The Office of the Attorney General today filed a motion in US District Court to remove court monitoring of the District of Columbia Department of Mental Health and return full management authority to local officials. The Fenty Administration asserts that in the three decades since court oversight was imposed in the Dixon lawsuit, the District’s mental health service delivery system has been transformed. Further, in light of the recent Supreme Court decision in Horne v. Flores, the motion argues that continued enforcement of the Court’s consent decree is not only unnecessary but improper.
In response to a lawsuit, the Court held in l975 that the District had violated the Ervin Act by failing to provide community-based alternatives to Saint Elizabeths Hospital for people with mental illness who could be treated in less-restrictive environments. At that time, more than 3,600 patients were in the Hospital which was then the joint responsibility of the District and federal governments. As a consequence of the Court finding, in 2003 the Court issued a Consent Decree that required the District to meet certain conditions, called “Exit Criteria”, under the oversight of a court monitor.
Today, the Department of Mental Health has shifted primary treatment from the Hospital to community based mental health providers. The Hospital population has been reduced from thousands to less than 400 patients—with a 77% decrease from 2003 alone. In fact, more than 98% of the people who use the public mental health system are treated in the community. The District’s motion asks that the lawsuit be dismissed since the original Ervin Act violation of unnecessary hospitalization has been remedied.
Moreover, the District asserts that it has complied or substantially complied with the conditions of the 2003 Consent Order and has built a mental health system that provides treatment in the least restrictive environment through a broad range of community based services and support including housing and supportive employment. The motion argues that the Supreme Court observed in its Horne decision that district courts are empowered to modify or vacate consent decrees based on changed circumstances in its Horne decision.
“Structural and legislative changes implemented by the District combined with continuous internal and external quality-improvement represent a substantial change of circumstances and ensure the durability of the District’s remedy,” Attorney General Peter Nickles said.
The District notes that the performance of the Department of Mental Health will be subject to multiple levels of external review imposed on any District agency—including the DC Auditor and the Inspector General—after the lawsuit is dismissed.
Finally, the District notes that current economic and fiscal conditions support dismissing the lawsuit. At a time of declining revenues, the District has paid $3.4 million for the services of the court monitor since Fiscal Year 2003 as well as $865,000 in fees and costs to plaintiff’s attorneys since 1997.