Olmstead v. L.C.

The United States Department of Justice, Civil Rights Division, has provided new information regarding Americans with Disabilities Act and Olmstead v. L.C. Please find the information here. The information discusses Olmstead and "informed choice."

The Olmstead Decision


History of Olmstead v. L.C. Implementation in the State of Kansas

Prior to the 1960s, children and adults with disabilities in Kansas, as well as other states, were either in institutional settings, or in their homes without the services necessary to become as independent as possible. Beginning in the 1850s, Kansas began building institutions to house those with mental health disabilities, and later those with intellectual and developmental disabilities. Living conditions in these institutions were often substandard.  

As a result of the passage of Federal and State laws, Kansas began moving away from institutionalization and toward community integration. Initially, people with disabilities were moved to smaller settings closer to their communities, such as intermediate care and nursing facilities. As these were still institutional settings, there was still a push for individuals to live in their own homes with support. Federal authority to fund Home and Community Based Services (HCBS) versus institutional settings, as well as the passage of the Americans with Disabilities Act in 1990 and the Supreme Court’s “Olmstead decision” in 1999, resulted in a major and positive impact on the lives of youth and adults with disabilities.   

In 1982, nine years before the passage of the Americans with Disabilities Act of 1990 and its subsequent protections for individuals with disabilities, and 17 years before the Supreme Court’s 1999 Olmstead decision, Kansas Medicaid received approval for its first HCBS waiver for people with disabilities and the elderly. Throughout the 1990s and into 2000, Kansas received approval for seven HCBS waivers to provide services that would meet the needs of youth and adults with different disabilities. At the same time, Kansas began closing its institutions, maintaining several for specific populations with specific needs. As of December 2019, 24,453 youth and adults with disabilities were receiving HCBS services.
KDADS is responsible for overseeing the seven HCBS Waiver programs, which includes insuring compliance with the Centers for Medicare and Medicaid Services (CMS) requirements for home and community-based settings. KDADS is also responsible for individuals in institutional settings, i.e., the remaining state institutions, intermediate care facilities and nursing facilities, as well as addressing advocate concerns about these facilities and their residents. 
Finally, while considerable progress has been made in moving people from institutions and other isolating settings to community settings, employment of youth and adults with disabilities lags their peers without disabilities. The Kansas Department of Health and Environment (KDHE) Division of Health Care Finance (DHCF), the Medicaid oversight agency, manages two employment incentive programs, Working Healthy and Work Opportunities Reward Kansans (WORK). DHCF also has approval to implement a supported employment pilot program in their 1115 Demonstration Waiver.