Texas Violated Federal Law by Institutionalizing Disabled in Nursing Homes, Judge Rules
SAN ANTONIO, Texas — A federal judge has ruled that Texas has violated federal law for decades by placing individuals with intellectual and developmental disabilities in nursing homes instead of offering them appropriate community-based services.
In a sweeping 475-page opinion issued Tuesday, U.S. District Judge Orlando Garcia said the state caused “irreparable injury” to thousands of people with severe disabilities by failing to provide required services under federal law. The ruling comes from a class-action lawsuit first filed in 2010 by disability advocates and six plaintiffs aged 26 to 46.
Lack of Screening and Support Leads to Institutionalization
Judge Garcia found that Texas routinely sends individuals with disabilities to nursing homes, often after hospital visits, without proper screening. Once admitted, many become trapped due to the lack of legal support or appropriate care.
“Although community programs are the most integrated setting appropriate to meet their needs, they remain unnecessarily institutionalized in nursing facilities, or at serious risk of such institutionalization,” Garcia wrote. “They are harmed by such institutionalization and deprived of living in a community setting.”
Advocates Applaud the Decision
Disability rights groups hailed the decision as a major victory. Garth Corbett, senior attorney for Disability Rights Texas, said the ruling confirms that Texans with disabilities have the right to transition out of institutional care.
“It underscores the right of persons admitted to nursing facilities with IDD to be provided the necessary supports and services required by federal Medicaid law,” said Corbett.
Steven Schwartz, special counsel with the Center for Public Representation and co-counsel in the case, described the opinion as “sweeping” and “breathtaking in its impact.”
Historical and Legislative Context
The ruling points to Texas’ failure to comply with several federal laws, including the Americans with Disabilities Act, the Medicaid Act, and the Nursing Home Reform Act of 1987. That act mandates screening before admitting individuals with intellectual disabilities to nursing facilities and aims to prevent inappropriate placements.
Despite a 2013 interim agreement to improve community services, the state withdrew from final settlement talks in 2014 after Gov. Greg Abbott took office. This decision extended the legal battle for over a decade.
“It would have clearly been a better resolution for everyone,” Schwartz said. “It would have been more timely, safer, less expensive, and would not have required a federal judge to issue all these orders.”
No Immediate Enforcement Actions
Though the ruling sets a strong legal precedent, it does not include immediate enforcement actions. Both sides must submit proposals for next steps by August 1. Judge Garcia will then determine specific requirements for the state.
“Texas knows how to serve people in the community with significant needs,” said Schwartz. “It just has to expand to do it.”
A spokesperson for Texas Health and Human Services said the agency is reviewing the court’s decision.