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Dixon Case
Because of a lawsuit dating back to 1974 when Saint Elizabeths Hospital was managed by the federal government, the Department of Mental Health (DMH) is required to report regularly to the US District Court on its progress in providing community based treatment alternatives to hospitalization for people with mental illness. Under the terms of the lawsuit, now known as Dixon et al v.Fenty et al, the Court evaluates its progress in meeting 19 defined performance measures—called the “Dixon Exit Criteria*”—that define the minimum standard for an effective public mental health system.
Background of Dixon et al. v. Fenty et al.
In 1974, a lawsuit was filed against the Federal Government and District Government on behalf of a class of individuals civilly committed to Saint Elizabeths Hospital, demanding community based treatment alternatives to hospitalization. The class included former, current and future patients. Because the lead plaintiff was William Dixon, the case is referred to as the “Dixon case.”
On October 1, 1987, operational responsibility for Saint Elizabeths Hospital officially was transferred from the Federal Government to the District Government. As a result of the transfer, the District Government became the sole defendant in the Dixon case. In 1996, the Dixon plaintiffs filed a motion in the US District Court, requesting the appointment of a receiver to operate the District’s public mental health system. This motion was granted in 1997 [Order Granting Motion for Appointment of Receiver dated June 13, 1997*].
In 2000, the US District Court appointed a Transitional Receiver to work with the District and the plaintiffs’ counsel on a plan to transition the daily operation of the public mental health system [Consent Order Appointing Transitional Receiver dated March 9, 2000*]. On April 2, 2001, the US District Court adopted the Transitional Receiver’s Final Court Ordered Plan [Final Court Ordered Plan adopted April 2, 2001*]. The Final Court Ordered Plan required the District to enact legislation establishing the Department of Mental Health as a cabinet-level agency reporting directly to the Mayor. It also set forth requirements for the organization and functions of the newly created department, including a requirement to construct a replacement for Saint Elizabeths Hospital.
On May 23, 2002, the US District Court issued a consent order that terminated the receivership, appointed a Court Monitor and adopted agreed upon exit criteria [Consent Order Vacating Receivership dated May 22, 2002*]. Dennis Jones, who had served as the Transitional Receiver, was appointed the new Court Monitor. The May 2002 Consent Order requires the Court Monitor to prepare and submit an annual monitoring plan to the parties for approval [Court Approved FY 2008 Monitoring Plan & Budget *, Amended FY 2008 Monitoring Budget*]. The Court Monitor also is required to submit bi-annual reports on monitoring activities to the Court. The Court Monitor began filing bi-annual reports on monitoring activities in January 2003 [Court Monitor Reports]. The Court Monitor visits DMH regularly throughout the year and meets with DMH employees and stakeholders to conduct monitoring.
The May 2002 Consent Order also identified 19 exit criteria. However, it did not specify performance targets or measurement criteria. The parties to the Dixon case negotiated the measurement criteria and performance targets for the Exit Criteria beginning in the summer of 2002. As outlined in Exit Criterion #3 and Exit Criterion #4, DMH conducts an annual review of its services to adults, children and youth.
In the fall of 2003, the District, the Court Monitor and the Dixon plaintiffs reached agreement about operational definitions, the measurement methods and performance levels required for each of the 19 agreed upon Exit Criteria. The terms of the agreement were approved by the US District Court and memorialized in a Consent Order adopted on December 12, 2003. [Consent Order Adopting Agreed Upon Exit Criteria dated December 12, 2003*. In addition, the District submits periodic status reports to the District Court about issues identified by the Court Monitor as critical District’s Status Reports to the Court.
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