Intellectual Disability Flashcards
Which Concerns Led to Conversation of Least Restrictive Alternative?
Liberty Concerns
Dixon v. Weinberger
- First case to focus on the right to community treatment or aftercare.
- Many patients were kept institutionalized when they no longer met the criteria.
- Court ruled that they had a right to aftercare / less restrictive care
- Many years of non-compliance following Dixon
In Re: S.L.
Ruling that special placement hearings would be scheduled in cases involving individuals who were not able to survive independently in the community.
Halderman v. Pennhurst State School - Developmentally Disabled Assistance and Bill of Rights Act (DD Act)
Argued: 1983
Decided: 1984
- 17 plaintiffs’ lawyers sought to merge arguments in support of a constitutional right to habilitation and a right to the LRA in “a direct assault on institutionalization of retarded persons.”
- Defense; no specific level of mandated treatment in PA Law or the US Constitution
- The district court found that institutional conditions violated residents’ rights to minimally adequate habilitation, to freedom from harm and to “non-discriminatory habilitation (citing the 8th and 14th amendments). Only Pennhurst as an organization was liable, not the individual charged. Based on the Developmentally Disabled Assistance and Bill of Rights Act (DDA) of 1975 not on constitutional grounds.
- (DD Act). That law, the court found, provided persons with mental retardation an enforceable federal statutory right to treatment, but the Supreme court disagreed, saying that the DD act was simply a federal-state grant program (voluntary). PA court then upheld their decision again using PA law / state statute, SC reversed again.
- Parties eventually settled
Goals - Goals of the plaintiff’s: To end the more than a century of incarceration of the retarded in the United States.
Terms of the Settlement in Halderman v. Pennhurst State School
Defendants agreed to develop, review and monitor individual, written habilitation plans for each member of the plaintiff class, and to afford each plaintiff:
(1) protection from harm;
(2) safe conditions;
(3) adequate shelter and clothing;
(4) medical, health-related, and dental care;
(5) protection from physical and psychological abuse, neglect, or mistreatment;
(6) protection from unreasonable restraint and the use of seclusion; and
(7) protection from the administration of excessive or unnecessary medication.40 State defendants agreed to make available sufficient funds to create sufficient community placement and services for Pennhurst residents, to allow for the facility’s closing by the target date, and to provide for community residents with mental retardation not residing there.
Youngberg v. Romeo (1982)
Finding there was no general right to services in the community.
Facts: Admitted to Pennhurst State Hospital in 1974 where they used restraints inappropriately and he was not given proper care. Sustained 70+ injuries, some self-inflicted, some by other residents, some became infected. His mother sued Superintendent (Youngberg) and director of residential life (Mathews) and Director of unit 9 (Conley)
Proceedings: Plaintiff lost jury trial. Reversed by Court of Appeals: “The present controversy inhabits the twilight area of developing law concerning the constitutional rights of the involuntarily committed mentally retarded”
USSC Holding: State has an obligation to provide the institutionalized mentally retarded “minimal habilitation,” along with at least “minimal services” that permit (1) the least restraint possible, and (2) basic safety. However, in so ruling, the Court recognized that these standards were somewhat open to interpretation. Presumption of correctness should be given to the professional. Part of the rationale of the Court for not guaranteeing any particular minimal standard for rehabilitation was the fact that Romeo was unlikely to achieve independent functioning with any level of rehabilitation available at the time.
City of Cleburne v. Cleburne Living Center
- Man purchased a building to make a group home for the mentally retarded, but the planning and zoning committee and city counsel denied the special use permit
- Lower court said quasi-suspect class and intermediate scrutiny should be applied, the denial was unconstitutional
- The Supreme court said not a suspect class, rational relation, but still there was not rational basis in this case
- A few judges concurred in part, dissented in part agreeing that persons with mental retardation cannot be deemed “presumptively unfit to live in a community.”
- Equal Protection Clauses
Olmstead v. LC (1999)
First coherent answer to the question of the right of institutionalized person with mental disabilities to community services under the Americans with Disabilities Act (ADA).
USSC Finding: ADA entitled plaintiffs to treatment in an integrated community setting as opposed to an “unnecessarily segregated” state hospital; the state had discriminated against the patients via unjustified isolation.
The ADA did not “condone termination of institutional settings for persons unable to handle or benefit from community settings”; states “generally may rely on the reasonable assessments of its own professionals” in determining whether an individual is eligible for community-based programs, and that there was no requirement that “community-based treatment be imposed on patients who do not desire it.
Under Title II of the ADA, States are required to provide community-based treatment for persons with mental disabilities when the State’s treatment professionals determine that such placement is appropriate, the affected persons do not oppose such treatment, and the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities
Key Points Re: Deinstitutionalization
- Deinstitutionalization leads to an increase of incarceration of the mentally ill.
- Hospitals were overpopulated and understaffed.
- Physical and chemical restraints often used, and there was much treatment neglect. Reports of beatings by staff and sexual assault.
Pennhurst Legacy
Spurred on the deinstitutionalization movement in America and eventually helped to spark Congressional reform of the rights of individuals with all disabilities. A affirmation of the civil rights of people with disabilities, and the beginning of casting vulnerable groups of people into lifelong poverty and homelessness.
“Mental Retardation” and Capital Offenses - Questions & USSC Response
Is state sponsored execution for offenders with mental retardation cruel and unusual?
In 2001 S.C. overturned death sentence because jury had heard mitigating evidence of defendant’s MR, but had no avenue to put any consideration into effect.
Many states enacted specific legislation banning death for offenders with MR.
Atkins v. Virginia (2002) - Facts & Appellate Courts
Facts: Defendant, unprovoked shot and killed an airman first class. Prosecutor argued for death based on violent history and the nature of this crime. A Dr. testified to defendant’s MR, but said there was no reason why he should not be able to appreciate the wrongfulness of his act. Defense declined an instruction from judge to jury to use MR as a mitigating factor prior to first deliberation on guilt. Sentenced to death.
Later the Defense reversed and wanted to use MR as mitigating factor why Atkins should not get death. Judge said the objection was untimely. Death sentence stood.
Appeals Court: MR instruction should have been given, but did not preclude a finding of death. Second trial, another dr. said defendant had average intelligence, not using IQ but vocabulary and knowledge of current events. Said deficits did not extend past the academic setting. Jury found death again.
Atkins v. Virginia (2002) Supreme Court Holdings
Question: Agreed to hear the appeal of the Atkins case, and limited it to the specific issue of whether execution of offenders with MR violates the Constitution’s Eighth Amendment protection against cruel and unusual punishment.
Holding: Yes, violation. State legislation shows public view that MR defendants are less culpable. o However, the Court made clear to that the ruling might not apply to all offenders who had ever received an MR diagnosis, so long as the diagnosis itself could be disputed as a fact of law.
Left open to states the manner in which they determined who does and does not have an intellectual disability.
Hall v. Florida (2004)
The U.S. Supreme Court ruled that states needed to consider three factors in determining disorder:
(1) IQ
(2) functional impairment
(3) presence of both (1) and (2) prior to age 18.
Additional Holding: The rigid “bright line” rules keyed to any particular IQ were unconstitutional, as the well-accepted error of the tests for assessing IQ would necessarily mean that individuals with actual low IQs would be excluded from the protected category.
Buck v. Bell (1927)
States are allowed to involuntarily sterilize persons (feeble minded)
