Policy Issues

Olmstead Decision

 

The state's response to the Olmstead Decision: A status report.

By

Wendy Fox-Grage

Kevin Horahan

Donna Folkemer

March 2001

In June 1999, the Supreme Court ruled in L.C. & E.W. vs. Olmstead that it is a violation of the Americans with Disabilities Act for states to discriminate against people by providing services in institutions when the individual could be served more appropriately in a community-based setting. States are required to provide community-based services for people with disabilities if treatment professionals determine that it is appropriate, the affected individuals do not object to such placement, and the state has the available resources to provide community-based services. The court suggests that a state could establish compliance with the Americans with Disabilities Act if it has 1) a comprehensive and effective working plan for placing qualified people in less restrictive settings, and 2) a waiting list for community-based services that ensures people can come of the list at a reasonable pace and receive services.

Purpose of the study

In light of this ruling, the National Conference of State Legislatures (NCSL) conducted a 50-state survey to determine the initial state responses to the Olmstead decision. The purpose of this study is to enhance informed decision making by helping state policy makers understand the choices states are making and the options that are available to meet the needs of people with disabilities.

The study is appropriately called a status report because states are in the early stages of implementing the Olmstead decision. The long-term effects of the decision are still unknown. NCSL will continue to track activity involving the implementation of the Olmstead decision and update this report pending permanent funding which NCSL is currently seeking.

Conclusion

At this point in time, it is too early to determine the full effects of the Olmstead decision. Every state is moving toward more home and community-based services, although some are moving faster than others. However, this study shows that most states are responding to the Olmstead decision by developing a plan, or appropriating more money toward home and community-based services, or in many cases are doing both.

The court's decision has caused providers, consumers, and state officials to come together with the shared commitment to provide more community-based services and reduce the waiting list for such services. It also has caused the federal government to revise its policies in this area and to offer states flexibility and funding for them to develop innovative solutions. At the same time, Several lawsuits have been filed or are pending in the states as a result of a lack of home and community-based alternatives. Olmstead implementation will take many years, and it involves not only health care but transportation, housing, education, and other social supports to fully intergrate people with disabilities into the least restrictive settings.

This study is a work in progress. Contact Wendy Fox-Grage at (202) 624-3571 or email at wendy.fox-grage@ncsl.org if the authors have incorrectly reported or inadvertently omitted certain Olmstead activities.