Thorpe v. District of Columbia, 894 F. Supp. 2d 1

This ADA/Section 504 case challenges the District of Columbia's long-term care system for disabled Medicaid beneficiaries, arguing inadequate community integration and excessive nursing facility placement.
Olmstead v. L.C. provides the integración mandate: services must be in the most integrated setting appropriate unless a plan shows otherwise.
DC relies on the EPD Waiver and MFP programs, plus the Medicaid State Plan, to fund community-based care and transitions from facilities.
The District maintains an EPD Waiver cap (3,940 slots) and uses a first-come, first-served waiting list; housing is not funded by these programs.
The MFP program has had limited actual transitions (three by fall 2011) and has faced barriers such as housing and service availability.
DMH administers PASRR to screen mental health residents, but plaintiffs argue PASRR fails to identify all who could be community-supported; housing and ISP issues persist.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether plaintiffs state an integration claim under the ADA/§504	District's actions cause unnecessary nursing facility confinement through its service system.	District does not causally place or fund plaintiffs; reliance on Olmstead plan defenses precludes liability.	Plaintiffs state a claim; district's administration/funding of services may cause segregation.
Whether the District has a valid Olmstead Integration Plan	DOJ framework requires concrete, measurable, time-bound commitments and actual deinstitutionalization progress.	Existing programs (EPD Waiver, MFP, PASRR) constitute an integration plan and they show progress.	No; undisputed facts show lack of measurable deinstitutionalization and plan deficiencies; no valid Olmstead Integration Plan.
Whether the District's programs suffice to defeat liability on summary judgment	Programs do not demonstrate comprehensive, effectively working plan with measurable outcomes.	Programs and funding demonstrate district's efforts to move to community-based care.	Genuine disputes remain; summary judgment denied on Olmstead Plan issue.
Whether individual defendants should be dismissed as redundant	Maintaining public accountability warrants continuing claims against officials.	Official-capacity claims are duplicative of District; dismissal appropriate for efficiency.	Individual defendants are dismissed; District remains the sole defendant.

Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581 (1999) (integration mandate prohibits unjustified isolation; plan must support community placement when appropriate)
Frederick L. v. Dep’t of Pub. Welfare, 422 F.3d 151 (3d Cir. 2005) (plan must demonstrate reasonably specific, measurable commitment to deinstitutionalization)
Pennsylvania Prot. & Advocacy, Inc. v. Pennsylvania Dept. of Public Welfare, 402 F.3d 374 (3d Cir. 2005) (plan must show accountability and action toward deinstitutionalization)
The Arc of Wash. State, Inc. v. Braddock, 427 F.3d 615 (9th Cir. 2005) (state must be genuinely moving individuals to integrated settings)
Sanchez v. Johnson, 416 F.3d 1051 (9th Cir. 2005) (court approves plan with individualized analysis and timetables for deinstitutionalization)
Disability Advocates, Inc. v. Paterson, 653 F. Supp. 2d 184 (E.D.N.Y. 2009) (integration claims may survive where state plans restrict community-based options)
Joseph S. v. Hogan, 561 F. Supp. 2d 280 (E.D.N.Y. 2008) (state must address involuntary nursing facility placement; public entity liability for plan/administration)
Monell v. New York City Dept. of Social Servs., 436 U.S. 658 (1978) (supervisory/municipal liability for official policy)
Kentucky v. Graham, 473 U.S. 159 (1985) (official-capacity claims principles)