WYATT BY AND THROUGH RAWLINS v. Rogers

MEMORANDUM OPINION

This class-action lawsuit, commonly referred to as the “Wyatt litigation,” was filed over 26 years ago by the plaintiffs (who represent all current and future mentally-retarded and mentally-ill residents in the Alabama Mental Health and Mental Retardation System) against the defendants (officials of the State of Alabama), claiming that conditions in the system’s facilities violated residents’ rights under state and federal law. In 1986, the court approved a consent decree resolving the parties’ continued conflicts over the defendants’ compliance with orders entered in the early 1970’s and the adequacy of the state’s funding and administration of the state’s mental health and retardation facilities. Wyatt v. Wallis, 1986 WL 69194 (M.D.Ala. Sept.22, 1986) (Thompson, J.).

In 1991, a new round of litigation began. On January 18, 1991, the defendants moved for a finding that they have met their obligations under the 1986 decree and for an order terminating this lawsuit. On January 22, 1993, the plaintiffs moved to enforce the 1986 consent decree and for further relief in light of both the defendants’ continuing failure to comply with the 1986 consent decree and the recently enacted Americans with Disabilities Act of 1990, commonly referred to as the “ADA,” 42 U.S.C.A. §§ 12101-12213. The court held a hearing on these motions for 35-trial days, spanning over several months, in 1995. The trial was followed by extensive briefing of the parties.

The hearing was, by agreement of the parties, a ‘summary proceeding.’ To try this case as a normal trial would have taken many months and the parties therefore agreed to try it as a summary proceeding. As a summary proceeding, the evidence was submitted in a jointly prepared record before the hearing, and both the defendants’ and the plaintiffs’ live and in-court examination of witnesses was limited to 60 hours of direct and 30 hours of cross-examination, with rebuttal testimony limited to two days. The purpose of the live testimony was to highlight the most pertinent and relevant parts of the already filed record. 1 Nevertheless, the rec *1361 ord that the court has had to review is comparable to that of a trial lasting many months.

Subsequent to the trial, on October 8,1996, the court held that the plaintiffs’ failure to follow proper court procedures for obtaining the defendants’ compliance with the 1986 consent decree warranted denial of their motion for enforcement except to the extent the plaintiffs seek relief other than under the consent decree. Wyatt v. Rogers, 942 F.Supp. 518 (M.D.Ala.1996) (Thompson, J.).

Based on the hearing and the evidentiary record and for the reasons that follow, the court now concludes that the defendants’ motion for a finding that they have met their obligations under the 1986 decree and for an order terminating this lawsuit should be granted in part and denied in part, and that the plaintiffs’ motion for relief other than under the 1986 consent decree should be denied.

I. BACKGROUND

Because, as will be explained later, the court must determine whether defendants have complied in good faith with the whole of the 1986 consent decree since its entry, it is necessary that the court provide a detailed historical review of the defendants’ past conduct and current attitudes.

This longstanding lawsuit began in 1970 when two classes of plaintiffs, former employees at Bryce Hospital and current patients, filed a complaint against various officials of the State of Alabama alleging that staff reductions deprived patients of their rights under state and federal law. 2 Since this date there have been four different phases of Wyatt litigation.

A. First Phase of Wyatt Litigation

In the 1970’s, in expansive and landmark opinions, the court, speaking through Judge Frank M. Johnson, Jr., found that conditions in the facilities operated by the Alabama Department of Mental Health and Mental Retardation violated patients’ constitutional rights, and the court entered injunctions requiring the defendants to bring the facilities into compliance with certain minimal constitutional standards.

WYATT STANDARDS ESTABLISHED: Beginning in 1971, the court found that the programs of treatment in use for the mentally ill at Bryce Hospital were “scientifically and medically inadequate” and that the treatment “failed to conform to any known minimums established for providing treatment for the mentally ill.” 3 Wyatt v. Stickney, 325 F.Supp. 781, 784 (M.D.Ala.1971) (Johnson, J.). The court further found that the majority of patients were involuntarily committed through noneriminal procedures and therefore had an unquestionable constitutional right “to receive such individual treatment as will give each of them a realistic opportunity to be cured or to improve his or her mental condition.” Id. The court, therefore, ordered the defendants to develop and implement within six months a treatment program to secure these rights. Id. at 785. Nine months later, the court reviewed the defendants’ progress in securing these rights. The evidence indicated that the treatment at Bryce Hospital continued to be “wholly inadequate.” Wyatt v. Stickney, 334 F.Supp. 1341, 1344 (M.D.Ala.1971) (Johnson, J.). Bryce lacked a humane psychological and physical environment, qualified staff in numbers sufficient to administer adequate treatment, and individualized treatment plans. Id. at 1343. As evidence of an inhumane psychological and physical environment, the court pointed to the fact that residents lived in barn-like structures with no privacy, they were provided shoddy apparel, and given non-therapeutie work to do. The facility was plagued by ventilation problems, fire and safety hazards, and overcrowding. And the *1362 defendants spent only 50 cents a day on providing food to each resident. As for staffing, Bryce was deficient in all areas. Not only did it not have enough staff, nonprofessional staff was poorly trained. And as to treatment, the records kept on patients were less than adequate and the treatment was geared to housekeeping functions only, not to improving the lot of the patient. Id. at 1343-44. The defendants were essentially warehousing patients in an inhumane environment. The court later enlarged the litigation to include patients involuntarily confined for mental treatment purposes at Searcy Hospital for the mentally ill and Partlow State School and Hospital for the mentally retarded and found that the conditions at these hospitals were no better than those at Bryce. Id. at 1344.

Noting that the plaintiffs’ rights were “present ones, and they must be not only declared but secured at the earliest practicable date,” the court held a hearing in order to establish minimum standards to be met by these facilities. Id. at 1344. After that hearing, in 1972, the court entered injunctions requiring the defendants to bring state facilities into compliance with certain minimum constitutional standards. Wyatt v. Stickney, 344 F.Supp. 373 (M.D.Ala.1972) (standards for mentally ill) (Johnson, J.), aff'd in relevant part, 503 F.2d 1305 (5th Cir.1974); Wyatt v. Stickney, 344 F.Supp. 387 (M.DAla. 1972) (standards for mentally retarded) (Johnson, J.), aff'd in relevant part, 503 F.2d 1305 (5th Cir.1974). These mental-illness and mental-retardation standards, which were developed with the assistance of the parties and experts in the fields of mental health and mental retardation, are commonly known as the ‘Wyatt standards.’ The Wyatt standards were designed to meet what the district court called the three “fundamental conditions for adequate and effective treatment,” Wyatt, 334 F.Supp. at 1343: “(1) a humane psychological and physical environment, (2) qualified staff in numbers sufficient to administer adequate treatment and (3) individualized treatment plans.” Id. Over the years, the court has periodically revisited these standards at the parties’ request, and has from time to time approved modifications to these standards in order to bring them into compliance with evolving professional standards. See, e.g., Wyatt v. Poundstone, 1995 WL 430939 (M.D.Ala. July 11, 1995) (Thompson, J.); Wyatt v. King, 793 F.Supp. 1058 (M.D.Ala.1992) (Thompson, J.); Wyatt v. Ireland, No. 3195-N, 1979 WL 48254 (M.D.Ala. Oct. 25,1979) (Johnson, J.); Wyatt v. Hardin, No. 3195 (M.D. Ala. June 29, 1976) (Johnson, J.).

WYATT STANDARDS EXTENDED: In 1975, the court extended the Wyatt standards to apply to all state facilities for the mentally ill and mentally retarded. Wyatt v. Hardin, No. 3195-N, 1975 WL 33692 (M.D.Ala. Feb. 28, 1975) (Johnson, J.). However, the establishment of the Wyatt standards proved to be only the first step in an extended struggle to secure the rights of mentally ill and mentally retarded residents of Alabama’s institutions. And as this litigation continued and the Alabama Department of Mental Health and Mental Retardation expanded, the litigation came to encompass a large number of facilities. This lawsuit is unique in its broad scope and all-encompassing nature in that it applies to so many facilities and to both the state’s mental-illness and mental-retardation systems.

B. Second Phase of Wyatt Litigation

LITIGATION RESUMES IN 1975: Litigation began again in 1975, when the court allowed the parties to reopen discovery to determine whether the defendants had complied with the 1972 orders. In 1977, the plaintiffs and amicus curiae United States of America filed a motion for further relief and requested, among other things, that the court appoint a special master or receiver to assure compliance.

SYSTEM PLACED IN RECEIVERSHIP AND PLAN OF COMPLIANCE APPROVED: In a separate petition, the Governor of Alabama advised the court that “the Alabama mental health system is in a distress situation” and that achievement “of an effective mental health system maintained and operated in the interest of the safety and welfare of the patients and indeed, all of the citizens of this state, require[s] the assertion of the extraordinary equitable power of this Court.” The Governor requested that the *1363 court appoint him receiver of the Department. The court determined that the defendants had not complied with its injunctive orders and appointed the Governor as receiver of the state mental health system. The Governor proposed a plan of compliance under which the defendants were to achieve compliance with all Wyatt standards within 18 months, except new physical plant construction or major renovation. The court approved the plan.

C. Third Phase of Wyatt Litigation

LITIGATION RESUMES IN 1981: In 1981, the plaintiffs returned to court again to ensure that the Wyatt standards were fully implemented as required by the Governor’s compliance plan. The plaintiffs moved for the provision of sufficient funds to enable compliance with the 1972 orders and implementation of the Governor’s plan. The defendants, in response, moved to eliminate all of the Wyatt standards and substitute in their place a requirement that the defendants achieve accreditation of the State’s mental illness facilities by the Joint Commission on the Accreditation of Healthcare Organizations (“JCAHO”) and certification of the mental retardation facilities through Title XIX of the Social Security Act, 42 U.S.C.A. § 1396, et seq. The defendants sought elimination of the Wyatt standards on the grounds that these standards exceeded minimum constitutional requirements. The Governor and the Commissioner of the Alabama Department of Mental Health and Mental Retardation also moved for termination of the receivership, and the plaintiffs moved to remove and replace the Governor as receiver.

In 1983, the Governor resigned as receiver. The court appointed a non-state official as receiver. Wyatt v. Ireland, No. 3195-N (M.D.Ala. Feb. 1, 1983) (Thompson, J.). The defendants appealed to, and obtained a stay of the appointment from, the Eleventh Circuit Court of Appeals. In response to the stay, this court appointed the governor’s legal advisor as receiver. Wyatt v. Ireland, No. 3195-N (M.D.Ala. March 8, 1983) (Thompson, J.). Also in 1983, the court held a hearing on both the defendants’ and plaintiffs’ motions but did not rule on them.

1986 CONSENT DECREE ENTERED: In 1986, the parties submitted to the court their proposed settlement of the litigation. After conducting a fairness hearing on the objections to the consent decree, the court approved the decree, which resolved the parties’ continued conflicts over the department’s failure to comply with all the Wyatt standards, funding, and other issues. Wyatt, 1986 WL 69194. In general, the final settlement reflected a resolution of three issues: (1) the defendants’ desire to terminate court supervision of the state system; (2) the. plaintiffs’ concern about the continued viability of the Wyatt standards; and (3) the plaintiffs’ efforts to focus the litigation on the provision of community facilities and programs and the placement of qualified patients in those facilities and programs. 4 The final settlement reflected a balancing of these concerns, and the memorandum opinion that accompanied the decree further underscored the tradeoffs that had been made by each side in order to reach a compromise.

Under the terms of the consent decree, the Department of Mental Health and Mental Retardation was freed from active judicial supervision. The settlement dissolved not only the receivership but the Office of Court Monitor, an office specifically created to monitor on a daily basis the defendants’ implementation of the court’s orders and standards. The consent decree, however, required several affirmative actions by the defendants. First, it required that all the Wyatt standards “remain in effect.” Wyatt, 1986 WL 69194, at *7. And it required that the defendants make substantial progress in achieving and maintaining compliance with all of the Wyatt standards. Id. at **3, 7. The court noted the significance of this provision in its accompanying memorandum opinion. The validity of the Wyatt standards had been vigorously attacked by the defendants, and a number of court decisions east doubt on whether they would withstand the defendants’ challenge. See, e.g., Young- *1364 berg v. Romeo, 457 U.S. 307, 102 S.Ct. 2452, 73 L.Ed.2d 28 (1982); Newman v. Graddick, 740 F.2d 1513 (11th Cir.1984). “As both the plaintiffs and the defendants ... observe[d], the incorporation of these standards into a settlement ma[de] these standards ... unsusceptible to challenges because of present and future changes in the law. Without question, one of the most significant things bargained away by the defendants in order to secure the plaintiffs’ approval of the settlement is the defendants’ vigorously asserted and often repeated contention that the court’s prior standards and orders are always subject to attack because of the present and future changes in the law.” Wyatt, 1986 WL 69194, at *4.

Second, the decree enjoined the defendants “to make all reasonable efforts to achieve full accreditation of Alabama’s mental health facilities by [JCAHO] and full certification of Alabama’s mental retardation facilities under Title XIX.” Id. Thus, under the settlement, the defendants’ motions to vacate and substitute the Wyatt standards with JCAHO accreditation and Title XIX certification and the plaintiffs’ motions for judicially ordered funding and appointment of an independent receiver were denied.

Third, and “perhaps most importantly,” as the court further noted in its discussions of trade-offs between the parties, “the settlement aehieve[d] something the plaintiffs were unable to achieve in the past: it substantially broaden[ed] the focus of the litigation to include community placement and require[d] that the defendants make substantial progress in placing people in the community. Indeed, part of the capital construction program contemplated by the settlement include[d] the construction of hundreds of community beds throughout the state.” Id. at *5.

The settlement provided that, should the defendants fail to comply with the significant provisions in the settlement, the court would entertain requests to reactivate its active supervision of the Mental Health and Mental Retardation System. Wyatt, 1986 WL 69194, at *8. Under the settlement, the parties were also ordered to establish a “patient advocate system, operated within and by the Alabama Department of Mental Health and Mental Retardation, to help protect the rights of the plaintiff class,” and a “quality assurance system operated by the central office of the Alabama Department of Mental Health and Retardation to monitor and assure the quality of care provided by the Department.” Id.

WYATT CONSULTANT COMMITTEE ESTABLISHED: Paragraph 11 of the consent decree placed on the plaintiffs and the defendants the affirmative obligation “to cooperate” to establish “a process” by which, first, “plaintiffs’ counsel will be apprised of the progress made by the defendants” in meeting the above three substantive requirements, and, second, “the defendants will continue to receive input from independent experts concerning means” of meeting the three requirements. Id. at *8. Paragraph 10 also directed the parties to comply with a number of plans of compliance contained in documents filed with the court. Id. Pursuant to ¶¶ 10 and 11 of the consent decree, the parties established what is now known as the “Wyatt Consultant Committee.” Wyatt v. Horsley, No. 3195-N (M.D.Ala. Jan.28, 1991) (Thompson, J.).

The committee consisted of five members: two appointed by the plaintiffs, two appointed by the department, and the fifth being the Director of Advocacy Services of the Department. The committee worked with the court, the defendants, and the plaintiffs and served three roles. First, it was a direct source of independent, expert advice for the department. It would periodically visit the department and then offer advice as to how the department could better and more swiftly meet its obligations under the orders of the court. Second, the committee was a direct source of information for the plaintiffs’ counsel as to how the department was progressing. The committee pinpointed and explained to plaintiffs’ counsel those areas which needed his immediate attention. With the aid of the committee, plaintiffs’ counsel, who is not an expert on mental health issues, was better able to meet the obligation he had to the plaintiff class to monitor closely the department’s efforts to comply with the consent decree. Third and finally, the commit *1365 tee assumed another role which was somewhat of an extension of the first two: that of the mediator.

The department and the plaintiffs did not always agree as to how those problems identified by the committee should be approached and resolved. When this happened, the committee would meet with plaintiffs’ counsel and department officials and their counsel, sometimes separately and sometimes together, to discuss the problem and to attempt to reach some agreement so as to avoid litigation. If this did not work, the committee would then meet with the court, identify what it considered to be a problem, and ask for the court’s assistance. The court, with the assistance of the committee, would then arrange for an informal meeting of all those involved: the court, plaintiffs counsel, the commissioner (or his representative) and his counsel, and the members of the committee. At these meetings, the court and the commissioner spoke directly to each other rather than through attorneys. Id 5

Between 1987 and 1990, the Wyatt Consultant Committee worked with defendants, their attorneys, plaintiffs’ attorneys, and the court to attempt to achieve compliance with the 1986 consent decree without resort to litigation. There were regular and extensive meetings. Through this process and with the aid of the committee, the department and the plaintiffs’ counsel were able to address effectively a number of continuing and recurring problems. These included: expansion of community facilities and the transfer of mentally ill and mentally retarded patients from state institutions to these community facilities; appropriate placement of mentally retarded and dually diagnosed patients; improvement of the Quality Assurance System and the Patient Advocacy System; revision of the Wyatt standards; and securing an adequate budget for the department. Id.

In the fall of 1990, in a meeting with the court, the Commissioner of the Alabama Department of Mental Health and Mental Retardation announced that he and his attorneys were contemplating filing a motion seeking to terminate the 1986 consent decree. At that time, the court, the commissioner, counsel for all parties, and the committee were in the midst of addressing a number of important matters. Indeed, resolution appeared near for some of them. For example, the commissioner had presented to the court a novel but very promising solution to some of the urgent problems the department was confronting at one of its institutions, the Eufaula Adolescent Center. Earlier in the year, the committee had reported to plaintiffs’ counsel and the court its concern that the majority of the children at the center were not in need of the type of restrictive and isolated environment the facility provides, and that these children could be more appropriately served in a less restrictive program closer to their homes and families. The committee was also working very closely with the commissioner and plaintiffs’ counsel on the department’s overall continuing efforts with regard to the expansion of community services and facilities and the transfer of eligible mentally ill and mentally retarded patients from state institutions to these facilities. The committee also had pending before it even more issues which did not involve the court.

On November 30, 1990, however, the commissioner, suddenly and without any prior notice—either to the court, the committee members, or plaintiffs’ attorneys—terminated the services of the Wyatt Consultant Committee. At the time, as stated, several urgent matters were pending before the committee. The commissioner did not allow the committee a period of time to wrap up its affairs. There was no phasing out of the committee. The commissioner stated that he believed that the department had substantially complied with the consent decree and that he would be seeking such a determination from the court. More specifically, the commissioner wrote each member of the commit *1366 tee that he was “of the opinion that there has been substantial compliance with the requirements of the consent decree” and that he “will therefore seek a court determination of such compliance.” He explained that he did “not feel that the consultant committee approach is necessary any longer.” 6

By order entered on January 28, 1991, the court reinstated the committee albeit only for three months. The court gave the following reasons: “The issue for the court, therefore, is where can it look for an interim ‘process’ to fulfill the requirements of the [1986] consent decree. First, because the commissioner acted so precipitously and failed to give advance notice of his intended action, the court has not had sufficient time to seek out alternatives and to have another interim ‘process’ ready for implementation upon the termination of the committee last November. The court, therefore, has only one place to turn: the current committee. Second, the committee is needed on an interim basis to wind up its affairs and provide an orderly transition to any new ‘process’ the parties may develop. An orderly transition could only be beneficial for all involved. The court, therefore, turns to the Wyatt Consultant Committee to fulfill the requirements of paragraph 11 of the consent decree, though only until the parties can fulfill their obligation under the same paragraph to ‘co-operate to establish’ the required ‘process.’ ” Wyatt v. Horsley, No. 3195-N at 16 (M.D.Ala. Jan.28, 1991) (Thompson, J.). The defendants filed an appeal but later dismissed it.

D. Fourth and Current Phase of Wyatt Litigation

DEFENDANTS’ MOTION FOR COMPLIANCE FINDING AND FOR TERMINATION OP LITIGATION FILED: In 1991, a new round of litigation began. On January 18,1991, the defendants moved for a finding that they have met their obligations under the 1986 consent decree and for an order terminating this lawsuit. In order to facilitate a quick and inexpensive resolution of the lawsuit, the court suggested the appointment of an independent expert. The parties, however, suggested instead the appointment of a two-expert panel, jointly selected by the plaintiffs and the defendants in lieu of discovery, to “investigate and report to the Court and the parties ... [t]he factual issues pertaining to defendants’ compliance with the outstanding orders of the Court.” 7 Neither of the experts were sufficiently neutral or independent of the parties to be considered “court-appointed” experts, under Federal Rule of Evidence 706. Nonetheless, the court approved the proposed two-expert panel as “an agreement” between the parties for the orderly and efficient resolution of the defendants’ motion. Wyatt v. Horsley, No. 3195-N (M.D.Ala. July 2, 1991) (Thompson, J.).

CLARENCE SUNDRAM APPOINTED: Subsequently, at the request of the parties, the court substituted one expert, Clarence Sundram, for the two-expert panel. Wyatt v. King, No. 3195-N (M.DAla. Oct. 25, 1991) (Thompson, J.). The court approved Sun-dram’s methodology, and in November 1992, he submitted a report on Bryce and the Abert P. Brewer Developmental Center as to their compliance with the Wyatt standards. Sundram’s proposed study consisted of three phases: first, to review the system’s compliance with court orders; second, to assess the adequacy and effectiveness of the process used to identify patients and residents who require less restrictive placements; and, third, to assess the adequacy and appropriateness of plans for post-institutional services for patients and residents who have been discharged from the defendants’ facilities. The plaintiffs and the defendants both had opportunities to review and comment on drafts of the reports. Sun-dram’s report on Brewer and Bryce found that the department had made significant progress as to certain Wyatt standards. He found that the defendants successfully made substantial efforts to improve the physical environments of their institutions and hospitals and increased staffing ratios beyond their prior grossly deficient levels, thus re- *1367 suiting in compliance with many standards. Yet, he also found that there remained significant problems and noncompliance as to other critical standards and rights, including treatment and habilitation, safety, assuring residents remain free from excessive and unnecessary medication, and, most significantly, unnecessary institutionalization. 8

Sundram was unable to complete his entire review of the system because the defendants breached their agreement regarding Sun-dram’s studies. The defendants hired Warren Bock, another expert, to duplicate Sun-dram’s review. Bock conducted tours of Bryce and Brewer following Sundram’s tours. When Sundram learned of this breach of the agreement, he resigned, believing that he could no longer function as an independent expert as a result of the defendants’ actions.

MARTIN PLAINTIFFS INTERVENE: Also in January 1991, Diane Martin and eleven other patients, now commonly referred to as the ‘Martin-intervenors,’ filed a eomplaintin-intervention asserting two claims: first, that the defendants failed to provide adequate procedural protections to ensure that involuntarily civilly-committed patients are released once they no longer meet the criteria for commitment established in Lynch v. Baxley, 386 F.Supp. 378, 387 (M.D.Ala.1974) (three-judge court); and, second, that the care and conditions at one of the state’s facilities, the Thomasville Adult Adjustment Center, violated the 1972 orders as well as federal statutory and constitutional law. On July 22, 1991, the court found that Alabama’s indefinite institutionalization of the involuntarily civilly committed was unconstitutional and ordered the defendants to conduct periodic post-commitment judicial reviews using the standards and safeguards articulated in Lynch. 9 Wyatt v. King, 773 F.Supp. 1508 (M.D.Ala.1991) (Thompson, J.). At the time, Alabama was one of only two states that allowed for indefinite institutionalization. Id. at 1516. The court emphasized that these new procedural safeguards “complemento, rather than supersede^, all other outstanding obligations the court has placed upon the defendants,” reiterating in particular that the defendants remained under an obligation to “immediately release any patient who ‘no longer requires hospitalization in accordance with the standards for commitment,’ Wyatt [J, 344 F.Supp. at 386 (standard 33), and ... [to] ‘provide adequate transitional treatment and care for all patients released after a period of involuntary confinement.’ Id. (standard 34).” Wyatt, 773 F.Supp. at 1517. 10 In a series of later orders the court adopted plans for implementing the July 22 order. 11 There was no appeal from these orders.

APPROVAL AND DISAPPROVAL OF MODIFICATIONS TO 1986 CONSENT DECREE: In May 1991, the parties sought court approval of two consent decrees that proposed to modify several of the Wyatt standards. Primarily because of the apparent lack of support for the consent decrees among the state’s mental health consumers and their advocates, the court refused to approve the decrees. Wyatt v. Horsley, 793 F.Supp. 1053 (M.D.Ala.1991) (Thompson, J.). The court cautioned the parties as follows: “The court understands the difficulties class counsel faces in endeavoring to solicit the views of such persons. However, to the extent plaintiffs’ counsel cannot receive input from class members, he must seek it from such secondary sources as public interest organizations, former mental patients, and family members and caregivers who have *1368 day-to-day contact with class members in the state’s institutions. While fulfilling this duty may render the settlement process more complex and problematic, it is essential if the class attorney is to persuade the court that an agreement is in the best interests of the class, rather than merely expect the court to trust his professional judgment. To allow any less in a class action would be to accept the cynical view that the attorney for the plaintiffs is ‘the dominus litus,’ that is, the true master of the lawsuit, and the plaintiffs ‘only a key to the courthouse door dispensable once entry has been effected.’ Saylor v. Lindsley, 456 F.2d 896, 899 (2nd Cir.1972).” Id. at 1056. See also Wyatt v. King, No. 3195-N, 1991 WL 365043 (M.D.Ala. Oct. 28, 1991) (Thompson, J.). In the fall of 1991, the court held a trial on the Martin-intervenors’ challenge to the care and conditions at the Thomasville Adult Adjustment Center, followed by briefing in January and February 1992.

In May 1992, the parties submitted, for court approval, three new consent decrees modifying mental-illness standards 7, 9(3), 21, 23, 26-29, 31, and 33. This time the court approved the decrees, noting, among other things, that “The three new consent decrees currently before the court differ in many respects from those submitted to the court previously; most importantly, these decrees, unlike the earlier versions, now appear to have the support of a large segment of the mental health community. This is primarily due to the efforts of counsel for the plaintiff class and counsel for defendants to involve the state’s primary and secondary consumers, consumer organizations, and advocacy groups ... in the revision of the decrees.” Wyatt v. King, 793 F.Supp. 1058, 1062 (M.D,Ala.l992) (Thompson, J.). Mental-illness standards 27, 28, 29, and 33 were deleted or superceded. 12 The remainder of mental-illness standards—7, 9(3), 21, 23, 26, and 31—were modified. 13

Later, in 1992, the court issued an order and memorandum opinion denying motions filed by the defendants that sought modification of the 1986 consent decree by eliminating certain requirements, including several provisions in the original 1972 Wyatt standards. Wyatt v. King, 803 F.Supp. 377 (M.D.Ala.1992) (Thompson, J.). The defendants had sought the elimination of the following: the minimum standards which guarantee patients’ rights to privacy, dignity and humane treatment (mental-illness standard l 14 and mental-retardation standard 15) 15 the standard that recognizes the right of mentally retarded patients “to a habilitation program which will maximize his human abilities and enhance his ability to cope with his environment (mental-retardation standard 2) 16 the standards which mandate the delivery of care and services in the least restrictive environment necessary (parts of mental-illness standards 2, 26, and 28) 17 and parts of mental-retardation standards 3, 9, and 11 18 and the provision in the 1986 consent decree that obligates the defendants to make substantial progress in placing residents of state institutions in community facilities and programs. The court held that the requirements for modification had not been met. Id. The defendants filed an appeal but later dismissed it. 19

The following January, in 1993, the court entered an order and memorandum opinion denying a motion filed by the defendants that sought the elimination of another Wyatt stan *1369 dard, mental-illness standard 34, which obligates them to provide class members with adequate transitional services following release from a state facility. 20 Wyatt v. King, 811 F.Supp. 1533 (M.D.Ala.1993) (Thompson, J.). The defendants had alternatively requested that, should the court decline to vacate mental-illness standard 34, the court should clarify that the defendants may fully discharge their obligations under the standard by placing patients in existing programs as space permits, without creating any new programs or services to accommodate patients’ needs, and by providing post-release care to each patient for a maximum period of one year following the patient’s release. The court held that the requirements for modification and clarification had not been met. The court began by noting that, in light of the court’s 1991 decision—condemning Alabama’s indeterminate institutionalization of the involuntarily civilly committed and mandating periodic judicial review of commitment decisions—“the defendants now believe that ‘it is no longer possible to continue to hospitalize patients involuntarily on the basis of their clinical needs.’” Id. at 1543 (footnote omitted). In other words, “Deprived of the option to keep patients institutionalized pending the availability of appropriate post-release care, the defendants now seek to be relieved of the obligation of Standard 34.” Id. The court rejected for several reasons this basis for eliminating Standard 34:

“First, the court’s 1991 decision did not create any new legal obligation to the extent it stated that the defendants were obligated to release immediately into the community with adequate transitional services those patients who no longer met the criteria for initial commitment; the court merely reaffirmed existing obligations. Included in the 1972 order establishing minimum constitutional standards was Standard 33, which provided that ‘If the patient no longer requires hospitalization in accordance with the standards for commitment ..., he must be released immediately unless he agrees to continue with treatment on a voluntary basis.’ It was no accident that, in the sequence of Wyatt standards, this standard immediately preceded Standard 34, which requires that the state provide transitional care for these patients once released. Together, these two standards established a scheme which was intended to assure that involuntarily confined patients who no longer meet the criteria for commitment will not be unnecessarily held in confinement but rather will be immediately released into community settings with adequate transitional services. Moreover, in 1972, this court specifically rejected the suggestion that the lack of community facilities would excuse any failure to comply with the Wyatt standards, holding that ‘the unavailability of neither funds, nor staff and facilities, will justify a default by defendants in the provision of suitable treatment for the mentally ill.’

“The principal import of the 1991 decision, in contrast, is that it established the procedures the state must follow in meeting its obligation under the scheme established by Standards 33 and 34. Under the 1991 decision, the defendants must do the following: conduct periodic post-commitment judicial reviews to determine when persons involuntarily confined because of mental illness should be released; conduct these reviews using the standards and safeguards articulated in Lynch; and conduct these reviews within 150 days of the initial commitment and, if the commitment is renewed, annually thereafter. The defendants’ argument that it was not until the 1991 decision that they had an obligation to release immediately into adequate community settings those patients who no longer meet commitment criteria is completely meritless.

“But second and more troubling is the fact that defendants even make this argument. With their argument, the defendants implicitly admit that, in order not to comply with Standard 34, they consciously violated Standard 33, with the result that they have essentially ignored both standards over the years. Now that the court has brought to an end their noncompliance with Standard 33, they seek to be relieved of compliance *1370 with Standard 84 so that they can continue with their overall non-compliance with the scheme established under both standards. They seek to bring the court into complicity with their unexcused failure for over 20 years to comply with both Standards 38 and 34. In this, the court cannot acquiesce. To the contrary, it is this court’s heavy responsibility finally to bring the defendants into immediate and full compliance with both standards.”

Id. at 1543-44 (footnotes omitted) (citations omitted). The defendants filed an appeal but later dismissed it. 21

Later, on July 11,1995, the court approved a proposal by amicus curiae United States to modify mental Wyatt mental-retardation standard 22(b) (medication: unnecessary, excessive, review, etc.). Wyatt v. Poundstone, 1995 WL 430939 (M.D.Ala.1995) (Thompson, J.).

PLAINTIFFS’ MOTI