“This is a momentous and historic settlement,” said Hogan, citing the case’s “long and tortured history.” He is the third federal trial judge to handle the case, which started before the District was granted home rule.
In the coming months, the District will alert more than 27,000 residents affected by the case about the pending settlement. Hogan scheduled a hearing for Feb. 2 to hear objections to final approval of the agreement.
Should he grant final approval, as is widely anticipated, the District would continue to report on its progress until Sept. 30, 2013. At that time, the plaintiffs could object to final dismissal of the case should the city not be in compliance with the settlement.
Stephen T. Baron, director of the city mental health department since 2006, expressed confidence in meeting the final terms. “We’re going to be able to make it happen; there’s no doubt about that,” he said.
The case dates to 1974 when William Dixon and other patients at St. Elizabeths Hospital sought treatment options other than the old and troubled institution straddling Martin Luther King Jr. Avenue SE. A year later, a judge expanded the case to cover all of the District’s mentally ill residents.
“It was a crumbling, wretched institution,” said Peter J. Nickles, who was among the Covington and Burling lawyers who filed the original case. “In no sense of the word did the city treat the folks who were captured in the mental health system in a tolerable, civilized fashion.”
The lawsuit sought to compel the District and the federal government, which then operated the hospital, to recognize that the widespread institutionalization of the mentally ill was costly, counterproductive and inhumane.
The District government in 1980 agreed to establish a network of community-based treatment options, but it had difficulty creating and managing the system. In 1997, Judge Aubrey E. Robinson Jr. placed the city’s mental health department under receivership.
The District regained control in 2000, and it subsequently agreed to meet 19 conditions to end the case, ranging from increasing billings to Medicaid to using more modern medications for residents with schizophrenia. In his most recent report, a court-appointed monitor said that 15 of the 19 criteria had been substantially met. Late last year, the District and plaintiffs began settlement talks, and the agreement presented to Hogan on Monday eased the remaining four requirements. They concern housing, employment services and follow-up mental health care for adults and children.