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Olmstead v. L.C. Resources

In the 1999 Olmstead v. L.C. Supreme Court Decision (PDF | 1.6 MB), the Court found that states are required to provide community-based services that enable individuals with disabilities, including those with serious mental illness (SMI) and serious emotional disturbance (SED), to live in the most integrated setting appropriate to them. To assist states and other stakeholders in their efforts to plan and implement systems of care that support community inclusion, SAMHSA has compiled a list of resources.

The Olmstead Supreme Court decision affirmed that people who have disabilities – including behavioral health disabilities – have a right to live in the community, beyond the walls of institutions.

Miriam E. Delphin-Rittmon, Ph.D., Assistant Secretary for Mental Health and Substance Use

SAMHSA and SAMHSA-Funded Resources

Webinars

Olmstead Planning: Where do we stand?

A webinar discussing the elements of a successful Olmstead plan and provides states and stakeholders guidance on the process of writing a Olmstead plan.

How State and Local Partnerships Can Make a Difference

A two-part webinar series discussing how states can collaborate with counties to expand the availability of crisis services

Housing Support: Reentry of People with SMI

A webinar exploring strategies to target housing resources to best help people with serious mental illness in obtaining housing after reentry from incarceration.

Criminal Justice, the Americans with Disabilities Act, and People with Mental Illnesses

A webinar discussing the over representation of individuals with disabilities in the criminal justice system overwhelmingly with nonviolent offenses, the causes of problem with respect to deinstitutionalization, and what can be done to address this problem.

Developing and Implementing State Olmstead Plans to Increase Access to Community-based Services

A webinar that helps to assist states in increasing the access of community-based services for adults with SMI and children with SMD. The webinar was hosted by former state officials who share their experiences and indicate the best ways to navigate improvements to Olmstead.

Federal Partner Resources

Empowering Community Inclusion with Health, Housing, and Independent-Living Partnerships

A webinar focused on community integration strategies to transition people with behavioral health needs to the community. The discussion informs broader community integration strategies for all people with disabilities.

Taking Olmstead into the Future: An Evolving Vision of Community Integration for People with Disabilities

A webinar discussion focused on how the Olmstead decision and the Americans with Disabilities Act’s 'integration mandate' have impacted the lives of people with disabilities and how disability service systems and the criminal justice system can work to prevent needless segregation.

Other Resources

State Olmstead Plans

After the Olmstead decision, and with the support of SAMHSA and other federal agencies, states began developing plans to expand the availability of integrated settings. This planning process continues in several states, in some cases in response to later lawsuits based on Olmstead. Below are examples of plans that remain publicly available and address (in whole or in part) the needs of adults with SMI and/or children with SED. The most recent plans are those developed by Arizona (2022), Minnesota (2022), North Carolina (2021), and the District of Columbia (2021), while about half of the plans listed were developed in 2016 or earlier.

The plans detail the need to expand and enhance services and supports that promote community integration. Some of the more common examples are affordable housing with supports, supportive employment, home- and community-based services, transition planning, transportation, person-centered planning, wellness activities, and crisis services. Some plans address children’s services separately.

Many of the plans also describe oversight structures, including centralizing data reporting and monitoring admissions to and transitions from institutional settings. Other process improvements include creating workforce initiatives (particularly for in-home direct care workers); involving people with lived experience, including family members, in Olmstead planning and oversight; and addressing demographic and geographic disparities in access.

  • Alabama Olmstead Decision
    This website provides an overview of the Alabama's response to Olmstead as well as the long term plan of the state in order to comply with the integration mandate in adults with SMI and children with SED. "The documents ... may help you understand the state's response to the Olmstead Decision and the Alabama Medicaid's role in that response."
  • Arizona Olmstead Plan
    In Arizona, "advocates, agencies, members, and community stakeholders ... collaborate on a guide to further improve upon access to services for members with disabilities to ensure they live and receive services in the most appropriate integrated setting in the community. Arizona considers the Olmstead Decision as an opportunity for self-examination and a continuous process of quality improvement when establishing priorities for the service delivery system in the context of other critical issues."
  • California Olmstead Plan: Update on its Implementation (PDF | 133 KB)
    California’s Olmstead Plan, released in May 2003, provides a blueprint for improving California’s long-term care delivery system to ensure that persons with disabilities and older adults have appropriate access and choice regarding community-based services and long-term care options. In 2005 and 2010, the California Health and Human Services Agency released updates on the state’s implementation (PDF | 133 KB) of the recommended action steps in the plan.
  • Colorado Olmstead Initiative
    The Colorado Community Living Plan calls for community-based services and supports and housing for individuals with disabilities who live in long-term care facilities and wish to return to the community, or who wish to remain in their own homes.
  • District of Columbia One Community for All: Olmstead Community Integration Plan Calendar Years 2021-2024 (PDF | 778 KB)
    This plan provides the community integration plan for the District of Columbia for 2021-2024. The plan was developed under the advice of the Olmstead Working Group which is comprised of representatives from District agencies and community stakeholders. The focuses of the 2021-2024 plan are housing, healthcare, and employment. The plan tracks the number of District residents transition into the community from long term care, highlights District programs, and serves as a guide for those in transition to inform them of resources.
  • Illinois Williams Consent Decree Implementation Plan Amendments
    The Illinois Department of Human Services has issued an implementation plan, including several amendments, designed to ensure community placements, as appropriate, for individuals with SMI who reside in nursing facilities/institutions for mental diseases (IMDs). The implementation plan and its amendments call for placement in the most integrated setting appropriate to an individual’s needs.
  • State of Maine Olmstead Roadmap to Change
    The Olmstead decision "resulted in the Department publishing the 2003 Roadmap for Change – Maine’s Response to the Olmstead Decision. The Department has updated its response to the Olmstead decision for the individuals with intellectual disabilities or autism. The Department will continue to identify programmatic strengths and weakness, and to strategically identify objectives moving forward as it pertains to Olmstead." This resource provides a roadmap for a response to the Olmstead decision for both adults with SMI and children with SED.
  • Commonwealth of Massachusetts Olmstead Plan and Update
    The Commonwealth of Massachusetts, the Committee on Housing and Services for People with Disabilities of the Interagency Council on Housing and Homelessness has made the decision to update the Commonwealth’s existing Olmstead Plan. The ICHH has designated an Olmstead Planning Committee with representatives from the EOHHS agencies, DHCD, and MassHousing to guide the review and development of the new Olmstead Plan.
  • Putting the Promise of Olmstead into Practice: Minnesota's Olmstead Plan (PDF | 1.3 MB)
    This plan provides a comprehensive overview of Minnesota’s Olmstead Plan and the recommendations of the state’s Olmstead Subcabinet.
  • A Vision for Community Integration: Nebraska's Olmstead Plan (PDF | 3.5 MB)
    This cross-disability plan covers seven key areas: individualized supports; safe, affordable, and accessible housing; services in settings appropriate to needs and preferences; education and competitive employment; affordable and accessible transportation; quality improvement; and workforce development.
  • New York Olmstead Report (PDF | 1.3 MB)
    This report provides an overview of the state of community integration Olmstead and the recommendations of the Olmstead board.
  • North Carolina's Olmstead Plan
    This plan covers both children and adults with various disabilities, including mental illness. The 11 priority areas include addressing workforce shortages, increasing inclusive community living, addressing disparities in access, increasing input from individuals with lived experience, and reducing transportation burdens.
  • Olmstead Plan for the Pennsylvania State Mental Health System
    The Olmstead Plan for the Pennsylvania State Mental Health system, first issued in 2011 and revised in 2013 and 2016, reflects the commonwealth's continued progress toward ending the unnecessary institutionalization of adults who have a serious and persistent mental illness. The plan details the specific steps that the commonwealth will take to achieve that goal and calls for implementation to be reviewed at regular intervals to assess progress and determine the need for revision and updates.
  • Revised Texas Promoting Independence Plan (PDF | 2 MB)
    This cross-disability plan offers eight goals focused on the following areas: community-based services, behavioral health services for children, managed care support for transitions to and remaining in the community, comprehensive behavioral health support for transitions to and remaining in the community, relocation services, housing opportunities for individuals leaving institutions, integrated employment opportunities, and workforce recruitment and retention.
  • Virginia’s Olmstead Strategic Plan (PDF | 1 MB)
    This plan provides a comprehensive, cross-governmental plan to assure continued community integration of Virginians with Disabilities.
  • West Virginia Olmstead Plan Update (PDF | 487 KB)
    The state’s most recent update establishes activities in support of eight goals for people with disabilities including mental illness: safeguard self-determination and informed choice, create and maintain a user-friendly system, expand and improve transitions to community-based settings, strengthen in-home services and the direct services workforce, improve and expand housing options, improve and expand transportation options, increase income and employment, and strengthen inclusive education.

Point of Contact:
Kimberly Reynolds, M.P.A., MEd, Public Health Advisor & Project Officer; kimberly.reynolds@samhsa.hhs.gov

Last Updated: 04/24/2023
Source: https://www.samhsa.gov/about-us/who-we-are/laws-regulations/olmstead?utm_source=newsletter&utm_medium=email&utm_content=SAMHSA%20Olmstead%20v.%20L.C.%20Resources&utm_campaign=UA-179397308-1