Guest columnist Al Norman: Fighting for care everyone deserves




Published: 06-09-2024 11:40 AM

I met attorney Steven Schwartz in 1972. We were working in Greenfield as VISTA volunteers for Franklin Community Action Corp. The following year Steven created the Greenfield office of Western Mass Legal Services, and a second office in Hampshire County.

In 1982, he founded the Center for Public Representation (CPR). For the past 42 years, Schwartz and his team of 10 attorneys have been freedom fighters for the elderly and disabled, aggressively litigating disability rights cases against Massachusetts and other states — winning rights to community-based care for tens of thousands of citizens segregated inside institutions.

Here are some highlights of CPR’s impressive advocacy victories:

■Brewster v. Dukakis (1978): Federal consent decree requires the state to create community mental health services for all people with mental illness in western Massachusetts.

■Rosie D v. Patrick (2006): Federal court requires the state to provide an array of home-based mental health services to over 30,000 children with serious emotional disturbances.

■Rolland v. Patrick (2000 and 2008): Federal court approves two settlements requiring the commonwealth to transition over 1,600 people with intellectual or developmental disabilities from nursing facilities into the community with housing and supports.

■Hutchinson v. Patrick (2008 and 2012): Federal court approves two settlements requiring the state to transition 1,200 individuals with brain injury from nursing facilities into new homes in the community.

■Marsters v. Healey (2024): Class-action settlement that expands opportunities for thousands of individuals in nursing facilities to receive the services they need to live in their communities with support.

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The Marsters settlement was especially meaningful to me, because when I was the executive director of Mass Home Care, I lobbied for passage of the “Equal Choice” bill, which was signed into law by Gov. Mitt Romney in 2006. The CPR class-action complaint filed in October 2022 explains that the Equal Choice law requires the state ”to provide pre-admission counseling and an assessment for community services to any person at risk of entering a nursing facility … and is intended to avoid unnecessary segregation in a nursing facility by ensuring that those at risk of institutionalization are provided meaningful choices and actual service options in the community.”

Even though in Massachusetts, roughly three out of four dollars spent on long-term care is for community supports, “there are approximately 22,000 Medicaid-eligible adults with disabilities institutionalized in Massachusetts nursing facilities … [and] there are another 1,500 individuals with serious mental illness residing in nursing facilities across the Commonwealth.”

Schwartz called me in 2018, four years before filing Marsters, asking me to review my files for information that would support a potential class-action lawsuit based on elderly plaintiffs who were unjustifiably segregated in nursing facilities. ”You were the original inspiration for this initiative many years ago,” Schwartz told me recently. “The [COVID] pandemic just elevated its urgency.”

“Over the past two and a half years,” the CPR complaint says, “during the COVID-19 pandemic, persons with disabilities in nursing facilities have suffered unique deprivations, including a serious risk of harm and death … They died at an alarming rate: One in every seven residents of nursing facilities in Massachusetts succumbed in the COVID-19 pandemic, which is one of the highest mortality rates in the country. At one point, nearly 66% of all deaths in Massachusetts involved persons with disabilities who lived in nursing facilities and other segregated long-term care settings. In just the first six months of the pandemic, over 6,400 Massachusetts residents died in long-term institutions like nursing facilities.”

As a result of the Marsters settlement, Gov. Maura Healey’s administration has committed to provide every person with a disability in nursing facilities with an informed choice about where to live, transitional assistance to leave the facility, and new residential programs that will allow at least 2,400 individuals to move from nursing facilities to the community over the next eight years. The administration will spend $1 billion to implement this class-action settlement.

The CPR complaint notes that ”Despite often being called nursing ‘homes,’ they are not real homes or even home-like. Rather, they are residential institutions that congregate large numbers of unrelated persons with disabilities who did not know each other before entering the facility, and have not chosen to live together.”

Schwartz remains committed to the mission: “For thousands of people with disabilities who are segregated in nursing facilities, this agreement will provide them a new home and services in the community, so they can be near their families and friends. This is what the law requires, and what everyone deserves.”

Al Norman’s Pushback column appears twice a month on Wednesdays in the Recorder.