Olmstead v. L.C. & E.W.

In 1991, two women, Lois Curtis and Elaine Wilson, were both residents of Georgia Regional Hospital in Atlanta. Both of these women had been diagnosed with mental illness and had been in and out of state institutions most of their lives. Lois and Elaine were suffering from the daily isolation and boredom of institutional life; they were lonely and depressed and they wanted to go home. Their doctors believed that they would fare better if they lived in the community and could participate in the routine of normal life. (Photo, left to right: Sue Jamieson, Elaine Wilson, and Lois Curtis.)

Unfortunately, the Georgia Department of Human Resources maintained that they had no resources for supporting Lois and Elaine to live in the community. While Georgia spends millions of dollars a year to support people with disabilities, virtually all of that money goes to state hospitals and nursing homes - even though experts in the field of disabilities, the Congress of the United States, and people with disabilities themselves understand that community-based services are more beneficial, and more humane. The State of Georgia however, was unwilling to allocate the funds that were necessary to support Lois and Elaine in the community.

In 1995, Sue Jamieson, a lawyer with the Atlanta Legal Aid Society, filed a case against the Georgia Department of Human Services on behalf of Lois and Elaine. The case was filed in the United States District Court for the Northern District of Georgia. In their petition, Sue claimed that Lois and Elaine’s civil rights were being violated under Title II of the Americans with Disabilities Act. The Americans with Disabilities Act requires that public services be administered in the “most integrated setting” that is appropriate to the individual. (28 CFR § 35-130 (d) (1998). Their lawyers maintained that, Since Lois and Elaine’s doctors had said that they could be treated in the community, their continued segregation in an institution or hospital was discriminatory and therefore unlawful under the ADA.

The case was filed against the commissioner of the Georgia Department of Human Resources (Tommy Olmstead), the Superintendent of Georgia Regional Hospital, and the Executive Director of the Fulton County Regional Board (collectively the State). The State claimed that it was not discriminating against Lois and Elaine because they were only keeping them in the hospital because the State couldn’t immediately find additional money for community-based services. The State held that forcing Georgia to fund more community services would “fundamentally alter” the State’s activities. (The ADA requires only “reasonable modifications” in order to comply with the law whereas anything that required more extensive changes constitutes “a fundamental alteration” and is therefore not required under the ADA.)

The Court, however, disagreed with Georgia’s claim and stated that since Georgia
already had programs in place that provided the kind of community services that Lois and Elaine needed, the State was indeed guilty of discrimination. The Court also stated that such discrimination could not be justified by a lack of funds. Lois and Elaine had won their case.

Georgia appealed the case to the Eleventh District, and that court also agreed that Lois and Elaine were being discriminated against under the ADA. To press their case further, Georgia had but one alternative – they appealed the case to the Supreme Court of the United States. In their petition, Georgia asked the Supreme Court to decide whether the Americans with Disabilities Act “compels the state to provide treatment and habilitation for mentally disabled persons in a community placement, when appropriate treatment and habilitation can also be provided to them in a State mental institution.”

The Court handed down its decision on June 22, 1999. In it’s decision, the Supreme Court upheld the decision made by the Georgia courts. Supreme Court Justice Ginsberg stated in the majority opinion that, “Unjustified isolation is properly regarded as discrimination based on disability” (527 U.S. at 598). In her summary, Justice Ginsberg also wrote: “recognition that unjustified institutional isolation of persons with disabilities is a form of discrimination reflects two evident judgements ... First, institutional placement of person who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life ... Second, confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment” (527 U.S. at 600-601).

According to Sue Jamieson, “the Olmstead Case factually set out what has been true for so many people for so long and finally in 1999, the Supreme Court is saying such an obvious thing – that people who are segregated in institutions are victims of disability discrimination. and allowed lawyers and advocates to make the elegant and simple statement that segregation of people with disabilities is wrong and unconstitutional – is it okay for a state to make people with disabilities live in institutions in order to get the services they need? Answer: No.”

The Supreme Court ruling also acknowledged that states must work within their budgets and need to maintain a full range of services. To help states to comply with the ADA without radically altering their programs, Justice Ginsberg suggested that, “if, for example, the State were to demonstrate that it had a comprehensive, effectively working plan for placing qualified persons with mental disabilities in less restrictive settings, and a waiting list that moved at a reasonable pace not controlled by the State’s endeavors to keep its institutions fully populated, the reasonable-modifications standard would be met” (527 U.S. at 605-606).

Since the Supreme Court issued its decision, many federal agencies have revised their policies for services and funding for people with disabilities, and state agencies across the nation have been very busy devising “Olmstead Plans.” This court case (that began to help Lois and Elaine leave the hospital and find homes in the community) became a national mandate to free tens of thousands of people with mental and physical disabilities from unnecessary and unjust institutionalization.

On June 18, 2001, the President of the United States issued an Executive Order calling for the “swift implementation of the Olmstead Decision,” asking all federal agencies to work with the states to ensure community-based alternatives for people with disabilities. Because of the Supreme Court’s ruling on Lois and Elaine’s case, the President proclaimed that, “The United States is committed to community-based alternatives for individuals with disabilities and recognizes that such services advance the best interests of Americans.”
Lois and Elaine are not unique. There are many thousands of people in Georgia who are now living in institutions and should not be there. IHDD believes that Institutional, congregate settings are harmful to the human condition because isolation and segregation are contrary to the natural development and well-being of all social beings. Isolation and segregation cause depression, loneliness, and despair. To deprive any person of home, family, friends, and community simply because they have a disability is inhuman.

To read more about Lois, Elaine, Sue, and the Olmstead decision, IHDD’s new publication entitled: “L.C. & E.W. v. Olmstead, The Story of the Olmstead Decision and Three Determined Women from Georgia.”