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Medicaid and the Olmstead Decision

The U.S. Supreme Court’s decision in Olmstead v. L.C. in 1999 represents a critical milestone in the development of Medicaid home and community-based services.  In that landmark case, Lois Curtis and Elaine Wilson, who had mental illness and developmental disabilities, were voluntarily admitted to a hospital where they were confined for treatment in a psychiatric unit. Their treatment professionals concluded that the women could be cared for appropriately in a community-based program, but the women remained institutionalized. A lawsuit was filed, and eventually, the Supreme Court held that the unjustified institutional isolation of people with disabilities is a form of unlawful discrimination under the Americans with Disabilities Act (ADA.)

Medicaid plays an important role in states’ efforts to achieve compliance with the ADA and the Olmstead decision, by providing services that help individuals transition from institutional to community settings and maintain their community living status. Since the passage of the ADA and the Olmstead decision, significant progress has been made to improve community living opportunities for people with disabilities, and Medicaid continues to develop new ways to support community-based care and community integration.  The demand for community services continues to grow, and many individuals in need of these services struggle without them. 

View stories of people whose lives have been changed dramatically by the Olmstead decision.

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