By Larry Jones

On April 21 the Supreme Court will hear arguments in Olmstead v. L.C. and E.W., a case that has far reaching financial and administrative implications for state and local governments. In this case two lower courts have ruled that the anti-discrimination provision of the Americans with Disability Act (ADA) requires a state to place mentally disabled persons in an integrated community setting when professionals treating such persons conclude that such a setting is appropriate. Federal courts can therefore order that such placements be made.

Two former patients in the Georgia Regional Hospital in Atlanta filed suit in federal district court starting in May 1995 alleging that under rights granted them under the ADA, they are entitled to state provided care in the most appropriate integrated setting. Such a setting, they contend, is a community-based treatment program rather than a state mental hospital. A federal district court on March 26, 1997 agreed with the patients and ordered the state to place them in an appropriate residential community placement. The court reasoned that "under the ADA, unnecessary institutional segregation of the disabled constitutes discrimination per se, which cannot be justified by a lack of funds."

In its unsuccessful attempt to get the district court to dismiss the case, the state of Georgia argued that the ADA requires the plaintiffs to show that the state’s failure to place them in a community setting was caused by their disabilities. The state also argued that it lacked the necessary funds to place the patients and that the Department of Justice’s (DOJ’s) integration regulation does not require the state to provide community treatment solely because treating professionals deem it to be appropriate. Unsatisfied with the decision, the state appealed to the Eleventh Circuit Court of Appeals which upheld the lower court’s ruling.

In reaching its decision, the court of appeals relied on DOJ’s integration regulation. This regulation provides that, "a public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities." According to the court of appeals, there is little doubt that the plain language of this regulation "prohibits a state from providing services to individuals with disabilities in an unnecessary segregated setting." The court reasoned that by confining the two patients to an institutionalized setting when a community placement is appropriate, "the state violated the ADA’s integration mandate."

After the court of appeals ruled against it, the state appealed to the U.S. Supreme Court. There the state argued that DOJ’s integration regulation was never interpreted as "requiring community placement for treatment of the disabled." Instead, "integration was considered in the context of providing equal opportunity for disabled persons to participate in federally assisted programs for the non-disabled." The state also criticized DOJ for supporting the plaintiffs’ position which, the state argued, conflicts with DOJ’s prior administrative interpretations as well as with prior judicial interpretations.

The State and Local Legal Center, which monitors lawsuits affecting state and local governments that are argued before the Supreme Court, has filed an amicus brief in support of the state of Georgia. So have numerous state Attorneys General, who contend that "the practical effect" of the Eleventh Circuit’s ruling, unless reversed by the Supreme Court, "will be mass deinstitutionalization."