The Olmstead Decision (1999)

In Olmstead v L.C., two women with mental disabilities brought suit against the State of Georgia. They were living in a state mental hospital even though professionals on staff had affirmed that they were capable of living in a community setting with supports. The Court found that unnecessary segregation of individuals in institutions is discrimination under the Americans with Disabilities Act. Learn more about the Court’s decision.

The implications of the Olmstead decision for people with disabilities are monumental. States have been slowly changing their systems of long term supports and services to comply with Olmstead, by expanding home and community based services and shrinking the size of or even closing residential facilities such as nursing homes and intermediate care facilities. States are also working to promote more options for integrated employment instead of depending upon sheltered workshops, since employment services, too, must comply with Olmstead principles.

Taskforce Background

In early 2000, Iowa Governor Tom Vilsack designated the Iowa Department of Human Services (DHS) as Iowa’s lead agency to respond to Olmstead. Governor Vilsack called upon DHS to:

  • Report on Iowa’s current service system
  • Develop the “effectively working plan” recommended by the Court in its Olmstead decision and by the Centers for Medicare and Medicaid Services in its letter to State Medicaid Directors in January 2000

DHS convened a statewide steering committee, which gathered input across the state to shape the 2001 Iowa Plan for Community Development. This represented the first step in identifying the broad range of supports needed by people with disabilities in order to live successfully in the community of their choice — housing transportation, personal assistance, accessible facilities and services, etc. Recognizing that the breadth and complexity of the issues required a coordinated inter-agency response, in 2003 Governor Vilsack issued Executive Order 27 calling upon state agencies to identify the barriers to community living posed by their policies and programs and to develop plans to remove them. Executive Order 27 also created the current Olmstead Consumer Taskforce to advise the Governor’s Office on strategies to promote community integration, including changes in policies or programs.

Role of the Taskforce in Developing the DHS State Mental Health and Disability Services Plan

In 2009 the Department of Human Services began development of a new DHS State Olmstead Plan for Mental Health and Disability Services. The Taskforce, along with the Mental Health and Disability Services Commission and the Mental Health Planning Council, were tasked with coordinating stakeholder input into the Plan. Once again, public meetings were held across the state to hear from people with disabilities, their families, advocates and providers about what it takes for people to live successfully in the community. The Plan was completed early in 2011, and the Taskforce receives regular updates on its implementation.

Recent Work of the Taskforce

The Taskforce monitored progress in the redesign of Iowa’s mental health and disability service system. It continues to track legislation, policies and planning by state agencies that have implications for Olmstead. The Taskforce also continues to get involved in critical issues at the federal level that affect the lives of Iowans with disabilities. This includes debate over the Center for Medicare and Medicaid Services rules defining integrated settings for home and community-based services.