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

Introduction
  1. 527 U.S. 581 (1999), available at http://www.law.cornell.edu/supct/html/98-536.ZS.html.

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  2. For previous discussions of Olmstead and Medicaid, see Kaiser Commission on Medicaid and the Uninsured, Olmstead v. L.C.:  The Interaction of the Americans with Disabilities Act and Medicaid (June 2004), available at https://www.kff.org/medicaid/event/olmstead-v-l-c-the-interaction-of/; Kaiser Commission on Medicaid and the Uninsured, Olmstead at Five:  Assessing the Impact (June 2004), available at https://www.kff.org/medicaid/report/olmstead-at-five-assessing-the-impact/; Kaiser Commission on Medicaid and the Uninsured, The Olmstead Decision:  Implications for Medicaid (March 2000), available at https://www.kff.org/medicaid/issue-brief/the-olmstead-decision-implications-for-medicaid/.

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Issue Brief
  1. A video interview with the Olmstead plaintiffs is available at Kaiser Commission on Medicaid and the Uninsured, Olmstead:  “I Did It” (June 2004), https://www.kff.org/medicaid/video/olmstead-i-did-it/.

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  2. The White House, Office of Public Engagement, Olmstead Champion Meets the President (June 22, 2011), available at http://www.whitehouse.gov/blog/2011/06/22/olmstead-champion-meets-president.

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  3. 527 U.S. 581, slip opin. at 7.

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  4. Id. at 7-8.

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  5. Id. at 8, n.6.

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  6. Id. at 3 (citing 42 U.S.C. §§ 12101(a)(2), (b)(1)).

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  7. Id.at 4 (citing 42 U.S.C. § 12132).

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  8. Id. at 6 (citing 28 C.F.R. § 35.130(d)).

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  9. Id. (citing 28 C.F.R. Pt. 35, App. A, p. 450).

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  10. Id. at 6-7 (citing 28 C.F.R. § 35.130(b)(7)).

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  11. Id. at 1.

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  12. Id.

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  13. See, e.g., State Medicaid Director Letter from Timothy M. Westmoreland, Director, Center for Medicaid and State Operations, Health Care Financing Administration and Thomas Perez, Director, Office for Civil Rights (Jan. 14, 2000), available at http://downloads.cms.gov/cmsgov/archived-downloads/SMDL/downloads/smd011400c.pdf.  The ADA applies to people with a “physical or mental impairment that substantially limits one or more [specified] major life activities” or who have a “record of such an impairment” or who are “regarded as having such an impairment.”  42 U.S.C. § 12102(2).

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  14. Id. at 15.

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  15. Id.

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  16. Id.

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  17. Id. at 21.

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  18. 527 U.S. 581, slip opin. at 16.

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  19. Kaiser Commission on Medicaid and the Uninsured, Medicaid Home and Community-Based Services Programs:  2010 Data Update (March, 2014), available at https://www.kff.org/medicaid/report/medicaid-home-and-community-based-service-programs/.  These figures reflect enrollment and expenditures for Medicaid state plan home health and personal care services and § 1915(c) waivers.  States also may provide Medicaid HCBS through § 1115 waivers, the Balancing Incentive Program, the Community First Choice state plan option, and § 1915(i).

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  20. For more information, see Kaiser Commission on Medicaid and the Uninsured, Medicaid Long-Term Services and Supports:  An Overview of Funding Authorities (Sept. 2013), available at https://www.kff.org/medicaid/fact-sheet/medicaid-long-term-services-and-supports-an-overview-of-funding-authorities/.

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  21. Kaiser Commission on Medicaid and the Uninsured, Medicaid Home and Community-Based Services Programs:  2010 Data Update (March, 2014), available at https://www.kff.org/medicaid/report/medicaid-home-and-community-based-service-programs/.

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  22. Id.

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  23. The White House, Office of the Press Secretary, President Obama Commemorates Anniversary of Olmstead and Announces New Initiatives to Assist Americans with Disabilities (June 22, 2009), available at http://www.whitehouse.gov/the_press_office/President-Obama-Commemorates-Anniversary-of-Olmstead-and-Announces-New-Initiatives-to-Assist-Americans-with-Disabilities; see also CMS, Center for Medicaid and CHIP Services Informational Bulletin, New Housing Resources to Support Olmstead Implementation (June 18, 2012), available at http://medicaid.gov/Federal-Policy-Guidance/Downloads/CIB-06-18-12.pdf.

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  24. U.S. Dep’t of Justice, Civil Rights Division, ADA.gov, Olmstead:  Community Integration for Everyone, available at http://www.ada.gov/olmstead/index.htm.

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  25. Testimony of Thomas E. Perez, Assistant Attorney General, Civil Rights Division, DOJ before the Senate Committee on Health, Education, Labor and Pensions, Olmstead Enforcement Update:  Using the ADA to Promote Community Integration (June 21, 2012), available at http://www.help.senate.gov/imo/media/doc/Perez4.pdf.

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  26. See National Disability Rights Network, Docket of Cases Related to Enforcement of the ADA Title II “Integration Regulation” at 13 (April 11, 2014) (organizing cases in these main categories), available at http://www.ndrn.org/images/Documents/Issues/Community_integration/Docket_of_Cases_Related_to_Enforcement_of_the_ADA_
    Title_II_Integration_Regulation_april_2014.pdf
    .

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  27. U.S. DOJ Office of Civil Rights, Questions and Answers on the ADA’s Integration Mandate and Olmstead Enforcement (June 22, 2011) (citing 28 C.F.R. Pt. 35, App. A), available at http://www.ada.gov/olmstead/q&a_olmstead.htm#_ftnref11.

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  28. U.S. Dep’t of Health and Human Servs., Office for Civil Rights, Serving People with Disabilities in the Most Integrated Setting:  Community Living and Olmstead, Olmstead Enforcement Results available at http://www.hhs.gov/ocr/civilrights/understanding/disability/serviceolmstead/.

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  29. For additional case examples, see U.S. DOJ Civil Rights Division, Olmstead Enforcement, available at http://www.ada.gov/olmstead/olmstead_enforcement.htm; U.S. Dep’t of Health and Human Servs., Olmstead Enforcement Success Stories, available at http://www.hhs.gov/ocr/civilrights/activities/examples/Olmstead/successstoriesolmstead.html; National Disability Rights Network, Docket of Cases Related to Enforcement of the ADA Title II “Integration Regulation” (April 11, 2014), available at http://www.ndrn.org/images/Documents/Issues/Community_integration/Docket_of_Cases_Related_to_Enforcement_of_the_ADA_
    Title_II_Integration_Regulation_april_2014.pdf
    ; University of Michigan Law School Civil Rights Litigation Clearinghouse, available at http://www.clearinghouse.net/results.php?searchSpecialCollection=7; Center for Personal Assistance Services, available at http://www.pascenter.org/state_based_stats/olmstead/index.php.

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  30. Amanda D. v. Hassan; U.S. v. N.H., 1:12-cv-53 (D.N.H. 2012), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla; see also NDRN docket at 26-27.

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  31. Steward v. Perry, 5:10-cv-1025 (W.D. Tex. 2010), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla; see also NDRN docket at 31-32.

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  32. U.S. v. Florida, 1:13-cv-61576 (S.D. Fla. 2013), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla.

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  33. U.S. v. Del., 11-cv-591 (D.Del. 2010), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla; see also NDRN docket at 17-18.

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  34. For more information, see Kaiser Commission on Medicaid and the Uninsured, Money Follows the Person:  A 2013 State Survey of Transitions, Services, and Costs (April 2014), available at https://www.kff.org/report-section/money-follows-the-person-a-2013-state-survey-of-transitions-services-and-costs-introduction/.

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  35. For more information, see Kaiser Commission on Medicaid and the Uninsured, How is the Affordable Care Act Leading to changes in Medicaid Long-Term Services and Supports Today?  State Adoption of Six LTSS Options (April 2013), https://www.kff.org/medicaid/issue-brief/how-is-the-affordable-care-act-leading-to-changes-in-medicaid-long-term-services-and-supports-ltss-today-state-adoption-of-six-ltss-options/.

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  36. U.S. DOJ Office of Civil Rights, Questions and Answers on the ADA’s Integration Mandate and Olmstead Enforcement at question 1 (June 22, 2011) (citing 28 C.F.R. Pt. 35, App. A), available at http://www.ada.gov/olmstead/q&a_olmstead.htm#_ftnref11.

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  37. U.S. v. N.Y., 13-cv-4165 (E.D.N.Y. 2013), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla; see also Disability Advocates v. Paterson, at id; NDRN docket at 41-42.

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  38. U.S. v. N.C., 5:12-cv-557 (E.D.N.C. 2012), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla; see also NDRN docket at 4, 43.

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  39. For more information, see Kaiser Commission on Medicaid and the Uninsured, How is the Affordable Care Act Leading to changes in Medicaid Long-Term Services and Supports Today?  State Adoption of Six LTSS Options (April 2013), https://www.kff.org/medicaid/issue-brief/how-is-the-affordable-care-act-leading-to-changes-in-medicaid-long-term-services-and-supports-ltss-today-state-adoption-of-six-ltss-options/.

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  40. For more information, see id.

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  41. Pashby v. Cansler (D.N.C. 2011), NDRN docket at 58-59.

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  42. Pitts v. Greenstein, 10-cv-635 (M.D.La. 2010), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla.

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  43. M.R. v. Dreyfus, 10-cv-2052 (W.D.Wash. 2011); see also NDRN docket at 7, 33.

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  44. Hiltibran v. Levy, 10-cv-4185 (W.D. Mo. 2010), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla.

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  45. For more information, see Kaiser Commission on Medicaid and the Uninsured, How is the Affordable Care Act Leading to changes in Medicaid Long-Term Services and Supports Today?  State Adoption of Six LTSS Options (April 2013), https://www.kff.org/medicaid/issue-brief/how-is-the-affordable-care-act-leading-to-changes-in-medicaid-long-term-services-and-supports-ltss-today-state-adoption-of-six-ltss-options/.

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  46. U.S. v. R.I., 1:14-cv-00175 (D.R.I. 2014), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla.

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  47. Lane v. Kitzhaber, 12-cv-00138 (D.Or. 2012), http://www.ada.gov/olmstead/olmstead_cases_list2.htm#fla; see also NDRN docket at 29.

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  48. SAMHSA, Medicaid Handbook:  Interface with Behavioral Health Services at 3-5 (2013), available at http://store.samhsa.gov/shin/content/SMA13-4773/SMA13-4773_Mod1.pdf.

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  49. Sidell v. Maram, (C.D. Ill. 2055), NDRN docket at 71.

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  50. Knowles v. Traylor, 10-10246 (N.D. Tex. 2008; 5th Cir. 2010), NDRN docket at 10, 70.

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  51. Chairman Tom Harkin, U.S. Senate Health, Education, Labor, and Pensions Committee, Separate and Unequal:  States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act at 18, 44, 46 (July 18, 2013) (citation omitted), available at http://www.harkin.senate.gov/documents/pdf/OlmsteadReport.pdf.  The report is based on a request to states for information about HCBS, to which 31 states provided substantive responses.

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  52. Id. at 60, 61.

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  53. Id. at 65.

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  54. 79 Fed. Reg. 2948-3039 (Jan. 16, 2014), available at http://www.gpo.gov/fdsys/pkg/FR-2014-01-16/pdf/2014-00487.pdf.

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  55. CMS, Guidance to States Using 1115 Demonstrations or 1915(b) Waivers for Managed Long Term Services and Supports Programs (May 20, 2013), available at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-Systems/Downloads/1115-and-1915b-MLTSS-guidance.pdf.

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Conclusion
  1. The White House, Office of Public Engagement, Olmstead Champion Meets the President (June 22, 2011), available at http://www.whitehouse.gov/blog/2011/06/22/olmstead-champion-meets-president; see also The Art and Advocacy of Lois Curtis, http://loiscurtisart.com/.  

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