The 17th Anniversary of Olmstead
VOR Celebrates the ADA and Recognizes the Full Meaning of the Olmstead Decision
The Department of Justice (DOJ) recently recognized the 17th anniversary of the U.S. Supreme Court Olmstead decision by pointing out the strides that have been made in providing more opportunities for individuals with disabilities in mainstream American life. As we celebrate this aspect of the Olmstead decision, let us not forget the fullness of the ruling and the emphasis the Court placed on individual choice to protect health and safety and the basic civil rights of individuals with intellectual and developmental disabilities (I/DD).
Too often, some disability rights advocates and federal agencies have read Olmstead as a mandate for all individuals with I/DD, regardless of their individual needs, to be served in community-only settings. Federal “Olmstead enforcement” activities are an example of how some have misread the Olmstead decision and the Americans with Disabilities Act (the ADA) to the detriment of the individual rights of those who were intended to be the beneficiaries of these landmark actions. Driven by the DOJ Civil Rights division and the Administration for Community Living (ACL) of the Department of Health and Human Services, these activities are aimed at eliminating opportunities for individuals with I/DD to live and work in more structured, congregate settings which provide higher levels of care, including nursing, therapy and behavioral supports. While community living may work well for many people who are capable of making decisions with a little help, congregate settings furnish life-sustaining services for those who need more care to assure their health and safety.
By closing down congregate homes and specialized work settings for individuals who choose and require these programs, Olmstead enforcement actions have had the effect of denying Americans with I/DD the freedom to choose where they live and work and with whom they associate, even going so far as to indicate just how many people with I/DD may live and work together in the same setting. .
In pursuing its one-size-fits all agenda, the DOJ fails to appreciate that it is undermining its own recognition of the fact that people with I/DD are not a monolithic group and should be treated as individuals:
"...public entities are required to ensure that their actions are based on facts applicable to individuals and not on presumptions as to what a class of individuals with disabilities can or cannot do,” (U.S. Dept. of Justice analysis of ADA)
Ironically, DOJ enforcement activities target the homes and workplaces of many of the most fragile individuals with disabilities, despite the Civil Rights Division’s pledge,
“to uphold and defend the civil and constitutional rights of all individuals, particularly some of the most vulnerable members of our society.”
These actions which restrict freedoms for people with I/DD are happening in direct contradiction to the law and Supreme Court decision that DOJ and ACL profess to be upholding.
Fortunately, a fair and honest reading of Olmstead provides a path that maximizes the living and work options for individuals with I/DD. While encouraging the maximum community integration, Olmstead makes the individual with disabilities the ultimate arbiter of what she or he believes is best. The Court’s respect for choice is recognized in the second prong of the holding which gives the individual the right to reject a placement, regardless of what anyone else thinks is best for her or him:
“(b) the transfer from institutional care to a less restrictive setting is not opposed by the affected individual,” Olmstead v. L.C., 527 U.S. 581, 587 (1999).
Justice Ginsburg expanded on the reason for this right in her majority opinion::
“...[N]othing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings...Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it.” Olmstead, at 601 – 602.
Justice Ginsburg went on to explain the ongoing role of large facilities in her concurring opinion:
“[For some individuals, no placement outside the institution may ever be appropriate . . . . ‘Some individuals, whether mentally retarded or mentally ill, are not prepared at particular times - perhaps in the short run, perhaps in the long run - for the risks and exposure of the less protective environment of community settings;’ for these persons, ‘institutional settings are needed and must remain available.’ ” . . . Each disabled person is entitled to treatment in the most integrated setting possible for that person – recognizing on a case-by-case basis, that setting may be an institution” Olmstead, at 605.
Sadly, the DOJ and ACL actions sweeping all individuals with I/DD into a monolithic group that can only be served in one officially sanctioned manner (i.e. small houses in urban settings) have led to tragic results for thousands of individuals with severe and profound I/DD, both in terms of quality of life and longevity of life. Investigative reporting by newspapers across the country (including The Washington Post and The New York Times) have documented the tragedies that have befallen people with I/DD when they have been forced out of their congregate care homes into a community unprepared to meet the health and safety needs required for their very survival..
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), disability farms, intentional communities, sheltered workshops and facility-based day programs all serve people with more intensive needs yet are labeled by the DOJ as “institutional” and out of compliance with Olmstead. Thus, the tragedy warned against by Justice Kennedy in Olmstead has come to pass:
“It would be unreasonable, it would be a tragic event, then, were the American with Disabilities Act of 1990 (ADA) to be interpreted so that States had some incentive, for fear of litigation, to drive those in need of medical care and treatment out of appropriate care and into settings with too little assistance and supervision.” Olmstead, at 610.
By focusing on the freedom of the individual to choose from a range of options, the ADA and the Olmstead decision reflect a uniquely American attitude toward services for the disabled, as well as the inherent goodness and compassion of the American people. Congress and the Supreme Court did not intend for the ADA and Olmstead to be used to eliminate opportunities and basic freedoms for our most vulnerable citizens. Rather, this law was meant to expand choices and protect rights.
The Congress must not allow DOJ and ACL to misuse Olmstead and the ADA to create a sub-class of American citizens whose personal lives are dictated by a one-way-suits-all lifestyle. As we celebrate the ADA and the anniversary of Olmstead, let’s protect and promote their full meaning so that all Americans with disabilities can live safe and happy lives of their choosing.
VOR is a national disability advocacy organization which supports a full continuum of quality care options for individuals with disabilities and individual choice of services. VOR supports community settings for those who choose and can benefit from them, but we also recognize and advocate for individuals with profound and other high needs who choose and require more intensive care in congregate settings.