The District pays more attention to its mentally and physically disabled residents who are plaintiffs in a long-running lawsuit than to its other disabled clients, according to an advocate for the mentally retarded and to a recent report by the court monitor in the federal court case.
Kelly Bagby, outgoing legal director for University Legal Services, raised those and other concerns on the eve of her departure last month from the organization, which runs a federally mandated advocacy program for the mentally retarded. She said plaintiffs in the lawsuit still aren't receiving the best care, but are better off than mentally disabled clients not covered by the suit.
The lawsuit, now known as Evans v. [Mayor Anthony A.] Williams, was filed in 1976 on behalf of residents of Forest Haven, then the District's institution for the mentally retarded.
"There are continuing problems with addressing life and safety issues for all of these people," said Bagby, who left University Legal Services for the inspector general's office at the U.S. Department of Health and Human Services.
The Evans lawsuit is a class-action case, and the roughly 700 mentally disabled residents covered by it are referred to as "class members." Bagby said she had found an "alarming bifurcated" -- or divided -- system "in which Evans class members are getting much higher priority than non-class members, and that's not a good thing."
Bagby's claim was supported by Elizabeth Jones, the court monitor in the 28-year-old lawsuit. In her quarterly report last month to the federal judge in the case, she said the District isn't as aggressive in monitoring the care of about 850 clients who never lived at Forest Haven and therefore aren't part of the suit.
"Non-class members experience significant delays in the investigation of serious reportable incidents and deaths," Jones said in the report.
Neil Albert, the District's deputy mayor for children, youth, families and elders, said in an interview last week that the mayor is committed to improving services in the entire system, not just services for plaintiffs in the lawsuit.
"Even though the class is what gets the attention [in court], we're focused on systemic reform for everyone" receiving services from the Mental Retardation and Developmental Disabilities Administration, Albert said. Its clients "are our brothers and our sisters."
Albert said the city has taken "personnel actions" and has aggressively restructured agency offices "to make sure people are receiving similar services." His aides said that about 500 class members and non-class members are receiving a broader range of Medicaid services than in the past and that the city is working to expand services to its disabled citizens systemwide.
But at a hearing last month on the Evans case, Bagby told U.S. Judge Ellen Huvelle that the District has sometimes put a priority on improving specific services for class-action members, while putting the needs of other District clients with mental retardation and developmental disabilities on a dangerous back burner.
Maria Amato, a lawyer with the D.C. Attorney General's Office, said it wasn't fair for Bagby to raise questions about clients not covered by the class-action suit that Judge Huvelle oversees.
"I have to object to bringing up non-class members before this court," she said.
Huvelle noted Amato's objection for the record, but asked Bagby to continue. The District, Bagby said, shouldn't be allowed to "fix life for [some] people and not for 900 others. . . . Our clients are at risk if the person next to them is at risk."
The judge did not comment on concerns raised about non-class members. But she agreed with Bagby's and the court monitor's complaints about the District's chronic failure to investigate serious incidents and deaths in a timely manner for class members in the lawsuit.
"This is absolutely critical," Huvelle said to Yvonne Gilchrist, director of the D.C. Department of Human Services, which includes the mental retardation agency. "We have got to get the reports done and we've got to get them done thoroughly. . . . We've been talking about this forever."
Gilchrist told the judge she hoped to solve the delays and investigation backlog by "focusing on building capacity in our staff. . . . This is something I'm trying to strengthen."
Huvelle also said she believed that the District's fatality review committee, which investigates all deaths of retardation agency clients, needs to be streamlined, because too many agencies share responsibility for the death probes.
Criticizing the "unwieldy structure" of the committee, she said no one office takes the lead in making sure that crises and systemic problems get the necessary response and attention.
"Isn't there a better way to do this?" Huvelle asked. "It's baffling to me. . . . I can't keep it straight myself."
Agency officials said Albert is considering an overhaul of the fatality review committee.
In the interview, Albert expressed disappointment with a recent report from the fatality review panel, which he said failed to identify serious care problems in group homes that might have contributed to some fatalities. He said that although the mental retardation agency conducts in-depth reviews of client care, the recent report was not as thorough as those he has seen for other jurisdictions.
"It doesn't help inform the situation," he said. "The report needs to do a better job of identifying problem trends that could be used to improve care in the homes."