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ADDITIONAL INFORMATION ON THE OLMSTEAD DECISION
FROM THE BAZELON CENTER WEBSITE:
Background on the case
The
Supreme Court's Opinion
Olmstead v. L.C. Supreme Court Briefs
More on the Supreme Court's Decision
The
President's June 18, 2001 executive order directing federal agencies
to assist states with Olmstead implementation.
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 What
is the 1999 Olmstead Decision?
The OLMSTEAD V. L. C. case involved two women from Georgia who
had mental and cognitive disabilities and lived in an institution. The
women did not want to remain in the institution and the state's own treatment
professionals determined that they could indeed live in a community setting
with appropriate support. But the state refused to move them because there
were no community-based service placements available.
In Olmstead vs. L.C., the U.S. Supreme Court ruled against the
state of Georgia and determined that the women's continued institutionalization
was a violation of their rights under the Americans with Disabilities
Act because the women were not in the most integrated setting possible
and did not choose to be institutionalized. The ruling requires states
to provide community-based services for people with disabilities who would
otherwise be entitled to institutional services.
In a 6-3 opinion authored by Justice Ruth Bader Ginsburg, the court affirmed
a ruling by the United States Court of Appeals for the Eleventh Circuit
that unjustified isolation of individuals with disabilities is properly
regarded as discrimination based on disability. The court held that unjustified
segregation in institutions is discrimination not only because it perpetuates
unwarranted assumptions that people with disabilities are incapable or
unworthy of participating in community life, but also because confinement
in an institution severely curtails everyday life activities, such as
family relations, social contacts, work, educational advancement and cultural
enrichment.
Nonetheless, the Supreme Court held, the states' need to maintain a range
of facilities for the care and treatment of individuals with diverse mental
disabilities must be recognized. In determining whether a state can successfully
assert a "fundamental alteration" defense (i.e., claim that providing
community-based services to an individual would fundamentally alter the
state's service-delivery system), courts must consider not only the cost
of providing community-based care to the litigants, but also the state's
obligation to mete out services to others with disabilities in an equitable
manner. If the state can show that immediate relief for the plaintiffs
would be inequitable "given the responsibility the state has undertaken
for the care and treatment of a large and diverse population of persons
with mental disabilities," it will meet the fundamental alteration defense.
For example, Justice Ginsberg wrote, if the state demonstrates that it
has a "comprehensive, effectively working plan for placing qualified persons
with mental disabilities in less restrictive settings, and a waiting list
that move[s] at a reasonable pace not controlled by the State's endeavors
to keep its institutions fully populated," an individual cannot skip to
the top of the waiting list by filing a lawsuit to obtain community services;
such a move would not be a reasonable modification.
Finally, the court held that a state may generally rely on the "reasonable
assessments of its own professionals" in determining whether a community-based
placement is appropriate. Additionally, the ADA does not require that
community-based treatment be imposed on individuals who oppose it.
The Olmstead decision should encourage states to begin planning
implementation strategies to comply with the ADA's integration
mandate, spelled out in regulations requiring that services be provided
"in the most integrated setting appropriate to the needs" of people with
mental or physical disabilities. Some states have already begun moving
in the direction of providing more mental health services in community-based
settings. Nonetheless, to comply with the integration mandate, state officials
will need to take significant steps to move institutionalized people more
quickly into more integrated settings.
The court heard the Georgia case on April 21, 1999. The suit had been
brought by two women with both mental retardation and psychiatric conditions
who were patients in a state hospital. Their treating professionals agreed
that the women should be served in community programs, but no slots were
available for them. Supporting Georgia's appeal to the Supreme Court,
some states argued that, while "virtually any person can safely and appropriately
be served in his or her home (or in the most integrated community setting),"
the cost of doing so would be unduly burdensome.
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