The right of people with developmental disabilities to live in the community was reinforced on June 22, 1999 in the landmark Supreme Court decision in the case of Olmstead v. L.C. In this case, the Supreme Court held that “unjustified isolation of individuals with disabilities” through “undue institutionalization,” constituted discrimination based on disability in violation of Title II of The Americans with Disabilities Act (“ADA”).
The Background of the Olmstead Case
In May 1995, the Atlanta Legal Aid Society brought a lawsuit in the U.S. District Court for the Northern District of Georgia on behalf of two women with developmental disabilities and mental illness who had been voluntarily committed to the psychiatric unit of the Georgia Regional Hospital, a state-run facility. Following completion of the women’s medical treatment, mental health professionals at the hospital determined that each woman was ready to move to a community-based program.
Despite this decision, the women remained confined in the institution for several more years. The Olmstead plaintiffs alleged that they had failed to receive “minimally adequate care and freedom from undue restraint,” in violation of under the Due Process Clause of the Fourteenth Amendment, as well as discrimination under the ADA.
By the time the case came before the District Court, both women had been moved to community-based programs. Nevertheless, the courts determined that the case was not moot, since both women were subject to being returned to institutional placement.
Lower Court Rulings
The Court granted the plaintiffs summary judgment on their ADA claim, holding that the plaintiffs were qualified individuals with disabilities who had been “excluded from participation in or denied the benefits of some public entity’s services, programs, or activities, or… otherwise discriminated against” by reason of their disability.
The Court found that ‘segregation’ of the plaintiffs through institutionalization violated the regulations promulgated by the Attorney General to implement Title II of the ADA, which clearly require public entities to administer services and programs “in the most integrated settings appropriate.” Because the defendants did offer community-based services to other people with disabilities, confining these plaintiffs to an institution was prohibited discrimination.
The Court found that it did not have to rule on the plaintiffs’ Fourteenth Amendment claims, since it had found their continued institutionalization unlawfully discriminatory under the ADA. None of the later courts reviewing this decision addressed the Fourteenth Amendment arguments.
The U.S. Court of Appeals for the Eleventh Circuit affirmed the District Court, but remanded the case for determination of whether the further expenditure of state funds that would be required to treat the plaintiffs in a community setting “would be so unreasonable given the demands of the State’s mental health budget that it would fundamentally alter the services it provides.”
The U.S. Supreme Court’s Olmstead Decision
In a 6-to-3 decision, the U.S. Supreme Court on June 22, 1999 rejected the state of Georgia’s appeal. The Court cited the Attorney General’s regulation quoted above, calling it the “integration regulation”, and affirmed that “[u]njustified isolation is properly regarded as discrimination based on disability.”
The Court explained that recognizing unjustified institutional isolation of persons with disabilities as a form of discrimination reflects two judgments. One is that “institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life.” The other is that “confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment.”
The majority opinion held that states are required to place persons with mental disabilities in community settings rather than in institutions when “reasonable assessments” of the state’s treatment professionals have determined that community placement is appropriate, and transfer from institutional care to a less restrictive setting is not opposed by the affected individual.
However, the Court continued, “[t]he State’s responsibility, once it provides community-based treatment to qualified persons with disabilities, is not boundless.” The ADA does permit a state to maintain a range of facilities to address the varying needs of persons with disabilities, including some institutional settings, and to consider, in making individual placement decisions among that range, “the allocation of available resources… given the responsibility the State has undertaken for the care and treatment of a large and diverse population of persons with mental disabilities.”
However, the Court suggested, to justify the inability to provide community treatment based on such a resource argument, a state would have to “demonstrate that it had a comprehensive, effectively working plan for placing qualified persons with mental disabilities in less restrictive settings, and a waiting list that moved at a reasonable pace not controlled by the State’s endeavors to keep its institutions fully populated.”
What Came Next?
Some commentators have questioned the impact of the Olmstead, noting that it is not based on a constitutional right, and fails to provide guidance on the standard of care required, or on the respective roles of the courts and legislatures in implementing its directives. Nor does Olmstead answer the related question of whether Medicaid’s cost-allocation arrangements that result in withholding of public funds for services provided to people with a disability living in community services violates the integration regulation.
Despite these questions, Olmstead clearly opened the door for people with disabilities and their families to demand a full range of community services as alternatives to services provided in institutional settings. In the wake of the decision, the federal government as set a clear direction for maximizing provision of services in community settings, issuing directives and suggestions to help states comply with Olmstead. Federal grants have been made available to expand community-based services and dozens of states organized task forces to develop implementation plans.
The Civil Rights Division of the Department of Justice maintains a website dedicated to enforcement of the integration mandate articulated in Olmstead, which includes a Technical Assistance Guide, and lists of D.O.J. Olmstead enforcement actions by circuit and by issue.
The U.S. Department of Health and Human Services maintains a similar website.
On June 22, 2011, the 12th anniversary of the Olmstead Decision, President Barack Obama reaffirmed the goal of the landmark ruling, saying “the unjustified institutional isolation of people with disabilities was a form of unlawful discrimination” under the Americans with Disabilities Act.
From Inclusion, 2016
The Olmstead Imperative: The Right to Live in the Community and Beyond
Robert Dinerstein, American University – Washington College of Law, discusses the significance of the Olmstead decision as it relates to previous case law, its enforcement and its later implications that go beyond the case itself. Dinerstein notes the enforcement of the Olmstead decision goes beyond institutional settings and extends to other settings, such as sheltered workshops.
Posted with permission of AAIDD
From Department of Justice, May 18, 2016
Justice Department reaches extension agreement to improve Georgia’s developmental disability and mental health system
The Justice Department announced an extension agreement between the department and the state of Georgia to improve the quality and availability of services for people with developmental disabilities in the community. The agreement will resolve seven deficiency areas noted by the department in a January court filing.
Olmstead Decision Resources and References
Videos and Multimedia Presentations
Is the ADA Working? ADA’s Future
Legal Resources and Documents
Olmstead v. L.C.
- ^Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 597 (1999)
- ^Id. at 593
- ^L.C. by Zimring v. Olmstead, 138 F.3d 893, 895 (11th Cir. 1998)
- ^Americans With Disabilities Act of 1990 As Amended, 41 U.S.C.§12132
- ^28 C.F.R. § 35.130(d)
- ^L.C. by Zimring v. Olmstead, 138 F.3d. 893,895 (11th Cir. 1998)
- ^Olmstead v. L.C. ex rel. Zimring, 527 U.S. at 597
- ^Id. at 602
- ^Id. at 603
- ^Id. at 604
- ^Id. at 605-606
- ^See Mark C. Weber, Home and Community-Based Services, Olmstead and Positive Rights: A Preliminary Discussion, 39 Wake Forest L. Rev. 269 (2004).
- ^The White House, Office of the Press Secretary, On Anniversary of Olmstead, Obama Administration Recommits to Assist Americans with Disabilities, June 22. 2011. Available at: