The Olmstead Decision (see links below for more detail)

The United States Supreme Court ruled in Olmstead v. L.C., that unjustified institutionalization of individuals with disabilities may constitute discrimination under the Americans with Disabilities Act (ADA).

The history of this issue revolves around L.C. and E.W. v. Olmstead...  In 1995, Atlanta Legal Aid filed suit on behalf of two women, Lois Curtis (L.C.), and Elaine Wilson (E.W.). L.C. and E.W. were hospitalized in a Georgia psychiatric hospital with mental retardation and mental illness. Their treating physicians recommended that they would be excellent candidates for discharge into community programs. At the time, no community "slots" were available.

L.C. and E.W. were shuttled back and forth between the State hospital and various, often abusive, community placements. Atlanta Legal Aid filed suit against several Georgia officials (the State), arguing that the State violated Title II of the ADA by failing to place the women in an appropriate community-based treatment program. The District Court rejected the State's argument that inadequate funding led to the retention of L.C. and E.W. The Court concluded that unnecessary institutional segregation constitutes discrimination under Title II.

The Eleventh Circuit affirmed the District Court's ruling, but remanded the case to the District Court to review the State's cost-based defense. The case ended up in the United States Supreme Court.

ADA Integration Mandate
In the ADA of 1990, Congress described the isolation and segregation of individuals with disabilities as a serious and pervasive form of discrimination.  Title II of the ADA specifies that no qualified individual with a disability shall, "by reason of such disability," be excluded from participation in the services, programs or activities of a public entity.

Olmstead v. L.C.
On June 22, 1999, the United States Supreme Court held in a 6-3 opinion, written by Justice Ruth Bader Ginsburg, that the unjustified isolation of individuals with disabilities constitutes discrimination.

The Supreme Court also held that the States must maintain a range of facilities for the treatment of individuals with diverse mental disabilities. In this historic decision, the Supreme Court reached two important conclusions:
1) The unjustified segregation of people with disabilities is discrimination because it perpetuates the incorrect assumption that they are incapable or unworthy of participating in community life.
2) It is wrong to restrict people with disabilities from important life activities simply because people with disabilities need certain medical services. The Court stated that people with disabilities should not have to "relinquish participation in community life…while persons without mental disabilities can receive the medical services they need without similar sacrifice."

How this Affects Americans with Brain Injury...

The Olmstead v. L.C. decision highlights the "integration mandate" of the ADA. This mandate requires the States to offer community services to institutionalized people with disabilities when:

1) The residents of institutions could be served appropriately in the community; and
2) The community setting would not alter fundamentally the State's service system or pose an undue burden on the State.

To avoid liability under Olmstead v. L.C., a State would have to prove that:

1) It would be "unreasonable" to provide community services to an institutionalized resident, because these services would create a "fundamental alteration" of the State's service system; or
2) The community services would create an "undue financial burden" on the State.

Read U.S. Department of Health and Human Services Secretary Tommy Thompson's Preliminary Report outlining actions that Federal Agencies will take in response to Executive Order #13217  http://www.hhs.gov/newfreedom/presidentrpt.html

Access the U.S. Department of Health and Human Services' (HHS) New Freedom Initiative Web site to read more.  http://www.hhs.gov/newfreedom/