Unnecessary Institutionalization is Discrimination: The Olmstead Decision

"Unnecessary institutionalization of people with disabilities is discrimination under the Americans with Disabilities Act". These few words summarized the opinion of the U.S. Supreme Court when it handed down its decision in the case of Olmstead v. L.C. on June 22, 1999. The Supreme Court further stated that people with disabilities have the right to receive services in the "most integrated setting", a provision of the ADA known as the "inclusion mandate".

History of the Olmstead decision

In 1994, Lois Curtis and Elaine Wilson were living in a Georgia psychiatric facility, but felt that they were ready to move into their communities. Both had intellectual and psychiatric disabilities, but their doctors and caregivers agreed that they were able to live on their own with appropriate services and supports.

The state of Georgia did not agree, and cited a number of reasons, including budgetary constraints, to justify their continued institutionalization. The following year, a lawsuit was brought against Tommy Olmstead, then Commissioner of the Georgia Department of Human Resources, on behalf of Lois Curtis. Later, Elaine Wilson also filed suit.

As their case wound through the court system, disability rights activists and organizations got involved, holding rallies and writing letters to the Supreme Court. During this time, Lois and Elaine were able to move into the community, but their lawyers decided to continue the case because of the high probability of this happening to someone else. It was heard before the Supreme Court on April 21, 1999.

Why is the Olmstead decision important?

The Olmstead decision is important because it affirms the right of people with disabilities to live in the community, and gives guidance to states so that unnecessary institutionalization does not occur. Each state must devise an Olmstead plan to transition institutionalized people with disabilities back into the community, if that is their wish, and prevent institutionalization of those at risk. As of 2009, 30 states have created an Olmstead plan.

Barriers to Compliance with the Olmstead decision

Two major barriers to compliance with the Olmstead decision are the lack of home and community-based services in some states, and the lack of accessible, affordable, integrated housing, overall. The housing crisis for people with disabilities is so prevalent that in some areas, it is the main reason why people are unable to transition into their communities.

Another reason for non-compliance with the Olmstead decision

A very important reason why there is non-compliance with the Olmstead decision is that the federal government is lax in its enforcement. This is slowly beginning to change as federal agencies such as the Center for Medicaid and Medicare Studies (CMS), the Office of Civil Rights of the Department of Health and Human Services (HHS), and the Department of Justice (DOJ) have begun to work in earnest with disability rights organizations.

Sources:

Olmstead v. L.C. Online Resource Center. Retrieved January 3, 2010 from http://www.bazelon.org/issues/disabilityrights/incourt/olmstead/index.htm

Terence Ng, Alice Wong & Charlene Harrington. Home and Community-Based Services: Introduction to Olmstead Lawsuits and Olmstead Plans. (2009). Retrieved January 3, 2010 from http://www.pascenter.org/olmstead/