The administration released a memo that seeks to upend landmark disability laws and court rulings that prioritize community-based care rather than institutionalization for people with disabilities, including mental illness and substance use disorder (SUD).

The details:

Section 504 of the Rehabilitation Act, the Americans with Disabilities Act, and the Supreme Court’s Olmstead decision established the right of people with disabilities not to be segregated in institutions to receive necessary care. They require states to provide community-based services that enable individuals with disabilities (which includes serious mental illness and SUD) to live in the most integrated setting appropriate to them.
The new Department of Justice (DOJ) Office of Legal Counsel memo, in response to an inquiry from the White House, argues that the “integration mandate” is not actually a mandate, especially for people with “severe mental illness or disabilities.” This breaks with decades of law and practice.

The big picture:

The memo does not change the existing laws or decisions that laid the groundwork for the integration mandate. But it signals the administration’s stance on the issue.
The memo comes a year after the administration significantly cut state Medicaid allocations, one of the key funding sources for home and community-based services.

What’s coming: Experts expect DOJ to pull back from its role as the enforcer of Olmstead and worry the memo tees up an attempt to dismantle the decision.

Why it’s important: People should not have to be institutionalized and removed from their communities in order to receive SUD care. Community-based treatment and supports are essential services for many individuals.