DOJ’s New Interpretation of Olmstead Threatens Community Integration for Disabled People and People Who Use Drugs
August 19, 2026
Overview
In the 1999 Supreme Court case, Olmstead v. L.C., the court ruled that unjustified institutionalization of people with disabilities is unlawful discrimination under Title II of the Americans with Disabilities Act of 1990 (“ADA”), and that a mandate within the Act requires public entities to provide services in the most integrated setting appropriate to the needs of people with disabilities. Now, the Department of Justice Office is arguing that providing care in integrated settings was not established as a mandate by this case, a position which has many concerned that this is part of a broader approach by the current administration to make institutionalization of people with disabilities, the unhoused and those who use drugs easier.
In the late 1990s, two women sued to be released from a psychiatric hospital after being confined for years despite mental health professionals declaring that community placement was safe and appropriate. The Supreme Court ruled in their case, Olmstead v. L.C., that the unjustified institutional isolation of people with disabilities is unlawful discrimination under Title II of the Americans with Disabilities Act of 1990 (“ADA”). Specifically, the Court held that the ADA’s ‘integration mandate‘—which requires public entities to provide services in the most integrated setting appropriate to the needs of people with disabilities—prohibits unjustified institutionalization.
The integration mandate protects the rights of people with disabilities to receive treatment and support within their communities instead of being forced into segregated institutions. For more than two decades, courts, Congress, and federal agencies have interpreted Olmstead and the ADA’s implementing regulations to require public entities to provide services to people with disabilities in community-based settings rather than institutions when community placement is appropriate and can reasonably be accommodated.
On June 18, 2026, however, the Department of Justice Office of Legal Counsel (OLC) issued a slip opinion that argues that while the Olmstead decision held that a state cannot institutionalize disabled individuals without justification, it did not establish a requirement that services be provided in the most integrated setting. The opinion is not binding on courts, but OLC opinions are generally authoritative within the executive branch.
The Department of Justice subsequently stated that it would no longer rely upon previous guidance on enforcing Title II, effectively withdrawing the agency’s previous enforcement position regarding the integration mandate. Combined with a recent trend toward institutionalization and involuntary mental health treatment, this is a serious cause for concern, as described by groups including the ACLU, AAPD, and DREDF. In addition to its impact on disability communities, this shift poses a danger to people who use drugs.
The slip opinion invokes the claim that deinstitutionalization increases the number of people with mental illness facing homelessness and incarceration. It is true that many disabled people do not receive adequate community support, but the problem is not the integration mandate but rather the fact that states have failed to fund sufficient community-based services. A 2013 Senate report found that only 12 states spent over 50 percent of their Medicaid budget for long-term services and supports on home and community-based services (“HCBS”), despite substantial evidence that community-based services can provide comparable or better outcomes at lower cost than institutional care for many populations. As of 2023, more than 692,000 people across 38 states were on Medicaid waiting or interest lists for HCBS . People who seek treatment for drug use also face barriers due to inadequate funding. Recent and proposed federal cuts to healthcare services worsen pre-existing gaps in community treatment.
In combination with a July 2025 Executive Order that calls for expanding the use of civil commitment as a way to reduce homelessness and a recently announced ban on the use of federal funding for certain harm reduction services, removing the integration mandate would further reduce access to essential services and personal autonomy for people who use drugs.
Many people with substance use disorders are protected by the ADA when their substance use disorder constitutes a disability. The ADA protects an individual’s right to health services and drug-rehabilitation services, even in many cases where a person is currently engaging in illicit drug use. By requiring community-care options where appropriate, the integration mandate ensures that a decision to seek treatment does not come at the expense of autonomy. It safeguards the right to support within the community, not the isolation of an institution.
Weakening community-integration protections could make institutionalization of people who use drugs easier, particularly for individuals with co-occurring disabilities. Orders to increase enforcement on prohibitions of open-air drug use and statements from political leaders reflect a policy approach that prioritizes removing visible drug use and homelessness from public spaces over expanding voluntary community-based services. If the DOJ’s opinion on the reach of the integration mandate is followed, many will face a longer or even impossible road to return to their lives and communities.
People who use drugs have the moral and legal right to treatment, services, and supports in their communities. The DOJ’s interpretive shift threatens to return us to a paternalist era where states could more readily institutionalize people against their will and “for their own good” with limited oversight and protection. Despite the OLC slip opinion, courts remain bound by Olmstead and other controlling judicial precedent, and it will ultimately be up to them to determine whether the ADA itself requires the community-integration protections that DOJ has now declined to enforce.
This post was written by Rachel Leeds, Summer Fellow, and reviewed by Corey Davis, Director, Harm Reduction Legal Project.
The Network promotes public health and health equity through non-partisan educational resources and technical assistance. These materials are provided solely for educational purposes and do not constitute legal advice. The Network’s provision of these materials does not create an attorney-client relationship with you or any other person and is subject to the Network’s Disclaimer. Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not represent the views of (and should not be attributed to) RWJF.