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The Olmstead Act
This is a scaled down version of the Olmstead Act. Only the things that pertain to the RHC's are used.
THE SUPREME COURT OF THE UNITED STATES
Opinion of the court No. 98-536 – OLMSTEAD v. L. C.
Opinion written by Justice Ginsburg
June 22, 1999
The 504 regulations (Rehabilitation Act) requires recipients of federal funds to “administer programs and activities in the most integrated settings appropriate to the needs of qualified handicapped persons”.
“A public entity shall make reasonable modifications in policies, practices, or procedures when the modifications are necessary to avoid discrimination on the basis of disability, unless the public entity can demonstrate that making the modifications would fundamentally alter the nature of the service, program or activity”.
The decision states – “Specifically, we 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, we hold, is a qualified yes. Such action is in order when:
1. The State’s treatment professionals have determined that community placement is appropriate,
2. The transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and
3. The placement can be reasonably accommodate, taking into account the resources available to the state and the needs of others.”
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.
“CHOICE” (not in document but what it really means)
Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it. See 28 CFR 35.130(e)(1) (1998) (“Nothing in this part shall be construed to require an individual with a disability to accept an accommodation . . . which such individual chooses not to accept.”)
“As already observed, the ADA is not reasonably read to impel States to phase out institutions, placing patients in need of close care at risk. Nor is it the ADA’s mission to drive States to move institutionalized patients into an inappropriate setting, such as a homeless shelter. Some individuals may need institutional care from time to time “to stabilize acute psychiatric symptoms. There may be times when a patient can be treated in the community, and others when an institutional placement is necessary. For other individuals, no placement outside the institution may ever be appropriate. Some individuals, whether mentally retarded or mentally ill, are not prepared at particular times – perhaps in the short run, perhaps in the long run – for the risks and exposure of the less protective environment of community settings; for these persons, institutional settings are needed and must remain available. Each disabled person is entitled to treatment in the most integrated setting possible for that person - recognizing that, on a case-by-case basis, that setting may be in an institution. For many mentally retarded people, the difference between the capacity to do for themselves within an institution and total dependence on the institution for all of their needs is as much liberty as they ever will know.”)
Footnote: Even if States eventually were able to close some institutions in response to an increase in the number of community placements, the States would still incur the cost of running partially full institutions in the interim.
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