December 4, 2023


Healthy Always

Commemorating the Olmstead Anniversary with Revitalized

3 min read


Twenty-four years in the past, Lois Curtis and Elaine Wilson helped change the world for folks with disabilities.  Lois and Elaine, two girls with psychiatric and mental disabilities, challenged their unjustified segregation in a Georgia psychiatric hospital in a lawsuit that reached america Supreme Court docket.  Within the 1999 landmark incapacity rights choice, Olmstead v. L.C., the Court docket dominated that unjustified segregation of individuals with disabilities violates the People with Disabilities Act and that folks with disabilities have a proper to obtain companies in essentially the most built-in setting acceptable to their wants.

The HHS Workplace for Civil Rights (OCR) is dedicated to advancing compliance with Olmstead and the combination mandate.  Working alongside our different federal companions, OCR federal nondiscrimination legal guidelines that require entities to serve folks with disabilities in essentially the most built-in setting, together with Part 504 of the Rehabilitation Act, which applies to HHS applications and entities receiving HHS funds, Part 1557 of the Inexpensive Care Act, which applies to well being applications and actions, and Title II of the People with Disabilities Act, which applies to state and native governments.

To that finish, we’ve pursued a broad vary of compliance, coverage, and coordination actions in the course of the previous yr to guard the rights of individuals with disabilities below the combination mandate.  On August 4, 2022, OCR revealed a Notice of Proposed Rulemaking (NPRM) for Section 1557 within the Federal Register.  The NPRM requires lined entities to manage medical health insurance protection and different health-related protection in essentially the most built-in setting acceptable to the wants of certified people with disabilities.  As introduced within the Federal Register, we additionally plan on proposing proposed laws this yr below Part 504 that replace and make clear incapacity rights obligations, together with these below Olmstead. 

OCR is happy with our partnerships all through the federal authorities to assist be sure that folks with disabilities have entry to the broader neighborhood.  Collectively, we’re dedicated to fulfilling the promise of Olmstead: that each one folks with disabilities can obtain companies in essentially the most built-in setting acceptable to their wants.  To that finish, we’re working with our HHS companions, together with the Administration for Neighborhood Residing, the Facilities for Medicare & Medicaid Providers, and the Substance Abuse and Psychological Well being Providers Administration, to supply technical help and coordination on their efforts to help neighborhood residing.  Earlier this yr, we additionally launched with the Division of Justice Civil Rights Division a Federal Interagency Coordinating Group to coordinate our Olmstead efforts within the Biden-Harris Administration precedence areas.

OCR can also be launching a reinvigorated Olmstead Initiative to bolster our enforcement, compliance, coverage, technical help, and outreach efforts to help neighborhood residing.

The Olmstead choice reworked federal and state coverage from a segregated, institutional service mannequin  to advertise community-based helps. But, we acknowledge that for a lot of, the promise of Olmstead continues to be unfulfilled, as some folks with disabilities proceed to spend their lives in establishments or prone to being institutionalized with out enough entry to options. This Initiative renews our dedication to advancing the phrase and spirit of neighborhood integration, the Olmstead choice, Part 504, Part 1557, and the ADA.

These efforts will embrace:

  • Endeavor compliance and enforcement efforts to handle OCR complaints and limitations to neighborhood residing;
  • Making certain that HHS recipients of federal funds and state and native entities below Title II of the People with Disabilities Act perceive and adjust to their obligations; and
  • Participating in technical help and outreach efforts to make sure that suppliers know their obligations and stakeholders know their rights below the regulation.

We welcome data from the general public about particular person and systemic Olmstead compliance points that will profit from OCR’s investigation, technical help, and enforcement actions.  In case you consider that an individual with a incapacity has been denied entry to community-based companies and helps, you might file a grievance with HHS OCR.

Melanie Fontes Rainer
Director, Workplace for Civil Rights
U.S. Division of Well being and Human Providers

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