26 Years of Olmstead: The Past, Present, and Future of Olmstead v. L.C.

On this 26^th anniversary of the Olmstead v. L.C. decision by the Supreme Court, we look back at the Supreme Court case that has come to shape modern disability law.

Before Olmstead

Since the founding of America, facilities have existed to treat people with disabilities. In colonial times, those with disabilities were kept in poor farms with prisoners and the indigent. Poor farms were overcrowded, dirty, and did not provide adequate treatment for those with disabilities.[1] Sometimes, disabled individuals were also placed in hospitals. Rich families paid hospitals to house and treat their disabled family members. The hospitals relied on these funds to stay open and continue to treat both disabled and poor people.[2]  The first public psychiatric hospital in America, Eastern State Hospital opened in Virginia in 1773.[3]

In the nineteenth century, mental asylums were made to take care of disabled individuals. Asylums were created in the countryside, because it was believed that the countryside would help the patients’ mental health.  These mental hospitals often would hold a wide variety of people including criminals, persons with serious mental illness, persons with developmental disabilities, and people with medical conditions.  These early facilities, often would have little attempt to separate patients by diagnosis.

The first dedicated facility for persons with developmental disabilities in the United States opened in Massachusetts in 1848.[4]  These early facilities were schools, but by the 1870s, these early training schools had evolved into large institutional settings similar to the asylums.[5]  By the twentieth century, people with developmental disabilities were moved into separate new facilities often termed state schools or colonies.   The first such facility in Virginia, the Lynchburg State Colony opened in 1910 which eventually became Central Virginia Training Center.[6]  The asylums, like the poor houses from earlier, were overcrowded and dirty and patients were subject to abuse and neglect.  Many of these facilities, including ones in Virginia, practiced eugenics based sterilizations – see the infamous Supreme Court decision of Buck v. Bell[7] involved Carrie Buck, a resident of Central Virginia Training Center.[8]  However, in the mid-twentieth century, thanks to improved treatments, mental health asylums started to close with some older individuals moved to nursing homes and other similar institutions and others released to receive care in the community.[9] However, that movement of persons with mental illness did not include persons with developmental disabilities.  In Virginia, such persons remained at the legacy facilities Central Virginia Training Center and Southside Virginia Training Center and during the 1970s three additional Training Centers throughout the state.[10] These training facilities were where people with intellectual and developmental disabilities were housed and taken care of. At the Training Centers, residents were provided with work opportunities, fed, and provided with time for recreation. As part of a settlement agreement between the DOJ and Virginia, four of the five Training Centers have been closed in Virginia due to their segregation of those with disabilities from the broader community.[11]

The mid-twentieth century saw an explosion of support for the disability rights movement. In 1973, the Rehabilitation Act was passed by Congress which sought to address disability discrimination.[12] Even though the Rehabilitation Act was groundbreaking, disability rights still had a long way to go, because the Act only prevented discrimination based on disabilities for entities that received federal funding or federal agencies.  In fact, the Act did not go into effect until 1977, following sit-ins led by disability rights advocates.[13]  Section 504 of the Rehabilitation Act, which is one of the best-known sections of the Act, prohibits disability discrimination in the workplace. The Americans with Disabilities Act, or ADA, was passed in 1990.[14] Title II of the ADA outlawed discrimination against “otherwise qualified individuals with disabilities” by public entities.[15] Title II of the ADA would be the act that the plaintiffs in Olmstead brought their claims under.

Olmstead Decision

The Olmstead decision focused on two individuals, Lois Curtis and Elaine Wilson. Both women had mental illness and developmental disabilities and spent most of their lives going in and out of psychiatric hospitals. Lois and Elaine would be sent to hospitals, released, and then would return to the hospitals, because they did not have the support that they needed at home. Atlanta Legal Aid filed a lawsuit on behalf of Lois and Elaine against Tommy Olmstead, the commissioner of the Georgia Department of Human Resources.[16]

At the trial court level, the United States District Court for the Northern District of Georgia sided with Lois and Elaine. The court ruled that the hospital’s failure to put patients in community-based programs violated title II of the ADA.[17] Similarly, the Eleventh Circuit Court of Appeals sided with Lois and Elaine again.[18] At the Supreme Court, Justice Ginsburg concluded in a six to three opinion that “Unjustified isolation, we hold, is properly regarded as discrimination based on disability.”[19] The Court also ruled that states are required to “provide community-based treatment for persons with mental disabilities when the State’s treatment professionals determine that such placement is appropriate, the affected persons do not oppose such treatment, and the placement can be reasonably accommodated.”[20] These three requirements that Justice Ginsburg laid out would define whether a person with disabilities could be kept in an institution.

After Olmstead

Following Olmstead, cases started to come in of individuals with disabilities trying to get moved from their isolation to better settings. As of July 10^th, 2024, there are currently 1,066 cases that cite Olmstead.[21] Many states have complied with the ruling, but some have not fully complied. Many of the cases that follow Olmstead have to do with whether a disabled individual is in the least-restrictive environment or the refusal to put a disabled individual into a community-based program. An example of one of these cases is State of Connecticut Off. of Prot. & Advoc. for Persons with Disabilities v. Connecticut.[22] In this case, the United States District Court for the District of Connecticut ruled that Connecticut was not providing its disabled residents in institutions with the ability to live in community-based settings.[23]

The future of Olmstead

Olmstead paints a very bright future for those with disabilities. For those with disabilities, Olmstead means that they will be free to live in the least-restrictive way possible. Individuals with disabilities will no longer be forced to live in the decrepit conditions found in the poor farms and asylums of the eighteenth through twentieth centuries. Last year for the 25^th anniversary of Olmstead, The White House and many states celebrated the landmark case, including Virginia Governor Glenn Youngkin who issued a special proclamation honoring the impact and importance of the decision.[24]

Even though states have made significant progress in moving people with disabilities from institutions to less restrictive environments, no state is in full compliance with the Olmstead decision. In 2009, the Department of Justice ramped up its enforcement efforts of the case.[25] The DOJ is constantly bringing suits against states for noncompliance with Olmstead. In Virginia, the DOJ investigated the state’s training centers for those with disabilities starting in 2008.[26] This investigation was triggered by the state not following the Olmstead decision due to the segregated nature of Virginia’s training centers. In 2012, Virginia and the DOJ reached a settlement agreement, which has led to the closure of four of the five training centers from 2014 to 2020 and the remaining training center downsized.[27] Despite the efforts at compliance of the settlement agreement including the closure of the training centers, Virginia failed to come in full compliance with the settlement agreement by its scheduled completion date of October 2021.[28] Virginia has worked to correct its noncompliance, with the governor creating a task force designed to bring the state into compliance with the ADA and settlement agreement. When Virginia remained out of compliance at the end of Fiscal Year 2023, the court issued a show cause to the Commonwealth. The United States and Virginia have jointly proposed to resolve this show cause motion with an agreement for a permanent injunction.[29] This has resulted in a proposal to resolve the show cause; however, this noncompliance, as mentioned before, is a widespread issue among the states.

This lack of compliance with the decision means that it will fall onto the next generation to bring the states into full compliance with Olmstead. Without full compliance with Olmstead, people with disabilities will continue to be placed in segregated and restrictive settings.

As we look back at how far we have come when it comes to disability rights and to the bright future that is painted for those with disabilities, we can all be thankful for the amazing work that the Olmstead decision has done to help with disabilities and the work it will do. We’re most grateful for the bravery of Lois Curtis and Elaine Wilson, who had to courage to fight for not only their rights but the rights of all people with disabilities. Without them, there would be no Olmstead.

[1] https://www.nps.gov/articles/disabilityhistoryearlytreatment.htm

[2] https://www.nursing.upenn.edu/nhhc/nurses-institutions-caring/history-of-psychiatric-hospitals/

[3] https://dbhds.virginia.gov/wp-content/uploads/2022/05/DBHDStimeline2018-1.pdf

[4] https://mn.gov/mnddc/parallels/four/4b/5.html

[5] https://mn.gov/mnddc/parallels/four/4c/2.html

[6] https://dbhds.virginia.gov/wp-content/uploads/2022/05/DBHDStimeline2018-1.pdf Virginia had established five hospitals for persons with mental illness prior to the establishment of the Lynchburg Colony, four of which are still open as state mental hospitals today although all have been replaced with newer buildings.  The fifth mental hospital Virginia started prior to the opening  became the now closed Weirton State Hospital in the state of West Virginia.  See,  https://dhhr.wv.gov/officeofhealthfacilities/Pages/William-R.-Sharpe,-Jr.-Hospital.aspx

[7] 273 U.S. 200 (1927).

[8] https://disabilityjustice.org/right-to-self-determination-freedom-from-involuntary-sterilization/

[9] https://www.nps.gov/articles/disabilityhistoryearlytreatment.htm

[10] https://dbhds.virginia.gov/assets/doc/settlement/indreview/final-edva-order-and-settlement-agreement.pdf   For a timeline of the opening of the training centers, see, https://dbhds.virginia.gov/wp-content/uploads/2022/05/DBHDStimeline2018-1.pdf

[11] https://dbhds.virginia.gov/assets/doc/settlement/indreview/final-edva-order-and-settlement-agreement.pdf

[12] https://www.umassp.edu/inclusive-by-design/who-before-how/history-disability-rights-united-states

[13] https://www.umassp.edu/inclusive-by-design/who-before-how/history-disability-rights-united-states

[14] https://www.nps.gov/articles/disabilityhistoryrightsmovement.htm

[15] 42 U.S.C.A. § 12131 (West)

[16] https://www.olmsteadrights.org/about-olmstead/

[17] L.C., by Zimring v. Olmstead, No. CIVA1:95-CV-1210-MHS, 1997 WL 148674 (N.D. Ga. Mar. 26, 1997)

[18] Olmstead v. L.C., 525 U.S. 1054, 119 S. Ct. 617, 142 L. Ed. 2d 556, amended, 525 U.S. 1062, 119 S. Ct. 633, 142 L. Ed. 2d 571 (1998)

[19] Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 597, 119 S. Ct. 2176, 2185, 144 L. Ed. 2d 540 (1999)

[20] Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 607, 119 S. Ct. 2176, 2190, 144 L. Ed. 2d 540 (1999)

[21] Olmstead v. L.C. ex rel. Zimring, 527 U.S. 581, 119 S. Ct. 2176, 144 L. Ed. 2d 540 (1999)

[22] 706 F. Supp. 2d 266, 272 (D. Conn. 2010)

[23] 706 F. Supp. 2d 266, 272 (D. Conn. 2010)

[24] https://www.governor.virginia.gov/newsroom/proclamations/proclamation-list/25th-anniversary-of-the-olmstead-decision.html

[25] https://www.justice.gov/crt/video/taking-olmstead-future-evolving-vision-community-integration-people-disabilities

[26] https://dbhds.virginia.gov/doj-settlement-agreement/

[27] https://dbhds.virginia.gov/assets/doc/settlement/indreview/final-edva-order-and-settlement-agreement.pdf

[28] https://dbhds.virginia.gov/assets/doc/settlement/indreview/final-edva-order-and-settlement-agreement.pdf

[29] https://dbhds.virginia.gov/assets/doc/settlement/indreview/final-edva-order-and-settlement-agreement.pdf