Dunakin v. Lashway: Class Action on Behalf of Nursing Facility Residents with Intellectual Disabilities and Related Conditions

Description of the action

Dunakin v. Lashway and Teeter, No. 2:14-cv-00567-JLR, is a class action lawsuit filed in the Western District Court of Washington. The Plaintiff, Adam Dunakin, brought this case against the Secretary of the Washington State Department of Social and Health Services (DSHS) as well as the Director of Washington’s Health Care Authority (HCA) on behalf of himself and hundreds of other private nursing facility residents with intellectual disabilities and related conditions. He alleged that because DSHS and HCA had not properly screened and evaluated him and other residents with intellectual disabilities and related conditions prior to placing them in a nursing facility, these agencies were violating the “Preadmission Screening and Resident Review” or “PASRR” requirements of the federal Nursing Home Reform Act and the “Integration Mandate” of the Americans with Disabilities Act. He further alleged that because DSHS and HCA were not providing “specialized services” to address his and other residents’ intellectual disabilities and related conditions, DSHS and HCA were violating the Medicaid Act. This lawsuit sought to secure systemic reforms to implement the requirements established under these federal laws. 

The Court certified a class of all individuals who:

  • (a) are or will be residents of Medicaid-certified, privately-operated nursing facilities in the State of Washington; and
  • (b) who [sic] are Medicaid recipients with an intellectual disability or related condition(s) such that they are eligible to be screened and assessed pursuant to 42 U.S.C. § 1396r(e)(7) and 42 C.F.R. § 483.122 et seq.

The Court further determined that under federal law, “intellectual disability or related conditions” include a broader group of conditions than the state’s “developmental disability” definition, and individuals may qualify for PASRR, even if they do not qualify for services from the state Developmental Disability Administration (DDA).

The parties reached a settlement agreement. On January 9, 2017, the Court held a Fairness Hearing, and ordered final approval of the Settlement Agreement [PDF].

Case documents

Summary of work: 

Milestone: January 9, 2017

The court approves the final settlement agreement, finding that it met the criteria for being fair, reasonable and adequate. The court will continue to have authority to make sure defendants follow through with their commitments under the agreement to provide timely and appropriate screens, thorough  evaluations, and necessary specialized or community-based services to help all class members maximize their potential. The Court approved the Plaintiff’s attorney fees of $590,345.00 and costs of $65,026.59. 

Milestone: September 12, 2016

Court enters preliminary approval of final settlement that added agreed outcome measures for the policy and training outcomes in the preliminary agreement, as well as provisions for DSHS and HCA to pay the Plaintiffs’ attorney fees and costs, which has initially been estimated to be $704,000.00 for the time and costs incurred by Disability Rights Washington and Sirianni Youtz Spoonemore Hamburger.

Milestone: April 1, 2016

Parties file preliminary agreement with policy and training outcomes for ensuring class members receive PASRR screening, evaluations, specialized services, and placement options for nursing facility alternatives.

Milestone: April 10, 2015

Court issues order certifying class and entering a partial summary judgment against DSHS and HCA for using an inappropriately narrow definition of “intellectual disability and related conditions” based on the state definition of “developmental disability” to determine who is eligible for PASRR screening, evaluations, and specialized services. Court rejected DSHS and HCA’s request to dismiss Plaintiffs’ Medicaid claims.

Milestone: February 19, 2015

Parties engage in a Mediation and agree to continue negotiations.

Milestone: April 16, 2014

Plaintiff files class action complaint alleging that the state’s Department of Social and Health Services (DSHS) and Health Care Authority (HCA) were warehousing him and hundreds of other individuals with intellectual disabilities and related conditions in nursing facilities without providing them with the specialized services they needed. The complaint asserted that DSHS and HCA were violating federal requirements to implement a “Preadmission Screening and Resident Review” (“PASRR”) system and to offer services in the most integrated settings appropriate to each individual’s needs.