Center for Personal Assistance Services University of California, San Francisco  
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Table of Contents

1. Introduction.

2. What is Olmstead?.

3. Why is Olmstead important?.

4. State Olmstead plans and alternative strategies.

5. Olmstead and Olmstead-related lawsuits.

6. Key trends.

7. References.

8. Download PDF or Word document of entire report.

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Home and Community-Based PAS > Reports > Introduction to Olmstead Lawsuits and Olmstead Plans

Why is Olmstead important?

The Olmstead ruling provides an important (landmark) interpretation of the ADA with which states must comply. Because the ADA applies to all public bodies and the use of public funds, the Olmstead decision has implications for the way that states provide services to people with disabilities. Olmstead is not a Medicaid case and does not require a restructuring of a State’s Medicaid program4. However Olmstead does have implications for state-funded programs, such as Medicaid. That is to say, Olmstead confirmed that states have to ensure that Medicaid-eligible persons do not experience discrimination by being institutionalized when they could be served in a more integrated (community) setting4.

To help states comply with the Olmstead ruling, the Federal government issued guidance5 based on the opinions given by the judges in making their decision. This guidance includes suggestions about how Medicaid can be used to promote home and community-based services and advises states to develop strategic ‘Olmstead Plans’ to systematically ensure people are receiving services in the appropriate setting. These plans are the subject of Table 1.

The Olmstead ruling also stimulated lawsuits raising similar issues in other states on behalf of people who are institutionalized or at risk of institutionalization because of a lack of community-based services. These lawsuits often invoke two different sets of Federal laws, civil rights laws (including the ADA, Olmstead ruling and the Rehabilitation Services Act 1973, upon which the ADA is based) and Medicaid law. These types of cases are the described in Table 2. The ruling also led to complaints being filed with Office of Civil Rights at the US Department of Health and Human Services7,8 ,

Given the importance of personal assistance services in helping disabled people to live independently in the community, it is appropriate that the Center for Personal Assistance Services tracks these lawsuits and strategic developments (such as state Olmstead plans) following the Olmstead decision.

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