Serving People with Disabilities in the Most Integrated Setting: Community Living and Olmstead

President Obama launched the "Year of Community Living," on June 22, 2009, in commemoration of the 10th Anniversary of the Supreme Court’s landmark decision in Olmstead v. L.C, 527 U.S. 581 (1999) [Olmstead].  In Olmstead, the Court held that the unjustified institutionalization of people with disabilities is a form of unlawful discrimination under the Americans with Disabilities Act (ADA).  The President celebrated the anniversary by launching “The Year of Community Living,” to reaffirm the Administration’s commitment to “vigorous enforcement of the civil rights for Americans with Disabilities and to ensuring the fullest inclusion of all people in the life of our nation.”The Department of Health and Human Services will play a key role in carrying out the President’s directive.  Among other activities, HHS Secretary Sebelius will be working with Secretary Donovan of the Department of Housing and Urban Development to identify ways to improve access to housing, community supports and independent living arrangements.

In recognition of the importance of the Olmstead decision and to implement community living initiative at HHS, Secretary Sebelius has created an HHS Coordinating Council, led by the Office on Disability.The Office for Civil Rights is a member of the Coordinating Council, along with the Administration for Children and Families, Administration on Aging, the Centers for Medicare & Medicaid Services, the Health Resources and Services Administration, the Office of the Assistant Secretary for Planning and Evaluation, the Office of Public Health and Science, and the Substance Abuse and Mental Health Services Administration. These agencies are tasked with aggressively addressing the barriers that prevent some individuals with disabilities from enjoying a meaningful life in their community.  The Office for Civil Rights is also partnering with the Department of Justice to promote “vigorous enforcement of the Americans with Disabilities Act and the Olmstead decision and to maximize the effectiveness of federal leadership in promoting civil rights and setting forth the Administration’s position in the federal courts.”

In addition to partnering with other HHS agencies and the Department of Justice, OCR works to promote community living through its enforcement program.  OCR investigates complaints alleging a violation of the Americans with Disabilities Act (ADA's) "integration regulation," which requires that individuals with disabilities receive public services in the most integrated setting appropriate to their needs.  This regulation was at issue in the Supreme Court's Olmstead decision. The Court held that states are required to provide community-based services for people with disabilities who would otherwise be entitled to institutional services when: (a) such placement is appropriate; (b) the affected person does not oppose such treatment; and (c) the placement can be reasonably accommodated, taking into account the resources available to the state and the needs of other individuals with disabilities.

OCR's response to Olmstead complaints has had a significant impact in facilitating the community integration of individuals with disabilities. OCR has received complaints filed by or on behalf of a wide range of individuals, including individuals with physical, psychiatric, developmental and cognitive impairments, and individuals of all ages, including children, young and middle-aged adults, and elderly persons. As a result of OCR's efforts, many individuals have been able to move from an institution to the community, and many individuals have avoided unnecessary institutionalization. For example:

• Community services are being provided to individuals who had been institutionalized for decades.
• Community services are being provided or restored to individuals who lost their housing and/or community-based supportive services when they entered institutions due to an acute health care problem.
• Community services are being provided to individuals with disabilities through "waiver" programs.
• Increased hours of personal care and assistance are being provided to individuals who need them to stay in the community.
• Individuals with disabilities are having greater control over their community-based care and services.
• Individuals are provided reasonable accommodations where they reside, rather than having to move to a more restrictive setting  

Recent OCR Olmstead Enforcement Success Stories

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) has conducted enforcement activities resulting in positive change for individuals needing community services to live in the least restrictive environment. Notably, the October 19, 2010 settlement agreement signed by the Department of Justice (DOJ), OCR and the State of Georgia will ensure that thousands of people with developmental disabilities and individuals with mental illness will receive community services instead of institutional care. Read about this Settlement Agreement & other Olmstead Enforcement Success Stories.