Justice Department says states not required to move disabled patients to community care

A Justice Department legal opinion has sharply narrowed the federal government’s view of disability rights, saying states are not required to move mentally disabled patients from institutions into community or home-based care. The memo, released by the Office of Legal Counsel, lands as families, advocates and state agencies continue to rely on Olmstead v. L.C. to press for services in the most integrated setting appropriate to a person’s needs.

The opinion, titled Application of the Rehabilitation Act and Americans with Disabilities Act to State Institutionalization of Patients with Severe Mental Illness or Disabilities, says neither Section 504 of the Rehabilitation Act nor Title II of the Americans with Disabilities Act imposed an integration mandate on states in their treatment of mentally disabled individuals. That directly cuts against the long-standing understanding that unnecessary segregation of people with disabilities can itself amount to discrimination.

Olmstead was decided by the Supreme Court on June 22, 1999, and the court described the unnecessary segregation of people with disabilities as discrimination. Current HHS and ADA guidance still says states are required to provide community-based services when those services are appropriate, the person does not oppose them, and the state can reasonably accommodate the request. The new Justice Department opinion argues that the case did not create the broader duty that disability-rights advocates and federal agencies have long enforced.

The practical effect could reach adults with mental health disabilities and other people now living in nursing facilities or state institutions when a community placement is available but contested. That is the group most likely to feel the immediate consequences if states take the memo as a signal to slow or narrow community placements, especially in systems where access to supportive housing, outpatient care and home services already falls short.

The policy shift could also affect active disputes over how far the Americans with Disabilities Act reaches. The opinion is relevant to Texas v. Kennedy, a case involving the integration mandate, and it arrives after the department took the opposite position in recent enforcement matters. On June 18, 2024, the department said Missouri violated the ADA by unnecessarily institutionalizing adults with mental health disabilities in nursing facilities. On December 18, 2025, it announced a settlement with South Carolina over access to community-based mental health services.

The Office of Legal Counsel advises the president and executive branch agencies, so its opinions can shape federal policy even without changing statutes or Supreme Court precedent. Disability advocates, including the American Council of the Blind, have already said the memo sharply narrows or undermines the integration mandate, raising new uncertainty for families trying to keep relatives out of institutions and in the community.