Olmstead’s Role in Community Integration for People with Disabilities Under Medicaid: 15 Years After the Supreme Court’s Olmstead Decision

The Supreme Court’s Olmstead decision has spurred progress toward community integration for people with disabilities, and the Medicaid program plays a key role in Olmstead implementation. Key trends in recent years include a continuing emphasis on deinstitutionalization, as well as efforts to provide services in the most integrated community setting, prevent institutionalization for beneficiaries at risk, increase opportunities for supported employment in the community, and eliminate disability-based discrimination that would otherwise prevent people with disabilities from participating in the community to the greatest extent possible. The benefits of Olmstead in all of these areas are illustrated by the cases described in this brief. Olmstead also impacted the life of plaintiff Lois Curtis, who in the last 15 years has lived in group homes and subsequently rented a house with a roommate where she self-directs her Medicaid home and community-based waiver services. She works as an artist and has presented one of her paintings to President Obama.¹  The on-going work of states, together with DOJ, CMS, people with disabilities, and others, along with the important support offered by the Medicaid program can continue to strengthen the ADA’s promise of community integration for people with disabilities.