Forum Session

Expanding Community-Based Care: Is the Olmstead Decision Making a Difference?
November 25, 2003


Randy A. Desonia


This meeting reviewed the Olmstead v. L.C. Supreme Court decision requiring states to provide long-term care services in the least-restrictive setting. Speakers reviewed the political milestones on the route towards living independently, culminating with the Americans with Disabilities Act, which serves as the legal foundation for the decision; the Supreme Court’s guidance for determining state compliance; subsequent lower court cases addressing the ambiguities of the ruling; and the federal government’s initiatives to expand Medicaid home- and community-based services. The meeting concluded with a discussion of emerging models for placing people in the community setting and of the potential impact of pending Supreme Court cases over state sovereignty.


Lex Frieden, Chairperson, National Council on Disabilities, and Senior Vice President, The Institute for Rehabilitation and Research, Houston; Sara Rosenbaum, JD, Harold and Jane Hirsh Professor of Health Law and Policy, and Chair, Department of Health Policy, George Washington University Medical Center; Steven Lutzky, PhD, Director, Division for Community Systems Improvement, Disabled and Elderly Health Programs Group, Center for Medicare and Medicaid Services, U.S. Department of Health and Human Services

Related Materials

More information available in the related background paper.

Other related Forum products include "National Spending for Long-Term Services and Supports (LTSS), 2012," (The Basics, March 27, 2014), and Forum sessions on Medicaid managed long-term care (April 2008), consumer direction and Money Follows the Person (November 2008), and informal caregiving (September 2007.

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