Olmstead at 22: A Legal Guarantee of ‘Home Care First’ for Persons with Disabilities

Capitol Report | June 2021

This month marked the 22nd anniversary of the landmark Olmstead decision in the Supreme Court on June 22, 1999.

For persons with disabilities, Olmstead provides a vital legal right to community-based care options.

What Is Olmstead?

This landmark ruling found that the unjustified segregation of people with disabilities is a form of unlawful discrimination under the Americans with Disabilities Act (ADA). The court held that states are required to provide community-based services for people with disabilities who would otherwise be entitled to institutional services whenever a community-based option is possible and appropriate.

Why Olmstead matters

Olmstead provides a vital protection to ensure that individuals with disabilities, whenever possible, can receive care in the least restrictive setting: namely, the home and community. The arguments in the case made clear the value of care at home as a primary option because it supports the dignity of persons with disabilities, avoids unnecessary institutional confinement, and supports a person’s integration with the larger family, community, social, and cultural relations that are vital to a person’s health and well-being.

But the spirit of this law is often under threat, sometimes from unintentional causes.

As you’ve read elsewhere in this month’s Capitol Report, the nursing shortage is putting enormous strain on families and their ability to care for medically fragile children at home. Under Olmstead, these children have a right to care at home as a first option, which is why we plead for the state to use all actions at its disposal to overcome these shortages through our ‘Home Care First’ agenda and HCA’s multi-pronged initiatives to stimulate recruitment and retention of a sustainable home care workforce.