The Department of Health and Human Services (HHS) has announced that is "moving vigorously" toward improving access to community-based services for people with disabilities in order to help states in complying with the Olmstead Supreme Court decision.

In its Olmstead decision of June 1999, the Supreme Court ruled that under certain circumstances, the Americans with Disabilities Act requires states to provide community-based treatment for persons with disabilities.

On June 18, 2001, President Bush issued this Executive Order directing federal agencies to assist states with swiftly implementing the Olmstead Supreme Court decision. In an agency press release of June 19, 2001, HHS Secretary Tommy G. Thompson stated that his agency would lead the federal government's coordinated efforts to work with states and to fully implement the Olmstead decision. 

"This administration has made it a top priority to tear down the barriers to equality facing people of all ages with disabilities," said Secretary Thompson. "We are committed to the goals the President has laid out. HHS will lead the federal government's efforts to ensure that all Americans have the opportunity to live as independently as possible and fully participate in community life."

HHS will provide $70 million in "Systems Change" grants to help states improve their community-based services. In February, Secretary Thompson announced the release of $50,000 awards from the Real Choice Systems Change Grant Program. The starter grants, available to every state that applies, will help pay for the development of public-private partnerships, including consumer task forces, in each state to advise on the use of federal grants that will increase services and supports to people with disabilities. As a part of these efforts, HHS is also working with the Department of Housing and Urban Development to make Section 8 housing vouchers available to states to assist in the transition of people with disabilities from institutional to community-integrated living.

HHS has supported a number of additional activities to educate state and local officials about their responsibilities under the Olmstead ruling and about the opportunities they have to improve the availability of community-based care. The department has sent a number of letters to state Medicaid directors providing information and answers to the most frequently asked questions about the decision. HHS' Office for Civil Rights, which investigates claims of discrimination against people with disabilities in federal health programs and provides technical assistance to health and human services programs, is providing outreach and training to states and advocacy organizations about both the Olmstead decision and the President's New Freedom Initiative. 

Finally, HHS' Substance Abuse and Mental Health Services Administration (SAMHSA) has formed a national coalition of more than 40 federal agencies, national mental health advocacy organizations, consumer groups and private sector companies to promote community-based care for persons with mental illness. SAMHSA is providing financial support to all 50 states, the District of Columbia, Puerto Rico and the Virgin Islands to establish similar coalitions in each jurisdiction. The agency is also conducting a $20 million study to determine the effectiveness of mental health service consumer-oriented programs as an adjunct to traditional mental health services.

In 2000, the federal government paid approximately $43 billion for Medicaid services on behalf of people with disabilities. Medicaid supports more than 200 state home- and community-based waivers that provide beneficiaries with alternatives to institutional care and enable seniors and people with disabilities to receive services at home. In 2000, federal Medicaid spending for individuals with disabilities served through these waivers was approximately $6.8 billion.