Contact DHS

Olmstead — Will it Shape Your Future?

While most Americans have never heard the word "Olmstead," it could shape your future. If not yours, then likely someone you know.

Olmstead is shortcut reference to a historic 1999 Supreme Court decision "OLMSTEAD. v. L. C."

The US Supreme Court found the State of Georgia was in violation of the American's with Disabilities Act (ADA) for placing two women in institutions when they could be served in the community. The ADA was signed into law by President George Bush in 1990 to prevent discrimination and promote the integration of people with disabilities into communities.

According to Sara Rosenbaum, JD, the central ruling in the Olmstead case is that the ADA prohibits states from: 1) unnecessarily institutionalizing persons with disabilities and 2) failing to serve them in the most integrated setting appropriate to their needs, if the provision of community services represents a reasonable accommodation and not a fundamental alteration of public programs.

In the Olmstead decision the Court stated directly that "Unjustified isolation ... is properly regarded as discrimination based on disability." It observed that (a) "institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life," and (b) "confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment."

While the Olmstead decision involved two women with developmental disabilities and mental illness who were residents of a psychiatric hospital, it has been interpreted to extend beyond these specific circumstances. This includes applicability to people with physical as well as mental disabilities, to those in nursing homes and other institutional settings in addition to psychiatric hospitals, and to those who live in the community and are at risk of institutionalization.

The Court suggested that a state could establish compliance with the Americans with Disabilities Act if it has 1) a comprehensive, effective working plan for placing qualified people in less restrictive settings, and 2) a waiting list for community-based services that ensures people can receive services and be moved off the list at a reasonable pace.

At least 40 states have or in the process of developing an Olmstead plan. The Governor's Integrated Services Task Force (GIST) was appointed to help Arkansas develop an Olmstead Plan. The GIST has adopted 114 draft recommendations. These are posted on the “Olmstead Arkansas” web site (http://www.state.ar.us/dhs/aging/olmsteadar.html).

The Arkansas Department of Human Services is drafting the Olmstead Plan in cooperation with the GIST. Next month, a series of meetings will be held around the state to receive public comment on the draft plan. When the dates and locations are finalized, they will posted on the Olmstead web page as well as a copy of the draft plan. Individuals will also be able to comment without attending a meeting.

Congress asked the General Accounting Office (GAO) to testify on the implications of the Supreme Court's Olmstead decision and the challenges in providing long term care. Kathryn Allen, Director, Health Care for GAO stated: "In summary, the extent to which the Olmstead decision will dictate major shifts in long-term care services from institutional to home and community-based settings — and for whom — is uncertain. What is more certain, however, is the responses to the decision will take place in the larger context of preparing for the tidal wave of aging baby boomers who will increasingly tax the current capacity of public and private resources. This aging generation, with the associated expected increase in the numbers of people with disabilities, could increase the number of disabled elderly people who will need care to between two and four times the current number."

Most of the Olmstead discussion and attention focuses on people in need of care today, especially people with developmental and physical disabilities. However, Olmstead's greatest impact may be on people not yet disabled — aging baby boomers who are tomorrow's elderly.