Changing Assumptions

This is the first post of a series about HCBS and HCBS waivers. To begin on the ground level, however, I'll start with a Supreme Court Decision, because, like certain Supreme Court justices, we don't like to read legal decisions or statutes. The stuff, let's face it, is so dry, if it is on paper, it crumbles to dust in the hands of the reader; it is that dry! Relax. I'll make this as brief as possible.

Two Georgia women, Lois Curtis and Elaine Wilson, both developmentally disabled, had become mentally ill adults. Each woman voluntarily admitted herself to Georgia Regional Hospital, a state-run institution. The treatment the women received in the hospital was successful. Both were declared ready to leave the hospital, and, once again, live in the mainstream. Community-based housing was available to each woman. Neither had an opportunity to reintegrate into her community; both remained confined to Georgia Regional Hospital. Several years passed. Curtis and Wilson filed suit to be released from the hospital under the ADA.

We can learn the art of fierce compassion - redefining strength, deconstructing isolation and renewing a sense  of community, practicing letting go of rigid us vs. them thinking, while cultivating power and clarity in response to difficult situations. -Sharon Salzberg

In June 1999, the U. S. Supreme Court held that the hospitalization of these women was discriminatory (unjustified segregation) in violation of Title II of the Americans with Disabilities Act. The implications were sweeping Thanks to the decision, public entities are legally obligated to provide community-based services to persons with disabilities, provided the services are appropriate and agreeable to the persons affected and accommodation is reasonable, given available public resources and the needs of others who receive disability services from the public entity.

The Court explained it's holding this way. First the institutionalization of people who are capable of living in community settings and would benefit from reintegration into community life, "perpetuates unwarranted assumptions" those held in institutions are incapable or unworthy of participating in community life. Second institutionalization severely diminishes the day-to-day lives and activities of the disabled, including family relationships, social interaction, the possibility of work and financial independence, not to mention educational and cultural opportunities.

The 1999 decision subsequently proved controversial, particularly in affordable (government subsidized) senior housing, as much of that housing now opened to younger, disabled applicants. There were successes and failures, but the principles upheld by the Supreme Court in Olmstead continue to contribute to the greater good.

My next post will talk about changes we've seen in the decade since the Olmstead decision. Stay tuned!