黑料正能量 Note: In the most recent publication from the Bazelon Center for Mental Health Law, they review how the ADA has been upheld through legal proceedings that have led to further community integration for persons with psychiatric disabilities. As NY begins to implement the transition of Adult Home residents into community residences, it is important to recognize where we have come from to get our system to this point, and how much work is still to be done to provide meaningful community integration for all persons with disabilities. The excerpt from the report 鈥淎 Place of My Own鈥 below details how the Olmstead decision was held up in NY, providing residents of impacted homes the opportunity to move to supported apartments in 2014.
听
The ADA鈥檚 听Integration Mandate and the Olmstead Decision
Bazelon Center; A Place of My Own: How the ADA is Creating Integrated Housing Opportunities for People with Mental Illnesses, 3/2014
听
The 听ADA, 听enacted 听in 听1990, 听was 听intended 听鈥渢o 听provide 听a 听clear 听and comprehensive national mandate for the elimination of 听discrimination against individuals with disabilities.鈥 Title II of the ADA prohibits discrimination based on disability 听by 听state 听and 听local 听government 听entities. In 听the 听ADA鈥檚 听findings, Congress recognized the longstanding problem of isolation and segregation of people with disabilities, stating that:
- 鈥渉istorically, society has tended to isolate and segregate 听individuals with disabilities, and, despite some improvements, such forms of discrimination against individuals with disabilities continue to be a serious and pervasive social problem;
- 鈥discrimination 听against 听individuals 听with 听disabilities 听persists 听in 听such critical areas as . . . institutionalization . . . ;
- 鈥individuals 听with 听disabilities 听continually 听encounter 听various 听forms 听of discrimination, including outright intentional exclusion, . . . failure to make modifications听听听听 听to existing facilities and practices, . . . [and] segregation . . . .鈥
Congress鈥檚 findings apply to all people with disabilities, including people with 听mental 听illnesses.听听 听The 听ADA鈥檚 听application 听to 听segregation 听is 听particularly relevant to individuals with serious mental illnesses, who have a long history of being physically segregated in state hospitals and other congregate facilities, resulting in negative stereotypes and social isolation.
In 1999, the Supreme Court interpreted the ADA鈥檚 integration mandate in Olmstead 听v. 听L.C.,19听 听a 听case 听brought 听by 听two 听women 听with 听mental 听illness 听and intellectual disabilities who challenged their continued confinement in a state psychiatric hospital 听after 听they 听had 听been 听determined ready 听for 听discharge.听听 听The 听Court 听held 听that needless 听institutionalization 听was 听a 听form 听of discrimination听听 听prohibited听听 听by听听 听the听听 听ADA. According to the Court, this holding reflected two 听evident 听judgments. First, 听needlessly institutionalizing 听individuals 听with 听disabilities 鈥減erpetuates unwarranted assumptions that persons听 听so听 听isolated听听 听are听 听incapable听 听or unworthy of participating in community life.鈥 Second,听听 听鈥渃onfinement听听 听in听听 听an听听 听institution severely听听 听diminishes听听 听the听听 听everyday听听 听life activities听 听of听 听individuals,听 听including听 听family relations,听 听social听 听contacts,听 听work听 听options, economic听听听听听 听independence,听听听听听 听educational advancement,听 听and听 听cultural听 听enrichment.鈥 States 听must 听offer 听services 听in 听community settings 听to 听interested 听individuals 听who听 听are needlessly institutionalized听 unless doing so would听 听fundamentally听 听alter听 听their听听 听service systems.
In Disability Advocates Inc. v. Paterson, later vacated on other grounds, a federal district court considered ADA integration claims brought by approximately 4,000 individuals with mental illness living in large, segregated board and care homes called 鈥渁dult homes.鈥听 听These are among the outdated facilities that, many decades ago, had been used by states to downsize their state psychiatric hospitals. 听The lawsuit involved adult homes with at least 120 beds 听and 听where 听at 听least 听25 听percent 听of 听the 听residents 听had 听a 听mental 听illness (individuals 听with 听mental 听illness 听constituted 听about 听80 听percent 听of 听the 听overall population of the homes in question). The court held that 黑料正能量 was violating the ADA鈥檚 integration mandate by administering, planning and funding its mental health system in such a way that, for thousands of individuals with mental illness, adult homes were the only residential option available.
While 听the 听adult 听homes 听are 听not 听operated 听by 听the 听state, 听the 听state 听is 鈥渞esponsible for determining what services to provide, in what settings to provide them, and how to allocate funds for each program.鈥 The State 鈥減lan[s] how and where services for individuals with mental illness will be provided, and . . . allocate[s] the State鈥檚 resources accordingly.鈥 The State licenses, monitors, inspects, 听and 听regulates 听adult 听homes, 听and has 听the 听power听 to 听determine 听their availability.
Applying the principles set forth in Olmstead, the district court found that adult homes are institutions that segregate people with mental illness from the community, that supported housing is a more integrated setting than adult homes (and the most integrated setting for virtually all adult home residents with mental illness), that virtually all adult home residents with mental illness are qualified to live in supported housing, and that many of these residents would choose to live in supported housing if afforded a meaningful choice. Accordingly, the district court held that 黑料正能量 discriminated against DAI鈥檚 constituents by needlessly institutionalizing them in adult homes. 听While a federal appeals court vacated the decision based on a finding that the plaintiff, Disability Advocates, Inc., did not have standing to bring the case, it left untouched all of the findings of fact and conclusions of law concerning the merits of the case.
The adult homes case was ultimately refiled as a class action case, and the United States Justice Department brought its own action against the state based 听on 听the 听same 听facts鈥擭ew 听York鈥檚 听continued 听needless 听segregation 听of individuals with mental illness in adult homes. 听The two cases were filed together with a settlement agreement between the class of adult home residents, the Justice Department, and 黑料正能量. 听That settlement was approved by the court and requires the state to develop supported housing for thousands of adult home residents 听with 听serious 听mental 听illness.听听 听It 听is 听described 听in 听the 听section 听below concerning Olmstead settlement agreements.
The case has been cited by many other courts, and the reasoning of the decision has been reflected in many subsequent community integration lawsuits and court decisions.
Access the full document 鈥楢 Place of My Own鈥 detailing housing opportunities through the ADA by going to the
听