Disability Law Index - Public Entities: Integration

Statute:

42 U.S.C. § 12101(a) - Findings (excerpt; italics for emphasis)

The Congress finds that -

(2) historically, society has tended to isolate and segregate individuals with disabilities, and, despite some improvements, such forms of discrimination against individuals with disabilities continue to be a serious and pervasive social problem;

(5) individuals with disabilities continually encounter various forms of discrimination, including... segregation

Regulations:

28 C.F.R. § 35.130(d)

A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.

28 C.F.R. pt. 35, App. A, p. 450 - Preamble to Regulation on Nondiscrimination on the Basis of Disability in State and Local Government Services (Published July 26, 1991).

Paragraphs (d)... provide(s) that the public entity must administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities, i.e., in a setting that enables individuals with disabilities to interact with nondisabled persons to the fullest extent possible, and that persons with disabilities must be provided the option of declining to accept a particular accommodation.

Case Law:

Olmstead v. L.C., 527 U.S. 581 (1999).

  • The respondents were confined for treatment in a psychiactric ward. They alleged that state officials violated Title II in failing to place them in a community-based program once treating professionals determined that such placement was appropriate.
  • The Supreme Court viewed unjustified institutional isolation of persons with disabilities as a form of discrimination."Institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life." "Confinement in an institution severely diminishes the everyday life activities of individuals, including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment."
  • States are required to provide community-based treatment for persons with mental disabilities when treatment professionals determine that such placement is appropriate, the affected persons do not oppose such treatment, and the placement can be reasonably accommodated, taking into account the resources available to the State and the needs of others with mental disabilities.

Frederick L. v. Department of Public Welfare of Com. of Pennsylvania, __ F.3d. __ (3rd Cir. April 13, 2004)

  • Olmstead plurality had allowed a state to assert a fundamental alteration defense to integration if it had a comprehensive, effectively working plan for placing qualified persons with mental disabilities in less restrictive settings, and a waiting list that moved at a reasonable pace not controlled by the State's endeavors to keep its institutions fully populated,
  • Just because a state has a good history of deinstitutionalisation doesn't excuse it from providing a current plan for placing qualified persons with mental disabilities in less restrictive settings. "The Commonwealth has not demonstrated that it has a comprehensive or actionable plan to support increased integration through community placements or any other mechanisms... Although the District Court did not err in taking into account the Commonwealth's past progress in evaluating its fundamental-alteration defense, it was unrealistic (or unduly optimistic) in assuming past progress is a reliable prediction of future programs... The issue is not whether there is a piece of paper that reflects that there will be ongoing progress toward community placement, but whether the Commonwealth has given assurance that there will be. In that connection what is needed at the very least is a plan that is communicated in some manner."
  • Allowing states to assert a fundamental-alteration defense based on immediate fiscal costs alone is inconsistent with Olmstead.

Fisher v. Oklahoma Health Care Authority, 335 F.3d 1175, (10th Cir. 2003).

  • State agency's decision to limit prescriptions for Medicaid recipients in the community was discriminatory when limit was not imposed on those in nursing homes. Forced people to go into nursing homes if they need to go over the limit
  • Institutionalization is a prerequisite to enforcement of the ADA's integration requirements.