Serving People with Disabilities in the Most Integrated Setting: Olmstead and the New Freedom Initiative

OCR works to ensure that federal policy promotes access to home and community-based services for individuals with disabilities.  As part of that effort, 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 work carries out the Supreme Court's 1999 decision in Olmstead v. L.C., 527 U.S. 581 (1999) [Olmstead], finding that the unnecessary institutionalization of qualified individuals with disabilities in institutions is a form of discrimination prohibited by the ADA. 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) treatment professionals reasonably determine that 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

OCR has conducted enforcement activities resulting in positive change for individuals needing community services to live in the least restrictive environment. Notably, the July 1, 2008, State of Georgia Settlement Agreement was the first cross-agency statewide agreement that will assist more than 2,500 individuals institutionalized in public psychiatric hospitals and mental retardation facilities to live in their home communities.  Read more about this Settlement Agreement and other OCR enforcement results.  Also, read "Delivering on the Promise," OCR's September 2006 Olmstead Report.

Archives - Chronology of Past HHS Actions in the Olmstead/New Freedom Initiative Arena

Other Resources available