ORDER FOR REPORTING ON SETTLEMENT AGREEMENT
DONOVAN W. FRANK, District Judge.
On May 28, 2015, this matter came before the Court for a Status Conference. (Doc. No. 456.) Following this Status Conference, the parties participated in mediation meetings with Magistrate Judge Becky R. Thorson between June 2015 and October 2015. On June 18, 2015, the Court stayed the parties' and the Court Monitor's reporting obligations to the Court based on the status of the mediation proceedings. (Doc. No. 462 at 2.) On July 9, 2015, the Court extended the stay of the reporting requirements during the pendency of the mediation period to August 10, 2015. (Doc. No. 472 at 2.) The Court reserved the right to address the resumption of status reports or any modified reporting obligations by separate Order. (Id.) On February 2, 2016, the Defendants submitted the Jensen Settlement Agreement Comprehensive Plan of Action (CPA) — Ninth Compliance Update Report, Reporting Period: May 1 — September 30, 2015 ("Gap Report").1 (Doc. No. 531.)
Currently before the Court is the Plaintiffs' Proposal for Reporting on Jensen Agreement, received by the Court on February 10, 2016 (Doc. No. 537), and the Defendants' Proposal on Compliance Reporting, received by the Court on February 12, 2016 (Doc. No. 539). Both parties seek an Order from the Court establishing a schedule for compliance reporting with respect to the Stipulated Class Action Settlement Agreement ("Settlement Agreement") (Doc. No. 136-1) and the Comprehensive Plan of Action ("CPA") (Doc. No. 283).
Based upon the submissions of the parties, the entire record before the Court, the Court's determination that there is a need for an Order establishing a schedule for compliance reporting, and the Court being otherwise duly advised in the premises, IT IS HEREBY ORDERED that:
1. The Minnesota Department of Human Services ("DHS") shall submit to the Court, Plaintiffs' Class Counsel, the Ombudsman for Mental Health and Developmental Disabilities, and the Executive Director of the Minnesota Governor's Council on Developmental Disabilities ("Consultants") exception, semi-annual, and annual Comprehensive Plan of Action ("CPA") reports based on the schedule listed in the attached Exhibit A entitled "Jensen Settlement Agreement Comprehensive Plan of Action Reporting Schedule. Appendix A." (See attached Exhibit A.)
2. Semi-annual reporting shall occur according to the following schedule:
a. First semi-annual (January, February, March, April, May, June) CPA report due date August 31.2
b. Second semi-annual (July, August, September, October, November, December) CPA report due date February 28, or, in the case of a leap year, February 29.
3. Annual Reports shall cover the period of January 1 to December 31 and shall be due on or before March 31.
4. Exception reporting is to be in accordance with the time frame and for the reasons listed in Exhibit A, with the exclusion of reports for Emergency Use of Manual Restraint ("EUMR") which are governed by the terms of the Stipulated Class Action Settlement Agreement (Doc. No. 136-1).
5. When the reporting date is a Saturday, Sunday, or a legal holiday, the reporting shall be effected on the next day that is not a Saturday, Sunday, or legal holiday, as provided in Federal Rule of Civil Procedure 6(a)(1)(C).
6. All data included in reports to the Court must be confirmed as reliable and valid. All statements made in the reports must be accurate, complete, timely, and verified.
7. DHS shall provide a draft of the semi-annual and annual reports for comment to the Consultants no fewer than fifteen (15) business days prior to the due date of each report.
8. The Consultants may provide comment or feedback to DHS no later than close of business seven (7) business days before the due date of each report.
9. DHS shall submit all reports to the Court according to formal court filing procedures.
10. The Court understands that DHS has hired Dr. Daniel Baker as the new Jensen Internal Reviewer, replacing Dr. Richard Amado. (See Doc. No. 531, Gap Report at 28-29.) The Court approves of this replacement. DHS shall advise the Court, after consultation with the Consultants regarding replacement of the Internal Reviewer (CPA Evaluation Criteria ("EC") 39), when the person responsible as the Internal Reviewer changes. Such change shall be reflected in the first semi-annual or annual CPA report following the change.
11. DHS shall reflect changes to a designated "Person responsible" in the first semi-annual or annual CPA report following the change.
12. Plaintiffs' Class Counsel and the Consultants are permitted, but not required, to submit written comments to the Court following DHS's submission of an exception, semi-annual, or annual report. Such comments must be submitted to the Court no later than ten (10) days following the report's submission.
13. The Court will convene bi-annual status conferences with Defendants' Counsel, Plaintiffs' Class Counsel, and the Consultants to facilitate the Court's continued oversight of the Defendants' compliance with the CPA and the Jensen Settlement Agreement. Status conferences will be convened by the Court each June and December, beginning in June 2016. Prior to each status conference, the Court will issue an Order clarifying the timing and location of each status conference as well as a planned agenda explaining topics to be discussed.
14. DHS shall consult with Plaintiffs' Class Counsel and the Consultants if DHS contemplates proposing to modify the reporting schedule or format, and any such proposals must be submitted to the Court for approval. If the Court requires modifications to the reporting schedule or format, it will notify DHS.
15. Prior orders of the Court (Doc. Nos. 136, 136-1, 159, 211, 212, 223, 224, 266, 284, 323, 340, 457, 462, & 472) and the CPA (Doc. No. 283), as they relate to the schedule for and submission of compliance reporting, are superseded by this Order to the extent they are inconsistent with this Order only as to reporting requirements.
16. The Court understands that DHS is developing a "pool" of independent subject matter experts. (See Doc. No. 531, Gap Report at 6.) The Court will consider proposals by both parties regarding how the independent subject matter experts may be utilized for external reporting. Such proposals must be submitted to the Court within seven (7) days of this Order.
17. The Court will issue separate Orders regarding the role and reporting requirements of the Court Monitor, the external reviewer, and the independent subject matter experts.
18. Based on all of the above and the current status of this matter, and pursuant to the Settlement Agreement § XVIII.B and the Court's September 3, 2014 Order (Doc. No. 340), the Court's jurisdiction is extended to December 4, 2019. The Court expressly reserves the authority and jurisdiction to order an additional extension of jurisdiction, depending upon the status of Defendants' compliance and absent stipulation of the parties.
Jensen Settlement Agreement Comprehensive Plan of Action Reporting Schedule. Appendix A.
EC Reporting Color Key Comprehensive Plan of Action Evaluation Criteria Exception Reporting:
# Green: Semi-Annual Exception Reporting has the meaning that the
Pink: Annual reporting will occur more frequently than
Purple: Exception semi-annually, if concerns are noted.
1 Annual 1. The Facilities will comply with Olmstead v. L.C. The Facilities are and will
remain licensed to serve people with developmental disabilities. The Facility will
eliminate unnecessary segregation of individuals with developmental disabilities.
People will be served in the most integrated setting to which they do not object.
Each individual's program will include multiple opportunities on an ongoing basis
to engage with: (1) citizens in the community, (2) regular community settings, (3)
participating in valued activities (4) as members of the community. These
community activities will be highly individualized, drawn from the person-centered
planning processes, and developed alongside the individual. C1+C1
1.1 Each individual's planning processes will specifically address integration within
the following life areas: (1) home; (2) work; (3) transportation; (4) lifelong
learning and education; (5) healthcare and healthy living; and (6) community and
1.2 Cambridge and successor facilities apply strong efforts to individualize and
personalize the interior setting of the home. This includes exerting maximal
feasible efforts to assist individuals to personalize and individualize their bedrooms
and common areas, to make each common area aesthetically pleasing, and to
actively support individuals to bring, care for, acquire, and display personal
possessions, photographs and important personal items. Consistent with
person-centered plans, this may include the program purchasing such items which will
build towards transition to a new place to live.
2 Semi-Annual 2. Facilities utilize person-centered planning principles and positive behavioral
supports consistent with applicable best practices including, but not limited to the
Association of Positive Behavior Supports, Standards of Practice for Positive
3 Semi-Annual 3. Facilities serve only "Minnesotans who have developmental disabilities and
exhibit severe behaviors which present a risk to public safety."
4 Annual 4. Facilities notify legal representatives of residents and/or family to the extent
permitted by law, at least annually, of their opportunity to comment in writing, by
e-mail, and in person, on the operation of the Facility.
5 Exception 5. The State/DHS immediately and permanently discontinues all the prohibited Reporting will occur more frequently than
restraints and techniques. semi-annually if concerns are noted.
6 Exception 6. The State/DHS has not used any of the prohibited restraints and techniques. Reporting will occur more frequently than
semi-annually or annually if concerns are
7 Exception 7. Medical restraint, and psychotropic/ neuroleptic medication have not been Reporting will occur more frequently than
administered to residents for punishment, in lieu of habilitation, training, behavior semi-annually or annually if concerns are
support plans, for staff convenience or as behavior modification. noted.
8 Exception 8. Restraints are used only in an emergency. Reporting will occur more frequently than
semi-annually or annually if concerns are
9 Exception 9. The Policy (Settlement Agreement Att. A, as it may be revised after court Reporting will occur more frequently than
approval, dissemination and staff training) was followed in each instance of manual semi-annually or annually if concerns are
10 Exception 10. There were no instances of prone restraint, chemical restraint, seclusion or time Reporting will occur more frequently than
out. [Seclusion: evaluated under Sec. V.C. Chemical restraint: evaluated under Sec. semi-annually or annually if concerns are
11 Exception 11. There were zero instances of the use of Seclusion. Facility policy shall specify Reporting will occur more frequently than
that the use of seclusion is prohibited. semi-annually or annually if concerns are
12 Exception 12. There were zero instances of the use of Room Time Out from Positive Reporting will occur more frequently than
Reinforcement. Facility policy shall specify that the use of time out from positive semi-annually or annually if concerns are
reinforcement is prohibited. noted.
13 Exception 13. There were zero instances of drug / medication use to manage resident behavior Reporting will occur more frequently than
OR to restrain freedom of movement. Facility policy specifies the Facility shall not semi-annually or annually if concerns are
use chemical restraint. A chemical restraint is the administration of a drug or noted.
medication when it is used as a restriction to manage the resident's behavior or
restrict the resident's freedom of movement and is not a standard treatment or
dosage for the resident's condition.
14 Exception 14. There were zero instances of PRN orders (standing orders) of drug/ medication Reporting will occur more frequently than
used to manage behavior or restrict freedom of movement. Facility policy specifies semi-annually or annually if concerns are
that PRN/ standing order medications are prohibited from being used to manage noted.
resident behavior or restrict one's freedom of movement.
22 Exception 22. The responsible Facility supervisor contacted the DHS medical officer on call Reporting will occur more frequently than
not later than 30 minutes after the emergency restraint use began. semi-annually or annually if concerns are
23 Exception 23. The medical officer assessed the situation, suggested strategies for de-escalating Reporting will occur more frequently than
the situation, and approved of, or discontinued the use of restraint. semi-annually or annually if concerns are
24 Exception 24. The consultation with the medical officer was documented in the resident's Reporting will occur more frequently than
medical record. semi-annually or annually if concerns are
25 Exception 25. All allegations were fully investigated and conclusions were reached. Reporting will occur more frequently than
Individuals conducting investigations will not have a direct or indirect line of semi-annually or annually if concerns are
supervision over the alleged perpetrators; the DHS Office of the Inspector General noted.
satisfies this requirement. Individuals conducting investigations, interviews and/or
writing investigative reports will receive competency-based training in best
practices for conducting abuse / neglect investigations involving individuals with
cognitive and/or mental health disabilities and interviewing.
28 Exception 28. Form 31032 (or its successor) was fully completed whenever use was made of Reporting will occur more frequently than
manual restraint. semi-annually or annually if concerns are
29 Exception 29. For each use, Form 31032 (or its successor) was timely completed by the end Reporting will occur more frequently than
of the shift. semi-annually or annually if concerns are
30 Exception 30. Each Form 31032 (or its successor) indicates that no prohibited restraint was Reporting will occur more frequently than
used. semi-annually or annually if concerns are
32 Exception 32. Within 24 hours, and no later than one business day, Form 31032 (or its Reporting will occur more frequently than
successor) in each instance was submitted to the Ombudsman for MH & DD semi-annually or annually if concerns are
33 Exception 33. Within 24 hours, and no later than one business day, Form 31032 (or its Reporting will occur more frequently than
successor) in each instance was submitted to the DHS Licensing semi-annually or annually if concerns are
35 Exception 35. Within 24 hours, and no later than one business day, Form 31032 (or its Reporting will occur more frequently than
successor) in each instance was submitted to the legal representative and/or family semi-annually or annually if concerns are
to the extent permitted by law. noted.
36 Exception 36. Within 24 hours, and no later than one business day, Form 31032 (or its Reporting will occur more frequently than
successor) in each instance was submitted to the Case manager. semi-annually or annually if concerns are
38 Annual 38. Other reports, investigations, analyses and follow up were made on incidents
and restraint use.
39 Semi-Annual 39. In consultation with the Court Monitor during the duration of the Court's
jurisdiction, DHS designates one employee as Internal Reviewer whose duties
include a focus on monitoring the use of, and on elimination of restraints.
40 Exception 40. The Facility provided Form 31032 (or its successor) to the Internal Reviewer Reporting will occur more frequently than
within 24 hours of the use of manual restraint, and no later than one business day. semi-annually or annually if concerns are
41 Semi-Annual 41. The Internal Reviewer will consult with staff present and directly involved with
each restraint to address: 1) Why/how de-escalation strategies and less restrictive
interventions failed to abate the threat of harm; 2) What additional behavioral
support strategies may assist the individual; 3) Systemic and individual issues
raised by the use of restraint; and 4) the Internal Reviewer will also review
Olmstead or other issues arising from or related to, admissions, discharges and
other separations from the facility.
45 Annual 45. The following have access to the Facility and its records: The Office of
Ombudsman for Mental Health and Developmental Disabilities, The Disability
Law Center, and Plaintiffs' Class Counsel.
46 Annual 46. The following exercised their access authority: The Office of Ombudsman for
Mental Health and Developmental Disabilities, The Disability Law Center, and
47 Semi-Annual 47. The State undertakes best efforts to ensure that each resident is served in the
most integrated setting appropriate to meet such person's individualized needs,
including home or community settings. Each individual currently living at the
Facility, and all individuals admitted, will be assisted to move towards more
integrated community settings. These settings are highly individualized and
maximize the opportunity for social and physical integration, given each person's
legal standing. In every situation, opportunities to move to a living situation with
more freedom, and which is more typical, will be pursued.
48 Semi-Annual 48. The State actively pursues the appropriate discharge of residents and provided
them with adequate and appropriate transition plans, protections, supports, and
services consistent with such person's individualized needs, in the most integrated
setting and to which the individual does not object.
49 Semi-Annual 49. Each resident, the resident's legal representative and/or family to the extent
permitted by law, has been permitted to be involved in the team evaluation,
decision making, and planning process to the greatest extent practicable, using
whatever communication method he or she (or they) prefer.
50 Semi-Annual 50. To foster each resident's self-determination and independence, the State uses
person-centered planning principles at each stage of the process to facilitate the
identification of the resident's specific interests, goals, likes and dislikes,
abilities and strengths, as well as support needs.
51 Semi-Annual 51. Each resident has been given the opportunity to express a choice regarding
preferred activities that contribute to a quality life.
52 Semi-Annual 52. It is the State's goal that all residents be served in integrated community settings
and services with adequate protections, supports and other necessary resources
which are identified as available by service coordination. If an existing setting or
service is not identified or available, best efforts will be utilized to create the
appropriate setting or service using an individualized service design process.
53 Semi-Annual 53. The provisions under this Transition Planning Section have been implemented
in accord with the Olmstead decision.
54 Annual 54. Facility treatment staff received training in positive behavioral supports,
person-centered approaches, therapeutic interventions, personal safety techniques,
crisis intervention and post crisis evaluation.
55 Annual 55. Facility staff training is consistent with applicable best practices, including but
not limited to the Association of Positive Behavior Supports, Standards of Practice
for Positive Behavior Supports (http://apbs.org). Staff training programs will be
competency-based with staff demonstrating current competency in both knowledge
56 Annual 56. Facility staff receive the specified number of hours of training: Therapeutic
interventions (8 hours); Personal safety techniques (8 hours); Medically monitoring
restraint (1 hour).
57 Annual 57. For each instance of restraint, all Facility staff involved in imposing restraint
received all the training in Therapeutic Interventions, Personal Safety Techniques,
Medically Monitoring Restraint.
58 Annual 58. Facility staff receive the specified number of hours of training: Person-centered
planning and positive behavior supports (with at least sixteen (16) hours on
person-centered thinking / planning): a total 40 hours; Post Crisis Evaluation and
Assessment (4 hours).
59 Annual 59. Residents are permitted unscheduled and scheduled visits with immediate
family and/or guardians, at reasonable hours, unless the Interdisciplinary Team
(IDT) reasonably determines the visit is contraindicated.
60 Annual 60. Visitors are allowed full and unrestricted access to the resident's living areas,
including kitchen, living room, social and common areas, bedroom and bathrooms,
consistent with all residents' rights to privacy.
61 Annual 61. Residents are allowed to visit with immediate family members and/or guardians
in private without staff supervision, unless the IDT reasonably determines this is
62 Annual 62. There is no marketing, recruitment of clients, or publicity targeted to
prospective residents at the Facility.
64 Semi-Annual 64. The Facility has a mission consistent with the Settlement Agreement and this
Comprehensive Plan of Action.
65 Annual 65. The Facility posts a Patient / Resident Rights or Bill of Rights, or equivalent,
applicable to the person and the placement or service, the name and phone number
of the person within the Facility to whom inquiries about care and treatment may be
directed, and a brief statement describing how to file a complaint with the
appropriate licensing authority.
66 Annual 66. The Patient / Resident Bill of Rights posting is in a form and with content
which is understandable by residents and family / guardians.
67 Semi-Annual 67. The expansion of community services under this provision allows for the
provision of assessment, triage, and care coordination to assure persons with
developmental disabilities receive the appropriate level of care at the right time, in
the right place, and in the most integrated setting in accordance with the U.S.
Supreme Court decision in Olmstead v. L.C., 527 U.S. 582 (1999).
68 Semi-Annual 68. The Department identifies, and provides long term monitoring of, individuals
with clinical and situational complexities in order to help avert crisis reactions,
provide strategies for service entry changing needs, and to prevent multiple
transfers within the system.
69 Semi-Annual 69. Approximately seventy five (75) individuals are targeted for long term
70 Semi-Annual 70. CSS mobile wrap-around response teams are located across the state for
proactive response to maintain living arrangements.
71 Semi-Annual 71. CSS arranges a crisis intervention within three (3) hours from the time the
parent or legal guardian authorizes CSS' involvement.
72 Semi-Annual 72. CSS partners with Community Crisis Intervention Services to maximize
support, complement strengths, and avoid duplication.
73 Semi-Annual 73. CSS provides augmentative training, mentoring and coaching.
74 Semi-Annual 74. CSS provides staff at community based facilities and homes with state of the
art training encompassing person-centered thinking, multi-modal assessment,
positive behavior supports, consultation and facilitator skills, and creative
75 Semi-Annual 75. CSS' mentoring and coaching as methodologies are targeted to prepare for
increased community capacity to support individuals in their community.
76 Semi-Annual 76. An additional fourteen (14) full time equivalent positions were added between
February 2011 and June 30, 2011, configured as follows: Two (2) Behavior Analyst
3 positions; One (1) Community Senior Specialist 3; (2) Behavior Analyst 1; Five
(5) Social Worker Specialist positions; and Five (5) Behavior Management
77 Semi-Annual 77. None of the identified positions are vacant.
78 Semi-Annual 78. Staff conducting the Functional Behavioral Assessment or writing or reviewing
Behavior Plans shall do so under the supervision of a Behavior Analyst who has
the requisite educational background, experience, and credentials recognized by
national associations such as the Association of Professional Behavior Analysts.
Any supervisor will co-sign the plan and will be responsible for the plan and its
79 According to the Olmstead 79. The State and the Department developed a proposed Olmstead Plan, and will
Plan reporting process implement the Plan in accordance with the Court's orders. The Plan will be
comprehensive and will use measurable goals to increase the number of people
with disabilities receiving services that best meet their individual needs and in the
"Most Integrated Setting," and which is consistent and in accord with the U.S.
Supreme Court's decision in Olmstead v. L.C., 527 U.S. 581 (1999). The Olmstead
Plan is addressed in Part 3 of this Comprehensive Plan of Action.
80 Annual 80. Rule 40 modernization is addressed in Part 2 of this Comprehensive Plan of
Action. DHS will not seek a waiver of Rule 40 (or its successor) for a Facility.
81 Annual 81. The State takes best efforts to ensure that there are no transfers to or
placements at the Minnesota Security Hospital of persons committed solely as a
person with a developmental disability.
82 Exception 82. There are no transfers or placements of persons committed solely as a person Reporting will occur more frequently than
with a developmental disability to the Minnesota Security Hospital (subject to the semi-annually or annually if concerns are
exceptions in the provision). noted.
83 Annual 83. There has been no change in commitment status of any person originally
committed solely as a person with a developmental disability without proper notice
to that person's parent and/or guardian and a full hearing before the appropriate
84 Annual 84. All persons presently confined at Minnesota Security Hospital who were
committed solely as a person with a developmental disability and who were not
admitted with other forms of commitment or predatory offender status set forth in
paragraph 1, above, are transferred by the Department to the most integrated setting
consistent with Olmstead v. L.C., 527 U.S. 581 (1999).
85 Exception 85. All AMRTC residents committed solely as a person with a developmental Reporting will occur more frequently than
disability and who do not have an acute psychiatric condition are transferred from semi-annually or annually if concerns are
AMRTC to the most integrated setting consistent with Olmstead v. L.C., 527 U.S. noted.
89 Annual 89. Staff hired for new positions as well as to fill vacancies, will only be staff who
have experience in community based, crisis, behavioral and person-centered
services and whose qualifications are consistent with the Settlement Agreement and
currently accepted professional standards. Staff reassigned from MSHS-Cambridge
will receive additional orientation training and supervision to meet
these qualifications within 6 months of reassignment.
90 Annual 90. Provide integrated vocational options including, for example, customized
91 Annual 91. All requirements in this Comprehensive Plan of Action are fully met for each
individual served in the area of Person-Centered Planning.
92 Annual 92. All requirements in this Comprehensive Plan of Action are fully met for each
individual served in the area of Transition Planning.
93 Semi-Annual 93. DHS will provide augmentative service supports, consultation, mobile teams,
and training to those supporting the person. DHS will create stronger diversion
supports through appropriate staffing and comprehensive data analysis.
94 Annual 94. All sites, programs and services established or utilized under this
Comprehensive Plan of Action shall be licensed as required by state law.
96 Annual 96. Training plan for staff strongly emphasizes providing tools and support services
in a person's home as quickly as possible. Staff will also be trained in delivering
community based programs and processes.
98 Semi-Annual 98. DHS will maintain therapeutic follow-up of Class Members, and clients
discharged from METO/MSHS-Cambridge since May 1, 2011, by professional
staff to provide a safety network, as needed, to help prevent re-institutionalization
and other transfers to more restrictive settings, and to maintain the most integrated
setting for those individuals.
100 Annual 100. Within the scope set forth above, the rule-making process initiated by the
Department of Human Services pursuant to the Settlement Agreement, the
Department shall by December 31, 2014 propose a new rule in accordance with this
Comprehensive Plan of Action ("Proposed Rule"). This deadline may be extended
for good cause shown upon application to the Court not later than 20 days prior to
Should the Department of Human Services believe that it requires additional
rule-making authority to satisfy the requirements of this Plan, in order to apply the
to all providers covered by Rule 40 and the scope of this Plan, the Department will
rule seek an amendments to statutes in the 2014 Minnesota Legislative session to
ensure that the scope of the Rule 40 modernization stated above is fulfilled and will
apply to all of the facilities and services to persons with developmental disabilities
governed by Rule 40. Any proposed amendment(s) are subject to the notice and
comment process under EC __ below.
If legislative approval for the requested authority is not obtained in the 2014
Minnesota Legislative session, the Court may use its authority to ensure that the
Adopted Rule will apply consistent with the scope set forth in EC 99.
By August 31, 2015, the Department of Human Services shall adopt a new rule to
modernize Rule 40 ("Adopted Rule"). This deadline may be extended for good
cause shown upon application to the Court not later than 60 days prior to the
101 Annual 101. The Proposed Rule shall address the temporary use and tapering of carefully
monitored individual medical restraints for self-injurious behavior while non-restraint
positive behavior supports are implemented under professional
In formulating the Proposed Rule, and any other methods or tools of
implementation, the Department shall carefully consider the recommendations of
Dr. Fredda Brown, whose consultation on the Rule 40 modernization the
Department requested with regard to matters on which the Advisory Committee had
not reached consensus. The Department shall document the results of this review.
103 Semi-Annual 103. Within thirty (30) days of the promulgation of the Adopted Rule, Plaintiffs' DHS is in the process of discussing items to
Class Counsel, the Court Monitor, the Ombudsman for Mental Health and be included in the Olmstead plan.
Developmental Disabilities, or the Executive Director of the Governor's Council on
Developmental Disabilities may suggest to the Department of Human Services
and/or to the Olmstead Implementation Office that there are elements in the Rule
40 Advisory Committee Recommendations on Best Practices and Modernization of
Rule 40 (Final Version — July 2013) which have not been addressed, or have not
adequately or properly been addressed in the Adopted Rule. In that event, those
elements shall be considered within the process for modifications of the Olmstead
Plan. The State shall address these suggestions through Olmstead Plan sub-cabinet
and the Olmstead Implementation Office. Unresolved issues may be presented to
the Court for resolution by any of the above, and will be resolved by the Court.