olmstead v. l.c. u.s. supreme court, no. 98-536 527 u.s. 581 (1999)
DESCRIPTION
Olmstead v. L.C. U.S. Supreme Court, No. 98-536 527 U.S. 581 (1999). “[W]e confront the question whether the proscription of discrimination may require placement of persons with mental disabilities in community settings rather than in institutions.” “The answer … is a qualified yes.”. - PowerPoint PPT PresentationTRANSCRIPT
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“[W]e confront the question whether the proscription of discrimination may require placement of persons with mental disabilities in community settings rather than in institutions.”
“The answer … is a qualified yes.”
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“A public entity shall administer services, programs and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.”
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“A public entity shall make reasonable accommodations in policies, practices and procedures …
unless … making the modifications would fundamentally alter the service, program or activity.”
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Two women, Lois Curtis and Elaine Wilson, who were institutionalized at Georgia Regional Hospital …
sued Tommy Olmstead, the Commissioner of the Georgia Department of Human Resources
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Ruled for Ms. Wilson & Ms. Curtis
Found that Georgia “could provide services to [Ms. Wilson & Ms. Curtis] in the community at considerably less cost than is required to institutionalize them.”
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Sent the case back to the trial judge on cost of community care
Asked “whether the additional expenditures … would be unreasonable given the demands of the State’s mental health budget.”
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“First, institutional placement of persons who can handle or benefit from community settings … perpetuates unwarranted assumptions … that persons so isolated are incapable or unworthy of participating in community life.”
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“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.”
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When “the State’s treatment professionals have determined that community placement is appropriate,
the transfer from the institution to a less restrictive setting is not opposed by the affected individual,
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and the placement can be reasonably accommodated, taking into account ◦ the resources available to the State ◦ and the needs of others with disabilities.”
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When the State, “generally rely[ing] on the reasonable assessments of its own professionals,” determines that habilitation needs can only be met in an institution.
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When “in the allocation of available resources, immediate relief … would be inequitable, given the responsibility the state has undertaken for the care and treatment of a large and diverse population of persons with disabilities.
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“If the State were to demonstrate that it had
a comprehensive, effectively working plan for placing qualified individuals with 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.”
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“[T]he range of facilities the State maintains for the care and treatment of persons with diverse mental disabilities,
and its obligation to administer services with an even hand.”
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“Nor is it the ADA’s mission to drive State’s to move institutionalized patients into an inappropriate setting, such as a homeless shelter.”
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“We emphasize that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings.”
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“Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it.”
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Source: Centers for Medicare and Medicaid Services
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Total Nursing Home Population in the United States:
~1.35 Million
SOURCE: CMS Minimum Data Set 2.0 (1st Q 2010)
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Medicaid: 54% (729,000) Medicare: 25% (337,500) VA: 1% (13,500) Self/family: 13% (175,500) Private insurance: 9% (121,500)
SOURCE: CMS MDS 2.0
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Total: $61 Billion Total: $45 Billion
Institutional Spending: Nursing Homes: $49 Billion ICF/MR (for persons
with developmental disabilities):
$12 Billion
Community Spending: Home and Community
services (waivers, all disabilities): $30 Billion
Personal Care option: $11 Billion
Home Health: $4 Billion
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Under 30: .5% (6,750) 31 to 64: 14% (189,000) 65 to 74: 14% (189,000) 75 to 84: 28% (378,000) Over 85: 50% (675,000)
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An acute care hospital: 61%
Another nursing home: 13%
A private home with no home health services: 10%
SOURCE: CMS MDS 2.0 (1st Q 2010)
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United States: 23% (310,500) California: 27% (26,460) Illinois: 25% (18,250) Louisiana: 16% (4,000) Michigan: 30% (11,700) New York: 21% (22,260) Oregon: 35% (2,555) Texas: 20% (18,600) Utah: 37% (1,872)SOURCE: CMS MDS 2.0 (1st Q 2010)