Olmstead v L.C.

DECISION SUMMARY:

On June 22, 1999, the Supreme Court ruled that unjustified isolation of people with disabilities is discrimination and is prohibited under the Americans with Disabilities Act. Georgia had appealed the case to the Supreme Court after the lower courts ruled in favor of two women with disabilities who sued the state under the "most integrated setting mandate" of the ADA. Title II of the ADA states that public services and programs must be provided in the most integrated setting appropriate. The Georgia state mental health agency had determined that home and community-based services were appropriate, but the two women had to remain in institutions because they were on a waiting list for community services.

The Justices ruled that states must provide community options if three conditions are met:

home and community-based services are appropriate,
the placement is not opposed by the individual, and
the community placement can be reasonably accommodated taking into account the needs of all people with disabilities served by the state.

The decision also said that states may have a defense against future lawsuits if they have comprehensive, effectively working plans to move people with disabilities into the community at a reasonable rate.

WHO AND WHAT DOES THE DECISION APPLY TO?

The Americans with Disabilities Act protects all people with disabilities against discrimination. The "most integrated setting" provision of the ADA, used by the Court in their decision, applies to all state funded services. Therefore, a plan to provide community options must address:

Community services for people in nursing facilities, institutional care facilities for the mentally retarded, group homes, state psychiatric facilities or people at risk of such institutional placement.

Options to the state schools for the disabled, i.e. Missouri Schools for the Deaf, Blind and Severely Handicapped.
Supported employment and other employment opportunities that are integrated in the community.
Other services such as housing and transportation.

HOW DOES THE STATE IMPLEMENT OLMSTEAD?

In response to the Supreme Court ruling, the state must have a comprehensive plan to provide state services in the "most integrated setting" or the state will have no defense against a lawsuit. Upon the decision by the Supreme Court, then United States Secretary of Health and Human Services (HHS) Donna Shalala made Olmstead implementation a priority for the HHS Office of Civil Rights (OCR). Now, Secretary Tommy Thompson is working with other US Departments on federal Olmstead initiatives and providing technical assisting to states.

In Missouri, the Olmstead Stakeholders Group - a statewide coalition of disability rights advocates, including members from the Brain Injury Association, Centers for Independent Living, Regional Advisory Councils, ADAPT, AARP and the Mental Health Association - has been meeting with federal and state officials since February 2000. The Olmstead advocates have developed recommendations, lobbied for Olmstead-related legislation and budget items, and served on Olmstead committees.

On April 18, 2000 Governor Mel Carnahan issued an Executive Order establishing an Olmstead Commission. The Commission was charged with developing a "comprehensive, effectively working plan," as recommended by the US Supreme Court. The plan was submitted to the Governor on December 29, 2000.

In early 20002, Governor Bob Holden appointed the Personal Independence Commission to implement the recommendations in the report and to create real systems change for individuals with disabilities and families.

THE PERSONAL INDEPENDENCE COMMISSION

The PIC has been meeting for two years. The state agencies have developed an action plan that focuses on activities related to personal assistance services, diversion, transition from institutions to the community, and implementation of the Real Choice Systems Change grant. PIC work groups have been meeting including Informed Choice, Community Outreach and Education, Housing and Cash and Counseling.

OLMSTEAD ADVOCACY ACTIVITIES

The Olmstead Stakeholders Group meets every other month in Jefferson City. The OSG members monitor the PIC, advocate for changes in services and programs, and lobby for a legislation and budget proposals that support Olmstead implementation. To read the OSG's statement of principles, click here. If you would like to join the OSG, send the a copy of the principles to kdunham@paraquad.org.

You can also join MADEN to receive alerts about legislation and advocacy activities related to Olmstead implementation. For a MADEN sign-up form, click here.

OLMSTEAD RESOURCES

Following the Olmstead decision, the US Department of Health and Human Services issued a number of fact sheets and policy clarification letters to help advocates and states implement Olmstead. You can also find policy papers and letters to State Medicaid Directors on the Center for Medicare and Medicaid Services Web site: www.cms.gov.

The National Protection and Advocacy issued a Question and Answer paper following the Olmstead. For more information visit: www.napas.org.

There are a number of websites that provide information on home and community-based services and community integration initiatives.

The National Conference of State Legislators has been tracking the progress of Olmstead implementation in the states. The Web site contains their updated report.

ADAPT is a national disability rights group that uses all advocacy strategies, including direct actions when necessary. ADAPT is fighting hard for MiCASSA, the Medicaid Community Attendant Services and Supports Act which would make home and community based services an entitlement under Medicaid. You can read about MiCASSA and a number of ADAPT activities on their Web site: www.adapt.org.

The Web site for the Clearinghouse for the Community Living Exchange Collaborative, designed to provide resources, studies, and technical assistance related to Olmstead implementation and home and community-based services.

The Center for Medicare and Medicaid Services in the US Department of Health and Human Services maintinas a Web site that has information regarding the New Freedom Initiative and other steps taken by the federal government to assist states and advocates in implementing Olmstead and creating real systems change.