In its 1999 Olmstead decision, the U.S. Supreme Court expanded the reach of the Americans with Disabilities Act of 1990 by finding that the unnecessary institutionalization of persons with disabilities constituted discrimination. States are obligated to provide services to persons with disabilities in the most integrated setting appropriate to their needs. However, the court was clear that this obligation is not unlimited. How far a state's obligation to expand community-based services extends and what the decision means on a practical basis is the subject of much debate and litigation. States are now presented with a challenge to re-examine their long-term care systems in light of this landmark decision.
This Issue Brief provides information about the decision and discusses compliance issues for states.