By Petula Dvorak
Washington Post Staff Writer
Thursday, May 25, 2006; A01

An advocacy group filed papers yesterday requesting a court takeover of the D.C. government agency in charge of caring for 2,000 mentally and physically disabled residents, saying that the city's repeated failures are putting vulnerable lives at risk.

The Justice Department delivered a separate warning, filing court papers that said the city agency is "in disarray and deteriorating rapidly." The Justice Department cited 14 "preventable and questionable" deaths since January 2003 and urged a judge to hold the District in contempt of court for not meeting promises to improve health care and other services, especially at group homes for mentally retarded wards.

University Legal Services, which represents the plaintiffs in a 30-year-old lawsuit over quality of care, said the problems are so severe and long-lasting that control should be stripped from the city and given to a receiver.

A contempt finding could lead to significant fines. Putting the agency in receivership is a much more drastic step and would mark the first time that an agency has been taken from the city's control during the tenure of Mayor Anthony A. Williams (D). When Williams took office in 1999, five agencies were in receivership, including those responsible for housing, mental health and child welfare. Williams made it a priority to regain control of them, and did by 2002.

"The mayor is very disappointed," said Williams's spokesman, Vince Morris. "He's worked to bring all of the District's agencies out of receivership and to a point where they're delivering excellent services. So it's frustrating, but we're going to continue trying to make [the agency] work for the people we serve."

U.S. District Judge Ellen Segal Huvelle, who has repeatedly expressed frustration with the city, could consider the issue as early as the next court hearing, June 29. She said this year that the D.C. Mental Retardation and Developmental Disabilities Administration was now working "against the clock" in improving services.

Most of the complaints involve care at group homes run by private providers under the city's oversight; there are about 360 such residences. Advocates and the Justice Department said that many residents are abused or neglected and that preventable health problems have led to deaths and serious illnesses. Last fall, a court monitor said neglect contributed to four deaths in a one-year period.

D.C. officials said yesterday that they are working to overhaul the system. The agency's administrator, Marsha H. Thompson, said receivership is "not a magic wand; it's not a fix."

"Having a receiver in place doesn't mean it's going to happen in two years, in five years," she said. "It's a very complex system."

Thompson, who took over the agency a year ago, said that she has fired many problem employees and is working on ways to better manage cases, but that the reforms cannot happen overnight.

Advocates for the residents said that they have waited long enough and that receivership is the best route to reform. "It really is our only option at this point," said Sandy Bernstein, legal director for University Legal Services.

The Justice Department conveyed a similar sense of urgency in its court filing. Justice attorneys cited several recent cases of abuse that occurred despite the agency's scrutiny by a court-appointed monitor and two special masters.

Besides the four deaths cited by the court monitor, the Justice Department listed 10 other cases of "preventable or questionable" fatalities. The city and its providers missed danger signs, such as significant weight loss and behavioral problems, or failed altogether to deliver proper treatment, the Justice Department said.

They included the case of a woman, identified by the pseudonym "Abigail," who died at 58. She became seriously ill in March 2004 but did not receive adequate attention for a week, the court filing said. Another woman, identified as "Olivia," was 54 when she died in 2004 of colon cancer. Her records showed that she had never been screened for colorectal cancer, the Justice Department stated.

Over the years, the court has issued numerous judgments against the city in the case, which was filed in 1976 on behalf of hundreds of residents of Forest Haven, then the city's institution for people with mental retardation. The Justice Department joined the suit.

University Legal Services, which is being aided by a Massachusetts law firm, said the city "continues to disobey Court orders, break commitments, and inflict abuse, neglect and untold harm upon the very individuals the litigation was brought to protect. . . . Individuals are dying and families are suffering."

University Legal Services and the Justice Department faulted the city for not keeping track of the needs of wards in its care and for not holding providers accountable for lapses leading to deaths and illnesses. High turnover in management and a cumbersome bureaucracy contribute to the trouble, they said.

The city failed to comply with a 90-day emergency plan this year to make a limited number of reforms.

Unlike the court monitor -- who has regularly issued dire progress reports to a judge -- a receiver would take charge of delivering a range of services for the developmentally disabled, everything from help with shopping for some who live in their own apartments to 24-hour care for those in the group homes.

Williams pledged six years ago to fix operations after a Washington Post series disclosed 350 cases of abuse and neglect, as well as profiteering, in group homes.

"It'll be a blight on the whole city if this goes into receivership," said D.C. Council member Adrian M. Fenty (D-Ward 4), who heads the council's Committee on Human Services and has been pressing the city to act.