Help us by making a
tax deductible donation

Olmstead Decision Can Cause Changes in Care

By Josselyn Winslow  -  Updated October 29, 2002

Two women with disabilities brought about the "Olmstead" decision. At the time the suit was filed, both plaintiffs lived in a state-run institution in Georgia. They wanted to move to a community setting. The state maintained they should continue to be institutionalized. In 1999, the United States Supreme Court found that states must administer their services, programs, and activities "in the most integrated setting appropriate to the needs of qualified individuals with disabilities."

The Court stated that: (a) "institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life," and (b) "confinement in an institution* severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment."

In response to the Olmstead Decision, Washington State is working to develop a comprehensive plan to provide community-based services for people with disabilities who would prefer to live in a more integrated setting. Members of the Disability Initiative Advisory Committee (DIAC) have agreed to work with Washington State's Department of Social and Health Services as it seeks to find ways to make it possible for "qualified individuals with disabilities" to live "in the most integrated setting appropriate to the[ir] needs."

As an example of the kinds of situations the Olmstead Decision addresses, a person living in a nursing home could chose to move into a more integrated community setting. Judy and her husband Rob, in this issue's "Someone Who Cares" story on page 3, are an example of a situation that the Olmstead Decision addresses. The State's current Medicaid waiver allows a person who is medically needy and has limited assets to receive full cost coverage to live in a nursing home. However, when Judy chose to move her husband to a less expensive, but appropriate, care situation she was asked to pay part of the costs of his care. Washington State's new approach to residential care - as required by the Olmstead Decision - should cover the full cost of Rob's care whether he lives in a nursing home or another community setting.

If you - or people you know - are living in a state institution or a nursing home and would prefer to live in the community it may be possible for that to happen in the future.

Questions to consider for you or your family members:

  • What does least restrictive/most integrated setting mean to you?
  • How can you see most integrated setting happening in your life...what would it look like to you?
  • What kind of supports will it take for you to live successfully in the most integrated setting?
  • Are there any geographic needs that are specific for where you live?

Mail, fax or email your comments to the Alzheimer Society and we will pass them on to people who are working to improve the options available for people with disabilities.

You can also call 1-888-437-4823 or email dshsolmstead@dshs.wa.gov for more information and/or to have your name added to the DSHS Olmstead information list.