What is Olmstead?

Olmstead is the name of a 1999 U.S. Supreme Court decision (Olmstead v. L.C. and E.W.) that interpreted certain provisions of the Americans with Disabilities Act.  Those provisions apply to how state and local governments administer services to individuals with disabilities.

Historically, the default public policy position was that persons with disabilities would live and receive services in segregated, often institutional settings.  Olmstead is about moving the default position to the other end of the spectrum so the starting assumption is community living and full integration and persons with disabilities only move away from that based on their individual disability-related needs and their personal preferences.  


The Olmstead case started in Georgia, in 1995, with two women named Lois Curtis and Elaine Wilson.  Both women had intellectual disabilities and mental health conditions.  Both had been living in a state psychiatric hospital for some time.  Both had benefited from treatment and the professionals who had treated them agreed they were ready to leave.  Both expressed a desire to return to homes in the community.  At the time, however, the State of Georgia did not have any community living options available that could meet their needs.  As a result, they had no choice but to remain in the institutional setting indefinitely.  Lois and Elaine believed that having to stay in a segregated setting when it was not necessary meant they were being discriminated against on the basis of their disabilities.  With the help of legal advocates, they brought suit to enforce their rights under the ADA to receive publicly funded services in an integrated community setting.

Lois and Elaine eventually won their case.  The resulting Supreme Court decision became a civil rights landmark, standing for the principle of non-discrimination against individuals with mental illness and disabilities, leading states and localities to re-examine their service delivery systems with the recognition that:

  • People with disabilities should have opportunities to live life like people without disabilities;

  • People with disabilities should have opportunities for true integration, independence, recovery, choice and self-determination in all aspects of life including where they live, spend their days, work, or participate in their community; and

  • People with disabilities should receive quality services that meet their individual needs.

Iowa’s Response

Since 2000, the Iowa Department of Human Services has been the state’s designated lead agency in responding to the Olmstead Decision.  The Olmstead Plan, which is now in its fourth edition, represents our vision for implementing Iowa’s obligation to provide individuals with disabilities opportunities to live, work, and be served in integrated settings.  The plan has been developed with input from a variety of stakeholders, including individuals who access public disability services, and we will continue to gather public input on an ongoing basis.

The Olmstead Plan Framework is the core plan document.  The plan is organized around nine goals, and the framework steps through them one at a time, laying out the objectives, programs, activities, and policies related to the goal, the indicators of progress that have been identified, and outcome data or links to data sources that will reflect progress.  The framework is designed to provide a solid structure for a flexible plan.  That means goals and objectives are expected to remain constant over time, although programs, activities, policies, and sometimes indicators of progress, may be updated to adapt to changes in law or regulation, new opportunities, and new challenges that develop.  The data will be reviewed and evaluated, and that information will be used to report periodically on progress.

Olmstead Overview and History is a supporting plan document outlining the circumstances of the Olmstead case, the history of the Olmstead Supreme Court decision and Iowa’s planning efforts.

Olmstead Plan Activity Descriptions is a supporting plan document that provides additional information about each of the programs, activities, and policies included in the plan.


For more information about Olmstead in Iowa, contact:

Connie B. Fanselow

Bureau of Community Services and Planning

Division of Mental Health and Disability Services