October 3, 2023


Twenty-four years in the past, Lois Curtis and Elaine Wilson helped change the world for folks with disabilities.  Lois and Elaine, two girls with psychiatric and mental disabilities, challenged their unjustified segregation in a Georgia psychiatric hospital in a lawsuit that reached america Supreme Courtroom.  Within the 1999 landmark incapacity rights choice, Olmstead v. L.C., the Courtroom 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 probably the most built-in setting applicable to their wants.

The HHS Workplace for Civil Rights (OCR) is dedicated to advancing compliance with Olmstead and the combination mandate.  Working alongside our different federal companions, OCR federal nondiscrimination legal guidelines that require entities to serve folks with disabilities in probably 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 Reasonably priced 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 yr to guard the rights of individuals with disabilities underneath the combination mandate.  On August 4, 2022, OCR printed a Notice of Proposed Rulemaking (NPRM) for Section 1557 within the Federal Register.  The NPRM requires lined entities to manage medical health insurance protection and different health-related protection in probably the most built-in setting applicable to the wants of certified people with disabilities.  As introduced within the Federal Register, we additionally plan on proposing proposed rules this yr underneath Part 504 that replace and make clear incapacity rights obligations, together with these underneath Olmstead. 

OCR is pleased with our partnerships all through the federal authorities to assist be certain that folks with disabilities have entry to the broader neighborhood.  Collectively, we’re dedicated to fulfilling the promise of Olmstead: that each one folks with disabilities can obtain companies in probably the most built-in setting applicable 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 offer technical help and coordination on their efforts to assist neighborhood dwelling.  Earlier this yr, 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 also be launching a reinvigorated Olmstead Initiative to bolster our enforcement, compliance, coverage, technical help, and outreach efforts to assist neighborhood dwelling.

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 continues to be unfulfilled, as some folks with disabilities proceed to spend their lives in establishments or liable to being institutionalized with out ample entry to options. This Initiative renews our dedication to advancing the phrase and spirit of neighborhood integration, the Olmstead choice, Part 504, Part 1557, and the ADA.

These efforts will embody:

  • Enterprise compliance and enforcement efforts to deal with OCR complaints and limitations to neighborhood dwelling;
  • 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
  • Participating 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.  When you imagine 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