The Cares team envisions a world where older adults and people with disabilities experience dignity, choice and community living. We celebrate the 27th anniversary of the Olmstead decision and its impact on our state and country!
About the Olmstead ruling
The 1999 U.S. Supreme Court decision Olmstead v. L.C. affirmed that unnecessary institutionalization of people with disabilities is a form of discrimination under the Americans with Disabilities Act (ADA). The Court held that people with disabilities have the right to receive services in the most integrated setting appropriate to their needs – meaning they should be supported to live in their communities whenever possible, rather than in segregated facilities.
When people of all ages with disabilities can live, work, and participate in their communities, they are better able to make choices about their own lives, maintain relationships, and contribute to society. It also leads to improved health and well-being, while fostering more inclusive, vibrant communities for everyone.
What Research Shows:
Research consistently shows that community living leads to better health, greater independence, stronger social connections, and higher quality of life while also supporting choice and reducing reliance on costly institutional care. Although the fulfillment of the infrastructure to support community living remains a major challenge, Olmstead remains a promise worth fighting for – that people with disabilities thrive when they are fully included in their communities. Consider that home and community-based services (HCBS) bring about:
- Better health and quality of life
- A 2024 scoping review of thousands of studies found that home- and community-based services (HCBS) are consistently associated with improved physical and mental health and fewer hospitalizations among older adults, although disparities remain.
- More choice, autonomy, and reduced loneliness
- Deinstitutionalization research tells us that those who moved to the community experience greater choice, more community participation, better quality of life, more friends, increased family contact, and improved adaptive behavior (Chowdhury & Benson, 2011; Kozma et al., 2009; Larson et al., 2012; McCarron et al., 2019; Stancliffe & Abery, 1997; Stancliffe & Lakin, 1998)
- Improved outcomes with potential cost advantages
- Policy research indicates HCBS can improve outcomes while often reducing or avoiding higher institutional care costs, making them both person-centered and cost-effective.
- A national shift backed by evidence (*This article highlights a three-state study, including North Carolina)
- Decades of research and policy change have driven a major shift away from institutions, reflecting evidence that community-based care better supports inclusion, dignity, and long-term outcomes.
