The opinion of the court was delivered by: ALESIA
Before the court are defendants Jim Edgar's and Ann Patla's motion for partial judgment on the pleadings and to simplify issues for trial, and plaintiffs' motion for leave to file an amended complaint. For the reasons that follow, defendants' motion for partial judgment on the pleadings and to simplify issues for trial is granted, and plaintiffs' motion for leave to amend their complaint is granted in part and denied in part.
The class plaintiffs in this long-pending action, which is newly before this court, are persons who are or will be institutionalized for mental illness in mental health facilities operated by the State of Illinois. Plaintiffs claim that the conditions and practices in the state mental health facilities violate their rights to safety, freedom of movement, and adequate medical and psychiatric care and treatment under the Fourteenth Amendment. They have filed a class action lawsuit under 42 U.S.C. § 1983 for declaratory and injunctive relief to redress the alleged violations of their rights.
A. Defendants' motion for partial judgment on the pleadings1
Defendants have moved for partial judgment on the pleadings pursuant to Federal Rule of Civil Procedure 12(c) to challenge what defendants call "plaintiffs' class-wide claims for community services." (Mem. in Support of Defs.' Mot. for Partial Judgment on the Pleadings at 2.) Specifically, defendants challenge the legal sufficiency of plaintiffs' allegations that:
(a) "the institutions experience an excessively high recidivism rate, and they fail to discharge patients to appropriate placements or programs in the community when needed to avoid further injury or deterioration;"
(b) "the institutions often attempt to keep patient population below the design capacity of the institution by abruptly discharging patients and refusing to admit others without regard to the needs of the patients or the presence of adequate therapeutic resources in the community;" and
(c) the institutions fail to plan for and deliver follow-up care needed to prevent these patients from becoming homeless."
(Mem. in Support of Defs.' Mot. for Partial Judgment on the Pleadings at 2 (quoting Compl. PP 23, 24).)
Defendants argue that these allegations seek to impose a duty on the state to fund or provide benefits to plaintiffs while they are free of state custody, but that the state is not constitutionally required to provide such services to its citizens. Plaintiffs counter that the state may not affirmatively exercise its power to endanger the health and safety of its citizens, but that this is what the state does by discharging plaintiffs to the streets or inadequate private mental health facilities.
As a preliminary matter, the court notes that plaintiffs make claims in their response to defendants' motion that go far beyond what plaintiffs' complaint actually alleges. In addition, plaintiffs attempt to buttress their arguments with findings and conclusions by the former court-appointed experts in this case. The court has terminated the appointment of these experts and barred the parties from using the data compiled by them in this case. (See Minute Order dated September 4, 1996.) Moreover, before the court is a motion for judgment on the pleadings, not a motion for summary judgment. Therefore, in deciding defendants' motion, the court will consider nothing but the allegations in plaintiffs' complaint.
In Youngberg v. Romeo, 457 U.S. 307, 102 S. Ct. 2452, 73 L. Ed. 2d 28 (1982), the United States Supreme Court considered for the first time the substantive rights of involuntarily committed mentally retarded persons under the Fourteenth Amendment. Romeo, a 33-year-old man with the mental capacity of an 18-month-old child, could not talk or take care of himself. Upon Romeo's father's death, Romeo's mother, who could not care for Romeo or control his violence, had him committed to a state mental health institution. Youngberg, 457 U.S. at 309, 102 S. Ct. at 2454-55.
While in the state institution, Romeo was injured, by his own violence and by other residents, at least 63 times in less than two years. On one occasion, after Romeo was transferred from his ward to the hospital for treatment of a broken arm, Romeo was physically restrained during portions of each day. Youngberg, 457 U.S. at 310-11, 102 S. Ct. at 2455.
Romeo's mother filed a complaint against the state, alleging that the defendant state officials knew or should have known that Romeo was suffering injuries and that they failed to institute appropriate preventive procedures; that they restrained Romeo for prolonged periods; and that they failed to provide him with appropriate treatment or programs for his mental retardation. Youngberg, 457 U.S. at 310-11, 102 S. Ct. at 2454-55.
After a jury trial, a jury returned a verdict for defendants, and Romeo appealed. The Court of Appeals for the Third Circuit reversed and remanded for a new trial, finding that the involuntarily committed retain liberty interests in freedom of movement and personal security, and have a liberty interest in habilitation designed to treat their mental retardation. Youngberg, 457 U.S. at 312-13, 102 S. Ct. at 2456-57. The Supreme Court granted certiorari to decide the question whether Romeo had substantive rights under the Fourteenth Amendment to safe conditions of confinement, freedom from bodily restraints, and training or habilitation. Youngberg, 457 U.S. at 309, 314, 102 S. Ct. at 2454, 2457.
The Supreme Court decided in short order that the rights to safe conditions of confinement and freedom from bodily restraints had been recognized in prior court decisions, and that those rights are not extinguished by involuntary commitment. Youngberg, 457 U.S. at 315-16, 102 S. Ct. at 2458. The Court found Romeo's claimed constitutional right to minimally adequate habilitation "more troubling." Youngberg, 457 U.S. at 316, 102 S. Ct. at 2458.
In addressing the asserted right to training, we start from established principles. As a general matter, a State is under no constitutional duty to provide substantive services for those within its borders. See Harris v. McRae, 448 U.S. 297, 318, 100 S. Ct. 2671, 2689, 65 L. Ed. 2d 784 (1980) (publicly funded abortions); Maher v. Roe, 432 U.S. 464, 469, 97 S. Ct. 2376, 2380, 53 L. Ed. 2d 484 (1977) (medical treatment). When a person is institutionalized -- and wholly dependent on the State--it is conceded by petitioners that a duty to provide certain services and care does exist, although even then a State necessarily has considerable discretion in determining the nature and scope of its responsibilities. See Richardson v. Belcher, 404 U.S. 78, 83-84, 92 S. Ct. 254, 258-259, 30 L. Ed. 2d 231 (1971); Dandridge v. Williams, 397 U.S. 471, 478, 90 S. Ct. 1153, 1158, 25 L. Ed. 2d 491 (1970). Nor must a State "choose between attacking every aspect of a problem or not attacking the problem at all." [ Dandridge ], [397 U.S.] at 486-487, 90 S. Ct. at 1162-1163.
Youngberg, 457 U.S. at 317, 102 S. Ct. at 2459.
The Court thus stated: "As we have recognized that there is a constitutionally protected liberty interest in safety and freedom from restraint, . . . training may be necessary to avoid unconstitutional infringement of those rights." Youngberg, 457 U.S. at 318, 102 S. Ct. at 2459. The Court also noted that because Romeo sought only training related to safety and freedom from restraints, the case did not present "the difficult question of whether a mentally retarded person, involuntarily committed to a state institution, has some general constitutional right to training per se, even when no type or amount of training would lead to freedom." Id.
In a case shortly following Youngberg, the Court of Appeals for the Seventh Circuit addressed whether Illinois violated the rights of persons in its mental health facilities by failing to develop less restrictive alternatives to the state facilities in which the persons were placed. See Phillips v. Thompson, 715 F.2d 365 (7th Cir. 1983).
The plaintiffs in Phillips were among several hundred higher functioning but mentally retarded adults who, in December 1979, were living at the privately owned and operated North Aurora Center under a program sponsored by the state. On December 15, 1979, the North Aurora Center closed, after giving only 24 hours' notice of its intent to do so. Representatives of the Illinois Department of Mental Health and Developmental Disabilities (DMHDD) then moved the state-sponsored residents to state mental institutions. Id. at 366.
Plaintiffs filed suit against the governor, officials of DMHDD, and the Illinois Department of Public Health, alleging that the state institutions in which the DMHDD placed them unnecessarily restricted their personal liberties, and that the defendants had failed to develop alternatives that would be less restrictive. Plaintiffs alleged that the defendants' failure to develop less restrictive alternatives violated plaintiffs' rights under the Fourteenth Amendment and other laws. Id.
After a bench trial, the district court decided against plaintiffs on certain issues and dismissed the rest of the case. Plaintiffs appealed. Among other things, plaintiffs argued that the district court should have heard and determined whether plaintiffs were illegally denied less restrictive alternative community residential living. Id. at 367.
The Seventh Circuit stated that it believed that Youngberg controlled the case. The court first found that the district court did not err in determining that the class members were not denied a due process right with respect to freedom of movement or training. Id. The court then stated that with respect to plaintiffs' claim that they had a substantive due process right under the Fourteenth Amendment to care in a community residential setting, "the short answer is, as stated in Youngberg : 'As a general matter, a State is under no constitutional duty to provide substantive services for those within its borders.'" Id. (quoting Youngberg, 457 U.S. at 317, 102 S. Ct. at 2459). The court thus rejected plaintiffs' claim to the right to care in a community residential setting.
Seven years later, in DeShaney v. Winnebago County Dept. of Social Services, 489 U.S. 189, 109 S. Ct. 998, 103 L. Ed. 2d 249 (1989), the Supreme Court again addressed the state's duty to protect its citizens, but in a context much different from that of Youngberg. Joshua DeShaney was a repeated victim of child abuse by his father, who was awarded custody of Joshua after he and Joshua's mother divorced. The Winnebago County authorities first learned that Joshua was a victim of child abuse in 1982, when Joshua was two or three years old. The Winnebago County Department of Social Services (DSS) interviewed the father, but he denied the accusations, and DSS did nothing further. DeShaney, 489 U.S. at 191-92, 109 S. Ct. at 1001.
Based on the team's recommendation, the court dismissed the child protection case and returned Joshua to his father's custody. A month later, hospital emergency room personnel reported to the DSS caseworker handling Joshua's case that Joshua had returned to the hospital with suspicious injuries. The caseworker found no basis for action. Id.
For the next six months, the caseworker monthly visited Joshua's home and noticed various injuries to Joshua's head; she also noticed that Joshua was not enrolled in school and that Joshua's father's girlfriend had not moved out. The caseworker recorded her observances and her suspicion that Joshua was being abused, but did nothing more. DeShaney, 489 U.S. at 192-93, 109 S. Ct. at 1001.
In November 1983, emergency room personnel notified DSS that Joshua had been treated again for injuries they suspected to be caused by child abuse. The caseworker visited Joshua's home twice more, but was told Joshua was too ill to see her. DSS still did nothing. DeShaney, 489 U.S. at 193, 109 S. Ct. at 1001.
In March 1994, Joshua's father beat him so severely that Joshua fell into a life-threatening coma. Joshua did not die but suffered brain damage so severe that he would spend the rest of his life in an institution for the profoundly retarded. DeShaney, 489 U.S. 189 at 193, 109 S. Ct. 998 at 1001-02, 103 L. Ed. 2d 249.
Joshua and his mother sued DSS and several of its employees, alleging that the defendants violated Joshua's rights under the Fourteenth Amendment by failing to intervene to protect him against a risk of violence by his father about which they knew or should have known. DeShaney, 489 U.S. at 193, 109 S. Ct. at 1002. The district court granted summary judgment for the defendants. The Court of Appeals for the Seventh Circuit affirmed, holding that the due process clause of the Fourteenth Amendment does not require the state to protect its citizens from "'private violence, or other mishaps not ...