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Community Inclusion and the “Olmstead” Plan

North Carolina recently went through an 18-month planning process to develop a new document outlining the steps that the state should take to ensure that people with disabilities are able to live, work, learn, and enjoy their lives alongside everyone else in their communities. Plans like this set meaningful goals to address the barriers people with disabilities face including difficulties accessing services and supports. Housing and residential options are limited, rights are restricted, and they have difficulties participating in school, work, and other activities like their peers. The plan is to help people in NC, and the state services system, get to a point where community inclusion is a natural, everyday reality.

How did this all come about and why is it called an Olmstead Plan?

Two women in Georgia, Lois Curtis and Elaine Wilson, were confined to a state institution and were not able to move out and live in their communities. They brought a suit against the state of Georgia, including the Commissioner for GADHHS, Tommy Olmstead. The case made its way up to the Supreme Court, and in 1999, the Supreme Court determined that people with disabilities have a right to receive state services and supports in a community setting rather than in an institution, as long as it’s deemed appropriate for the person, the person does not object to community living, and these community services could be provided with reasonable accommodation. Read more. 

Given the changes in community-based services, advancements in technology, health care, and evidence-based services, most people can successfully live in a setting of their choice with reasonable supports.

During court proceedings the names of the two women were listed as L.C. and E.W. to protect privacy. The case decision was called “Olmstead vs LC”, giving name to so-called “Olmstead Plans” that were required to be developed by each state to move away from institutional living into community-based services as a way of life.

Since 2001, our state has repeatedly “reformed” community and institutional systems that serve people with intellectual and developmental disabilities, mental health needs and substance use disorders.

In 2004, North Carolina developed its first Olmstead Plan and, in the years following, developed many proposals for how our system would shift to allow more choice and more inclusion for people with disabilities, including autism.

Changes to our system of support and care continue today as Medicaid transforms into an integrated health managed care mode under present day transformation.

Because the goals of community inclusion were never realized from North Carolina’s first Olmstead Plan,  Disability Rights North Carolina (DRNC) brought an “Olmstead” suit against the state of NC in 2017 alleging that people’s rights to receive services in the least restrictive setting have been violated. In 2020, the judge issued a declaratory judgment stating that North Carolina had indeed violated the NC Persons with Disabilities Protection Act: that long waits for services (e.g. Innovations waitlist), lack of adequate direct support, and limited access to community services all put people at risk for institutionalization.

The recent Olmstead planning process was in response to the Judge’s decision in the recent DRNC lawsuit (Samantha R.) and the need to develop a remedy for the case that will address the lack of access to community-based services.

The draft plan from NC DHHS was released on October 12, 2021 and comments on the plan were due on November 8. The Autism Society of North Carolina provided comments on the draft, focusing its comments on the overarching focus of the plan, noting where we felt the plan lacked information and making suggestions on what could be improved. These comments cannot capture the full scope of what is needed to address problems in the NC system. Knowing that many individuals and organizations submitted comments, we urge you to monitor the NCDHHS Olmstead page for updates including the public comments.

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