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Supreme Court Upholds ADA 'Integration Mandate' in Olmstead decision

Washington, DC, June 22, 1999 -- In rejecting the state of Georgia's appeal to enforce institutionalization of individuals with disabilities, the Supreme Court today affirmed the right of individuals with disabilities to live in their community in its 6-3 ruling against the state of Georgia in the case Olmstead v. L.C and E.W.

Under Title II of the federal Americans with Disabilities Act, said Justice Ruth Bader Ginsburg, delivering the opinion of the court, "states are required to place persons with mental disabilities in community settings rather than in institutions when the State’s treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities. "

The 'integration mandate' of the Americans with Disabilities Act requires public agencies to provide services "in the most integrated setting appropriate to the needs of qualified individuals with disabilities." The high court upheld that mandate, ruling that Georgia's department of human resources could not segregate two women with mental disabilities in a state psychiatric hospital long after the agency's own treatment professionals had recommended their transfer to community care.

The lower courts ruled the state violated the ADA's "integration mandate" and Georgia appealed, claiming the ruling could lead to the closing of all state hospitals and disruption of state funding of services to people with mental disabilities.

However, the women were supported by a number of states, disability organizations and others, including the U.S. solicitor general, who said "The unjustified segregation of people in institutions, when community placement is appropriate, constitutes a form of discrimination prohibited by Title II [of the ADA]."

Originally, 26 states had signed onto an Amicus Brief in support of Georgia's position. However, an extensive education campaign by the disability rights movement reduced that number to just seven.

Legislative history. . .

The Americans with Disabilities Act is a plenary civil rights statute designed to halt all practices that segregate persons with disabilities and those that treat them . . . differently. By enacting the ADA, we are making a conscious decision to reverse a sad legacy of segregation and degradation.

Statement of Rep. Ron Dellums (D.- Calif.) during the final passage of the ADA in the House of Representatives
I have seen these institutions. The smell of human waste and detergent has stuck in my throat. I have looked into the vegetative eyes of its inmates in their sterile environments, I have heard of the premature death ratio and prevalence of pneumonia and necrotic decubitus, literally allowing them to rot in their beds, these living dead, our imprisoned Americans with disabilities. At a hearing on the bill before the Subcommittee on Select Education of the House Committee on Education and Labor in 1989, Cindy Miller talked about her "realistic," "constant fear" that she might be institutionalized. "Please enact the ADA quickly," she told members of Congress.

"Getting people . . . out of institutions" was named specifically by Senator Tom Harkin (D.-Iowa) in his remarks introducing the 1989 version of the ADA in the 101st Congress. Our country had "created monoliths of isolated care in institutions and in segregated educational settings," former Sen. Lowell Weicker testified during 1989 Senate hearings on the bill. Society made disabled people "invisible by shutting them away in segregated facilities" Rep. George Miller (D.-Calif.) said in a Congressional debate on the bill.

Senator Harkin noted that the Act was needed to address the absence of protection against discrimination in "all services provided by State and local governments. . . ." (Statement accompanying his introduction of the ADA bill in the Senate, 135 CONG. REC. 8505, 8508 (1989)

Title II is intended "to cover all programs of state or local governments, regardless of the receipt of federal financial assistance," said a House Judiciary report. (House Judiciary Committee Report at 49, reprinted in 1990 U.S.C.C.A.N. at 472 ) The Senate Committee report and the report of the House Committee on Education and Labor declared in identical language that the "first purpose" of Title II is "to make applicable the prohibition against discrimination on the basis of disability . . . to all programs, activities, and services provided or made available by state and local governments." (Senate Report at 44; Education & Labor Committee Report at 84, reprinted in 1990 U.S.C.C.A.N. at 366)

One June 22, 1999, the U. S. Supreme Court ruled in the case Olmstead v. L.C. and E.W. that the "integration mandate" of the Americans with Disabilities Act requires public agencies to provide services "in the most integrated setting appropriate to the needs of qualified individuals with disabilities." Disabled people segregated in institutions have used it to require states provide services in the community.

Olmstead v. L.C. and E.W. reached the Supreme Court when the Georgia Department of Human Resources appealed a decision by the 11th Circuit that it had violated the ADA's "integration mandate" by segregating two women with mental disabilities in a state psychiatric hospital -- long after the agency's treatment professionals had recommended their transfer to community care.

Lois Curtis, 31, and Elaine Wilson, 47, have mental disabilities. Each was hospitalized repeatedly over two decades, with periodic discharges to inappropriate settings--including a homeless shelter--followed by return to the hospital. Only after Atlanta Legal Aid attorney Susan Jamieson brought a lawsuit in 1995 were they moved to a small group home.

Attorneys general withdraw support for Georgia's appeal

When Georgia asked the Supreme Court to review the decision of the U.S. Court of Appeals for the 11th Circuit, 22 state attorneys general, led by Florida's, filed a supporting brief. They contended that the ruling would lead to lawsuits forcing closure of all state hospitals and disrupting states' funding of services for people with mental disabilities.

However, by the deadline for filing on Georgia's behalf, 12 of the 22 states had withdrawn their support for Georgia's appeal, and more states are continuing to distance themselves from the position taken by Georgia. The 12 were Alabama, California, Delaware, Florida, Maryland, Michigan, Nebraska, New Hampshire, Pennsylvania, South Dakota, Utah and West Virginia, plus the territory of Guam. For the latest updates on which states have removed themselves from the brief, contact the
Bazelon Center.

This highly unusual action has prompted news coverage in many states. Among newspapers covering this story, see

The Seattle Times'
"State's legal stance worries the disabled,"
By Dionne Searcey
Feb. 12, 1999

The Boston Globe's
"State's move enrages advocates for disabled,"
By Shelley Murphy
Feb. 26, 1999

From the briefs. . .

"One of the congressional hearings on the ADA legislation in the 100th Congress devoted considerable attention to institutionalization. Americans with Disabilities Act of 1988: Hearing on H.R. 4498 Before the Subcommittee on Select Education of the House Committee on Education and Labor, 100th Cong. (1988). Witnesses provided dramatic, and at times graphic, descriptions of the damaging effects of segregated treatment facilities. Senator Harkin made the intent to address segregated treatment programs crystal clear, when, in introducing the 1989 version of the ADA in the 101st Congress, he expressly listed, as one of the intended consequences of the legislation, "getting people . . . out of institutions . . ."

To refute the argument made by the remaining 11 states, Oregon's director of human resources and 57 former commissioners of mental health and directors of developmental disabilities, representing 36 states and the District of Columbia, have submitted a brief on behalf of the women. They point out that at least three quarters of the states are already reorganizing their systems to provide most services for people with mental disabilities in the community, at less than half the cost of institutional care. Therefore, their brief asserts, Georgia and the states supporting its appeal are wrong to contend that the lower courts' decision would unreasonably burden states or result in "careless deinstitutionalization." Read this brief at the Bazelon Center site

The commissioners' brief and another, filed by 30 national and seven Georgia organizations, document the cost differential between institutional and community care. For example, the daily cost of care in the mental retardation unit at Georgia Regional Hospital-Atlanta, where the women were confined, was $283 in 1996, compared to the daily cost for community services of $118 to $124. National studies cited in the briefs show a similar pattern. For example, one compared community costs, including housing, of $60,000 per year for a discharged psychiatric patient to $130,000 for institutional care.








Expert sources

Implementing the Olmstead decision in communities

From the Disability and Business Technical Assistance Centers:

Historical Context of the ADA

ADA definition of disability

Overview of law's structure

The ADA is changing the landscape of America -- commentary

"The ADA changed my life" -- personal stories

The meaning of "disability" under ADA

"A misunderstood law" -- commentary

The ADA Notification Act

Supreme Court ADA decisions:

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