In the Americans with Disabilities Act of 1990 (ADA), Congress described the isolation and segregation of individuals with disabilities as a serious and pervasive form of discrimination. Title II of the ADA prohibits discrimination in the provision of public services and specifies that no qualified individual with a disability shall, Any reason of such disability, be excluded from participation in, or be denied the benefits of, a public entity's services, programs, or activities. Congress instructed the Attorney Generals Office to issue regulations implementing Title II's anti-discrimination provisions. One such regulation, known as the Aintegration regulation, requires a Apublic entity to administer programs in the most integrated setting appropriate to the needs of qualified individuals with disabilities. The regulations further requires Areasonable modifications to avoid Adiscrimination on the basis of disability, but does not require measures that would Afundamentally alter the nature of the entity's programs.
The defendants were two Georgia women. Both women had been voluntarily admitted to a psychiatric hospital for treatment. The professionals treating the two women eventually determined that each of the women could be cared for appropriately in a community-based program, the women remained institutionalized. One of the two women filed a suit against the State seeking community care. Her case alleged that the State had violated Title II in failing to place her in a community-based program once her treating professionals determined that such placement was appropriate. Later the second woman joined the suit. The District court ruled in favor of the two women but the State appealed the judgment to the Eleventh Circuit Court. The State appealed claiming that community care would be unreasonable given the demands of State's mental health budget.
Justice Ginsburg in delivering the Courts judgment stated that: Institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life and institutional confinement severely diminishes individuals everyday life activities. Dissimilar treatment correspondingly exist in this key respect: In order to receive needed medical services, persons with mental disabilities must, because of those disabilities, relinquish participation in community life they could enjoy given reasonable accommodations, while persons without mental disabilities can receive the medical services they need without similar sacrifice. Olmstead Decision Home Page.