On June 22, 1999 the United States Supreme Court held in Olmstead vs. L.C. that the unnecessary segregation of individuals with disabilities in institutions may constitute discrimination based on disability. The court ruled that the Americans with Disabilities Act may require states to provide community-based services rather than institutional placements for individuals with disabilities.
Following are responses to frequent questions regarding Olmstead activities. The Federal Government, through HCFA, also has a listing of "frequently asked questions", and for some of the questions below the reader will be directed to the federal web-site for the current response by the Federal Government.
Two women with dual diagnosis (developmental disability and mental illness) were being treated in a Georgia, inpatient, state operated, psychiatric hospital. State professionals believed that the women could be treated in a community setting. The women sued, under the Americans with Disabilities Act, claiming a right to community placement. (Posted August 2000)
The claim was based upon the Attorney General's regulations regarding integration. (Posted August 2000)
A public entity is required to administer programs and activities in "the most integrated setting" appropriate to the needs of qualified individuals with disabilities, when: The state's treatment professionals determine that such placement is appropriate; and the affected person does not oppose such treatment; and the placemenet can be reasonably accomodated, taking into the account the resources available to the State and the needs of others with mental disabilities.
Public entities must make "reasonable modifications" to avoid discrimination on the basis of disability, unless those modifications would entail a 'fundamental alteration' of the nature of the services, program, or activity.
In the Olmstead case it was known that the cost of care for the plaintiffs would have been less expensive in the community than in a Georgia State institution. The United States' Supreme Court felt the decision required a more sophisticated analysis, "... we recognize, as well, the states' need to maintain a range of facilities for the care and treatment of persons with diverse mental disabilities, and the states' obligation to administer services with an even hand. The District Court must consider, in view of the resources available to the state, not only the cost of providing community-based care to the litigants, but also the range of services the state provides others with mental disabilities, and the states' obligation to deliver those services equitably."
Unfortunately the U.S. Supreme Court did not make a finding on that point. Instead they returned the case to the lower court to determine the answer to that question. The Supreme Court did give some guidance to the lower court. It appears that the lower court will be required to consider: state cost of providing the community-based integrated services to the individual; and state resources available; and whether provision of such services would effect the state's ability to meet the needs of others with disabilities.
The definition is apparently not yet absolute. However, the U.S. Supreme Court required, upon remand, that the lower court consider "Whether the additional cost for treatment of (the individual plaintiffs) in the community-based care would be unreasonable given the demands of the state's mental health budget."
The United States Supreme Court has remanded the case to a lower court.
Well, the United States Supreme Court has agreed to hear a case challenging whether individuals may bring actions against the States to enforce the Americans with Disabilities Act. The case law in various federal circuits is in opposition on this point. The Seventh Circuit (includes Illinois) has ruled that individuals may not file claims under Title I of the ADA in Federal Court.
If State professionals have indentified the persons who could be served in integrated settings; who are not so served and the state offers such services and such services would not require a "fundamental alteration" of the state's program(s) then the State may comply with the Americans with Disability Act by providing the integrated services or "reasonably accomodating" the individuals. The U.S. Supreme Court said that a comprehensive, effective working plan for placing qualified persons with mental disabilities in integrated settings and a waiting list that moves at a reasonable pace constitutes a reasonable accomodation.
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