DAL 10-09: Disability Advocates, Inc. v.Paterson, et al. -- Remedial Order and Judgment

September 9, 2010

DAL: DAL 10-09

Subject: Disability Advocates, Inc. v.Paterson, et al.
Remedial Order and Judgment

Dear Administrator:

As you are aware, the Department of Health (the Department) is a defendant in a lawsuit brought by Disability Advocates, Inc. (DAI). On March 1, 2010, United States District Judge Nicholas G. Garaufis issued a Remedial Order and Judgment (hereinafter referred to as the "Remedial Order") setting forth requirements to be followed regarding residents of certain adult homes. On April 5, 2010, Judge Garaufis issued an Order Appointing Monitor (hereinafter "Appointment Order"), which appointed a court Monitor to monitor defendants' compliance with the Remedial Order. The Department and certain adult homes under its auspices must comply with the terms of the Orders.

This DAL is to clarify the role of the adult homes under the Remedial Order. The only adult homes affected by the Remedial Order are those specifically named in such Order. As a result of the Remedial Order it is necessary for those adult homes to:

  • grant the court-appointed Monitor, Martha Knisley, and her staff access to any individuals (including residents), information, documents, materials, programs, services, facilities and premises relevant to the Remedial Order that she requires to perform her duties subject to the terms of the Appointment Order;
  • grant access to facility residents, as often as necessary, to service providers and representatives of supported housing who will be conducting in-reach activities;
  • inform all prospective residents with a mental health diagnosis, before being offered placement in an adult home, of other options available to them through supported housing;
  • document in case management or other notes adult home staff discussions with residents regarding housing options; and
  • provide quarterly reports to the Department concerning the number of new admissions, the source of payment for the new admissions and the total facility census.

Under the Appointment Order, the Department is obligated to ensure that the Monitor and her staff have access to adult homes, residents, and relevant records.

18 NYCRR § 485.14(a)(1)-(3) is interpreted in conjunction with the Remedial Order to mean that residents cannot be impeded from seeing supported housing providers or representatives, as often as necessary. The Order also requires that case managers, clinicians, adult home staff and others, when discussing housing options, accurately and fully inform residents about supported housing, its benefits and

the array of services and supports available to those in supported housing, and the Supplemental Security Income (SSI), rental subsidy, and any other income they will receive while in supported housing. It will be the Department's responsibility, as ordered by the court, to monitor whether the affected residents are being discouraged by adult home operators from exploring alternatives to adult homes, or not being fully and accurately informed of their options, and if so, to take corrective action. The Department must also report any instances of residents being discouraged from exploring alternatives to adult homes to the court, the Monitor and the plaintiffs.

The Department is committed to complying with the Court's Orders to make sure that on a permanent and ongoing basis no individual with mental illness who is qualified for supported housing is offered placement in an adult home affected by the Remedial Order unless, after being fully informed, he or she declines the opportunity to receive services in supported housing.

Copies of the March 1, 2010 Remedial Order and Judgment and the April 5, 2010 Order Appointing Monitor are available on the Department's website. Thank you for your continued cooperation.


Mark Kissinger
Deputy Commissioner
Office of Long Term Care