A court-ordered report shows that the District fails to properly serve some of its developmentally disabled residents.

For more than three decades, the city has failed to fully comply with a court ruling that found that D.C. violated the rights of some of the city's institutionalized, developmentally disabled residents' rights to be free from harm and to be given necessary support.

In an attempt to assess the District's progress, the report reviewed the city's performance and found a number of problems.

One that stood out: None of the wheelchair-bound residents were adjusted in their chair frequently enough to meet medical guidelines.

Although officials argued that in some cases it was due to failures in documentation, not performance, Councilman Jim Graham, who led Thursday's hearing, said he found the statistic troubling.

"It's not rocket science," Graham said. "Even in this basic care, there is 100 percent failure."

The case, now called Evans et al. v. Gray, began when 650 former residents of Forest Haven -- an institution for people with developmental disabilities -- collectively sued the city for violations of their constitutional rights.

The city has failed to comply with many of the court's requirements, so the case has hounded the District for decades. Altogether, the District has met only 21 of 70 requirements to get out from under the court's supervision.

Numerous problems remain.

Some people still wait months, or years, for wheelchairs to be replaced or repaired.

The report also found that many of the nursing and support staff were not properly informed about their wards' medical needs.

The report, issued June 5, found that 43 percent of individuals prescribed psychotropic medication did not have documented consent.

"In the current review, 43 percent of the provider agency staff was rated as knowledgeable about [health care plans]," the report says. "While an improvement, this finding was unacceptable."

The city recently transitioned health care providers after years of problems. City leaders argued that the rapid transition had hurt performance.

Officials repeatedly cited staffing quality and property training as top impediments to a higher quality of care.

Despite problems, Laura Nuss, director of the Department on Disability Services, said during the hearing, "We're poised to make the final advances and cross the finish line in the fourth year of Mayor Gray's term."

Still, she criticized the court's high requirements, calling them "extremely high."