September 27, 2023


Twenty-four years in the past, Lois Curtis and Elaine Wilson helped change the world for individuals with disabilities.  Lois and Elaine, two ladies with psychiatric and mental disabilities, challenged their unjustified segregation in a Georgia psychiatric hospital in a lawsuit that reached america Supreme Court docket.  Within the 1999 landmark incapacity rights choice, Olmstead v. L.C., the Court docket dominated that unjustified segregation of individuals with disabilities violates the People with Disabilities Act and that individuals with disabilities have a proper to obtain companies in essentially the most built-in setting acceptable to their wants.

The HHS Workplace for Civil Rights (OCR) is dedicated to advancing compliance with Olmstead and the mixing mandate.  Working alongside our different federal companions, OCR federal nondiscrimination legal guidelines that require entities to serve individuals with disabilities in essentially the most built-in setting, together with Part 504 of the Rehabilitation Act, which applies to HHS applications and entities receiving HHS funds, Part 1557 of the Inexpensive Care Act, which applies to well being applications and actions, and Title II of the People with Disabilities Act, which applies to state and native governments.

To that finish, we have now pursued a broad vary of compliance, coverage, and coordination actions in the course of the previous 12 months to guard the rights of individuals with disabilities underneath the mixing mandate.  On August 4, 2022, OCR revealed a Notice of Proposed Rulemaking (NPRM) for Section 1557 within the Federal Register.  The NPRM requires coated entities to manage medical insurance protection and different health-related protection in essentially the most built-in setting acceptable to the wants of certified people with disabilities.  As introduced within the Federal Register, we additionally plan on proposing proposed rules this 12 months underneath Part 504 that replace and make clear incapacity rights obligations, together with these underneath Olmstead. 

OCR is happy with our partnerships all through the federal authorities to assist make sure that individuals with disabilities have entry to the broader group.  Collectively, we’re dedicated to fulfilling the promise of Olmstead: that every one individuals with disabilities can obtain companies in essentially the most built-in setting acceptable to their wants.  To that finish, we’re working with our HHS companions, together with the Administration for Neighborhood Residing, the Facilities for Medicare & Medicaid Companies, and the Substance Abuse and Psychological Well being Companies Administration, to supply technical help and coordination on their efforts to assist group residing.  Earlier this 12 months, we additionally launched with the Division of Justice Civil Rights Division a Federal Interagency Coordinating Group to coordinate our Olmstead efforts within the Biden-Harris Administration precedence areas.

OCR can be launching a reinvigorated Olmstead Initiative to bolster our enforcement, compliance, coverage, technical help, and outreach efforts to assist group residing.

The Olmstead choice reworked federal and state coverage from a segregated, institutional service mannequin  to advertise community-based helps. But, we acknowledge that for a lot of, the promise of Olmstead remains to be unfulfilled, as some individuals with disabilities proceed to spend their lives in establishments or prone to being institutionalized with out adequate entry to alternate options. This Initiative renews our dedication to advancing the phrase and spirit of group integration, the Olmstead choice, Part 504, Part 1557, and the ADA.

These efforts will embody:

  • Enterprise compliance and enforcement efforts to handle OCR complaints and boundaries to group residing;
  • Guaranteeing that HHS recipients of federal funds and state and native entities underneath Title II of the People with Disabilities Act perceive and adjust to their obligations; and
  • Partaking in technical help and outreach efforts to make sure that suppliers know their obligations and stakeholders know their rights underneath the regulation.

We welcome data from the general public about particular person and systemic Olmstead compliance points that will profit from OCR’s investigation, technical help, and enforcement actions.  In case you consider that an individual with a incapacity has been denied entry to community-based companies and helps, chances are you’ll file a grievance with HHS OCR.

Melanie Fontes Rainer
Director, Workplace for Civil Rights
U.S. Division of Well being and Human Companies