Deputy Director Nuss sent A.T. a letter on September 4, 2009, confirming that A.T. was ineligible for DDA services, but advising that she was instead eligible for services offered through the Rehabilitation Services Administration, which offers vocational training, assistance in finding a job, and help with independent living skills, but does not offer housing. Deputy Director Nuss based her decision on the documentation presented, most notably the results of psychological evaluations performed from December 2004 through April 2008. The letter served as the final administrative decision on A.T.'s eligibility for DDA services and advised that A.T. had the right to bring a civil action in the Superior Court to review the agency's decision.